Second Department of Neurology, Faculty of Medicine, Comenius University Bratislava, University Hospital Bratislava, Slovakia; Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czechia.
Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czechia.
Explore (NY). 2024 Mar-Apr;20(2):188-195. doi: 10.1016/j.explore.2023.07.011. Epub 2023 Aug 6.
One of the most debilitating problems encountered by people with multiple sclerosis (MS) is the loss of balance and coordination. Our study aimed to comprehensively evaluate the effectiveness of one year of Tai-chi exercise in patients with MS using both subjective and objective methods, including posturography.
This was a single-group longitudinal one-year study performed from the 1st of January 2019 to the 1st of January 2020. The primary outcomes of interest were the Mini-Balance Evaluation Systems Test (Mini-BESTest) and static posturography measures as objective methods to detect subtle changes associated with postural control/balance impairment. Secondary outcomes were measures of depression, anxiety, cognitive performance, and quality of life. All objective and subjective parameters were assessed four times: at baseline, and after three, six and 12 months of regular Tai-chi training. The difference was calculated as a subtraction of baseline values from every timepoint value for each measurement. If the normality test was passed, parametric one-sample t-test was used, if failed, Wilcoxon signed ranks test was used to test the difference between the baseline and each timepoint. Alpha was set to 0.017 using Bonferroni correction for multiple comparisons.
Out of 25 patients with MS enrolled, 15 women with MS (mean age 44.27 years) were included for statistical analyses after completing the 12-month program. After 12 months, significant improvements were found in all objective balance and gait tests: Mini-BESTest (p<0.001), static posturography measures (total area of the centre of foot pressure - TA; p = 0.015), 25 Feet Walk Test (25FWT; p = 0.001), anxiety (Beck Anxiety Inventory - BAI; p = 0.005) and cognition tests (Paced Auditory Serial Addition Test - PASAT; p = 0.003). Measures of depression (Beck Depression Inventory - BDI; p = 0.071), cognition (Symbol Digit Modalities Test - SDMT; p = 0.079), and health-related quality of life (European Quality of Life 5-Dimensions Questionnaire - EQ-5D-5L; p = 0.095) showed a trend of improvement but were not significant, which could be the result of a small sample and increased bias due the type II error.
According to these preliminary results, this study indicates the possible beneficial effects of long-term Tai-chi training on patients with MS. Although these findings need to be confirmed by further studies with a larger sample of participants of both genders and require more rigorous randomized controlled trials (RCT) design, our findings support the recommendation of regular and long-term Tai-chi exercise in patients with MS.
GOV IDENTIFIER (RETROSPECTIVELY REGISTERED): NCT05474209.
多发性硬化症（MS）患者最令人衰弱的问题之一是失去平衡和协调能力。我们的研究旨在使用主观和客观方法（包括姿势描记术）全面评估泰拳锻炼对 MS 患者的一年疗效。
这是一项从 2019 年 1 月 1 日至 2020 年 1 月 1 日进行的单组纵向为期一年的研究。主要结果是 Mini-Balance Evaluation Systems Test（Mini-BESTest）和静态姿势描记术测量，作为检测与姿势控制/平衡障碍相关的细微变化的客观方法。次要结果是抑郁、焦虑、认知表现和生活质量的测量。所有客观和主观参数均评估四次：基线时，以及在进行 3、6 和 12 个月的常规泰拳训练后。差值为每次测量的基线值减去每个时间点的值。如果通过正态性检验，使用参数单样本 t 检验，如果未通过，使用 Wilcoxon 符号秩检验测试基线与每个时间点之间的差异。使用 Bonferroni 校正进行多重比较，将 α 设置为 0.017。
在 25 名入组的 MS 患者中，有 15 名患有 MS 的女性（平均年龄 44.27 岁）在完成 12 个月的项目后纳入了统计分析。经过 12 个月，所有客观的平衡和步态测试都有显著改善：Mini-BESTest（p<0.001）、静态姿势描记术测量（足底压力中心总面积-TA；p=0.015）、25 英尺步行测试（25FWT；p=0.001）、焦虑（贝克焦虑量表-BAI；p=0.005）和认知测试（Paced Auditory Serial Addition Test-PASAT；p=0.003）。抑郁（贝克抑郁量表-BDI；p=0.071）、认知（符号数字模态测试-SDMT；p=0.079）和健康相关生活质量（欧洲生活质量 5 维问卷-EQ-5D-5L；p=0.095）的测量结果显示出改善的趋势，但并不显著，这可能是由于样本量较小和 II 型错误导致的偏倚增加所致。
根据这些初步结果，本研究表明长期泰拳训练对 MS 患者可能有益。尽管这些发现需要进一步研究，并且需要更多具有男女两性更大样本量的更严格的随机对照试验（RCT）设计来证实，但我们的研究结果支持建议 MS 患者定期进行长期泰拳锻炼。
政府标识符（回顾性注册）：NCT05474209。
