太极拳训练对帕金森病患者运动和平衡功能影响的Meta分析

Meta analysis of the effect of Taijiquan exercise on motor and balance function in patients with Parkinson’s disease

目的:探讨太极拳训练对帕金森病患者运动和平衡功能的影响。方法:对7个中英文数据库进行检索,检索内容包括所有关于探讨太极拳运动对帕金森病患者作用的随机对照试验。检索时间是从建库时间至2022年1月31日。按照Cochrane手册5.1.0标准,由2名研究者独立对每一篇纳入文献进行质量和偏倚风险评估,并提取数据。应用Rev Man 5.4.1软件进行Meta分析。结果:共纳入12项随机对照试验,样本量共585例。结果显示,太极拳运动能够降低帕金森病患者的美国帕金森病综合评分量表Ⅲ(The Unified Parkinson’s Disease Rating Scale PartⅢ,UPDRSⅢ)评分[平均差:-3.09(95%置信区间:-4.54~-1.64);P<0.0001]和计时起立行走测试(Timed Up and Go Test,TUG)评分[平均差:-1.33(95%置信区间:-1.83~-0.84);P<0.00001],提高Berg平衡量表评分[平均差:6.73(95%置信区间:6.55~6.90);P<0.00001],但对6 min步行距离测试(6-minute Walk Test,6-MWT)评分无明显影响[平均差:4.54(95%置信区间:-10.63~19.72),P=0.56]。结论:太极拳运动能够提高帕金森病患者的运动和平衡功能,改善生活质量;但是对于步行能力的改善,尚无足够的证据。

Objective:To explore the effect of Taijiquan exercise on motor and balance function of patients with Parkinson’s disease(PD).Methods:To search the randomized controlled trials of the efficacy of Taijiquan exercise in patients with PD from 7 Chinese and English databases.The search time is from the database establishment date to January 31,2022.According to the Cochrane Handbook 5.1.0 standard,two researchers independently evaluated the quality and bias risk of each included literature,and extracted data.Meta analysis was conducted using RevMan 5.4.1 software.Results:A total of 12 randomized controlled trials(RCTs)were included,involving 585 patients.The Meta analysis results showed that Taijiquan exercise can significantly reduce the Unified PD Rating Scale PartⅢ(UPDRSⅢ)scores[mean difference:-3.09(95%confidence interval:-4.54 to-1.64);P<0.0001]and Timed Up and Go Test(TUG)scores[mean difference:-1.33(95%confidence interval:-1.83 to-0.84);P<0.00001],increased the Berg Balance Scale scores[mean difference:6.73(95%confidence interval:6.55 to 6.90);P<0.00001].However,there was no significant impact on the 6-minute Walk Test(6-MWT)scores[mean difference:4.54(95%confidence interval:-10.63 to 19.72);P=0.56].Conclusion:Taijiquan exercise can improve the motion and balance abilities of patients with PD,and improve their quality of life.However,there is insufficient evidence for the improvement of walking ability.