太极拳运动对老年人认知功能影响的系统评价与Meta分析

Systematic Review and Meta-analysis on Effect of Tai Chi Exercise on Cognitive Function of the Aged

目的评价太极拳运动对老年人认知功能的影响。方法检索中国知网数据库、万方数据知识服务平台、重庆维普中文科技期刊数据库、中国生物医学文献数据库、Pub Med、Cochrane Library和Embase,收集在老年人群中开展太极拳运动、研究其认知功能结局的临床研究文献,进行Cochrane偏倚风险评估,对有效信息进行系统评价与Meta分析。结果共纳入8项随机对照临床试验,所有研究均描述为随机,但仅有2项研究描述了随机方法,1项研究设盲,整体方法学质量偏低。Meta分析结果显示:对认知功能缺损老年人的认知功能结局评价中,太极组在整体认知功能[MD=0.91,95%CI(0.37,1.46),I^2=0,P=0.001]、语言流畅度[MD=2.17,95%CI(0.88,3.45),I^2=0,P<0.001]和延迟回忆测验[MD=0.7,95%CI(0.29,1.11),I^2=0,P<0.001]评价中均显著优于对照组,对记忆广度改善不明显[MD=0.16,95%CI(-0.14,0.45),I^2=55%,P=0.30]。在健康老年人的结局指标评价中,太极组在整体认知功能[MD=0.7,95%CI(0.11,1.29),P=0.02]评价中明显优于对照组,语言流畅度评价[MD=0.32,95%CI(0.01,0.64),I^2=0,P=0.05]差异无统计学意义,但有潜在优势;在执行力评价连线测验A(TMT-A)[MD=1.53,95%CI(0.1,2.96),I^2=26%,P=0.04]中优于对照组,在连线测验B(TMT-B)[MD=1.24,95%CI(-5.20,7.67),I^2=94%,P=0.71]中较对照组差异无统计学意义。结论太极拳运动对于健康与认知缺损老年人的认知功能有较好的改善效果。

Objective To evaluate the effect of Tai Chi exercise on cognitive function of the aged. Methods Searched China National Knowledge Infrastructure database,Wanfang data knowledge service platform,Chongqing VIP Chinese science and technology periodical database, China biomedical literature database, Pub Med, The Cochrane Library and Embase. Collected the clinical research literature in which the elder population practiced Tai Chi and cognitive function outcomes were researched. Conducted Cochrane bias risk assessment. Conducted systematic review and Meta-analysis for the effective information. Results Included 8 randomized controlled trials in total. All studies were described as random,but only two studies described the random method,with one study with blinding.The overall methodological quality was low. Meta-analysis results showed that, the cognitive function outcome evaluation in the aged with cognitive function defect,the overall cognitive function [MD = 0. 91,95% CI（ 0. 37,1. 46）,I^2= 0,P = 0. 001],language fluency [MD = 2. 17,95% CI（ 0. 88,3. 45）,I^2= 0,P〈0. 001] and delayed recall test [MD = 0. 7,95% CI（ 0. 29,1. 11）,I^2= 0,P〈0. 001]evaluation in the Tai Chi group were significantly better than that in the control group,with no significant improvement in memory span [MD = 0. 16,95% CI（-0. 14,0. 45）,I^2= 55%,P = 0. 30]. In the outcome indicators evaluation of the healthy elder people,the overall cognitive function evaluation [MD = 0. 7,95% CI（ 0. 11,1. 29）,P = 0. 02] in the Tai Chi group was significantly better than the control group. In language fluency evaluation [MD = 0. 32,95% CI（ 0. 01,0. 64）,I^2= 0 P =0. 05 ],the difference was not statistically significant,but there is a potential advantage; in evaluation of execution of test line A（ TMT-A） [MD = 1. 53,95% CI（ 0. 1,2. 96）,I^2= 26%,P = 0. 04],the Tai Chi group was better than the control group; in evaluation of execution of test line B（ TMT-B） [MD = 1. 24,95% CI（-5. 20,7. 67）,I^2=94%,P = 0. 71] the difference between the Tai Chi group and the control group was not significant. Conclusion Tai Chi could effectively improve cognitive function of the healthy elder people and those with cognitive impairment.