School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
Shanghai Health Education Institute, Shanghai, China.
Int J Nurs Stud. 2015 Jan;52(1):368-79. doi: 10.1016/j.ijnurstu.2014.05.009. Epub 2014 May 28.
Self-reported sleep disorders are common in older adults, resulting in serious consequences. Non-pharmacological measures are important complementary interventions, among which Taichi exercise is a popular alternative. Some experiments have been performed; however, the effect of Taichi exercise in improving sleep quality in older people has yet to be validated by systematic review. Using systematic review and meta-analysis, this study aimed to examine the efficacy of Taichi exercise in promoting self-reported sleep quality in older adults.
Systematic review and meta-analysis of randomized controlled studies.
4 English databases: Pubmed, Cochrane Library, Web of Science and CINAHL, and 4 Chinese databases: CBMdisc, CNKI, VIP, and Wanfang database were searched through December 2013.
Two reviewers independently selected eligible trials, conducted critical appraisal of the methodological quality by using the quality appraisal criteria for randomized controlled studies recommended by Cochrane Handbook. A standardized data form was used to extract information. Meta-analysis was performed.
Five randomized controlled studies met inclusion criteria. All suffered from some methodological flaws. The results of this study showed that Taichi has large beneficial effect on sleep quality in older people, as indicated by decreases in the global Pittsburgh Sleep Quality Index score [standardized mean difference=-0.87, 95% confidence intervals (95% confidence interval) (-1.25, -0.49)], as well as its sub-domains of subjective sleep quality [standardized mean difference=-0.83, 95% confidence interval (-1.08, -0.57)], sleep latency [standardized mean difference=-0.75, 95% confidence interval (-1.42, -0.07)], sleep duration [standardized mean difference=-0.55, 95% confidence interval (-0.90, -0.21)], habitual sleep efficiency [standardized mean difference=-0.49, 95% confidence interval (-0.74, -0.23)], sleep disturbance [standardized mean difference=-0.44, 95% confidence interval (-0.69, -0.19)], and daytime dysfunction [standardized mean difference=-0.34, 95% confidence interval (-0.59, -0.09)]. Daytime sleepiness improvement was also observed.
Weak evidence shows that Taichi exercise has a beneficial effect in improving self-rated sleep quality for older adults, suggesting that Taichi could be an effective alternative and complementary approach to existing therapies for older people with sleep problems. More rigorous experimental studies are required.
老年人中常见的自我报告睡眠障碍会导致严重后果。非药物措施是重要的补充干预措施，其中太极拳运动是一种流行的替代方法。已经进行了一些实验；然而，太极拳运动改善老年人睡眠质量的效果尚未通过系统评价得到验证。本研究采用系统评价和荟萃分析，旨在检验太极拳运动对改善老年人自我报告睡眠质量的疗效。
随机对照研究的系统评价和荟萃分析。
2013 年 12 月前，通过 4 个英文数据库（PubMed、Cochrane 图书馆、Web of Science 和 CINAHL）和 4 个中文数据库（CBMdisc、CNKI、VIP 和万方数据库）进行检索。
两位评审员独立选择合格的试验，使用 Cochrane 手册推荐的随机对照研究质量评价标准对方法学质量进行批判性评估。使用标准化数据表格提取信息。进行荟萃分析。
符合纳入标准的 5 项随机对照研究均存在一定的方法学缺陷。研究结果表明，太极拳对老年人的睡眠质量有很大的益处，表现在全球匹兹堡睡眠质量指数评分的降低[标准化均数差（standardized mean difference，SMD）=-0.87，95%置信区间（95% confidence interval，95%CI）（-1.25，-0.49）]，以及其主观睡眠质量[SMD=-0.83，95%CI（-1.08，-0.57）]、睡眠潜伏期[SMD=-0.75，95%CI（-1.42，-0.07）]、睡眠时间[SMD=-0.55，95%CI（-0.90，-0.21）]、习惯性睡眠效率[SMD=-0.49，95%CI（-0.74，-0.23）]、睡眠障碍[SMD=-0.44，95%CI（-0.69，-0.19）]和日间功能障碍[SMD=-0.34，95%CI（-0.59，-0.09）]的亚域。还观察到日间嗜睡的改善。
证据薄弱表明，太极拳运动对改善老年人的自我报告睡眠质量有有益影响，提示太极拳可能是一种有效的替代和补充治疗方法，适用于有睡眠问题的老年人。需要进行更严格的实验研究。
