Ren Fei-Fei, Chen Feng-Tzu, Zhou Wen-Sheng, Cho Yu-Min, Ho Tsung-Jung, Hung Tsung-Min, Chang Yu-Kai
Department of Physical Education, Beijing Language and Culture University, Beijing, China.
Sport Neuroscience Division, Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan.
Front Psychol. 2021 May 21;12:656141. doi: 10.3389/fpsyg.2021.656141. eCollection 2021.
Chinese mind-body exercises (CMBEs) are positively associated with executive function (EF), but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through June 2020 (PubMed, Web of Science, Embase, Cochrane Controlled Trials Register, Wanfang, China National Knowledge Infrastructure, and Weipu). Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment (MCI) and with or without chronic diseases were included. A total of 29 studies ( = 2,934) ultimately were included in this study. The results indicated that CMBEs improved overall EF (Standardized Mean Differences = 0.28, 95% CI 0.12, 0.44), as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type (Tai Chi, Qigong), frequency of group classes (≤2 time, 3-4 time, ≥5 times), session time (≤45 min, 46-60 min), total training time (≥150 to ≤300 min, >300 min), and length of the CMBEs (4-12 week, 13-26 week, and >26 week), in addition to that more frequent participation in both group classes and home practice sessions (≥5 times per week) resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age (50-65 years old, >65 years old), sex (only female, both), and cognitive statuses (normal, MCI, not mentioned), health status (with chronic disease, without chronic disease), as well as training mode (group class, group class plus home practice) and study language (English, Chinese). This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES (effect size) samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF.
中医身心锻炼（CMBEs）与执行功能（EF）呈正相关，但尚未通过系统评价和荟萃分析的综合证据来研究其对EF的影响。因此，本项荟萃分析的系统评价试图确定CMBEs是否会影响EF及其子领域，以及锻炼方式、样本和研究特征如何调节CMBEs与中老年人EF之间的因果关系。检索了七个电子数据库，以查找从每个数据库创建到2020年6月发表的相关研究（PubMed、科学网、Embase、Cochrane对照试验注册库、万方、中国知网和维普）。纳入了至少一项针对平均年龄≥50岁、认知功能正常或轻度认知障碍（MCI）、有无慢性病的成年人进行的CMBEs对EF影响的结局指标的随机对照试验。本研究最终共纳入29项研究（n = 2934）。结果表明，CMBEs改善了整体EF（标准化均数差 = 0.28，95%CI 0.12，0.44）及其工作记忆和转换的子领域。无论类型（太极拳、气功）、集体课程频率（≤2次、3 - 4次、≥5次）、课时（≤45分钟、46 - 60分钟）、总训练时间（≥150至≤300分钟、>300分钟）以及CMBEs的时长（4 - 12周、13 - 26周、>26周），CMBEs对EF均有有益影响，此外，更频繁地参与集体课程和家庭练习（每周≥5次）会产生更有益的效果。无论参与者的平均年龄（50 - 65岁、>65岁）、性别（仅女性、男女皆有）、认知状态（正常、MCI、未提及）、健康状况（有慢性病、无慢性病）、训练模式（集体课程、集体课程加家庭练习）以及研究语言（英语、中文）如何，CMBEs对EF的积极影响均得到证实。因此，本综述表明，CMBEs可作为一种有效方法，在增强EF方面具有小到中等程度的积极影响，且更频繁的集体课程和家庭练习可能会增强这些效果。然而，某些局限性，包括研究设计严格、特定变量的效应量（ES）样本有限以及可能存在的发表偏倚，需要在进一步探索CMBEs对EF的影响时特别关注。
