太极运动对健康老年人群运动功能影响的META分析

The Effects of Tai Chi Exercise on Motor Functions in the Elderly:A Systematic Review and Meta-Analysis

目的:系统评价太极运动对健康老年人运动表现、平衡、肌力等运动功能的影响。方法:检索国内外医学数据库文献,收集相关的随机对照实验(RCTs),按照改良Jadad方法评价纳入研究的质量,采用RevMan5.3软件进行Meta分析。结果:共纳入20篇临床实验,共4455例老年人。结果:太极运动组在起立行走测试(TUG)(MD=2.62,95%CI[-4.00,1.24],P<0.00001)、5次“坐-站”试验(5tSS)(MD=-1.74,95%CI[-2.77,-0.70],P=0.001)、30 s坐站测试(30 sCST)(MD=4.02,95%CI[-0.20,8.24],P=0.06)、Berg平衡量表评分(BBS)(MD=1.41,95%CI[-0.06,2.87],P=0.06)、功能性前伸试验(FRT)(MD=2.16,95%CI[0.94,3.38],P=0.0005)、闭眼单腿站立时间(MD=3.18,95%CI[0.70,5.67],P=0.01)、睁眼单腿站立时间(MD=10.08,95%CI[4.62,-15.55],P=0.0003)等指标结果均优于对照组;太级干预组相比对照组在提高手握力(SMD=0.46,95%CI[0.00,0.93],P=0.05)、提升髋关节屈曲肌力(SMD=0.58,95%CI[0.25,0.92],P=0.0007)、增强膝关节伸展肌力(SMD=0.55,95%CI[0.25,0.85],P=0.0003)、提升踝关节背屈肌力(SMD=0.64,95%CI[0.16,1.13],P=0.009)等指标上可能具有优势效应。结论:现阶段的临床证据表明,太极运动能有效提高健康老年人的运功表现、平衡能力和肌力等相关运动功能。受纳入研究数量和质量限制,上述结论尚待更多高质量研究予以验证。

To systematically evaluate the effects of Tai Chi exercise on physical performance,balance,muscle strength and other motor functions in the healthy elders.Methods:The domestic and international medical databases were electronically searched to collect randomized controlled trials(RCTs).The quality of the included studies was evaluated according to the modified Jadad method.Then meta-analysis was performed by using RevMan5.3 software.Results:A total of 20 clinical trials with 4455 old people were included.The results of Meta-analysis showed that the Tai Chi group was superior to the control group in the TUG test(Times up and go,TUG)(MD=2.62,95%CI[-4.00,1.24],P<0.00001),5tSS(Five Times Sit-to-Stand Test,5tSS)(MD=-1.74,95%CI[-2.77,-0.70],P=0.001),30 sCST(30 s chairs test,30 s CST)MD=(4.02,95%CI[-0.20,8.24],P=0.06),BBS(Berg balance scale,BBS)(MD=1.41,95%CI[-0.06,2.87],P=0.06),FRT(Functional reach test,FRT)(MD=2.16,95%CI[0.94,3.38],P=0.0005),Eyes-closed SLS(Single-leg standing test,SLS)(MD=3.18,95%CI[0.70,5.67],P=0.01),and eyes-open SLS (MD=10.08, 95%CI[4.62,15.55], P=0.000 3);Compared with the control group, the Tai Chi intervention group might have more advantageous effect in improving handgrip strength(SMD=0.46, 95%CI[0.00,0.93], P=0.05), hip flexor strength(SMD=0.58, 95%CI[0.25,0.92], P=0.000 7), knee extensor strength(SMD=0.55, 95%CI[0.25,0.85], P=0.000 3), and ankle dorsiflexion strength(SMD=0.64, 95%CI[0.16,1.13], P=0.009). Conclusion: The current clinical evidence suggests that Tai Chi exercise is effective in improving motor functions such as physical performance, balance and muscle strength in the healthy elders. Due to the limitation of the quantity and quality of the included studies, the above conclusions need to be validated by more high-quality studies.