The influence of Tai Chi on the fall and balance function of middle-aged and the elderly: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Yijie ¹ ,  JIN Rongjiang ¹ , ZHONG Dongling ¹ , LI Juan ¹ , LI Yuxi ² , SHI Lihong ¹

1. School of Health Preservation and Rehabilitation, Chengdu University of TCM, Chengdu, 610075, P.R.China;
2. School of Acupuncture and Massage, Chengdu University of TCM, Chengdu, 610075, P.R.China;

Corresponding?author：

JIN Rongjiang, Email: jrj133@126.com

Keywords：

Tai Chi; Middle-aged and elderly; Balanced fall; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201908090

Video：

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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.

Citation： HUANG Yijie, JIN Rongjiang, ZHONG Dongling, LI Juan, LI Yuxi, SHI Lihong. The influence of Tai Chi on the fall and balance function of middle-aged and the elderly: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(3): 281-288. doi: 10.7507/1672-2531.201908090 Copy

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2.	Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing, 2006, 35 (Suppl 2): i7-i11.
3.	Maki BE, McIlroy WE. Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. Age Ageing, 2006, 35 (Suppl 2): i12-i18.
4.	郝燕萍, 劉雪琴, 靳海如. 老年人跌倒致傷情況分析. 護理研究, 2006, 20(22): 2017-2018.
5.	Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35 (Suppl 2): i37-i41.
6.	Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med, 2002, 18(2): 141-158.
7.	Stevens JA, Corso PS, Finkelstein EA, et al. The costs of fatal and non-fatal falls among older adults. Inj Prev, 2006, 12(5): 290-295.
8.	穆光宗, 張團. 我國人口老齡化的發展趨勢及其戰略應對. 華中師范大學學報(人文社會科學版), 2011, (5): 29-36.
9.	本刊編輯部. 《中國老齡事業發展報告(2013)》發布. 城市規劃通訊, 2013, (5): 12.
10.	邱丕相, 田學建. 論太極拳的普遍和諧價值觀. 體育學刊, 2005, (3): 70-72.
11.	郭志禹. 太極拳養生文化考. 上海體育學院學報, 2004, (2): 49-52, 59.
12.	Hosseini L, Kargozar E, Sharifi F, et al. Tai Chi Chuan can improve balance and reduce fear of falling in community dwelling older adults: a randomized control trial. J Exerc Rehabil, 2018, 14(6): 1024-1031.
13.	Chewning B, Hallisy KM, Mahoney JE, et al. Disseminating Tai Chi in the Community: Promoting Home Practice and Improving Balance. Gerontologist, 2019, doi: 10.1093/geront/gnz006.
14.	Xie G, Rao T, Lin L, et al. Effects of Tai Chi Yunshou exercise on community-based stroke patients: a cluster randomized controlled trial. Eur Rev Aging Phys Act, 2018, 15: 17.
15.	李博, 鐘清玲, 余紅, 等. 太極拳訓練對帕金森患者平衡功能及害怕跌倒的影響. 中國康復醫學雜志, 2017, 32(3): 309-312.
16.	Del-Pino-Casado R, Obrero-Gaitán E, Lomas-Vega R. The effect of Tai Chi on reducing the risk of falling: a systematic review and meta-analysis. Am J Chin Med, 2016, 44(5): 895-906.
17.	Huang ZG, Feng YH, Li YH, et al. Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open, 2017, 7(2): e013661.
18.	熊俊, 陳日新. 系統評價/Meta 分析方法學質量的評價工具 AMSTAR. 中國循證醫學雜志, 2011, 11(9): 1084-1089.
19.	Rockwood K. Frailty and its definition: a worthy challenge. J Am Geriatr Soc, 2005, 53(6): 1069-1070.
20.	邱玉宇, 崔焱. 太極拳鍛煉對防止老年人跌倒作用機制的研究. 護理研究, 2008, 22(6): 490-491.
21.	孫皎, 王黎, 張秀英, 等. 太極拳運動對老年人腦功能及體力的改善作用. 中國老年學雜志, 2011, 31(23): 4688-4689.
22.	王蕊, 李玉周. 16 周規律太極拳練習對中老年人下肢本體感覺和肌力的影響. 河南師范大學學報(自然科學版), 2016, (3): 172-177.
23.	Audette JF, Jin YS, Newcomer R, et al. Tai Chi versus brisk walking in elderly women. Age Ageing, 2006, 35(4): 388-393.
24.	Hwang HF, Chen SJ, Lee-Hsieh J, et al. Effects of home-based tai chi and lower extremity training and self-practice on falls and functional outcomes in older fallers from the emergency department-a randomized controlled trial. J Am Geriatr Soc, 2016, 64(3): 518-525.
25.	Blake H, Hawley H. Effects of Tai Chi exercise on physical and psychological health of older people. Curr Aging Sci, 2012, 5(1): 19-27.
26.	Voukelatos A, Cumming RG, Lord SR, et al. A randomized, controlled trial of Tai Chi for the prevention of falls: the Central Sydney Tai Chi trial. J Am Geriatr Soc, 2007, 55(8): 1185-1191.
27.	Huang HC, Liu CY, Huang YT, et al. Community-based interventions to reduce falls among older adults in Taiwan - long time follow-up randomised controlled study. J Clin Nurs, 2010, 19(7-8): 959-968.
28.	Huang TT, Yang LH, Liu CY. Reducing the fear of falling among community-dwelling elderly adults through cognitive-behavioural strategies and intense Tai Chi exercise: a randomized controlled trial. J Adv Nurs, 2011, 67(5): 961-971.
29.	Li JX, Xu DQ, Hong Y. Effects of 16-week Tai Chi intervention on postural stability and proprioception of knee and ankle in older people. Age Ageing, 2008, 37(5): 575-578.
30.	Logghe IH, Zeeuwe PE, Verhagen AP, et al. Lack of effect of Tai Chi Chuan in preventing falls in elderly people living at home: a randomized clinical trial. J Am Geriatr Soc, 2009, 57(1): 70-75.
31.	Saravanakumar P, Higgins IJ, van der Riet PJ, et al. The influence of tai chi and yoga on balance and falls in a residential care setting: A randomised controlled trial. Contemp Nurse, 2014, 48(1): 76-87.
32.	Taylor D, Hale L, Schluter P, et al. Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial. J Am Geriatr Soc, 2012, 60(5): 841-848.
33.	Tousignant M, Corriveau H, Roy PM, et al. Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial. Disabil Rehabil, 2013, 35(17): 1429-1435.
34.	Zhang JG, Ishikawa-Takata K, Yamazaki H, et al. The effects of Tai Chi Chuan on physiological function and fear of falling in the less robust elderly: an intervention study for preventing falls. Arch Gerontol Geriatr, 2006, 42(2): 107-116.
35.	Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci, 2005, 60(2): 187-194.
36.	Sattin RW, Easley KA, Wolf SL, et al. Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults. J Am Geriatr Soc, 2005, 53(7): 1168-1178.
37.	Wolf SL, Sattin RW, Kutner M, et al. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc, 2003, 51(12): 1693-1701.
38.	Zhao Y, Chung PK, Tong TK. Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial. Geriatr Nurs, 2017, 38(6): 491-497.
39.	Faber MJ, Bosscher RJ, Chin A Paw MJ, et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial. Arch Phys Med Rehabil, 2006, 87(7): 885-896.
40.	國家應對人口老齡化戰略研究總課題組. 國家應對人口老齡化戰略研究總報告. 北京: 華齡出版社, 2014.
41.	趙俊男, 劉玥, 張穎, 等. 中西醫結合老年醫學研究的進展與思考. 中國循證醫學雜志, 2018, 18(11): 1191-1197.
42.	趙媛, 王燕, 徐旭東, 等. 太極拳運動對老年人平衡功能和跌倒預防效果的Meta分析. 中國循證醫學雜志, 2013, 13(3): 339-345.

1. Gibson MJ, Andres RO, Isaacs B, et al. The prevention of falls in later life. Dan Med Bullet, 1987, 34 Suppl 4(12): 1.
2. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing, 2006, 35 (Suppl 2): i7-i11.
3. Maki BE, McIlroy WE. Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. Age Ageing, 2006, 35 (Suppl 2): i12-i18.
4. 郝燕萍, 劉雪琴, 靳海如. 老年人跌倒致傷情況分析. 護理研究, 2006, 20(22): 2017-2018.
5. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35 (Suppl 2): i37-i41.
6. Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med, 2002, 18(2): 141-158.
7. Stevens JA, Corso PS, Finkelstein EA, et al. The costs of fatal and non-fatal falls among older adults. Inj Prev, 2006, 12(5): 290-295.
8. 穆光宗, 張團. 我國人口老齡化的發展趨勢及其戰略應對. 華中師范大學學報(人文社會科學版), 2011, (5): 29-36.
9. 本刊編輯部. 《中國老齡事業發展報告(2013)》發布. 城市規劃通訊, 2013, (5): 12.
10. 邱丕相, 田學建. 論太極拳的普遍和諧價值觀. 體育學刊, 2005, (3): 70-72.
11. 郭志禹. 太極拳養生文化考. 上海體育學院學報, 2004, (2): 49-52, 59.
12. Hosseini L, Kargozar E, Sharifi F, et al. Tai Chi Chuan can improve balance and reduce fear of falling in community dwelling older adults: a randomized control trial. J Exerc Rehabil, 2018, 14(6): 1024-1031.
13. Chewning B, Hallisy KM, Mahoney JE, et al. Disseminating Tai Chi in the Community: Promoting Home Practice and Improving Balance. Gerontologist, 2019, doi: 10.1093/geront/gnz006.
14. Xie G, Rao T, Lin L, et al. Effects of Tai Chi Yunshou exercise on community-based stroke patients: a cluster randomized controlled trial. Eur Rev Aging Phys Act, 2018, 15: 17.
15. 李博, 鐘清玲, 余紅, 等. 太極拳訓練對帕金森患者平衡功能及害怕跌倒的影響. 中國康復醫學雜志, 2017, 32(3): 309-312.
16. Del-Pino-Casado R, Obrero-Gaitán E, Lomas-Vega R. The effect of Tai Chi on reducing the risk of falling: a systematic review and meta-analysis. Am J Chin Med, 2016, 44(5): 895-906.
17. Huang ZG, Feng YH, Li YH, et al. Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open, 2017, 7(2): e013661.
18. 熊俊, 陳日新. 系統評價/Meta 分析方法學質量的評價工具 AMSTAR. 中國循證醫學雜志, 2011, 11(9): 1084-1089.
19. Rockwood K. Frailty and its definition: a worthy challenge. J Am Geriatr Soc, 2005, 53(6): 1069-1070.
20. 邱玉宇, 崔焱. 太極拳鍛煉對防止老年人跌倒作用機制的研究. 護理研究, 2008, 22(6): 490-491.
21. 孫皎, 王黎, 張秀英, 等. 太極拳運動對老年人腦功能及體力的改善作用. 中國老年學雜志, 2011, 31(23): 4688-4689.
22. 王蕊, 李玉周. 16 周規律太極拳練習對中老年人下肢本體感覺和肌力的影響. 河南師范大學學報(自然科學版), 2016, (3): 172-177.
23. Audette JF, Jin YS, Newcomer R, et al. Tai Chi versus brisk walking in elderly women. Age Ageing, 2006, 35(4): 388-393.
24. Hwang HF, Chen SJ, Lee-Hsieh J, et al. Effects of home-based tai chi and lower extremity training and self-practice on falls and functional outcomes in older fallers from the emergency department-a randomized controlled trial. J Am Geriatr Soc, 2016, 64(3): 518-525.
25. Blake H, Hawley H. Effects of Tai Chi exercise on physical and psychological health of older people. Curr Aging Sci, 2012, 5(1): 19-27.
26. Voukelatos A, Cumming RG, Lord SR, et al. A randomized, controlled trial of Tai Chi for the prevention of falls: the Central Sydney Tai Chi trial. J Am Geriatr Soc, 2007, 55(8): 1185-1191.
27. Huang HC, Liu CY, Huang YT, et al. Community-based interventions to reduce falls among older adults in Taiwan - long time follow-up randomised controlled study. J Clin Nurs, 2010, 19(7-8): 959-968.
28. Huang TT, Yang LH, Liu CY. Reducing the fear of falling among community-dwelling elderly adults through cognitive-behavioural strategies and intense Tai Chi exercise: a randomized controlled trial. J Adv Nurs, 2011, 67(5): 961-971.
29. Li JX, Xu DQ, Hong Y. Effects of 16-week Tai Chi intervention on postural stability and proprioception of knee and ankle in older people. Age Ageing, 2008, 37(5): 575-578.
30. Logghe IH, Zeeuwe PE, Verhagen AP, et al. Lack of effect of Tai Chi Chuan in preventing falls in elderly people living at home: a randomized clinical trial. J Am Geriatr Soc, 2009, 57(1): 70-75.
31. Saravanakumar P, Higgins IJ, van der Riet PJ, et al. The influence of tai chi and yoga on balance and falls in a residential care setting: A randomised controlled trial. Contemp Nurse, 2014, 48(1): 76-87.
32. Taylor D, Hale L, Schluter P, et al. Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial. J Am Geriatr Soc, 2012, 60(5): 841-848.
33. Tousignant M, Corriveau H, Roy PM, et al. Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial. Disabil Rehabil, 2013, 35(17): 1429-1435.
34. Zhang JG, Ishikawa-Takata K, Yamazaki H, et al. The effects of Tai Chi Chuan on physiological function and fear of falling in the less robust elderly: an intervention study for preventing falls. Arch Gerontol Geriatr, 2006, 42(2): 107-116.
35. Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci, 2005, 60(2): 187-194.
36. Sattin RW, Easley KA, Wolf SL, et al. Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults. J Am Geriatr Soc, 2005, 53(7): 1168-1178.
37. Wolf SL, Sattin RW, Kutner M, et al. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc, 2003, 51(12): 1693-1701.
38. Zhao Y, Chung PK, Tong TK. Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial. Geriatr Nurs, 2017, 38(6): 491-497.
39. Faber MJ, Bosscher RJ, Chin A Paw MJ, et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial. Arch Phys Med Rehabil, 2006, 87(7): 885-896.
40. 國家應對人口老齡化戰略研究總課題組. 國家應對人口老齡化戰略研究總報告. 北京: 華齡出版社, 2014.
41. 趙俊男, 劉玥, 張穎, 等. 中西醫結合老年醫學研究的進展與思考. 中國循證醫學雜志, 2018, 18(11): 1191-1197.
42. 趙媛, 王燕, 徐旭東, 等. 太極拳運動對老年人平衡功能和跌倒預防效果的Meta分析. 中國循證醫學雜志, 2013, 13(3): 339-345.

Chinese Journal of Evidence-Based Medicine

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

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