Effectiveness of Tai Chi for health promotion for adults with health conditions: a scoping review of Meta-analyses

To complete a scoping review of meta-analyses summarizing evidence of the effectiveness of Tai Chi for adults with health conditions. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health and the Cochrane Library from database inception to early September 2018. Multistage deduplication and screening processes identified full-length, unique, peer-reviewed meta-analyses. Two people independently appraised 42 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. “High” and “moderate” quality evidence indicates that Tai Chi can significantly benefit adults with health conditions including cancers, chronic obstructive pulmonary disease, coronary heart disease, depression, heart failure, hypertension, low back pain, osteoarthritis, osteoporosis, Parkinson’s Disease and stroke. Outcomes included significant improvements in activities of daily living, balance, exercise capacity, gait, mastery, mental health, mobility, motor function, participation in daily life, physical function, quality of life, range of motion, and strength; with reductions in blood pressure, body mass index, depression, disability, dyspnea, falls, fatigue, pain, stiffness, and waist circumference. Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion. IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates “high” and “moderate” quality evidence of the effectiveness of Tai Chi in improving important outcomes for people with numerous health conditions.This information can be useful for healthcare providers who wish to recommend effective community-based physical activity to clients they are serving. Tai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings. Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion. This scoping review of meta-analyses elucidates “high” and “moderate” quality evidence of the effectiveness of Tai Chi in improving important outcomes for people with numerous health conditions. This information can be useful for healthcare providers who wish to recommend effective community-based physical activity to clients they are serving.

本研究旨在开展一项范围综述（scoping review），对汇总太极拳针对罹患各类健康疾病成年人群的疗效证据的荟萃分析（meta-analysis）进行系统梳理。研究从各数据库建库起至2018年9月初，检索了Medline、Embase、AMED、CINAHL、SPORTDiscus、PsycINFO、Web of Science、PubMed Health以及Cochrane Library等数据库。经过多阶段去重与筛选流程，最终纳入完整、独立且经同行评议的荟萃分析。两名研究者基于GRADE系统（GRADE）独立对42项荟萃分析开展质量评价，并将研究结果整理为3个附录，后续进一步归类为异质性有统计学意义、异质性无统计学意义的三类表格。“高质量”与“中等质量”的证据表明，太极拳可显著改善罹患各类健康疾病成年人群的健康状况，所覆盖的疾病包括癌症、慢性阻塞性肺疾病、冠心病、抑郁症、心力衰竭、高血压、腰背痛、骨关节炎、骨质疏松症、帕金森病以及脑卒中。研究的结局指标包括日常生活活动能力、平衡能力、运动耐力、步态、掌控感、心理健康、移动能力、运动功能、日常参与度、躯体功能、生活质量、关节活动范围以及肌力的显著改善；同时可降低血压、体质量指数、抑郁症状、残疾程度、呼吸困难、跌倒发生率、疲劳程度、疼痛、僵硬程度以及腰围。当前医疗服务提供者可借助本研究结果，为罹患健康疾病的患者提供太极拳对整体健康促进疗效的相关咨询建议。康复领域应用启示：太极拳是一种安全、愉悦、轻至中等强度的有氧体育运动，适用于成年人群，且在各类社区场景中开展成本低廉。罹患健康疾病的成年人群需要通过体育运动预防继发性功能障碍并促进整体健康。本项针对荟萃分析的范围综述阐明了“高质量”与“中等质量”的证据，证实太极拳可改善罹患多种健康疾病人群的多项关键结局指标。该研究结果可为医疗服务提供者向服务对象推荐有效的社区体育运动方案提供参考依据。太极拳是一种安全、愉悦、轻至中等强度的有氧体育运动，适用于成年人群，且在各类社区场景中开展成本低廉。罹患健康疾病的成年人群需要通过体育运动预防继发性功能障碍并促进整体健康。本项针对荟萃分析的范围综述阐明了“高质量”与“中等质量”的证据，证实太极拳可改善罹患多种健康疾病人群的多项关键结局指标。该研究结果可为医疗服务提供者向服务对象推荐有效的社区体育运动方案提供参考依据。