Objective To objectively evaluate the effectiveness of Tai Chi in fall prevention and balance function in the elderly. Methods Databases such as PubMed, Web of Science, The Cochrane Library (Issue 8, 2012), EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched to collect the randomized controlled trials (RCTs) published from 2000 to 2012, and the relevant references of the included articles were also manually searched. According to the inclusion and exclusion criteria, the literature was screened, the data were extracted and the methodological quality of the included studies was assessed. Then meta-analyses were performed by using RevMan 5.1 software. Results A total of 6 RCTs involving 2 796 participants were included. The results of meta-analyses showed that the Tai Chi group was superior to the control group in decrease of the incidence rate of fall (RR=0.82, 95%CI 0.73 to 0.92, P=0.000 6), Timed Up and Go Test (MD=0.71, 95%CI 0.29 to 1.12, P=0.000 9), Functional Reach Test (MD=0.78, 95%CI 0.33 to 1.23, P=0.000 7) and Berger Balance Scale (MD=2.45, 95%CI 1.47 to 3.43, Plt;0.000 01), and there were statistical differences. Conclusion Tai Chi can effectively reduce the risk of fall for the elderly and improve their balance function.
ObjectiveTo systematically review the effectiveness of Tai Chi for improving negative symptoms and activity participation in patients with schizophrenia. MethodsDatabases including PubMed, The Cochrane Library (Issue 3, 2016), EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched to collect the randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCT) about Tai Chi for improving negative symptoms and activity participation in patients with schizophrenia from inception to Apirl 1st 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of three RCTs and two quasi-RCTs were included. The result of meta-analyses showed that no significant difference was found in negative symptom scores (MD=–0.95, 95% CI –3.78 to –1.89, P=0.51) and positive symptoms scores of PANSS (MD=–0.02, 95% CI –0.50 to 0.46, P=0.94) between two groups. However, the Tai Chi group was superior to the control group in items including attention, avolition, anhedonia-asociality, alogia and affective flattening/blunting of SANS (all P values<0.05). ConclusionTai Chi may have positively influence on various negative symptoms in patients with schizophrenia, but no evidence to support the Tai Chi's effects for activities participation. Larger and higher quality studies are needed.
ObjectiveTo systematically review the efficacy of Tai Chi on patients with heart failure.MethodsDatabases including CNKI, VIP, WanFang Data, Web of Science, PubMed, EMbase and The Cochrane Library (Issue 8, 2016) were searched from inception to August, 2016 to collect randomized controlled trials (RCTs) of Tai Chi for heart failure patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs involving 689 patients were included. The results of meta-analysis showed that, compared with the control group, the heart failure patients in Tai Chi group had better score of minnesotaliving with heart failure questionnaire (MLHFQ) (MD=–9.37, 95%CI –13.09 to –5.65, P<0.000 01), longer six minute walk test (6MWT) (MD=40.37, 95%CI 9.48 to 71.27, P=0.01), higher left ventricular ejectionfractions (LVEF) (MD=7.89, 95%CI 3.01 to 12.77, P=0.002) and lower level of BNP (brain natriuretic peptide) (MD=–10.75, 95%CI –13.20 to –8.30, P<0.000 01); however, as to the maximal oxygen consumption (VO2max) (MD=0.29, 95%CI –1.223 to 1.81, P=0.71), systolic pressure (SBP) (MD=–2.81, 95%CI –8.52 to 2.90, P=0.33) and diastolic pressure (DBP) (MD=0.37, 95%CI –3.73 to 4.48, P=0.86), there were no significant differences between both groups.ConclusionThe current evidence shows that Tai Chi is feasible for patients with heart failure as it has positive effects on life quality, physiological functions. Due to the limited quality and quantity of included studies, the above conclusion should be validated by more high quality studies.
ObjectiveTo assess the methodological quality of systematic reviews of Tai Chi for preventing falls in the elderly and the quality of evidence for outcome indicators.MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, CBM and VIP databases were electronically retrieved. According to the inclusion criteria and exclusion criteria, the final articles were selected and the relevant literature information was extracted by reading the abstract and the full text. The methodological quality of the included systematic reviews was evaluated using AMSTAR 2 tool, and the quality of the outcome indicators of the included systematic reviews was further graded according to the GRADE system.ResultsA total of 11 systematic reviews/meta-analyses were included. The AMSTAR 2 evaluation showed that 10 studies were in critically-low methodological quality, and 1 study was in low methodological quality. The GRADE evaluation results showed that among the 36 outcome indicators included, there were 10 intermediate quality indicators, 20 low-level quality indicators and 6 extremely low-level quality indicators. Among the indicators of intermediate quality, single-leg stand test (MD = 5.33, 95%CI 3.35 to 7.32, P< 0.01; WMD = 1.76, 95%CI −7.00 to 10.52, P< 0.01), time up and go test (MD = 1.04, 95%CI 0.67 to 1.41, P< 0.01), the berg balance scale (MD = 2.18, 95%CI 0.93 to 3.43, P< 0.01), number of falls (RR = 0.82, 95%CI 0.73 to 0.92), P< 0.01), the incidence of 2-falls (OR = 0.69, 95%CI 0.49 to 0.97, P< 0.01) and the incidence of 3-falls (OR = 0.39, 95%CI 0.21 to 0.73, P< 0.01). The results of the above indicators were statistically significant, indicating that Tai Chi was better than control group.ConclusionsAt present, the methodological quality of relevant systematic reviews of Tai Chi for preventing falls in the elderly was relatively low and the quality of the evidence was not good, so it can’t be proved that Tai Chi can effectively prevent falls in the elderly, which needs to be further studied at a high level.
ObjectivesTo systematically evaluate the impact of Tai Chi on the fall and balance function of middle-aged and the elderly.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the influence of Tai Chi on the balance function and fall of middle-aged and the elderly from inception to August, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsA total of 20 RCTs involving 3 842 patients were included. The results of meta-analysis showed that the Tai Chi group was superior to the control group in the improvement of the fall rate (RR=0.82, 95%CI 0.75 to 0.90, P<0.000 01), single-leg standing test (MD=5.76, 95%CI 0.62 to 10.90, P=0.03), Berg balance scale (MD=1.04, 95%CI 0.23 to 1.85, P=0.01), timed up and go (MD=−0.71, 95%CI −0.88 to −0.54, P<0.000 01), chair stand test (MD=0.87, 95%CI 0.05 to 1.70, P=0.04) and other indicators, and the difference was statistically significant.ConclusionsThe current evidence shows that Tai Chi can improve the balance function of middle-aged and the elderly, reduce the fall rate, and have a certain preventive effect on falls. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement–Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. This study showed that the contact stress of the ankle joint during BKTS was generally less than that during walking. However, the maximum tensile force of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament during BKTS was 130 N, 169 N and 89 N, respectively, while it was only 57 N, 119 N and 48 N during walking. Therefore, patients with arthritis of the ankle can properly practice Tai Chi. Practitioners with sprained lateral ligaments of the ankle joint were suggested to properly reduce the ankle movement range during BKTS.
With the increasing prominence of population aging, the cognitive decline of the elderly has gradually become a hotspot of clinical research. As a traditional rehabilitation exercise, Tai Chi has been proved to have a positive effect on improving cognitive function and delaying cognitive decline in the elderly. However, the related brain function mechanism is still unclear. In this paper, we collected studies which observed the changes of Tai Chi on brain regions related to cognitive function in the elderly using magnetic resonance imaging (MRI), electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS). We summarized relevant studies from perspective of structural and functional changes in the brain. The results showed that Tai Chi may delay and improve cognitive decline in the elderly by reshaping the structure and function of brain regions related to cognitive function such as memory, attention and execution. The effect of Tai Chi for cognitive function may be associated with positive regulation of cardiovascular function, emotion and meditation level of the elderly. In addition, the improvement of cognitive function further enhances the balance of the elderly. We also found that practice time, frequency and intensity of Tai Chi could be factors influencing the improvement of cognitive function and brain function in the elderly.