Purpose To systematically evaluate and quantify the effects of Tai Chi/Qigong (TCQ) on motor (UPDRS III, balance, falls, Timed-Up-and-Go, and 6-Minute Walk) and non-motor (depression and cognition) function, and quality of life (QOL) in patients with Parkinson’s disease (PD). Methods A systematic search on 7 electronic databases targeted clinical studies evaluating TCQ for individuals with PD published through August 2016. Meta-analysis was used to estimate effect sizes (Hedge’s g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed by two raters. Results Our search identified 21 studies, 15 of which were RCTs with a total of 755 subjects. For RCTs, comparison groups included no treatment (n=7, 47%) and active interventions (n=8, 53%). Duration of TCQ ranged from 2 to 6 months. Methodological bias was low in 6 studies, moderate in 7, and high in 2. Fixed-effect models showed that TCQ was associated with significant improvement on most motor outcomes (UPDRS III [ES=-0.444, p<.001], balance [ES=0.544, p<.001], Timed-Up-and-Go [ES=−0.341, p=.005], 6MW [ES=−0.293, p=.06]), falls [ES=−.403, p=.004], as well as depression [ES=−0.457, p=.008] and QOL [ES=−0.393, p<.001], but not cognition [ES= −0.225, p=.477]). I2 indicated limited heterogeneity. Funnel plots suggested some degree of publication bias. Conclusion Evidence to date supports a potential benefit of TCQ for improving motor function, depression and QOL for individuals with PD, and validates the need for additional large-scale trials.

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Stroke survivors suffer from disease-associated symptoms. Tai Chi can be a beneficial approach to provide an adapted form of intervention to manage their symptoms. The study aimed to determine the effects of a Tai Chi-based stroke rehabilitation program on symptom clusters, physical and cognitive functions, and stroke-specific quality of life among stroke survivors in Korea. Thirty-four stroke survivors were randomly assigned to receive either the Tai Chi-based program or the stroke-symptom management program. The feasibility of the program and its effects on the outcomes were assessed at baseline, 3 months, and 6 months. Repeated measures ANOVA showed that most symptoms improved in both groups during the 6-month period, but swallowing-related symptoms improved significantly in the Tai Chi group. Based on the interaction effect, Tai Chi was more effective on flexor muscle strength, ambulation, and activities of daily living and cognitive function over 6 months than their counterparts. Among SS-QOL dimensions, the Tai Chi group showed significant improvements in the thinking and self-care dimensions. The Tai Chi-based stroke rehabilitation program was feasible and safely applicable to stroke survivors in the community settings. This program could improve symptoms, physical and cognitive function, leading to improvements in the self-care dimension of the SS-QOL among stroke survivors.

The findings of this meta-analysis suggest that persons with a low risk of falling should practice t'ai chi for 3 months to improve their balance. The effects of t'ai chi on balance in those with a high risk of falling were small but significant at 3 months, supporting the safety and effectiveness of t'ai chi. It is important to select reliable and sensitive measures for balance to examine the effects of t'ai chi.

Purpose:This study was done to analyze the effects of Tai Chi on fall-related risk factors through meta-analysis of randomized clinical trials published in English and Korean between 2000 and 2010. Methods: Using health related database and hand search of references and Google, 28 randomized studies were collected from doctoral dissertation and published peer reviewed articles. The Comprehensive Meta-analysis version 2.0 was used for the analysis. Results: The effect sizes for Tai Chi for 3 months were significant with ES= 0.54 for static balance, ES= 0.24 for dynamic balance, ES= 0.69 for balance measured by scale, and ES= 0.40 for flexibility, ES= 0.48 for muscle strength, ES= 0.71 for ADL, and ES= 0.37 for fear of falling. Also, the effect sizes of Tai Chi for 6 months were significant for most fall-related variables. The 6 month data for flexibility was not analyzed since only one study was published. Conclusion: The analysis of studies of randomized clinical trials indicate that Tai Chi is effective in improving balance, flexibility, muscle strength, activities of daily living, and fear of falling when applied for 3 or 6 months. The findings provide the objective evidence to apply Tai Chi as a fall preventive intervention.

The study aims were to examine motivation factors for behavioral modification among individuals with metabolic syndrome at each stage of behavioral change. Methods: The correlational research design was used to explore motivation factors of self-efficacy, perceived benefits, perceived barriers, and emotional salience to explain health behaviors. Total of 239 patients with metabolic syndrome completed the structured questionnaire and the data were analyzed by SPSS/WIN 22.0 for ANOVA and multiple regression analysis. Results: The average age of participants were 59 years old, and 52.3% perceived their health relatively worse than others. The motivation and health behaviors except for smoking cessation were significantly different at each stage of planning, preparation, and action-maintenance. The motivation factors explained 25% of variance in health behavior at planning stage, 38% at preparation stage, and 31% at action-maintenance stage. Self-efficacy and perceived barriers were significant predictors at the planning and action-maintenance stages, while self-efficacy was a significant predictor at preparation stage. Conclusion: The performance of health behaviors was significantly different at the stages of change along with a different set of motivation factors. Nursing strategies should focus on cognitive and emotional motivation factors to lead initiation and maintenance of behavioral modification in individuals with metabolic syndrome.

The prevalence of chronic disease associated with unhealthy lifestyles has been increasing worldwide. Health professionals have recognized that self-management programs (SMPs) can provide health benefits by promoting health behaviors, especially when applied to individuals with lifestyle-related chronic disease. This review performed a meta-analysis of the features of SMPs using randomized studies and analyzed the magnitude of the combined effects of self-management on behavioral modification. We searched the PubMed, CINAHL, ScienceDirect, SCOPUS, Web of Science, Embase, Cochrane Library, DBpia, and KISS to identify randomized trials that evaluated the behavioral outcomes of SMPs. Subgroup analyses were performed for program duration, providers, type of comparisons, and program settings. We selected 25 studies (N = 5,681) to perform analyses with random-effects models. The effect sizes of SMPs were small but significant for physical activity (standardized difference in means [SDM] = 0.25), dietary habits (SDM = 0.28), and health responsibility (SDM = 0.18), and not significant for stress management and smoking behaviors. A short-term SMPs (less than 12 weeks) was indicated as being effective in modifying physical activity, dietary habits, and health responsibility, while the program effects on dietary habits were significant only with expert-delivered education and when compared with inactive controls. The findings of this study indicate that SMPs can effectively improve physical activity, dietary habits, and health responsibility in individuals with chronic disease, with a small but significant effect size. Future studies should explore the effects of SMPs on stress management and smoking cessation and assess the long-term maintenance of healthy lifestyles in individuals with lifestyle-related chronic disease.

The purpose of this study was to validate the Korean version of the mild cognitive impairment questionnaire (K-MCQ) to assess quality of life of older adults with mild cognitive impairment. Methods: The translation and linguistic validation process was completed according to Oxford University's guidelines and the K-MCQ's developer. The K-MCQ was expertly reviewed to calculate the content validity index (CVI). After pilot testing, the K-MCQ's final format was applied to 130 adults with mild cognitive impairment for reliability and validity testing using item analysis, exploratory and confirmatory factor analysis, and internal consistency. The SF-12 is an established quality-of-life instrument that measures criterion validity and the MoCA-K measures concurrent validity. Results: The K-MCQ consisted of 13 items on a 5-point Likert scale and two factors (practical and emotional concerns) explained 67.0% and 72.9%, respectively. The K-MCQ verified discriminant validity in confirmatory factor analysis, criterion validity with a significant correlation with the SF-12, and concurrent validity with a significant correlation with cognitive function. Reliability was confirmed with Cronbach's ⍺=.92. Conclusion: These findings indicate that the K-MCQ is a reliable and valid measure of quality of life, which can assess quality of life of older Korean adults with mild cognitive impairment.