Document Type : Original Article

Authors

1 Associate Professor of Physical Education & Sport Sciences, Kharazmi University, Tehran, Iran.

2 MSc of Physical Education & Sport Sciences Physiology, Kharazmi University, Tehran, Iran.

Abstract

Background and Aim: Since stroke increases pro-inflammatory cytokines and affects sleep quality, the effect of Tai Chi training on Tumor necrosis factor alpha (TNF-α) serum levels and sleep quality in women with stroke were studied in this research. Materials and Methods: Twenty women in Qom city with stroke (mean age: 65.80±3.55y, weight: 68.41±14.00kg and body mass index: 26.33±5.15kg.m2) were voluntarily chosen and randomly divided into experimental (10 patients) and control groups (10 patients). Experimental group were trained 6 weeks, three time per week for 60 minutes, but during this period, the control group did not participate in any physical activity. Serum TNF-α was analyzed in pretest and post-testing all subjects, during the fasting state. To measure the serum levels of TNF-α, a TNF-α kit from the China-USA Casabio tech Company, with a sensitivity of 1.95 pg/ml, was used; Also sleep quality was assessed by Pittsburgh sleep quality index. Data were analyzed using the independent samples t-test and paired samples t-test (p<0.05). Results: Tai Chi group showed a significant improvement in serum TNF-α (p<0.007). Despite the improvement in sleep quality, no significant differences were observed between the two groups (p>0.05). Conclusion: The results of this study showed that Tai Chi can be considered as a useful intervention to improve women inflammatory status with stroke.

Keywords

Bokhari, F. A., Shakoori, T. A., Butt, A., & Ghafoor, F. (2014). TNF-alpha: a risk factor for ischemic stroke. Journal of Ayub Medical College Abbottabad, 26(2), 111-114. [Persian]
Buman, M. P., Hekler, E. B., Bliwise, D. L., & King, A. C. (2011). Moderators and mediators of exercise-induced objective sleep improvements in midlife and older adults with sleep complaints. Health Psychology, 30(5), 579. 
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213.
Castellano, V., Patel, D. I., & White, L. J. (2008). Cytokine responses to acute and chronic exercise in multiple sclerosis. Journal of Applied Physiology, 104(6), 1697-1702.
Castellanos, M., Castillo, J., García, M. M., Leira, R., Serena, J., Chamorro, A., & Dávalos, A. (2002). Inflammation-mediated damage in progressing lacunar infarctions a potential therapeutic target. Stroke, 33(4), 982-987.
Cho, Y. H. (2015). Impact of respiratory muscle exercises on pulmonary function and quality of sleep among stroke patients. Korean Society of Physical Medicine, 10(4), 123-131. 
Ekdahl, C. T., Claasen, J. H., Bonde, S., Kokaia, Z., & Lindvall, O. (2003). Inflammation is detrimental for neurogenesis in adult brain. Proceedings of the National Academy of Sciences, 100(23), 13632-13637.
DiGiacomo, M., Lam, P., Roberts, B. L., Lau, T. C., Song, R., & Davidson, P. M. (2010). Exploring the reasons for adherence to T'ai Chi practice. The Journal of Alternative and Complementary Medicine, 16(12), 1245-1246.
Domaç, F. M., Somay, G., Misirli, H., & Erenoglu, N. Y. (2007). Tumor necrosis factor alpha serum levels and inflammatory response in acute ischemic stroke. Neurosciences, 12(1), 25-30.
Elosua, R., Bartali, B., Ordovas, J. M., Corsi, A. M., Lauretani, F., & Ferrucci, L. (2005). Association between physical activity, physical performance, and inflammatory biomarkers in an elderly population: the InCHIANTI study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60(6), 760-767.
Goldhammer, E., Tanchilevitch, A., Maor, I., Beniamini, Y., Rosenschein, U., & Sagiv, M. (2005). Exercise training modulates cytokines activity in coronary heart disease patients. International Journal of Cardiology, 100(1), 93-99.
Hallenbeck, J. M. (1997). Cytokines, macrophages, and leukocytes in brain ischemia. Neurology, 49(5), 5-9.
Irwin, M. R., Carrillo, C., & Olmstead, R. (2010). Sleep loss activates cellular markers of inflammation: sex differences. Brain, Behavior, and Immunity, 24(1), 54-57. 
Irwin, M. R., & Olmstead, R. (2012). Mitigating cellular inflammation in older adults: a randomized controlled trial of Tai Chi Chih. The American Journal of Geriatric Psychiatry, 20(9), 764-772.
Irwin, M. R., Olmstead, R., & Motivala, S. J. (2008). Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Tai Chi Chih. Sleep, 31(7), 1001-1008.
Irwin, M. R., Wang, M., Campomayor, C. O., Collado-Hidalgo, A., & Cole, S. (2006). Sleep deprivation and activation of morning levels of cellular and genomic markers of inflammation. Archives of Internal Medicine, 166(16), 1756-1762.
Jiang, Y., Wei, N., Lu, T., Zhu, J., Xu, G., & Liu, X. (2011). Intranasal brain-derived neurotrophic factor protects brain from ischemic insult via modulating local inflammation in rats. Neuroscience, 172, 398-405. 
Kim, H., Kim, Y. L., & Lee, S. M. (2015). Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients. International Journal of Rehabilitation Research, 38(2), 156-161.
Kim, J. S., Yoon, S. S., Kim, Y. H., & Ryu, J. S. (1996). Serial measurement of interleukin-6, transforming growth factor-α, and S-100 protein in patients with acute stroke. Stroke, 27(9), 1553-1557.
Koeda, S., Sumigawa, K., Koike, Y., Sato, C., Imai, H., Osanai, E., ... & Osanai, T. (2014). Relationship between sleep disorder and subjective feelings of recovery in convalescent stroke patients. Japanese Journal of Comprehensive Rehabilitation Science, 5, 125-130.
Letombe, A., Cornille, C., Delahaye, H., Khaled, A., Morice, O., Tomaszewski, A., & Olivier, N. (2010). Early post-stroke physical conditioning in hemiplegic patients: a preliminary study. Annals of Physical and Rehabilitation Medicine, 53(10), 632-642.
Logghe, I. H., Verhagen, A. P., Rademaker, A. C., Bierma-Zeinstra, S., van Rossum, E., Faber, M. J., & Koes, B. W. (2010). The effects of Tai Chi on fall prevention, fear of falling and balance in older people: a meta-analysis. Preventive Medicine, 51(3-4), 222-227. 
Montgomery, P., & Dennis, J. (2002). Physical exercise for sleep problems in adults aged 60+. Cochrane Database of Systematic Reviews, 4(4).
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., ... & Huffman, M. D. (2015). Executive summary: heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation, 131(4), 434-441.
Nascimento, C. M., Pereira, J. R., de Andrade, L. P., Garuffi, M., Talib, L. L., Forlenza, O. V., … & Stella, F. (2014). Physical exercise in MCI elderly promotes reduction of pro-inflammatory cytokines and improvements on cognition and BDNF peripheral levels. Current Alzheimer Research, 11(8), 799-805.
Nguyen, M. H., & Kruse, A. (2012). A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese. Clinical Interventions in Aging, 7, 185.
Pasic, Z., Smajlovic, D., Dostovic, Z., Kojic, B., & Selmanovic, S. (2011). Incidence and types of sleep disorders in patients with stroke. Medical Archives, 65(4), 225.
Passos, G. S., Poyares, D. L. R., Santana, M. G., Tufik, S., & Mello, M. T. d. (2012). Is exercise an alternative treatment for chronic insomnia? Clinics, 67(6), 653-660. 
Pedersen, B., & Bruunsgaard, H. (2003). Possible beneficial role of exercise in modulating low‐grade inflammation  in the elderly. Scandinavian Journal of Medicine & Science in Sports, 13(1), 56-62.
Perry, V. H. (2004). The impact of systemic inflammation on brain inflammation. ACNR, 4(3), 8-9.
Santos, R., Tufik, S., & De Mello, M. (2007). Exercise, sleep and cytokines: is there a relation? Sleep Medicine Reviews, 11(3), 231-239.
Santos, R. D., Viana, V. A. R., Boscolo, R. A., Marques, V. G., Santana, M. G. D., Lira, F. S. D., ... & De Mello, M. T. (2012). Moderate exercise training modulates cytokine profile and sleep in elderly people. Cytokine, 60(3), 731-735.
Smart, N. A., Larsen, A. I., Le Maitre, J. P., & Ferraz, A. S. (2011). Effect of exercise training on interleukin-6, tumour necrosis factor alpha and functional capacity in heart failure. Cardiology Research and Practice, 2011.
Taylor-Piliae, R. E., Hoke, T. M., Hepworth, J. T., Latt, L. D., Najafi, B., & Coull, B. M. (2014). Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors. Archives of Physical Medicine and Rehabilitation, 95(5), 816-824.
Wang, X., Zhang, M., Feng, R., Li, W. B., Ren, S. Q., Zhang, J., & Zhang, F. (2014). Physical exercise training and neurovascular unit in ischemic stroke. Neuroscience, 271, 99-107.
Youngstedt, S. D., Kripke, D. F., Elliott, J. A., & Rex, K. M. (2005). Circadian phase-shifting effects of a laboratory environment: a clinical trial with bright and dim light. Journal of Circadian Rhythms, 3(1), 11.
Zhang, Y., Liu, H., Zhou, L., Chen, K., Jin, H., Zou, Y., & Li, Z. (2014). Applying Tai Chi as a rehabilitation program for stroke patients in the recovery phase: study protocol for a randomized controlled trial. Trials, 15(1), 484.