Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review

Background: Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health concern. The common functional, psychological, and cognitive changes associated with TBI and recent trends in its management, such as recommending sub-threshold aerobic activity, and multi-mo...

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Main Authors: Laskosky, Nicole Alexandra, Huston, Patricia, Lam, Wai Ching, Anderson, Charlotte, Zhong, Linda Lidan
Other Authors: School of Biological Sciences
Format: Article
Language:English
Published: 2024
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Online Access:https://hdl.handle.net/10356/175742
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Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-175742
record_format dspace
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Medicine, Health and Life Sciences
Tai chi
Qigong
spellingShingle Medicine, Health and Life Sciences
Tai chi
Qigong
Laskosky, Nicole Alexandra
Huston, Patricia
Lam, Wai Ching
Anderson, Charlotte
Zhong, Linda Lidan
Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review
description Background: Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health concern. The common functional, psychological, and cognitive changes associated with TBI and recent trends in its management, such as recommending sub-threshold aerobic activity, and multi-modal treatment strategies including vestibular rehabilitation, suggest that Tai Chi/Qigong could be beneficial for TBI. Tai Chi and Qigong are aerobic mind-body practices with known benefits for maintaining health and mitigating chronic disease. To date, no systematic review has been published assessing the safety and effectiveness of Tai Chi/Qigong for traumatic injury. Methods: The following databases were searched: MEDLINE, CINAHL Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. All people with mild, moderate, or severe TBI who were inpatients or outpatients were included. All Types of Tai Chi and Qigong, and all comparators, were included. All measured outcomes were included. A priori, we chose “return to usual activities” as the primary outcome measure as it was patient-oriented. Cochrane-based risk of bias assessments were conducted on all included trials. Quality of evidence was assessed using the grading of recommendation, assessment, development, and evaluation (GRADE) system. Results: Five trials were assessed; three randomized controlled trials (RCTs) and two non-RCTs; only two trials were conducted in the last 5 years. No trial measured “return to normal activities” or vestibular status as an outcome. Four trials - two RCTs and two non-RCTS - all found Tai Chi improved functional, psychological and/or cognitive outcomes. One RCT had a low risk of bias and a high level of certainty; one had some concerns. One non-RCTs had a moderate risk of bias and the other a serious risk of bias. The one Qigong RCT found improved psychological outcomes. It had a low risk of bias and a moderate level of certainty. Only one trial reported on adverse events and found that none were experienced by either the exercise or control group. Conclusion: Based on the consistent finding of benefit in the four Tai Chi trials, including one RCT that had a high level of certainty, there is a sufficient signal to merit conducting a large, high quality multi-centre trial on Tai Chi for TBI and test it against current trends in TBI management. Based on the one RCT on TBI and Qigong, an additional confirmatory RCT is indicated. Further research is indicated that reflects current management strategies and includes adverse event documentation in both the intervention and control groups. However, these findings suggest that, in addition to Tai Chi’s known health promotion and chronic disease mitigation benefits, its use for the treatment of injury, such as TBI, is potentially a new frontier. Systematic review registration: PROSPERO [CRD42022364385].
author2 School of Biological Sciences
author_facet School of Biological Sciences
Laskosky, Nicole Alexandra
Huston, Patricia
Lam, Wai Ching
Anderson, Charlotte
Zhong, Linda Lidan
format Article
author Laskosky, Nicole Alexandra
Huston, Patricia
Lam, Wai Ching
Anderson, Charlotte
Zhong, Linda Lidan
author_sort Laskosky, Nicole Alexandra
title Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review
title_short Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review
title_full Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review
title_fullStr Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review
title_full_unstemmed Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review
title_sort are tai chi and qigong effective in the treatment of traumatic brain injury? a systematic review
publishDate 2024
url https://hdl.handle.net/10356/175742
_version_ 1800916322223128576
spelling sg-ntu-dr.10356-1757422024-05-06T15:32:10Z Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review Laskosky, Nicole Alexandra Huston, Patricia Lam, Wai Ching Anderson, Charlotte Zhong, Linda Lidan School of Biological Sciences Medicine, Health and Life Sciences Tai chi Qigong Background: Traumatic brain injury (TBI) adversely affects both young and old and is a growing public health concern. The common functional, psychological, and cognitive changes associated with TBI and recent trends in its management, such as recommending sub-threshold aerobic activity, and multi-modal treatment strategies including vestibular rehabilitation, suggest that Tai Chi/Qigong could be beneficial for TBI. Tai Chi and Qigong are aerobic mind-body practices with known benefits for maintaining health and mitigating chronic disease. To date, no systematic review has been published assessing the safety and effectiveness of Tai Chi/Qigong for traumatic injury. Methods: The following databases were searched: MEDLINE, CINAHL Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database. All people with mild, moderate, or severe TBI who were inpatients or outpatients were included. All Types of Tai Chi and Qigong, and all comparators, were included. All measured outcomes were included. A priori, we chose “return to usual activities” as the primary outcome measure as it was patient-oriented. Cochrane-based risk of bias assessments were conducted on all included trials. Quality of evidence was assessed using the grading of recommendation, assessment, development, and evaluation (GRADE) system. Results: Five trials were assessed; three randomized controlled trials (RCTs) and two non-RCTs; only two trials were conducted in the last 5 years. No trial measured “return to normal activities” or vestibular status as an outcome. Four trials - two RCTs and two non-RCTS - all found Tai Chi improved functional, psychological and/or cognitive outcomes. One RCT had a low risk of bias and a high level of certainty; one had some concerns. One non-RCTs had a moderate risk of bias and the other a serious risk of bias. The one Qigong RCT found improved psychological outcomes. It had a low risk of bias and a moderate level of certainty. Only one trial reported on adverse events and found that none were experienced by either the exercise or control group. Conclusion: Based on the consistent finding of benefit in the four Tai Chi trials, including one RCT that had a high level of certainty, there is a sufficient signal to merit conducting a large, high quality multi-centre trial on Tai Chi for TBI and test it against current trends in TBI management. Based on the one RCT on TBI and Qigong, an additional confirmatory RCT is indicated. Further research is indicated that reflects current management strategies and includes adverse event documentation in both the intervention and control groups. However, these findings suggest that, in addition to Tai Chi’s known health promotion and chronic disease mitigation benefits, its use for the treatment of injury, such as TBI, is potentially a new frontier. Systematic review registration: PROSPERO [CRD42022364385]. Published version 2024-05-06T00:58:54Z 2024-05-06T00:58:54Z 2024 Journal Article Laskosky, N. A., Huston, P., Lam, W. C., Anderson, C. & Zhong, L. L. (2024). Are Tai Chi and Qigong effective in the treatment of traumatic brain injury? A systematic review. BMC Complementary Medicine and Therapies, 24(1), 78-. https://dx.doi.org/10.1186/s12906-024-04350-3 2662-7671 https://hdl.handle.net/10356/175742 10.1186/s12906-024-04350-3 38321432 2-s2.0-85184547030 1 24 78 en BMC Complementary Medicine and Therapies © The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. application/pdf