Effects of Ping-Shuai-Gong and Arm-Swing-Exercise

Study Overview
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Brief Summary
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Ping Shuai Gong (PSG) and Arm Swing Exercise (ASE) are two similar exercise with different arm-swinging strategies. This study is plan to explore the relationship between characteristics of arm-swinging movement and skin blood flow during exercise.

Detailed Description
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With the development of an aging society, the health and social systems of the elderly population have become issues that cannot be ignored. Due to the features of low difficulty and small space requirements, Ping Shuai Gong (PSG) and Arm Swing Exercise (ASE) become very popular within the older population. These physical activities have been proved to show advancement in cardiovascular and physical functions. Hence, this study is design to explores the health effects of two different arm-swinging strategies, and to explore the relationship between characteristics of arm-swinging movement and skin blood flow during exercise. 40 elderly people over 60 years old who have no regular exercise habits were divided into PSG group and ASE group, and each group was given two months of exercise training (at least 24 times of exercise, 30 minutes totally within one day). PSG group was asked to perform PSG exercises (actions were synchronized with the hands raised to shoulder height and then swinging down and back, with two squatting movements at the fifth time). ASE group was asked to perform ASE exercises (actions were to raise both hands synchronously to a 30-degree bend and then 60-degree shoulder extension, and to control the stability of the upper body when swinging arms). Evaluation procedures of the pretraining evaluation and post-training evaluation are exactly the same.

Official Title
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Training Effects on Ping-Shuai-Gong and Arm-Swing-Exercise

Conditions
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Effects of; Movement, Inactivity, Physical, Degeneration

Intervention / Treatment
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* Behavioral: Low intensity exercise - Ping-Shuai Gong (PSG)
* Behavioral: Low intensity exercise - Arm-Swing Exercise (ASE)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age over 60 able to stand unassisted for at least 30 minutes able to understand and follow the instructions no good exercise habits (frequency > 3 times / wk.), intensity (rated perceived exertion > 12/20), time > 30 min.) for at least 3 months able to attend the experiment for 2 months Exclusion Criteria: uncontrolled cardiovascular disease severe arrhythmia peripheral artery disease respiratory system diseasehemodialysis patients unresolved upper or lower extremity injury

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 2-month Ping-Shuai Gong (PSG) training<br>Ping-Shuai Gong (PSG) is pioneered by Qi Gong master, Li Feng-shan. It is featured in synchronous and rhythmic arm-swinging movement, with arms straightly forward flexing to shoulder level and backward extending repeatedly, and combined with lightly squat twice while arms swing to the fifth time and continue this cycle. They were asked to conduct and record 30 minutes of PSG in one day lasting for 2-month, and at least 3 days a week. | Behavioral: Low intensity exercise - Ping-Shuai Gong (PSG)<br>* Participants were asked to conduct and record 30 minutes of PSG in one day lasting for 2-month, and at least 3 days a week. A record sheet were sent to the participants in the first time, and the contact information of examiner were given as well. The examiner will check the completion of exercise execution via phone every two to three days and visit participants to confirm the correctness of movement at least one time during the 2-month intervention period.<br>|
| Active Comparator: 2-month Arm-Swing-Exercise (ASE) training<br>Participents in Arm-Swing-Exercise (ASE) group were instructed to keep whole upper limbs pronated, and maintain their trunk straight while movement. The movement is to swing bilateral arms forward to around 30 degree and backward to around 60 degree continuously. The participants need to stabilize their trunk, pelvic, and legs while bilateral arms swinging passing through the side of the trunk. The most significant difference from PSG group is the way they pull the arm, not just swing backward and downward. They were asked to conduct and record 30 minutes of ASE in one day lasting for 2-month, and at least 3 days a week. | Behavioral: Low intensity exercise - Arm-Swing Exercise (ASE)<br>* Participants were asked to conduct and record 30 minutes of ASE in one day lasting for 2-month, and at least 3 days a week. A record sheet were sent to the participants in the first time, and the contact information of examiner were given as well. The examiner will check the completion of exercise execution via phone every two to three days and visit participants to confirm the correctness of movement at least one time during the 2-month intervention period.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cardiovascular system | Heart rate (HR), heart rate variability (HRV) to assess cardiac autonomic regulation. | 2 months | 
| cardiovascular system | blood pressue | 2 months | 
| cardiovascular system | Static photoplethysmography (PPG) signals were applied to measure low frequency oscillations of microvascular system, calculated as coefficient of variation (CV) of specific pulsation oscillation frequency, to assess vessel conditions for dynamic adaption in hemodynamics and biological signals. In each frequency interval, cardiac activity intensity is represented in 0.6 to 2 Hz oscillation and respiratory activity is from 0.145 to 0.6 Hz, myogenic activity is from 0.052 to 0.145 Hz, neurogenic activity is from 0.021 to 0.052 Hz, and NO-dependent endothelial activity is microvessel oscillation from 0.0095 to 0.021 Hz. | 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cerebrovascular system | Changes in oxygenated (HbO) and deoxygenated (Hb) hemoglobin concentrations measured from NIRs to assess brain activation in motor-related cortex. | 2 months | 
| balance ability | Ground reaction force, rate of force development (RFD)/body weight , and total time in five-time sit to stand test (5XSST) measured from forceplates to assess strength. | 2 months | 
| balance ability | Center of pressure of five-time sit to stand test (5XSST) measured from forceplates to assess dynamic stability. | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ping Shuai Gong, Arm Swing Exercise, low intensity exercise, cardiovascular system, cerebrovascular system, microcirculatory blood flow, balance