Sage Journals: Discover world-class research

Abstract

Objective:

To evaluate the effect of Tai Chi on balance and reducing falls incidence in neurological disorders.

Data sources:

AMED, Embase, Web of Science, SCOPUS, EBSCO and Medline from inception until February 2018.

Review method:

Randomized controlled trials of Tai Chi compared with active or no treatment control, measuring balance with the Berg Balance Scale or the Timed Up and Go Test and number of falls in neurological disorders were included. Methodological quality was assessed using PEDro and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

Results:

A total of 10 studies involving 720 participants were reviewed. Seven studies were in Parkinson’s disease and three in stroke. Seven studies were of high methodological quality and three were low. Meta-analyses of balance measured with the Timed Up and Go Test in Parkinson’s disease revealed a statistically significant effect of Tai Chi compared to no treatment (weighted mean difference (WMD), –2.13; 95% confidence interval (CI), −3.26 to −1.00; P < 0.001) and was insignificant (WMD, −0.19; 95% CI, −1.74 to 1.35; P = 0.81) when compared with active treatment. Tai Chi significantly reduced falls incidence in Parkinson’s disease (odds ratio (OR), 0.47; 95% CI, 0.29 to 0.77; P = 0.003) and stroke (OR, 0.21; 95% CI, 0.09 to 0.48; P < 0.001). Balance measured with the Timed Up and Go Test comparing Tai Chi and active treatment was insignificant (WMD, 0.45; 95% CI, –3.43 to 2.54; P = 0.77) in stroke.

Conclusion:

Tai Chi is effective in reducing falls incidence in Parkinson’s disease and stroke. This systematic review did not find high-quality studies among other neurological disorders.

Keywords

Nervous system diseases Tai Ji Tai Chi accidental falls meta-analysis

Get full access to this article

View all access options for this article.

References

Stolze

Klebe

Zechlin

et al . Falls in frequent neurological diseases. J Neurol 2004; 251: 79–84.

Wolf

Coogler

Exploring the basis for Tai Chi Chuan as a therapeutic exercise approach. Arch Phys Med Rehabil 1997; 78: 886–892, http://www.taichifuture.com/uploads/4/6/3/7/46373393/overall_non_specific_benefits.pdf (accessed 20 January 2017).

Koh

Tai Chi Chuan. Am J Chin Med 1981; 9: 15–22, http://www.worldscientific.com/doi/pdf/10.1142/S0192415X81000032 (accessed February 2017).

Tsang

WN.

Efficacy of tai chi in improving sensori-motor and postural control in the well elderly. Hong Kong: The Hong Kong Polytechnic University, 2004, http://hdl.handle.net/10397/149 (accessed 12 February 2017).

Tsang

Hui-Chan

Comparison of muscle torque, balance, and confidence in older tai chi and healthy adults. Med Sci Sports Exerc 2005; 37: 280–289.

McGibbon

Krebs

Parker

et al . Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: preliminary report. BMC Neurol 2005; 5: 3.

Tsang

Hui-Chan

CW.

Effects of Tai Chi on joint proprioception and stability limits in elderly subjects. Med Sci Sports Exerc 2003; 35: 1962–1971.

Gao

Leung

Yang

et al . Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial. Clin Rehabil 2014; 28(8): 748–753.

Harmer

Fitzgerald

et al . Tai Chi and postural stability in patients with Parkinson’s disease. N Engl J Med 2012; 366: 511–519.

10.

Taylor-Piliae

Hoke

Hepworth

et al . Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors. Arch Phys Med Rehabil 2014; 95: 816–824.

11.

Azimzadeh

Hosseini

Nourozi

et al . Effect of Tai Chi Chuan on balance in women with multiple sclerosis. Complement Ther Clin Pract 2015; 21: 57–60.

12.

Shapira

Chelouche

Yanai

et al . Tai Chi Chuan practice as a tool for rehabilitation of severe head trauma: 3 case reports. Arch Phys Med Rehab 2001; 82(9): 1283–1285.

13.

Winser

Kannan

Tsang

et al . Tai Chi for improving balance in cerebellar ataxia: a feasibility study. Arch Phys Med Rehabil 2017; 98(10): e113–e114.

14.

Tsang

Gao

Chan

et al . Sitting Tai Chi improves the balance control and muscle strength of community-dwelling persons with spinal cord injuries: a pilot study. Evid Based Complement Alternat Med 2015; 2015: 52385.

15.

Zhou

Yin

Gao

et al . A meta-analysis on the efficacy of Tai Chi in patients with Parkinson’s disease between 2008 and 2014. Evid Based Complement Alternat Med 2015; 2015: 593263.

16.

Song

Grabowska

Park

et al . The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson’s disease: a systematic review and meta-analysis. Parkinsonism Relat Disord 2017; 41: 3–13.

17.

Yang

X-Y

Gong

et al . Tai Chi for improvement of motor function, balance and gait in Parkinson’s disease: a systematic review and meta-analysis. PLoS ONE 2014; 9: e102942.

18.

Taylor

Taylor-Piliae

RE.

The effects of Tai Chi on physical and psychosocial function among persons with multiple sclerosis: a systematic review. Complement Ther Med 2017; 31: 100–108.

19.

Chen

B-L

Guo

J-B

Liu

M-S

et al . Effect of traditional Chinese exercise on gait and balance for stroke: a systematic review and meta-analysis. PLoS ONE 2015; 10: e0135932.

20.

Liu

et al . Efficacy and safety of Tai Chi for Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE 2014; 9: e99377.

21.

Maher

Sherrington

Herbert

et al . Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003; 83(8): 713–721.

22.

Maher

CG.

A systematic review of workplace interventions to prevent low back pain. Aust J Physiother 2000; 46: 259–269.

23.

Guyatt

Oxman

Vist

et al . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336: 924–926, http://wp.vcu.edu/vcuem/wp-content/uploads/sites/4827/2015/03/BMJ-2008–1-Rating-Evidence-and-Strength-of-recommendation.pdf (accessed 28 January 2017).

24.

Oxman

Group

GW.

Grading quality of evidence and strength of recommendations. BMJ 2004; 328: 1490–1494.

25.

Guyatt

Oxman

Montori

et al . GRADE guidelines: 5. Rating the quality of evidence – publication bias. J Clin Epidemiol 2011; 64: 1277–1282.

26.

Au-Yeung

Hui-Chan

Tang

JC.

Short-form Tai Chi improves standing balance of people with chronic stroke. Neurorehabil Neural Repair 2009; 23(5): 515–522.

27.

Choi

H-J

Garber

Jun

T-W

et al . Therapeutic effects of Tai Chi in patients with Parkinson’s disease. ISRN Neurol 2013; 2013: 548240.

28.

Gladfelter

. The Effect of Tai Chi Exercise on Balance and Falls in Persons with Parkinson’s. Valparaiso University: Valparaiso, Indiana, 2011.

29.

Hackney

Earhart

GM.

Tai Chi improves balance and mobility in people with Parkinson disease. Gait Posture 2008; 28(3): 456–460.

30.

Kim

Lee

SM.

Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients. Int J Rehabil Res 2015; 38(2): 156–161.

31.

Zhang

T-Y

Nie

Z-Y

et al . Effects of Tai Chi and multimodal exercise training on movement and balance function in mild to moderate idiopathic Parkinson disease. Am J Phys Med Rehabil 2015; 94(10): 921–929.

32.

Zhu

et al . Effect of Taijiquan on motion control for Parkinson’s disease at early stage. Chin J Rehabil Theory Pract 2011; 17: 355–358.

33.

Higgins

Green

. The standardized mean difference. In, Cochrane Handbook for Systematic Reviews of Interventions. Publisher, The Cochrane Collaboration 2011. Available at: http://handbook-5-1.cochrane.org/chapter_9/9_2_3_2_the_standardized_mean_difference.htm (accessed 21 January 2018)

34.

Winser

SJ.

Clinical measures of balance for people with cerebellar ataxia: use and recommendations. Doctoral Thesis, University of Otago, Dunedin, New Zealand, 2015, http://hdl.handle.net/10523/5750 (accessed 22 January 2017).

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.80 MB

Does Tai Chi improve balance and reduce falls incidence in neurological disorders? A systematic review and meta-analysis

Abstract

Objective:

Data sources:

Review method:

Results:

Conclusion:

Keywords

Get full access to this article

References

Supplementary Material