Tai Chi for preventing falls in the elderly: an overviews of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

XIAO Qiwei , YE Jing , JIN Rongjiang , LIANG Fanrong ,  LI Juan

Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P.R.China;

Corresponding author：

LI Juan, Email: 785939016@qq.com

Keywords：

Tai Chi; Falls in the elderly; Balance; Overviews of systematic reviews

DOI：

10.7507/1672-2531.201905013

Video：

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Objective To assess the methodological quality of systematic reviews of Tai Chi for preventing falls in the elderly and the quality of evidence for outcome indicators.Methods PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, CBM and VIP databases were electronically retrieved. According to the inclusion criteria and exclusion criteria, the final articles were selected and the relevant literature information was extracted by reading the abstract and the full text. The methodological quality of the included systematic reviews was evaluated using AMSTAR 2 tool, and the quality of the outcome indicators of the included systematic reviews was further graded according to the GRADE system.Results A total of 11 systematic reviews/meta-analyses were included. The AMSTAR 2 evaluation showed that 10 studies were in critically-low methodological quality, and 1 study was in low methodological quality. The GRADE evaluation results showed that among the 36 outcome indicators included, there were 10 intermediate quality indicators, 20 low-level quality indicators and 6 extremely low-level quality indicators. Among the indicators of intermediate quality, single-leg stand test (MD = 5.33, 95%CI 3.35 to 7.32, P< 0.01; WMD = 1.76, 95%CI −7.00 to 10.52, P< 0.01), time up and go test (MD = 1.04, 95%CI 0.67 to 1.41, P< 0.01), the berg balance scale (MD = 2.18, 95%CI 0.93 to 3.43, P< 0.01), number of falls (RR = 0.82, 95%CI 0.73 to 0.92), P< 0.01), the incidence of 2-falls (OR = 0.69, 95%CI 0.49 to 0.97, P< 0.01) and the incidence of 3-falls (OR = 0.39, 95%CI 0.21 to 0.73, P< 0.01). The results of the above indicators were statistically significant, indicating that Tai Chi was better than control group.Conclusions At present, the methodological quality of relevant systematic reviews of Tai Chi for preventing falls in the elderly was relatively low and the quality of the evidence was not good, so it can’t be proved that Tai Chi can effectively prevent falls in the elderly, which needs to be further studied at a high level.

Citation： XIAO Qiwei, YE Jing, JIN Rongjiang, LIANG Fanrong, LI Juan. Tai Chi for preventing falls in the elderly: an overviews of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2020, 20(2): 191-198. doi: 10.7507/1672-2531.201905013 Copy

1.	刘琪. 联合国发表多项议题, 关注世界人口老龄化问题. 上海城市管理, 2017, 26(5): 96.
2.	Khanuja K, Joki J, Bachmann G, et al. Gait and balance in the aging population: fall prevention using innovation and technology. Maturitas, 2018, 110: 51-56.
3.	Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35(Suppl 2): ii37-ii41.
4.	Cooper JW, Burfield AH. Medication interventions for fall prevention in the older adult. J Am Pharm Assoc, 2009, 49(3): e70-e82.
5.	石丹, 李铮, 叶盛, 等. 群组运动预防社区老年人跌倒效果的系统评价. 护士进修杂志, 2017, 32(4): 316-321.
6.	Davis JC, Robertson MC, Comans T, et al. Guidelines for conducting and reporting economic evaluation of fall prevention strategies. Osteoporos Int, 2011, 22(9): 2449-2459.
7.	Jahnke R, Larkey L, Rogers C, et al. A comprehensive review of health benefits of qigong and tai chi. Am J Health Promot, 2010, 24(6): e1-e25.
8.	代丽, 陈立典. 太极. 按摩与康复医学(中旬刊), 2012, 3(4): 1-1.
9.	Li F, Harmer P, Fisher KJ, et al. Tai Chi: improving functional balance and predicting subsequent falls in older persons. Med Sci Sports Exerc, 2004, 36(12): 2046-2052.
10.	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.
11.	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.
12.	陈薇, 方赛男, 刘建平, 等. 国际循证医学证据分级体系的发展与现状. 中国中西医结合杂志, 2017, (12): 1413-1419.
13.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
14.	陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR 2解读. 中国循证医学杂志, 2018, 18(1): 101-108.
15.	Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines: 4. Rating the quality of evidence-study limitations (risk of bias). J Clin Epidemiol, 2011, 64(4): 407-415.
16.	Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 7. Rating the quality of evidence-inconsistency. J Clin Epidemiol, 2011, 64(12): 1294-1302.
17.	Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 8. Rating the quality of evidence-indirectness. J Clin Epidemiol, 2011, 64(12): 1303-1310.
18.	Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines 6. Rating the quality of evidence-imprecision. J Clin Epidemiol, 2011, 64(12): 1283-1293.
19.	Guyatt GH, Oxman AD, Montori V, et al. GRADE guidelines: 5. Rating the quality of evidence--publication bias. J Clin Epidemiol, 2011, 64(12): 1277-1282.
20.	曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用GRADE系统. 中国循证医学杂志, 2011, 11(9): 985-990.
21.	Langer G, Meerpohl JJ, Perleth M, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
22.	Hu YN, Chung YJ, Yu HK, et al. Effect of Tai Chi exercise on fall prevention in older adults: systematic review and meta-analysis of randomized controlled trials. Int J Gerontol, 2016, 10(3): 131-136.
23.	Huang Y, Liu X. Improvement of balance control ability and flexibility in the elderly Tai Chi Chuan (TCC) practitioners: a systematic review and meta-analysis. Arch Gerontol Geriatr, 2015, 60(2): 233-238.
24.	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.
25.	Leung DP, Chan CK, Tsang HW, et al. Tai Chi as an intervention to improve balance and reduce falls in older adults: a systematic and meta-analytical review. Altern Ther Health Med, 2011, 17(1): 40-48.
26.	Liu H, Frank A. Tai Chi as a balance improvement exercise for older adults: a systematic review. J Geriatr Phys Ther, 2010, 33(3): 103-109.
27.	Lomas-Vega R, Obrero-Gaitán E, Molina-Ortega FJ, et al. Tai chi for risk of falls: a meta-analysis. J Am Geriatr Soc, 2017, 65(9): 2037-2043.
28.	Low S, Ang LW, Goh KS, et al. A systematic review of the effectiveness of Tai Chi on fall reduction among the elderly. Arch Gerontol Geriatr, 2009, 48(3): 325-331.
29.	Verhagen AP, Immink M, van der Meulen A, et al. The efficacy of Tai Chi Chuan in older adults: a systematic review. Fam Pract, 2004, 21(1): 107-113.
30.	Zhao Y, Wang Y. Tai Chi as an intervention to reduce falls and improve balance function in the elderly: a meta-analysis of randomized controlled trials. Chinese Nursing Research, 2016, 3(1): 28-33.
31.	李晓军. 太极拳对老年人平衡功能影响的系统评价. 福建中医药大学, 2017.
32.	郑萍萍, 张军, 童莉. 太极拳减少居家老人跌倒效果的Meta分析. 中华现代护理杂志, 2013, 19(10): 1123-1127.

1. 刘琪. 联合国发表多项议题, 关注世界人口老龄化问题. 上海城市管理, 2017, 26(5): 96.
2. Khanuja K, Joki J, Bachmann G, et al. Gait and balance in the aging population: fall prevention using innovation and technology. Maturitas, 2018, 110: 51-56.
3. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 2006, 35(Suppl 2): ii37-ii41.
4. Cooper JW, Burfield AH. Medication interventions for fall prevention in the older adult. J Am Pharm Assoc, 2009, 49(3): e70-e82.
5. 石丹, 李铮, 叶盛, 等. 群组运动预防社区老年人跌倒效果的系统评价. 护士进修杂志, 2017, 32(4): 316-321.
6. Davis JC, Robertson MC, Comans T, et al. Guidelines for conducting and reporting economic evaluation of fall prevention strategies. Osteoporos Int, 2011, 22(9): 2449-2459.
7. Jahnke R, Larkey L, Rogers C, et al. A comprehensive review of health benefits of qigong and tai chi. Am J Health Promot, 2010, 24(6): e1-e25.
8. 代丽, 陈立典. 太极. 按摩与康复医学(中旬刊), 2012, 3(4): 1-1.
9. Li F, Harmer P, Fisher KJ, et al. Tai Chi: improving functional balance and predicting subsequent falls in older persons. Med Sci Sports Exerc, 2004, 36(12): 2046-2052.
10. 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.
11. 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.
12. 陈薇, 方赛男, 刘建平, 等. 国际循证医学证据分级体系的发展与现状. 中国中西医结合杂志, 2017, (12): 1413-1419.
13. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
14. 陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR 2解读. 中国循证医学杂志, 2018, 18(1): 101-108.
15. Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines: 4. Rating the quality of evidence-study limitations (risk of bias). J Clin Epidemiol, 2011, 64(4): 407-415.
16. Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 7. Rating the quality of evidence-inconsistency. J Clin Epidemiol, 2011, 64(12): 1294-1302.
17. Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 8. Rating the quality of evidence-indirectness. J Clin Epidemiol, 2011, 64(12): 1303-1310.
18. Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines 6. Rating the quality of evidence-imprecision. J Clin Epidemiol, 2011, 64(12): 1283-1293.
19. Guyatt GH, Oxman AD, Montori V, et al. GRADE guidelines: 5. Rating the quality of evidence--publication bias. J Clin Epidemiol, 2011, 64(12): 1277-1282.
20. 曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用GRADE系统. 中国循证医学杂志, 2011, 11(9): 985-990.
21. Langer G, Meerpohl JJ, Perleth M, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4): 383-394.
22. Hu YN, Chung YJ, Yu HK, et al. Effect of Tai Chi exercise on fall prevention in older adults: systematic review and meta-analysis of randomized controlled trials. Int J Gerontol, 2016, 10(3): 131-136.
23. Huang Y, Liu X. Improvement of balance control ability and flexibility in the elderly Tai Chi Chuan (TCC) practitioners: a systematic review and meta-analysis. Arch Gerontol Geriatr, 2015, 60(2): 233-238.
24. 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.
25. Leung DP, Chan CK, Tsang HW, et al. Tai Chi as an intervention to improve balance and reduce falls in older adults: a systematic and meta-analytical review. Altern Ther Health Med, 2011, 17(1): 40-48.
26. Liu H, Frank A. Tai Chi as a balance improvement exercise for older adults: a systematic review. J Geriatr Phys Ther, 2010, 33(3): 103-109.
27. Lomas-Vega R, Obrero-Gaitán E, Molina-Ortega FJ, et al. Tai chi for risk of falls: a meta-analysis. J Am Geriatr Soc, 2017, 65(9): 2037-2043.
28. Low S, Ang LW, Goh KS, et al. A systematic review of the effectiveness of Tai Chi on fall reduction among the elderly. Arch Gerontol Geriatr, 2009, 48(3): 325-331.
29. Verhagen AP, Immink M, van der Meulen A, et al. The efficacy of Tai Chi Chuan in older adults: a systematic review. Fam Pract, 2004, 21(1): 107-113.
30. Zhao Y, Wang Y. Tai Chi as an intervention to reduce falls and improve balance function in the elderly: a meta-analysis of randomized controlled trials. Chinese Nursing Research, 2016, 3(1): 28-33.
31. 李晓军. 太极拳对老年人平衡功能影响的系统评价. 福建中医药大学, 2017.
32. 郑萍萍, 张军, 童莉. 太极拳减少居家老人跌倒效果的Meta分析. 中华现代护理杂志, 2013, 19(10): 1123-1127.

Chinese Journal of Evidence-Based Medicine

Tai Chi for preventing falls in the elderly: an overviews of systematic reviews

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