| Objective:(1)Sleep disorders are one of the most common difficulties facing older people. Meditative movement interventions(MMI), a new category of exercise integrating physical activity and meditation(e.g., tai chi, yoga, and qigong), may benefit older people with sleep problems. In this systematic review, we synthesized the evidence on the effect of MMIs on older people’s quality of sleep.(2)To built and revise the tai-ji qigong exercise intervention project for pre-frail elderly, and to evaluate the feasibility and safety of this intervention;(3)To evaluate the effectiveness of tai-ji qigong exercise intervention on improving sleep quality, frailty status and quality of life in pre-frail elderly.Methods: Three stages of research were included.(1) We searched Pub Med, EMBASE, CINAHL, Psyc INFO, Scopus, the Cochrane Library, the Chinese Scientific Journal Database(VIP), and the China National Knowledge Infrastructure(CNKI)—through to March 2014—for randomized controlled trials. Articles were screened and selected by two researchers. Data were extracted from the included studies using specified forms. The same researchers independently evaluated the quality of each article. A meta-analysis was conducted to examine the pooled effect of MMI on slee p quality compared to the control groups.(2)Build the tai-ji qigong exercise plan and adpoted Delphi method to collect the advices of experts and evaluate the potential effectiveness, feasibility and applicability of the intervention plan. To motify the contents of the intervention according to the evaluation results of expert and the fesability test.(3) The study design was clustered randomized, single-blind control design.A sample of one hundred and ten older people were randomisd to experimental group and control group according to the nursing home. A 12 weeks tai-ji qigong exercise intervention was implemented three times per week as the intervention for the participants in experimental group, and control group were wait-list control.Sleep quality, frailty status(handgrip, walking speed), timed up-and-go test and quality of life was evaluated in baseline, 6 week and 12 week of intervention.Results:(1) Fourteen out of 1049 studies were included, involving 1,225 subjects. Interventions included tai chi, yoga, qigong, and multi-component MMI, lasting 12-24 weeks. Ten studies had a low risk of bias. The interventions resulted in significantly better sleep quality scores than either active therapy or usual care/wait-list controls(SMD:-0.70, 95%CI:-0.96,-0.43).(2) Subgroup analyses revealed that the effect of MMI on sleep quality was not influenced by the type or duration of the intervention. However, pooled results of studies with intervention frequency of fewer than 3 times per week did not show a positive effect on sleep quality. Lower-quality studies had larger effect sizes than high-quality studies. No adverse events were reported.(3) 1. 64% of score of items higher than 0.78; expers gave revised advisces on study difficulty, execise frequency and intervention duration. In the results of feasibility test, majority coincidence rate of index of “safe movement criteria” reached 100%. Some aspects of intervention plan such as inculsion criteria, implemention of intervention, accident prevention and adherence of participants were revised.(4) Total of 115 participants were employed in this study, 58 were randamised to experimental group and 57 were randamised to control group. ITT results indicated that the global PSQI score, sleep efficiency and sleep disturbance subscale score of experiental group was significantly improved after 12 week intervention comparied to control group(P<0.05). The 4.5m walking speed, TUGT time, PCS-12 and MCS-12 subscale score was significantly improved after 12 weeks intervention compared to control group.(P<0.05)Conclusion:(1) The current review showed that MMI had a moderate effect on improving the quality of sleep for older people with sleep complaints. However, the evidence is inconclusive due to the varying study quality and MMI modalities. This study highlights the need for higher-quality RCTs and more sufficient intervention implementation fidelity to confirm the results. It also shows the need for comparing the effectiveness of MMI on different subgroups of the elderly population.(2) The tai-ji qigong exercise intervention project have moderated activity intensity, this intenvntion were safty and easy to learn for pre-frail elderly.(3) Tai chi qigong exercise intervention can help to improve overall sleep quality, sleep efficiency,sleep disorder and daytime dysfunction; can help to improve walking speed, balance ability and quality of life for pre-frail elderly; but not have significant effect on improving sleep duration,upper limb muscle strength. |
PDF Full Text Request