| Overweight/obesity is defined as excessive or abnormal fat accumulation that is harmful to health.In clinical diagnosis and treatment,it is generally considered that BMI≥24 is overweight,and when BMI≥28 is obesity.According to the survey results of the World Health Organization,as of 2016,a total of 1.9 billion adults worldwide were overweight,of which more than 650 million were obese,especially in Asia;Among 380 million overweight children and adolescents,more than 124 million are obese.The number of overweight and obesity increased by nearly 300%compared with that in 1975.Overweight and obesity have an increasing impact on the increase of medical burden and related mortality worldwide.It is urgent to prevent and treat overweight/obesity.Tai Chi Chuan,as the most vigorous representative of the guided regimen of traditional Chinese medicine at present,is a valuable choice for the rehabilitation and health preservation of both body and spirit suitable for the practice of hospitals,communities and families through the simultaneous coordination of consciousness,movement and breathing,so that the exercisers can improve their physical and mental quality while improving their spiritual quality.At present,there are few relevant studies on the difference between the effects of standard and simplified Tai Chi Chuan on muscle strength and happiness index of overweight and obese patients.Therefore,this study explored the impact of standard Tai Chi Chuan on overweight/obese patients through exploratory research,and explored the possible causes of knee joint injury in Tai Chi Chuan practice through kinematics and dynamics analysis.PART I:Effect of Standard Tai Chi Chuan on Exercise Ability and Happiness Index in Overweight Adults with Exercise Deficiency:An Exploratory Research Objective:To explore the differences in the effects of standard and simplified Taijiquan on muscle strength and mental health in overweight and obese patients.Methods:A randomized,controlled,and open exploratory study design was used to recruit 20 overweight/obese subjects who lacked exercise at Xiyuan Hospital of the Chinese Academy of Traditional Chinese Medicine.After receiving baseline testing and safety education for exercise intervention in accordance with the research design requirements,all selected subjects were completely randomized into a standard Taijiquan group and a simplified Taijiquan group for 8 weeks of intervention.By comparing the evaluation of exercise ability and mental health between the two groups before and after the intervention,the differences in the efficacy of standard Taijiquan and simplified Taijiquan were explored.Exercise ability includes isokinetic muscle strength testing and balance ability testing;The overall well-being scale and the Pittsburgh Sleep Quality Index scale were used to assess mental health status.Results:A total of 20 subjects were included in this study,including 10 in the standard Taijiquan group(experimental group)and 10 in the simplified Taijiquan group(control group).The likelihood ratio of gender distribution between the test group and the control group was 1,and there was no significant difference in age and weight(both P>0.05),indicating comparability.Before the intervention,there were no statistical differences between the two groups in terms of BMI index,exercise ability,and happiness index(P>0.05),and the data in each group were comparable.The BMI index of both groups showed a downward trend after intervention,and the improvement in the experimental group was more significant(P<0.05).After the intervention,the muscle strength and balance ability of the two groups were significantly improved(both P.The improvement of the overall well-being scale and the Pittsburgh sleep quality index scale in the experimental group was significantly better than that in the control group(both P<0.05).Conclusion:Compared to simplified Taijiquan,standard Taijiquan is a high-quality choice for traditional Chinese medicine sports that conforms to psychosomatic exercise and has the effects of both maintaining physical health and improving mental health.Moreover,there are no adverse events during the research process,which is safe and worthy of wide promotion and application in clinical diagnosis and research.PART II:Kinematics and Dynamics Characteristics of Horse Step Movement of Correct and Wrong Tai Chi Chuan Based on Optitrack and Bertec SystemObjective:To explore the possible kinematical and dynamic factors of knee joint injury caused by standard and non-standard horse steps during Tai Chi Boxing practice.Methods:Using the Optitrack Motion Capture System and the Bertec Gait Analysis and Force Measurement System,subjects were subjected to standard orthostatic and standard lateral equine gait tests,and compared with non-standard orthostatic and non-standard lateral equine gait tests.Test data were collected through the Dynamic Body software and analyzed.The content of kinematics analysis includes the overall movement of the body,the angle of the knee joint,the displacement of the hip joint,and the relative position of the knee joint and the toe;The dynamic analysis includes the distribution of lower limb forces and lower limb moments.Results:The results of kinematics analysis showed that during the standard horse stance,the subjects’ torso was upright,their knee joints were not excessively rotated outward,and their relative positions were close to the toes.This met the motion requirements of Tai Chi Boxing horse stance,with upright posture,hip sinking,sacral adduction,two feet spread out,shoulder width apart,knee joints aligned with the toes,and the relative positions of knee joints and toes close to or not exceeding the toes.Compared with standard movements,non standard movements have a tendency to lean the body,with the upright horse step leaning forward and the lateral horse step leaning to the right;The average difference between the flexion angles of both knee joints in the non-standard lateral equine stance is greater than 25°;The squat was too shallow(43.174 vs 58.06)in non-standard upright horse stance movements and too deep(119.844 vs 89.982)in lateral horse stance movements;In a non standard ortho equine stance,the knee joint is positioned anteriorly and posteriorly beyond the toe of the foot(left-68.838 vs-26.74,right-72.852 vs-12.778),while in a lateral stance,the right knee joint is positioned to the right beyond the toe of the foot 76.738.The results of the dynamic analysis are as follows:① Distribution of force:The left and right Z axes of non-standard movements in the orthostatic equine stance are unevenly distributed due to body tilt(311.738 vs 339.298),while the standard movements are evenly distributed(323.298 vs 323.79).In the lateral equine stance,the force distribution in the X,Y,and Z axes of the standard movement is uniform,and the center of gravity of the lower limbs and the overall center of gravity are close to the center line of the human body and relatively stable.The Z axis force of the left and right lower limbs during non-standard movements varies greatly,with the average value on the right side being greater than that on the left side(456.682 vs 191.53),resulting in a shift in the center of gravity to the right,which increases the pressure on the right knee joint.In contrast,the magnitude of the Z axis forces on the left and right sides of the standard action is similar(336.486 vs 318.166)Torque:In the orthostatic horse stance,the torque of each axis of standard and non-standard movements is similar,and some differences may be caused by personal factors of the subject.In the lateral equine stance,the difference in Y-axis torque between the left and right lower limbs during the standard maneuver was small(34.04 vs-32.702),and the degree of lateral rotation of both knee joints was similar;The difference in Y-axis torque between the right lower limb and the left lower limb during non-standard movements was significant(-59.509 vs 17.588),and the degree of lateral rotation of the right knee joint was greater than that of the left knee joint.During non-standard movements,uneven distribution of gravity and large differences in upper and lower torque among subjects lead to a shift in the center of gravity,and excessive differences in left and right direction torque increase joint pressure and shear force.Conclusion:The occurrence of body tilt,squatting too deep or too shallow,significant differences in knee flexion angles between both sides,excessive lateral rotation of the knee joint,and knee joint exceeding the toe position during non-standard movements can lead to increased knee joint pressure,uneven joint stress distribution,reversal of the antagonistic ratio of the quadriceps and popliteal muscles,and imbalance in the forces at the articular surface of the femoral tibial joint and the patellofemoral joint,increasing the potential risk of knee joint injury. |
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