Effect of Tai Chi Combined with Mental Imagery on Cutaneous Microcirculatory Function and Blood Pressure in a Diabetic and Elderly Population
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Measurements
2.3. Intervention
2.4. Procedures
2.5. Sample Size Estimation
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Petrofsky, J.S.; Alshammari, F.; Bains, G.S.; Khowailed, I.A.; Lee, H.; Kuderu, Y.N.; Lodha, R.D.; Rodrigues, S.; Nguyen, D.; Potnis, P.A.; et al. What is more damaging to vascular endothelial function: Diabetes, age, high BMI, or all of the above? Med. Sci. Monit. 2013, 19, 257–263. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Petrofsky, J.S.; Lawson, D.; Suh, H.J.; Rossi, C.; Zapata, K.; Broadwell, E.; Littleton, L. The influence of local versus global heat on the healing of chronic wounds in patients with diabetes. Diabetes Technol. Ther. 2007, 9, 535–544. [Google Scholar] [CrossRef] [PubMed]
- Accurso, V.; Shamsuzzaman, A.S.; Somers, V.K. Rhythms, rhymes, and reasons—spectral oscillations in neural cardiovascular control. Auton. Neurosci. 2001, 90, 41–46. [Google Scholar] [CrossRef]
- Petrofsky, J.; Lee, S.; Cuneo, M. Effects of aging and type 2 diabetes on resting and post occlusive hyperemia of the forearm; the impact of rosiglitazone. BMC Endocr. Disord. 2005, 5, 4. [Google Scholar] [CrossRef] [Green Version]
- Sagliocco, L.; Sartucci, F.; Giampietro, O.; Murri, L. Amplitude loss of electrically and magnetically evoked sympathetic skin responses in early stages of type 1 (insulin-dependent) diabetes mellitus without signs of dysautonomia. Clin. Auton. Res. 1999, 9, 5–10. [Google Scholar] [CrossRef]
- Fealey, R.D.; Low, P.A.; Thomas, J.E. Thermoregulatory sweating abnormalities in diabetes mellitus. Mayo Clin. Proc. 1989, 64, 617–628. [Google Scholar] [CrossRef]
- Petrofsky, J.S.; Besonis, C.; Rivera, D.; Schwab, E.; Lee, S. Heat tolerance in patients with type I and type II diabetes. J. Appl. Res. Clin. Exp. ther. 2003, 3, 328–334. [Google Scholar]
- Anggard, E. Nitric oxide: Mediator, murderer, and medicine. Lancet 1994, 343, 1199–1206. [Google Scholar] [CrossRef]
- Johnstone, M.T.; Creager, S.J.; Scales, K.M.; Cusco, J.A.; Lee, B.K.; Creager, M.A. Impaired endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. Circulation 1993, 88, 2510–2516. [Google Scholar] [CrossRef] [Green Version]
- Taddei, S.; Virdis, A.; Mattei, P.; Ghiadoni, L.; Fasolo, C.B.; Sudano, I.; Salvetti, A. Hypertension causes premature aging of endothelial function in humans. Hypertension 1997, 29, 736–743. [Google Scholar] [CrossRef]
- Taddei, S.; Virdis, A.; Mattei, P.; Ghiadoni, L.; Gennari, A.; Fasolo, C.B.; Sudano, I.; Salvetti, A. Aging and endothelial function in normotensive subjects and patients with essential hypertension. Circulation 1995, 91, 1981–1987. [Google Scholar] [CrossRef] [PubMed]
- Kvernmo, H.D.; Stefanovska, A.; Kirkeboen, K.A.; Osterud, B.; Kvernebo, K. Enhanced endothelium-dependent vasodilatation in human skin vasculature induced by physical conditioning. Eur. J. Appl. Physiol. Occup. Physiol. 1998, 79, 30–36. [Google Scholar] [CrossRef] [PubMed]
- Delp, M.D. Effects of exercise training on endothelium-dependent peripheral vascular responsiveness. Med. Sci. Sports Exerc. 1995, 27, 1152–1157. [Google Scholar] [CrossRef] [PubMed]
- Dickstein, R.; Deutsch, J.E. Motor imagery in physical therapist practice. Phys. Ther. 2007, 87, 942–953. [Google Scholar] [CrossRef] [Green Version]
- Malouin, F.; Richards, C.L. Mental practice for relearning locomotor skills. Phys. Ther. 2010, 90, 240–251. [Google Scholar] [CrossRef] [Green Version]
- Wang, J.S.; Lan, C.; Wong, M.K. Tai Chi Chuan training to enhance microcirculatory function in healthy elderly men. Arch. Phys. Med. Rehabil. 2001, 82, 1176–1180. [Google Scholar] [CrossRef]
- Wang, J.S.; Lan, C.; Chen, S.Y.; Wong, M.K. Tai Chi Chuan training is associated with enhanced endothelium-dependent dilation in skin vasculature of healthy older men. J. Am. Geriatr. Soc. 2002, 50, 1024–1030. [Google Scholar] [CrossRef]
- Lan, C.; Chen, S.Y.; Wong, M.K.; Lai, J.S. Tai Chi training for patients with coronary heart disease. Med. Sport Sci. 2008, 52, 182–194. [Google Scholar] [CrossRef] [Green Version]
- Tsai, J.C.; Wang, W.H.; Chan, P.; Lin, L.J.; Wang, C.H.; Tomlinson, B.; Hsieh, M.H.; Yang, H.Y.; Liu, J.C. The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. J. Altern/ Complement. Med. 2003, 9, 747–754. [Google Scholar] [CrossRef]
- Pan, X.; Zhang, Y.; Tao, S. Effects of Tai Chi exercise on blood pressure and plasma levels of nitric oxide, carbon monoxide and hydrogen sulfide in real-world patients with essential hypertension. Clin. Exp. Hypertens. 2015, 37, 8–14. [Google Scholar] [CrossRef]
- Sun, J.; Buys, N. Community-based mind-body meditative tai chi program and its effects on improvement of blood pressure, weight, renal function, serum lipoprotein, and quality of life in Chinese adults with hypertension. Am. J. Cardiol. 2015, 116, 1076–1081. [Google Scholar] [CrossRef] [Green Version]
- Powell, L.E.; Myers, A.M. The Activities-specific Balance Confidence (ABC) Scale. J. Gerontol. A Biol. Sci. Med. Sci. 1995, 50A, M28–M34. [Google Scholar] [CrossRef] [PubMed]
- Talley, K.M.; Wyman, J.F.; Gross, C.R. Psychometric properties of the activities-specific balance confidence scale and the survey of activities and fear of falling in older women. J. Am. Geriatr. Soc. 2008, 56, 328–333. [Google Scholar] [CrossRef] [PubMed]
- Duncan, P.W.; Weiner, D.K.; Chandler, J.; Studenski, S. Functional reach: A new clinical measure of balance. J. Gerontol. 1990, 45, M192–M197. [Google Scholar] [CrossRef] [PubMed]
- Vellas, B.J.; Wayne, S.J.; Romero, L.; Baumgartner, R.N.; Rubenstein, L.Z.; Garry, P.J. One-leg balance is an important predictor of injurious falls in older persons. J. Am. Geriatr. Soc. 1997, 45, 735–738. [Google Scholar] [CrossRef] [PubMed]
- Jonsson, E.; Seiger, A.; Hirschfeld, H. One-leg stance in healthy young and elderly adults: A measure of postural steadiness? Clin. Biomech. 2004, 19, 688–694. [Google Scholar] [CrossRef] [PubMed]
- Menant, J.C.; Steele, J.R.; Menz, H.B.; Munro, B.J.; Lord, S.R. Optimizing footwear for older people at risk of falls. J. Rehabil. Res. Dev. 2008, 45, 1167–1181. [Google Scholar] [CrossRef] [PubMed]
- Tsai, Y.J.; Lin, S.I. Older adults adopted more cautious gait patterns when walking in socks than barefoot. Gait Posture 2013, 37, 88–92. [Google Scholar] [CrossRef]
- Cohen, J. Statistical Power Analysis for the Behavioral Sciences; Academic Press: Cambridge, MA, USA, 2013. [Google Scholar]
- Zhong, D.; Xiao, Q.; Xiao, X.; Li, Y.; Ye, J.; Xia, L.; Zhang, C.; Li, J.; Zheng, H.; Jin, R. Tai Chi for improving balance and reducing falls: An overview of 14 systematic reviews. Ann. Phys. Rehabil. Med. 2020. [CrossRef]
- Kendrick, D.; Kumar, A.; Carpenter, H.; Zijlstra, G.A.; Skelton, D.A.; Cook, J.R.; Stevens, Z.; Belcher, C.M.; Haworth, D.; Gawler, S.J.; et al. Exercise for reducing fear of falling in older people living in the community. Cochrane Database Syst. Rev. 2014. [CrossRef]
- Nyman, S.R.; Ingram, W.; Sanders, J.; Thomas, P.W.; Thomas, S.; Vassallo, M.; Raftery, J.; Bibi, I.; Barrado-Martin, Y. Randomised controlled trial of the effect of Tai Chi on postural balance of people with dementia. Clin. Interv. Aging 2019, 14, 2017–2029. [Google Scholar] [CrossRef] [Green Version]
- Barrado-Martin, Y.; Heward, M.; Polman, R.; Nyman, S.R. Acceptability of a dyadic Tai Chi intervention for older people living with dementia and their informal carers. J. Aging Phys. Act. 2019, 27, 166–183. [Google Scholar] [CrossRef] [Green Version]
- Mercuris, K.; Lowry, K.; Espey, S. Does instructor experience impact balance and health-related quality of life in healthy older adult participants following a Tai Chi for arthritis program? J. Commun. Health Nurs. 2020, 37, 26–34. [Google Scholar] [CrossRef]
- Zhou, Z.; Zhou, R.; Li, K.; Zhu, Y.; Zhang, Z.; Luo, Y.; Luan, R. Effects of tai chi on physiology, balance and quality of life in patients with type 2 diabetes: A systematic review and meta-analysis. J. Rehabil. Med. Off. J. UEMS Eur. Board Phys. Rehabil. Med. 2019, 51, 405–417. [Google Scholar] [CrossRef] [Green Version]
- Chao, M.; Wang, C.; Dong, X.; Ding, M. The effects of tai chi on type 2 diabetes mellitus: A meta-analysis. Journal Diabetes Res. 2018, 2018, 7350567. [Google Scholar] [CrossRef] [Green Version]
- Alsubiheen, A.; Petrofsky, J.; Daher, N.; Lohman, E.; Balbas, E.; Lee, H. Tai Chi with mental imagery theory improves soleus H-reflex and nerve conduction velocity in patients with type 2 diabetes. Complement. Ther Med. 2017, 31, 59–64. [Google Scholar] [CrossRef]
- Yim, J.; Petrofsky, J.; Berk, L.; Daher, N.; Lohman, E.; Moss, A.; Cavalcanti, P. Protective effect of anti-oxidants on endothelial function in young Korean-Asians compared to Caucasians. Med. Sci. Monitor. Int. Med. J. Exp. Clin. Res. 2012, 18, CR467–CR479. [Google Scholar] [CrossRef] [Green Version]
- Yim, J.; Petrofsky, J.; Berk, L.; Daher, N.; Lohman, E. Differences in endothelial function between Korean-Asians and Caucasians. Med. Sci. Monitor. Int. Med. J. Exp. Clin. Res. 2012, 18, CR337–CR343. [Google Scholar] [CrossRef]
Characteristic | Diabetic (n = 12) | Healthy Subjects (n = 17) | p Value a | ||
---|---|---|---|---|---|
Mean (SD) | n (%) | Mean (SD) | n (%) | ||
Age (years) | 63.8 (8.1) | 63.6 (6.5) | 0.91 | ||
Gender (Female) | 8 (66.7) | 13 (76.5) | 0.43 | ||
Weight (Kg) | 86.8 (17.2) | 77.4 (17.4) | 0.16 | ||
Height (m) | 1.8 (0.1) | 1.7 (0.1) | <0.01 | ||
BMI (Kg/m2) | 27.9 (5.5) | 27.1 (4.3) | 0.66 | ||
Duration of diabetes (years) | 10.8 (5.4) | ||||
HbA1C | 6.8 (0.8) |
Tool | Group | Median [Min, Max] Mean (SD) | Pre-Post p Value | Between Group p Value | |
---|---|---|---|---|---|
ABC | Diabetic | Pre | 88.8 [45.6, 95.6] | <0.01 a | 0.17 b |
Post | 95.0 [75.6, 99.7] | ||||
Healthy Subjects | Pre | 95.0 [87.3, 100.0] | <0.01 a | ||
Post | 96.9 [92.5, 100.0] | ||||
Single Limb Stance | Diabetic | Pre | 11.0 [2.0, 133.0] | <0.01 a | 0.17 b |
Post | 25.1 [4.7, 198.0] | ||||
Healthy Subjects | Pre | 28.0 [4.3, 127.0] | <0.01 a | ||
Post | 57.3 [11.3, 168.0] | ||||
Functional Reach Test | Diabetic | Pre | 11.2 (1.6) | <0.001 c | 0.91 d |
Post | 12.8 (2.2) | ||||
Healthy Subjects | Pre | 11.7 (1.8) | <0.01 c | ||
Post | 13.3 (1.7) |
Time | Diabetic (n = 12) | Healthy Subjects (n = 17) | ||||
---|---|---|---|---|---|---|
Pre | Post | Pre | Post | |||
Baseline | 30 s | 13.1 (2.3) | 12.6 (1.8) | 14.0 (1.7) | 13.7 (1.3) | |
Heat | Heat On | 1 m | 13.1 (1.8) | 13.9 (2.1) | 12.9 (1.7) | 13.5 (1.3) |
2 m | 29.4 (2.5) | 36.3 (5.9) | 57.5 (13.5) | 40.6 (5.1) | ||
3 m | 62.7 (6.0) | 61.2 (9.6) | 111.2 (18.9) | 80.2 (7.8) | ||
4 m | 67.3 (7.9) | 73.9 (16.0) | 120.9 (18.3) | 89.1 (8.5) | ||
5 m | 62.2 (10.0) | 65.8 (17.3) | 116.8 (20.7) | 80.7 (7.8) | ||
5 m 15 s | 60.5 (10.2) | 62.5 (16.7) | 112.1 (19.9) | 73.9 (7.7) | ||
5 m 30 s | 62.5 (16.7) | 56.8 (9.5) | 110.6 (20.0) | 71.1 (7.9) | ||
5 m 45 s | 59.1 (16.6) | 56.3 (8.9) | 107.0 (19.5) | 68.5 (7.2) | ||
6 m | 56.3 (8.9) | 58.9 (17.5) | 105.2 (19.6) | 65.2 (7.8) | ||
Occlusion On | 1 m | 13.0 (3.5) | 8.0 (1.3) | 11.3 (1.7) | 24.4 (6.3) | |
2 m | 13.0 (3.9) | 6.0 (0.6) | 10.1 (1.4) | 15.9 (4.0) | ||
3 m | 10.8 (3.0) | 5.6 (0.7) | 8.1 (1.4) | 12.1 (2.9) | ||
4 m | 9.3 (2.4) | 6.1 (0.7) | 7.8 (1.2) | 10.0 (2.3) | ||
Occlusion off | 4 m 15 s | 57.6 (10.9) | 58.7 (13.1) | 106.4 (22.4) | 62.2 (9.2) | |
4 m 30 s | 77.6 (13.5) | 80.5 (19.3) | 139.8 (25.4) | 86.7 (12.2) | ||
4 m 45 s | 85.1 (13.9) | 90.4 (21.4) | 153.4 (26.1) | 93.0 (12.4) | ||
5 m | 85.3 (13.8) | 92.7 (21.7) | 157.8 (27.7) | 96.4 (11.4) | ||
5 m 15 s | 83.5 (13.5) | 92.9 (22.1) | 162.9 (28.8) | 97.4 (11.2) | ||
5 m 30 s | 82.2 (13.5) | 89.0 (20.5) | 162.0 (29.4) | 98.5 (10.9) | ||
5 m 45 s | 81.9 (13.5) | 85.1 (20.1) | 161.4 (29.0) | 85.0 (9.9) | ||
6 m | 78.2 (12.4) | 82.9 (20.2) | 157.4 (28.5) | 92.6 (10.1) | ||
6 m 15 s | 75.2 (12.5) | 80.9 (19.4) | 152.2 (28.3) | 92.4 (10.4) | ||
6 m 30 s | 75.0 (12.4) | 77.7 (18.2) | 151.8 (29.1) | 93.7 (10.7) | ||
6 m 45 s | 72.2 (12.0) | 77.7 (18.8) | 152.0 (29.4) | 91.6 (10.2) | ||
7 m | 73.6 (12.3) | 75.3 (18.0) | 150.1 (29.8) | 91.9 (9.6) |
Tool | Group | Mean (SD) | Pre-Post p-Value a | Between Group p-Value b | |
---|---|---|---|---|---|
Systolic Blood Pressure (SBP) | Diabetic | Pre | 141.4 (3.7) | 0.002 | 0.16 |
Post | 128.8 (4.2) | ||||
Healthy Subjects | Pre | 132.9 (4.9) | 0.009 | ||
Post | 120.8 (4.2) | ||||
Diastolic Blood Pressure (DBP) | Diabetic | Pre | 80.8 (2.2) | <0.001 | 0.37 |
Post | 71.6 (2.3) | ||||
Healthy Subjects | Pre | 75.8 (2.3) | 0.03 | ||
Post | 71.0 (2.3) |
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Alsubiheen, A.; Petrofsky, J.; Yu, W.; Lee, H. Effect of Tai Chi Combined with Mental Imagery on Cutaneous Microcirculatory Function and Blood Pressure in a Diabetic and Elderly Population. Healthcare 2020, 8, 342. https://doi.org/10.3390/healthcare8030342
Alsubiheen A, Petrofsky J, Yu W, Lee H. Effect of Tai Chi Combined with Mental Imagery on Cutaneous Microcirculatory Function and Blood Pressure in a Diabetic and Elderly Population. Healthcare. 2020; 8(3):342. https://doi.org/10.3390/healthcare8030342
Chicago/Turabian StyleAlsubiheen, Abdulrahman, Jerrold Petrofsky, Wonjong Yu, and Haneul Lee. 2020. "Effect of Tai Chi Combined with Mental Imagery on Cutaneous Microcirculatory Function and Blood Pressure in a Diabetic and Elderly Population" Healthcare 8, no. 3: 342. https://doi.org/10.3390/healthcare8030342