Effect of Tai Chi versus Aerobic Training on Improving Hand Grip Strength, Fatigue, and Functional Performance in Older Adults Post-COVID-19: a randomized controlled trial
Main Article Content
Keywords
Tai Chi, Aerobic, Grip strength, Fatigue, Covid-19
Abstract
Background: The recent pandemic of COVID-19 has left a wide range of after-effects on the health of older adults. The effects of the pandemic have been particularly felt in the areas of physical strength, fatigue, and functional performance.
Material and methods: Fifty-four participants were allocated into three groups: Tai Chi (TC) attended 4 sessions of 60-min TC training per week for consecutive 12 weeks, Aerobic Training (AT) attended 4 sessions of 60-min aerobic training per week for 12 weeks, and Control (CON) instructed to maintain a daily routine. Hand grip strength (HGS) and Fatigue Severity Scale (FSS) were used to evaluate the participants. Functional performance outcomes were determined The functional performance outcome was determined by The 30-second Chair Stand Test (CST), The 30-second Arm Curl Test (ACT), The 8-feet Up-and-Go test (TUG), and The 2 min steps. Pre-post comparisons of all outcomes in each group and comparisons between groups were analyzed using the ANOVA test with SPSS software.
Results: After the intervention, TC and AT groups both experienced significant improvements in HGS, fatigue levels, CST, ACT, TUG, and 2-minute steps compared to baseline (all P < 0.001). The Tai Chi group also experienced significantly improved hand grip strength (p =0.0435, mean difference of - 2.5), and ACT (p =0.0235, mean difference of 1) compared to the AT group.
Conclusions: Tai Chi is an integrated rehabilitation program that had a positive effect on hand grip strength, fatigue levels, and functional performance compared to aerobic training in the elderly post-COVID-19.
References
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25. Mustian, K. M., Katula, J. A., & Zhao, H. A pilot study to assess the influence of tai chi chuan on functional capacity among breast cancer survivors. The Journal of Supportive Oncology. 2006;4(3), 139–145.
26. Mustian, K. M., Palesh, O. G., & Flecksteiner, S. A. Tai Chi Chuan for Breast Cancer Survivors. Medicine and Sport Science. 2008;209–217.
27. Al-Shreef, F., Al-Jiffri, O., & El-Kader, S. Bone metabolism and hand grip strength response to aerobic versus resistance exercise training in non-insulin dependent diabetic patients. African Health Sciences 2015;15(3), 896.
28. Raub, J. A. Psychophysiologic Effects of Hatha Yoga on Musculoskeletal and Cardiopulmonary Function: A Literature Review. The Journal of Alternative and Complementary Medicine. 2002;8(6), 797–812.
29. Xiang, Y., Lu, L., Chen, X., & Wen, Z. Does Tai Chi relieve fatigue? A systematic review and meta-analysis of randomized controlled trials. PLOS ONE. 2017;12(4), e0174872
30. Wu, K., Li, Y., Zou, Y., Ren, Y., Wang, Y., Hu, X., Wang, Y., Chen, C., Lu, M., Xu, L., Wu, L., & Li, K. Tai Chi increases functional connectivity and decreases chronic fatigue syndrome: A pilot intervention study with machine learning and
fMRI analysis. PLOS ONE. 2022;17(12), e0278415.
31. Purvis Lively, C. Social Isolation of Older Adults in Long Term Care as a Result of COVID-19 Mitigation Measures During the COVID-19 Pandemic. Voices in Bioethics. 2021;7.
32. Kriswanto, E. S., Setijono, H., & Mintarto, E. The Effect Of Cardiorespiratory Fitness And Fatigue Level On Learning Ability Of Movement Coordination. Jurnal Cakrawala Pendidikan. 2019;38(2), 320–329.
33. Nehme, M., Braillard, O., Chappuis, F., Courvoisier, D. S., & Guessous, I. Prevalence of Symptoms More Than Seven Months After Diagnosis of Symptomatic COVID-19 in an Outpatient Setting. Annals of Internal Medicine. 2021;174(9), 1252–1260.
34. Keklicek, H., Selçuk, H., Kurt, L., Ulukaya, S., & Öztürk, G. Individuals with a COVID-19 history exhibit asymmetric gait patterns despite full recovery. Journal of Biomechanics. 2022;137, 111098.
35. Youssef Elhamrawy, M., W., Yasser Saif, M., Elkholy, A., & Said, M. Effect of vestibular rehabilitation therapy on spatio-temporal gait parameters in elderly patients with post-stroke hemineglect. Advances in Rehabilitation. 2021;35(3), 17–24.
36. Nnodim, J. O. Balance and its Clinical Assessment in Older Adults - A Review. Journal of Geriatric Medicine and Gerontology. 2015;1(1).
37. Chyu, M. C., James, C. R., Sawyer, S. F., Brismée, J. M., Xu, & Shen, C. L. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal women with osteopaenia: a randomized clinical study. Clinical Rehabilitation. 2010;4(12), 1080–1090.
38. Ko, B. J., Lee, T. T., Hsu, T. Y., & Huang, C. F. The Effects of Tai Chi Chuan Exercise Training on the Lower Extremities of Middle-Aged and Elderly. Applied Sciences. 2022;12(9), 4460.
39. Lou, L., Zou, L., Fang, Q., Wang, H., Liu, Y., Tian, Z., & Han, Y. Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial. Evidence-Based Complementary and Alternative Medicine. 2017;1–9.
40. Maciaszek, J., & Osiński, W. The Effects of Tai Chi on Body Balance in Elderly People — A Review of Studies from the Early 21st Century. The American Journal of Chinese Medicine. 2010;38(02), 219–229.
2. Hasenoehrl, T., Palma, S., Huber, D. F. X., Kastl, S., Steiner, M., Jordakieva, G., & Crevenna, R. Post-COVID: effects of physical exercise on functional status and work ability in health care personnel. Disability and Rehabilitation. 2022;1–7.
3. Szmul, G., Podufały, A., A., Wiśniowska-Szurlej, A., & Sozański, B. Assessment of the correlations between the level of physical activity and sociodemographic factors, functional capabilities and cognitive capabilities of elderly persons from south-eastern Poland. Advances in Rehabilitation. 2018;32(4), 5–11.
4. Yamada, M., Kimura, Y., Ishiyama, D., Otobe, Y., Suzuki, & Arai, H. Effect of the COVID-19 Epidemic on Physical Activity in Community-Dwelling Older Adults in Japan: A Cross-Sectional Online Survey. The Journal of Nutrition, Health &Amp; Aging. 2020;24(9), 948–950.
5. Tamai, K., Terai, H., Takahashi, S., N., Habibi, H., & Nakamura, H. Decreased daily exercise since the COVID-19 pandemic and the deterioration of health-related quality of life in the elderly population: a population-based cross-sectional study. BMC Geriatrics. 2022;22(1).
6. Cattadori, G., Di Marco, S., Baravelli, M., Picozzi, A., & Ambrosio, G. Exercise Training in Post-COVID-19 Patients: The Need for a Multifactorial Protocol for a Multifactorial Pathophysiology. Journal of Clinical Medicine. 2022;11(8), 2228.
7. Pratama, I. K., & Setiati, S. Correlation between hand grip strength and functional mobility in elderly patients. Journal of Physics: Conference Series. 2018;1073, 042034.
8. Del Brutto, O. H., Mera, R. M., , B. Y., Costa, A. F., & Sedler, M. J. Hand grip strength before and after SARS‐CoV‐2 infection in community‐dwelling older adults. Journal of the American Geriatrics Society. 2021;69(10), 2722–2731.
9. Ceban, F., Ling, S., Lui, L. M., Lee, Y., Gill, H., Teopiz, K. M., Rodrigues, N. B., Subramaniapillai, M., & McIntyre, R. S. Fatigue and cognitive impairment in Post-COVID-19 Syndrome: A systematic review and meta-analysis. Brain, Behavior, and Immunity. 2022;101, 93–135.
10. Lopez-Leon, S., Wegman-Ostrosky, T., Perelman, C., Sepulveda, R., Rebolledo, & Villapol, S. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Scientific Reports. 2021;11(1).
11. Wehner, C., Blank, C., Arvandi, M., Wehner, C., & Schobersberger, W. Effect of Tai Chi on muscle strength, physical endurance, postural balance and flexibility: a systematic review and meta-analysis. BMJ Open Sport &Amp; Exercise Medicine. 2021;7(1), e000817.
12. Song, J., Wei, L., Cheng, K., Lin, Q., Xia, P., Wang, X., Wang, X., Yang, T., Chen, B., Ding, A., Sun, M., Chen, A., & Li, X. The Effect of Modified Tai Chi Exercises on the Physical Function and Quality of Life in Elderly Women With Knee Osteoarthritis. Frontiers in Aging Neuroscience. 2022;14.
13. Maugeri, G., Castrogiovanni, P., Battaglia, G., Pippi, R., D’Agata, V., Palma, A., Di Rosa, M., & Musumeci, G. The impact of physical activity on psychological health during Covid-19 pandemic in Italy. Heliyon. 2020;6(6), e04315.
14. Goodwin, E., Hawton, A., & Green, C. Using the Fatigue Severity Scale to inform healthcare decision-making in multiple sclerosis: mapping to three quality-adjusted life-year measures (EQ-5D-3L, SF-6D, MSIS-8D). Health and Quality of Life Outcomes. 2019;17(1).
15. Rikli, R. E., & Jones, C. J. Development and Validation of Criterion-Referenced Clinically Relevant Fitness Standards for Maintaining Physical Independence in Later Years. The Gerontologist. 2012;53(2), 255–267.
16. Langhammer, B., & Stanghelle, J. K. The Senior Fitness Test. Journal of Physiotherapy. 2015;61(3), 163.
17. El Osta, N., Kanso, F., Saad, R., Khabbaz, L. R., Fakhouri, J., & El Osta, L. Validation du SF-36, questionnaire générique de la qualité de vie liée à la santé chez les personnes âgées au Liban. Eastern Mediterranean Health Journal. 2019;25(10), 706–714.
18. Klok, F. A., Boon, G. J., Barco, S., Endres, M., Geelhoed, J. M., Knauss, S., Rezek, S. A., Spruit, M. A., Vehreschild, J., & Siegerink, B. The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. European Respiratory Journal. 2020;56(1), 2001494.
19. Farham, B. Tai Chi and postural stability in patients with Parkinson’s disease. Continuing Medical Education. 2012;30(5), 181.
20. Solloway, M. R., Taylor, S. L., Shekelle, P. G., Miake-Lye, I. M., Beroes, J. M., Shanman, R. M.,& Hempel, S. An evidence map of the effect of Tai Chi on health outcomes. Systematic Reviews. 2016;5(1).
21. Williams, N. The Borg Rating of Perceived Exertion (RPE) scale. Occupational Medicine. 2017;67(5), 404–405.
22. Chang, W. H., Kim, M. S., Huh, J. P., Lee, P. K. W., & Kim, Y. H. Effects of Robot-Assisted Gait Training on Cardiopulmonary Fitness in Subacute Stroke Patients. Neurorehabilitation and Neural Repair. 2011;26(4), 318–324.
23. Suomi, R., & Collier, D. Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. Archives of Physical Medicine and Rehabilitation. 2003;84(11), 1589–1594.
24. Nygård, A. J., Taraldsen, K., Granbo, R., Selbæk, G., & Helbostad, J. L. Impacts of COVID-19 restrictions on level of physical activity and health in home-dwelling older adults in Norway. European Review of Aging and Physical Activity. 2022;19(1).
25. Mustian, K. M., Katula, J. A., & Zhao, H. A pilot study to assess the influence of tai chi chuan on functional capacity among breast cancer survivors. The Journal of Supportive Oncology. 2006;4(3), 139–145.
26. Mustian, K. M., Palesh, O. G., & Flecksteiner, S. A. Tai Chi Chuan for Breast Cancer Survivors. Medicine and Sport Science. 2008;209–217.
27. Al-Shreef, F., Al-Jiffri, O., & El-Kader, S. Bone metabolism and hand grip strength response to aerobic versus resistance exercise training in non-insulin dependent diabetic patients. African Health Sciences 2015;15(3), 896.
28. Raub, J. A. Psychophysiologic Effects of Hatha Yoga on Musculoskeletal and Cardiopulmonary Function: A Literature Review. The Journal of Alternative and Complementary Medicine. 2002;8(6), 797–812.
29. Xiang, Y., Lu, L., Chen, X., & Wen, Z. Does Tai Chi relieve fatigue? A systematic review and meta-analysis of randomized controlled trials. PLOS ONE. 2017;12(4), e0174872
30. Wu, K., Li, Y., Zou, Y., Ren, Y., Wang, Y., Hu, X., Wang, Y., Chen, C., Lu, M., Xu, L., Wu, L., & Li, K. Tai Chi increases functional connectivity and decreases chronic fatigue syndrome: A pilot intervention study with machine learning and
fMRI analysis. PLOS ONE. 2022;17(12), e0278415.
31. Purvis Lively, C. Social Isolation of Older Adults in Long Term Care as a Result of COVID-19 Mitigation Measures During the COVID-19 Pandemic. Voices in Bioethics. 2021;7.
32. Kriswanto, E. S., Setijono, H., & Mintarto, E. The Effect Of Cardiorespiratory Fitness And Fatigue Level On Learning Ability Of Movement Coordination. Jurnal Cakrawala Pendidikan. 2019;38(2), 320–329.
33. Nehme, M., Braillard, O., Chappuis, F., Courvoisier, D. S., & Guessous, I. Prevalence of Symptoms More Than Seven Months After Diagnosis of Symptomatic COVID-19 in an Outpatient Setting. Annals of Internal Medicine. 2021;174(9), 1252–1260.
34. Keklicek, H., Selçuk, H., Kurt, L., Ulukaya, S., & Öztürk, G. Individuals with a COVID-19 history exhibit asymmetric gait patterns despite full recovery. Journal of Biomechanics. 2022;137, 111098.
35. Youssef Elhamrawy, M., W., Yasser Saif, M., Elkholy, A., & Said, M. Effect of vestibular rehabilitation therapy on spatio-temporal gait parameters in elderly patients with post-stroke hemineglect. Advances in Rehabilitation. 2021;35(3), 17–24.
36. Nnodim, J. O. Balance and its Clinical Assessment in Older Adults - A Review. Journal of Geriatric Medicine and Gerontology. 2015;1(1).
37. Chyu, M. C., James, C. R., Sawyer, S. F., Brismée, J. M., Xu, & Shen, C. L. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal women with osteopaenia: a randomized clinical study. Clinical Rehabilitation. 2010;4(12), 1080–1090.
38. Ko, B. J., Lee, T. T., Hsu, T. Y., & Huang, C. F. The Effects of Tai Chi Chuan Exercise Training on the Lower Extremities of Middle-Aged and Elderly. Applied Sciences. 2022;12(9), 4460.
39. Lou, L., Zou, L., Fang, Q., Wang, H., Liu, Y., Tian, Z., & Han, Y. Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial. Evidence-Based Complementary and Alternative Medicine. 2017;1–9.
40. Maciaszek, J., & Osiński, W. The Effects of Tai Chi on Body Balance in Elderly People — A Review of Studies from the Early 21st Century. The American Journal of Chinese Medicine. 2010;38(02), 219–229.
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Apr 15, 2023
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Mohammed Y. Elhamrawy, Abd el hamied Ibrahim el sayed Mohammad el sherbini, Maha M. Mokhtar, Ahmed Mashaal, Sabah Mohamed Elkady, Samah M. Elsadany, & Mohammed T. Said. (2023). Effect of Tai Chi versus Aerobic Training on Improving Hand Grip Strength, Fatigue, and Functional Performance in Older Adults Post-COVID-19: a randomized controlled trial. Journal of Population Therapeutics and Clinical Pharmacology, 30(7), 190–198. https://doi.org/10.47750/jptcp.2023.30.07.024
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