太极拳对中老年人跌倒及平衡功能影响的Meta分析

目的系统评价太极拳对中老年人跌倒及平衡功能的影响。方法计算机检索PubMed、EMbase、Web of Science、The Cochrane Library、CNKI和WanFang Data数据库,搜集太极拳对中老年人平衡功能及跌倒影响的随机对照试验(RCT),检索时限均为建库至2019年8月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入20个RCT,包括3 842例中老年人。Meta分析结果显示,太极拳组能减少跌倒率RR=0.82,95%CI(0.75,0.90),P<0.000 1],且在单腿站立时间MD=5.76,95%CI(0.62,10.90),P=0.03]、Berg评分MD=1.04,95%CI(0.23,1.85),P=0.01]、起立步行测试MD=-0.71,95%CI(-0.88,-0.54),P<0.000 01]、椅子站立测试MD=0.87,95%CI(0.05,1.70),P=0.04]等指标的改善方面均优于对照组,其差异有统计学意义。结论当前证据表明,太极拳可改善中老年人平衡功能,减少跌倒率,对中老年人跌倒有一定的防治作用。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

The influence of Tai Chi on the fall and balance function of middle-aged and the elderly:a meta-analysis

Objectives To systematically evaluate the impact of Tai Chi on the fall and balance function of middle-aged and the elderly. Methods PubMed, 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. Results A 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. Conclusions The 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.