Wayne Peter M, Krebs David E, Wolf Steven L, Gill-Body Kathleen M, Scarborough Donna M, McGibbon Chris A, Kaptchuk Ted J, Parker Stephen W
Research Department, New England School of Acupuncture, Watertown, MA 02472, USA.
Arch Phys Med Rehabil. 2004 Jan;85(1):142-52. doi: 10.1016/s0003-9993(03)00652-x.
To evaluate the rationale and scientific support for Tai Chi as an intervention for vestibulopathy and to offer recommendations for future studies.
A computer-aided search, including MEDLINE and Science Citation Index, to identify original Tai Chi studies published in English; relevant references cited in the retrieved articles were also included.
A preliminary screening selected all randomized controlled trials (RCTs), non-RCTs, case-control studies, and case series that included Tai Chi as an intervention and had at least 1 outcome variable relevant to postural stability.
Authors critically reviewed studies and summarized study designs and outcomes in a summary table.
Twenty-four Tai Chi studies met screening criteria. No studies specifically studying Tai Chi for vestibulopathy were found. Collectively, the 24 studies provide sometimes contradictory but generally supportive evidence that Tai Chi may have beneficial effects for balance and postural impairments, especially those associated with aging. Ten RCTs were found, of which 8 provide support that Tai Chi practiced alone, or in combination with other therapies, can reduce risk of falls, and/or impact factors associated with postural control, including improved balance and dynamic stability, increased musculoskeletal strength and flexibility, improved performance of activities of daily living (ADLs), reduced fear of falling, and general improvement in psychologic well-being. Studies using other designs support the results observed in RCTs.
At present, few data exist to support the contention that Tai Chi specifically targets the impairments, functional limitations, disability, and quality of life associated with peripheral vestibulopathy. There are, however, compelling reasons to further investigate Tai Chi for vestibulopathy, in part because Tai Chi appears useful for a variety of nonvestibulopathy etiologic balance disorders, and is safe. Especially needed are studies that integrate measures of balance relevant to ADLs with other psychologic and cognitive measures; these might help identify specific mechanisms whereby Tai Chi can remedy balance disorders.
评估太极拳作为前庭病干预措施的基本原理和科学依据，并为未来研究提供建议。
通过计算机辅助检索，包括MEDLINE和科学引文索引，以识别用英文发表的关于太极拳的原始研究；检索到的文章中引用的相关参考文献也包括在内。
初步筛选选取了所有将太极拳作为干预措施且至少有1个与姿势稳定性相关的结局变量的随机对照试验（RCT）、非随机对照试验、病例对照研究和病例系列。
作者对研究进行了严格审查，并在汇总表中总结了研究设计和结果。
24项太极拳研究符合筛选标准。未发现专门研究太极拳治疗前庭病的研究。总体而言，这24项研究提供了有时相互矛盾但总体上支持性的证据，表明太极拳可能对平衡和姿势障碍有益，尤其是与衰老相关的障碍。发现了10项RCT，其中8项支持单独练习太极拳或与其他疗法结合可以降低跌倒风险和/或影响与姿势控制相关的因素，包括改善平衡和动态稳定性、增加肌肉骨骼力量和灵活性、改善日常生活活动（ADL）表现、减少跌倒恐惧以及总体改善心理健康。使用其他设计的研究支持了RCT中观察到的结果。
目前，几乎没有数据支持太极拳专门针对与外周前庭病相关的损伤、功能限制、残疾和生活质量这一观点。然而，有令人信服的理由进一步研究太极拳治疗前庭病，部分原因是太极拳似乎对多种非前庭病病因的平衡障碍有用且安全。特别需要将与ADL相关的平衡测量与其他心理和认知测量相结合的研究；这些研究可能有助于确定太极拳可以纠正平衡障碍的具体机制。
