大学生太极拳活动的心理健康效益：基于ICF的系统综述

doi:10.3969/j.issn.1006-9771.2023.01.007

Abstract

Abstract:

Objective To construct the mental health benefits of physical activity of Tai Chi and framework for college students based on International Classification of Functioning, Disability, and Health (ICF), and to systematically review the effect of physical activity of Tai Chi on anxiety, depression and sleep quality of college students.

Methods Relevant literatures about the health outcomes on anxiety, depression and sleep quality of college students participating in physical activity of Tai Chi were retrieved from databases of Web of Science, PubMed, Medline, Scopus, CNKI, Wanfang data, from the establishment to November 10th, 2022, and screened and reviewed.

Results Ten randomized controlled trials were included finally, from China and U.S.， involving 960 participants (aged 16.4 to 40 years). The main sources were from journals about physical activity and health, with publication dates from 2016 to 2021. The quality of the included literatures was evaluated using the Physical Therapy Evidence Database (PEDro) scale with a mean score of 6.3. The main mental health problems of college students mainly focused on depression, anxiety, high stress, and poor sleep quality. The physical activity of Tai Chi included 24 simplified Tai Chi and Chen style Tai Chi. The frequency of physical activity of Tai Chi was mainly 1 to 6 times a week, 45 to 90 minutes (60 minutes mostly) a time, for 4 to 18 weeks. The health benefits of Tai Chi on anxiety, depression, and sleep quality for college students in the ICF were mainly in the affective function (b152), psychomotor function (b147), energy and drive function (b130), and sleep function (b134). The beneficial outcomes of physical activity of Tai Chi involved reducing anxiety, alleviating depressive symptoms and reducing stress. Compared with physical activity of Tai Chi, physical activity of Tai Chi with the addition of a twenty-four-pattern Taijiquan theory course was more effective in improving depression levels in patients with mild and moderate depression. Tai Chi also can help to improve sleep quality, shorten the time to sleep, and reduce sleep disturbances and daytime dysfunction.

Conclusion A PICO framework of Tai Chi for the health benefits of college students has been constructed using ICF. Tai Chi engaged in by college students are mainly 24 simplified Tai Chi. The frequency of physical activity of Tai Chi is 45 to 90 minutes (60 minutes mostly) a time, 1 to 6 times a week, for 4 to 18 weeks. The physical activities of Tai Chi can benefit in reducing anxiety and depression of college students and improving the quality of sleep.

Key words: Tai Chi, college student, anxiety, depression, sleep quality, systematic review

CLC Number:

CUI Jiabao, LIN Jian, LIU Yucheng, WANG Peng, ZENG Hongfa. Mental health benefits of Tai Chi for college students: a systematic review using ICF[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 48-54.

Figures/Tables 4

纳入研究	国家	样本特征	健康和功能状况	干预方式	干预场所	干预方案	比较	心理健康效益
华正春等^[23] (2021)	中国	大二学生210例	身体健康	二十四式简化太极拳	大学课堂	每次80 min，每周1次，12周	太极拳能改善抑郁和焦虑	太极拳改善焦虑和抑郁效果显著
Zhang等^[24](2018)	中国	大一、大二学生共64例， (18.41±2.01)岁	有低于阈值的抑郁症状	二十四式简化太极拳	大学课堂	每次90 min，每周2次，8周	太极拳活动能降低抑郁状态和重度抑郁症发生率；减轻压力	太极拳能缓解抑郁症状并降低压力水平
胡平^[25] (2018)	中国	大一、大二、大三学生共60例	轻度和重度焦虑	二十四式简化太极拳	课外活动	每次65 min，每周> 4次，18周	二十四式太极拳可改善轻度焦虑	参与太极拳活动能减轻焦虑
李小芳等^[26] (2017)	中国	大一、大二学生共58例，(20.5±0.96)岁	轻度和中度抑郁	二十四式简化太极拳	课外活动	每次60 min，每周3次，12周	参与太极拳活动能改善抑郁	参与太极拳活动降低了抑郁水平
毛雪晨^[27] (2018)	中国	男大学生72例，(20.33±1.38)岁	身体健康	太极拳	大学课堂	每次60 min，每周2次，8周	参加太极拳活动能有效降低状态焦虑	参与太极拳活动降低了特质焦虑和状态焦虑
朱景芳等^[28] (2019)	中国	本科生125例，(19.15±0.87)岁	身体健康	二十四式简化太极拳	课外活动	每次60 min，每周5次，4周	参加太极拳活动能有效缓解抑郁	参与太极拳活动减轻抑郁情绪和压力
王磊^[29] (2021)	中国	女本科生60例	身体健康	太极拳活动	大学课堂	每次60~90 min，每周3~4次，16周	太极拳组的抑郁、焦虑等心理指标均显著改善	太极拳能显著减轻焦虑和抑郁
谢小婷等^[30] (2020)	中国	女大学生 104例	正常压力和高压力学生	二十四式简化太极拳	课外活动	每次60 min，每周5次，6周	参与太极拳活动能降低焦虑、抑郁和压力评分	参与太极拳活动能降低焦虑、抑郁和压力水平
沈鹤军等^[31] (2018)	中国	本科生132例，18~25岁	身体健康	二十四式太极拳	课外活动	每次45 min，每周5~6次，8周	太极拳组入睡时间、睡眠障碍和日间功能障碍显著改善	太极拳活动能改善睡眠质量
Caldwell等^[32](2016)	美国	大学生75例，18~40岁	轻、中度焦虑及轻度抑郁	陈氏太极拳	课外活动	每次60 min，每周2次，10周	太极拳对焦虑的影响较小，能改善睡眠质量	参与太极拳活动4周焦虑水平降低，睡眠改善

References 47

[1]	Boston University. Mental health of college students is getting worse[EB/OL]. (2022-04-21) [2022-12-27]. https://www.bu.edu/articles/2022/mental-health-of-college-students-is-getting-worse/.
[2]	World Health Organization. Depression[EB/OL]. (2022-10-22) [2022-12-28]. https://www.who.int/health-topics/depression#tab=tab_1.
[3]	GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2018, 392(10159): 1859-1922. doi: 10.1016/S0140-6736(18)32335-3
[4]	SIVERTSEN B, KNAPSTAD M, PETRIE K, et al. Changes in mental health problems and suicidal behaviour in students and their associations with COVID-19-related restrictions in Norway: a national repeated cross-sectional analysis[J]. BMJ Open, 2022, 12(2): e057492.
[5]	CHEKROUD S R, GUEORGUIEVA R, ZHEUTLIN A B, et al. Association between physical exercise and mental health in 12 million individuals in the USA between 2011 and 2015: a cross-sectional study[J]. Lancet Psychiatry, 2018, 5(9): 739-746. doi: 10.1016/S2215-0366(18)30227-X
[6]	GERBER M, LUDYGA S, MÜCKE M, et al. Low vigorous physical activity is associated with increased adrenocortical reactivity to psychosocial stress in students with high stress perceptions[J]. Psychoneuroendocrinology, 2017, 80: 104-113. doi: S0306-4530(16)30945-3 pmid: 28324699
[7]	MARGULIS A, ANDREWS K, HE Z, et al. The effects of different types of physical activities on stress and anxiety in college students[J]. Current Psychology, 2021, 2021: 1-7.
[8]	MIKKELSEN K, STOJANOVSKA L, POLENAKOVIC M, et al. Exercise and mental health[J]. Maturitas, 2017, 106: 48-56. doi: S0378-5122(17)30856-3 pmid: 29150166
[9]	KVAM S, KLEPPE C L, NORDHUS I H, et al. Exercise as a treatment for depression: a meta-analysis[J]. J Affective Disord, 2016, 202: 67-86. doi: 10.1016/j.jad.2016.03.063
[10]	GORDON B R, MCDOWELL C P, HALLGREN M, et al. Association of efficacy of resistance exercise training with depressive symptoms: meta-analysis and meta-regression analysis of randomized clinical trials[J]. JAMA Psychiatry, 2018, 75(6): 566-576. doi: 10.1001/jamapsychiatry.2018.0572 pmid: 29800984
[11]	GRASDALSMOEN M, ERIKSEN H R, LØNNING K J, et al. Physical exercise and body-mass index in young adults: a national survey of Norwegian university students[J]. BMC Public Health, 2019, 19(1): 1354. doi: 10.1186/s12889-019-7650-z pmid: 31646998
[12]	ROSENTHAL S R, CLARK M A, MARSHALL B D L, et al. Alcohol consequences, not quantity, predict major depression onset among first-year female college students[J]. Addict Behav, 2018, 85: 70-76. doi: S0306-4603(18)30116-3 pmid: 29860191
[13]	DINIS J, BRAGANÇA M. Quality of sleep and depression in college students: a systematic review[J]. Sleep Sci, 2018, 11(4): 290-301. doi: 10.5935/1984-0063.20180045 pmid: 30746048
[14]	ZOU L, SASAKI J E, WEI G X, et al. Effects of mind-body exercises (Tai Chi/Yoga) on heart rate variability parameters and perceived stress: a systematic review with meta-analysis of randomized controlled trials[J]. J Clin Med, 2018, 7(11): 404. doi: 10.3390/jcm7110404
[15]	YANG F C, DESAI A B, ESFAHANI P, et al. Effectiveness of Tai Chi for health promotion of older adults: a scoping review of meta-analyses[J]. Am J Lifestyle Med, 2022, 16(6): 700-716. doi: 10.1177/15598276211001291
[16]	EASWARAN K, GOPALASINGAM Y, GREEN D D, et al. Effectiveness of Tai Chi for health promotion for adults with health conditions: a scoping review of meta-analyses[J]. Disabil Rehabil, 2021, 43(21): 2978-2989. doi: 10.1080/09638288.2020.1725916
[17]	GUO J B, CHEN B L, LU Y M, et al. Tai Chi for improving cardiopulmonary function and quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis[J]. Clin Rehabil, 2016, 30(8): 750-764. doi: 10.1177/0269215515604903
[18]	CAI Q, CAI S B, CHEN J K, et al. Tai Chi for anxiety and depression symptoms in cancer, stroke, heart failure, and chronic obstructive pulmonary disease: a systematic review and meta-analysis[J]. Complement Ther Clin Pract, 2022, 46: 101510.
[19]	邱卓英, 李伦, 陈迪, 等. 基于世界卫生组织国际健康分类家族康复指南研究:理论架构和方法体系[J]. 中国康复理论与实践, 2020, 26(2): 125-135.
	QIU Z Y, LI L, CHEN D, et al. Research on rehabilitation guidelines using World Health Organization Family of International Classifications: framework and approaches[J]. Chin J Rehabil Theory Pract, 2020, 26(2): 125-135.
[20]	SCHIAVENATO M, CHU F. PICO: What it is and what it is not[J]. Nurse Educ Pract, 2021, 56: 103194.
[21]	ORWIN R G. A fail-safe N for effect size in meta-analysis[J]. J Educat Stat, 1983, 8(2): 157-159.
[22]	CASHIN A G, MCAULEY J H. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale[J]. J Physiother, 2020, 66(1): 59. doi: S1836-9553(19)30092-X pmid: 31521549
[23]	华正春, 孙健. 身心练习对大学生焦虑、抑郁和压力影响的实验研究[J]. 广州体育学院学报, 2021, 41(1): 95-102.
	HUA Z C, SUN J. Effects of mind-body practice on anxiety,depression and stress of college students[J]. J Guangzhou Sport Univ, 2021, 41(1): 95-102.
[24]	ZHANG J, QIN S, ZHOU Y, et al. A randomized controlled trial of mindfulness-based Tai Chi Chuan for subthreshold depression adolescents[J]. Neuropsychiatr Dis Treat, 2018, 14: 2313-2321. doi: 10.2147/NDT.S173255
[25]	胡平. 24式太极拳对湖北第二师范学院学生焦虑情绪的干预研究[J]. 安徽体育科技, 2018, 39(4): 49-51, 59.
	HU P. The intervention of 24-Postured Shadow-Boxing on students' anxiety in Hubei University of Education[J]. J Anhui Sports Sci, 2018, 39(4): 49-51, 59.
[26]	李小芳, 王芳婷, 杜晓侠. 太极拳对治疗医科大学学生抑郁症的实验研究[J]. 四川体育科学, 2017, 36(4): 59-62.
	LI X F, WANG F T, DU X X. Experimental study on Tai Chi's treatment of medical students' depression[J]. Sichuan Sports Sci, 2017, 36(4): 59-62.
[27]	毛雪晨. 三类运动干预法对男大学生状态焦虑和特质焦虑的作用[J]. 吉林体育学院学报, 2018, 34(5): 53-58.
	MAO X C. The effect of three different types of exercise intervention methods on college students with their state and trait anxiety[J]. J Jilin Sport Univ, 2018, 34(5): 53-58.
[28]	朱景芳, 谢小婷, 宋健, 等. 太极拳对医学生心理健康的影响[J]. 世界最新医学信息文摘, 2019, 19(16): 27-28.
	ZHU J F, XIE X T, SONG J, et al. Effects of Taijiquan intervention on medical students' mental health[J]. World Latest Med Inform, 2019, 19(16): 27-28.
[29]	王磊. 健身操和太极拳对女大学生体成分、身体机能及心理指标的影响[J]. 兰州文理学院学报(自然科学版), 2021, 35(4): 88-93.
	WANG L. Efects of body-building exercise and Tai Chi on body composition, physical function and psychological indicators of female colege students[J]. J Lanzhou Univ Arts Sci (Nat Sci Ed), 2021, 35(4): 88-93.
[30]	谢小婷, 朱景芳, 宋健, 等. 太极拳对不同压力水平女大学生负性情绪的影响[J]. 亚太传统医药, 2020, 16(3): 121-124.
	XIE X T, ZHU J F, SONG J, et al. The effect of TaiChi on negative emotions of female colege students with diferent stress levels[J]. Asia-Pacific Tradit Med, 2020, 16(3): 121-124.
[31]	沈鹤军, 曹彦俊, 裴悦, 等. 不同中医运动治未病锻炼对大学生睡眠质量、抑郁与焦虑水平的影响[J]. 中国中医药信息杂志, 2018, 25(2): 15-19.
	SHEN H J, CAO Y J, PEI Y, et al. Effects of different TCM exercises for preventive treatment of diseases on sleep quality, depression and anxiety of college students[J]. Chin J Inform Tradit Chin Med, 2018, 25(2): 15-19.
[32]	CALDWELL K L, BERGMAN S M, COLLIER S R, et al. Effects of Tai Chi Chuan on anxiety and sleep quality in young adults: lessons from a randomized controlled feasibility study[J]. Nat Sci Sleep, 2016, 8: 305-314. pmid: 27895522
[33]	SAXENA S, SETOYA Y. World Health Organization's Comprehensive Mental Health Action Plan 2013-2020[J]. Psychiatry Clin Neurosci, 2014, 68(8): 585-586. doi: 10.1111/pcn.12207
[34]	WAINBERG M L, SCORZA P, SHULTZ J M, et al. Challenges and opportunities in global mental health: a research-to-practice perspective[J]. Curr Psychiatry Rep, 2017, 19(5): 28. doi: 10.1007/s11920-017-0780-z
[35]	TEH C, NGO C, ZULKIFLI R, et al. Depression, anxiety and stress among undergraduate students: a cross sectional study[J]. Open J Epidemiol, 2015, 5: 260-268. doi: 10.4236/ojepi.2015.54030
[36]	GRASDALSMOEN M, ERIKSEN H R, LØNNING K J, et al. Physical exercise, mental health problems, and suicide attempts in university students[J]. BMC Psychiatry, 2020, 20(1): 175. doi: 10.1186/s12888-020-02583-3 pmid: 32299418
[37]	GHANDALI E, MOGHADAM S T, HADIAN M R, et al. The effect of Tai Chi exercises on postural stability and control in older patients with knee osteoarthritis[J]. J Bodyw Mov Ther, 2017, 21(3): 594-598. doi: S1360-8592(16)30190-5 pmid: 28750970
[38]	YANG G Y, SABAG A, HAO W L, et al. Tai Chi for health and well-being: a bibliometric analysis of published clinical studies between 2010 and 2020[J]. Complement Ther Med, 2021, 60: 102748.
[39]	ZHU D, XU D, DAI G, et al. Beneficial effects of Tai Chi for amphetamine-type stimulant dependence: a pilot study[J]. Am J Drug Alcohol Abuse, 2016, 42(4): 469-478. doi: 10.3109/00952990.2016.1153646 pmid: 27211290
[40]	CHA N H, JEON G E, CHO Y, et al. Effects of Tai Chi therapy on body mass index and physical index of intellectual disability[J]. Jpn J Nurs Sci, 2020, 17(2): e12292.
[41]	SALEHIAN M H, YADOLAZADEH A, RANJBARI S. Comparison of the effect of cognitive-spiritual method of hope therapy and Tai Chi exercises on anxiety caused by corona disease in university students[J]. Pakistan J Med Health Sci, 2021, 15(3): 938-947.
[42]	WINSER S J, TSANG W W, KRISHNAMURTHY K, et al. Does Tai Chi improve balance and reduce falls incidence in neurological disorders? A systematic review and meta-analysis[J]. Clin Rehabil, 2018, 32(9): 1157-1168. doi: 10.1177/0269215518773442 pmid: 29737198
[43]	YANG Y L, WANG Y H, WANG S R, et al. The effect of Tai Chi on cardiorespiratory fitness for coronary disease rehabilitation: a systematic review and meta-analysis[J]. Front Physiol, 2018, 8: 1091. doi: 10.3389/fphys.2017.01091
[44]	LEUNG L Y, CHAN A W, SIT J W, et al. Tai Chi in Chinese adults with metabolic syndrome: a pilot randomized controlled trial[J]. Complement Ther Med, 2019, 46: 54-61. doi: 10.1016/j.ctim.2019.07.008
[45]	HUANG J, WANG D, WANG J. Clinical evidence of Tai Chi exercise prescriptions: a systematic review[J]. Evid Based Complement Alternat Med, 2021, 2021: 5558805.
[46]	ROBERT-MCCOMB J J, CHYU M DC, TACÓN A, et al. The effects of Tai Chi on measures of stress and coping style[J]. Focus Altern Complem Ther, 2015, 20(2): 89-96. doi: 10.1111/fct.12179
[47]	ZHENG G, LAN X, LI M, et al. Effectiveness of Tai Chi on physical and psychological health of college students: results of a randomized controlled trial[J]. PLoS One, 2015, 10(7): e0132605.

纳入研究	资格标准	随机分配	分配隐藏	基线相似性	评定者施盲	被试流失率≤15%	意向治疗分析	组间统计比较	报告点测量和变异测量	总分
华正春等^[23](2021)	√	√	√			√	√	√	√	6
Zhang等^[24](2018)	√	√	√	√	√		√	√	√	7
胡平^[25](2018)	√	√				√	√	√	√	5
李小芳等^[26](2017)	√	√	√			√	√	√	√	6
毛雪晨^[27](2018)	√	√	√	√		√	√	√	√	7
朱景芳等^[28](2019)	√	√	√			√	√	√		5
王磊^[29](2021)	√	√	√	√		√	√	√		6
谢小婷等^[30](2020)	√	√	√	√	√	√	√	√	√	8
沈鹤军等^[31](2018)	√	√	√	√		√	√	√		6
Caldwell等^[32](2016)	√	√	√	√	√	√		√	√	7

Mental health benefits of Tai Chi for college students: a systematic review using ICF

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 47

Related Articles 15

Metrics

Comments

Recommended 0

[1]	WANG Hangyu, GE Keke, FAN Yonghong, DU Lilu, ZOU Min, FENG Lei. Effect of active music therapy on cognitive function for older adults with cognitive impairment: a systematic review based on ICD-11 and ICF [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 36-43.
[2]	WEN Jianing, JIN Qiuyan, ZHANG Qi, LI Jie, SI Qi. Effect of cognitively engaging physical activity on developing executive function of children and adolescents: a systematic review based on ICF [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 44-53.
[3]	GE Keke, FAN Yonghong, WANG Hangyu, DU Lilu, LI Changjiang, ZOU Min. Health benefit of mindfulness intervention for older adults with insomnia disorders: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 54-60.
[4]	ZHANG Jingya, ZOU Min, SUN Hongwei, SUN Changlong, ZHU Juntong. Effect of psychological intervention on anxiety or depression in children and adolescents with hearing impairment: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1004-1011.
[5]	WANG Junyu, YANG Yong, YUAN Xun, XIE Ting, ZHUANG Jie. Effect of high-intensity interval training on executive function for healthy children and adolescents: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1012-1020.
[6]	WEI Xiaowei, YANG Jian, WEI Chunyan. Psychological and behavioral benefits of adapted yoga exercise for children with autism spectrum disorder in special education schools: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1021-1028.
[7]	YANG Yaru, YANG Jian. School-based physical activity-related health services and their health benefits within the World Health Organization health-promoting school framework: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1040-1047.
[8]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[9]	SHI Jiawei, LI Lingyu, YANG Haojie, WANG Qinlu, ZOU Haiou. Effect of preoperative prerehabilitation training on total knee arthroplasty: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1057-1064.
[10]	JIANG Changhao, HUANG Chen, GAO Xiaoyan, DAI Yuanfu, ZHAO Guoming. Effect of neurofeedback training on cognitive function in the elderly: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 903-909.
[11]	WEI Xiaowei, YANG Jian, WEI Chunyan, HE Qiling. Adapted physical education programs for psychomotor development in school settings for children with intellectual and developmental disabilities: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 910-918.
[12]	WANG Shaopu, CHEN Gang. Psychological-behavioral health services and its outcome based on World Health Organization health-promoting school framework: a systematic review of systematic reviews [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 800-807.
[13]	JIANG Changhao, GAO Xiaoyan. Effect of acute physical activity on cognitive function in children: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 667-672.
[14]	YU Zhongqi, WANG Chao, HE Gang, ZHANG Liang, WANG Ruiyan. Effect of short-foot exercise on adult flatfoot: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 551-557.
[15]	LAN Shiling, PANG Wei, LI Xin, LIU Mengyun, ZHAN Yujun. Effect of action observation therapy on upper limb function in cerebral palsy: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 558-564.