The Feasibility of Tai Chi Exercise as a Beneficial Mind-Body Intervention in a Group of Community-Dwelling Stroke Survivors with Symptoms of Depression

Abstract

Depression is prevalent among one-third to two-thirds of acute and chronic stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even for 5–10 years after stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms. Thus, the feasibility of Tai Chi, alongside conventional care, to manage poststroke depression was investigated using a single-group pre-post intervention design. Recruitment and retention, intervention adherence, safety, acceptability, and fidelity were assessed. Symptoms of depression, anxiety, and stress were assessed using standardized questionnaires, objective sleep was assessed via a research-grade triaxial accelerometer, and blood samples were taken to measure oxidative stress, inflammatory markers, and a neurotrophic growth factor using commercially available kits per manufacturer’s protocol. Pre-post intervention changes were assessed using paired t-tests. We enrolled stroke survivors (N = 11, mean age = 69.7 ± 9.3) reporting depression symptoms. After the intervention, we observed significant reductions in symptoms of depression (−5.3 ± 5.9, p = 0.01 ), anxiety (−2.2 ± 2.4, p = 0.01 ), and stress (−4.6 ± 4.8, p = 0.01 ), along with better sleep efficiency (+1.8 ± 1.8, p = 0.01 ), less wakefulness after sleep onset (−9.3 ± 11.6, p = 0.04 ), and less time awake (−9.3 ± 11.6, p = 0.04 ). There was a 36% decrease in oxidative stress ( p = 0.02 ), though no significant changes in the other biomarkers were found (all p values >0.05). Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage poststroke depression, aid in reducing symptoms of anxiety and stress, and improve sleep.

Stroke Survivors’ Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study

“…A total of nine stroke survivors (82%) in the feasibility study agreed to participate in the focus group interview and provided written informed consent prior to data collection. Recruitment for the feasibility study has been described elsewhere [ 29 ]. However, two participants were unable to join the focus group interview due to technical challenges ( n = 1) or a medical appointment ( n = 1).…”

“…The participants in this focus group had a pre-existing relationship and the shared experience of participating together in a series of in-person, group-based tai chi intervention classes for one hour, three times per week, for eight weeks [ 29 ]. Participants were informed about the purpose of the focus group during the consent process.…”

Exercise for Stroke Rehabilitation: A Bibliometric Analysis of Global Research From 2001 to 2021

“…Physical exercises combined with cognitive training produced greater benefits on cognitive function in survivors with vascular cognitive impairment (Johnson et al, 2018;Bo et al, 2019). Chinese traditional exercises could help reduce symptoms of anxiety and stress and improve the sleep of the patients with stroke (Taylor-Piliae et al, 2021). Stroke was closely related to cardiovascular health; the effect of intensity and duration of exercise on cardiorespiratory fitness in patients with stroke could be a good topic in future research (Langhammer et al, 2014;Johnson et al, 2018;Luo et al, 2020).…”