Huang Zhi-Guan, Feng Yun-Hui, Li Yu-He, Lv Chang-Sheng
Engineering Research Center for Sports Assistive Devices Design, Guangzhou Sport University, Guangzhou, People's Republic of China.
Department of Physical Education, School of Physical Education and Sports Science, Guangzhou University, Guangzhou, People's Republic of China.
BMJ Open. 2017 Feb 6;7(2):e013661. doi: 10.1136/bmjopen-2016-013661.
It remains unclear whether Tai Chi is effective for preventing falls in older adults. We undertook this systematic review to evaluate the preventive effect of Tai Chi by updating the latest trial evidence.
Systematic review and meta-analysis.
The Cochrane Library, MEDLINE and EMBASE were searched up to February 2016 to identify randomised trials evaluating Tai Chi for preventing falls in older adults. We evaluated the risk of bias of included trials using the Cochrane Collaboration's tool. Results were combined using random effects meta-analysis.
Number of fallers and rate of falls.
18 trials with 3824 participants were included. The Tai Chi group was associated with significantly lower chance of falling at least once (risk ratio (RR) 0.80, 95% CI 0.72 to 0.88) and rate of falls (incidence rate ratio (IRR) 0.69, 95% CI 0.60 to 0.80) than the control group. Subgroup analyses suggested that the preventive effect was likely to increase with exercise frequency (number of fallers: p=0.001; rate of falls: p=0.007) and Yang style Tai Chi was likely to be more effective than Sun style Tai Chi (number of fallers: p=0.01; rate of falls: p=0.001). The results might be influenced by publication bias as the funnel plots showed asymmetry. Sensitivity analyses by sample size, risk of bias and comorbidity showed no major influence on the primary results.
Tai Chi is effective for preventing falls in older adults. The preventive effect is likely to increase with exercise frequency and Yang style Tai Chi seems to be more effective than Sun style Tai Chi.
太极拳对预防老年人跌倒是否有效仍不明确。我们进行了这项系统评价，以通过更新最新试验证据来评估太极拳的预防效果。
系统评价和荟萃分析。
检索截至2016年2月的Cochrane图书馆、MEDLINE和EMBASE，以识别评估太极拳预防老年人跌倒的随机试验。我们使用Cochrane协作工具评估纳入试验的偏倚风险。结果采用随机效应荟萃分析进行合并。
跌倒者数量和跌倒发生率。
纳入18项试验，共3824名参与者。与对照组相比，太极拳组至少跌倒一次的几率（风险比（RR）0.80，95%置信区间0.72至0.88）和跌倒发生率（发病率比（IRR）0.69，95%置信区间0.60至0.80）显著更低。亚组分析表明，预防效果可能随运动频率增加而增强（跌倒者数量：p=0.001；跌倒发生率：p=0.007），且杨式太极拳可能比孙式太极拳更有效（跌倒者数量：p=0.01；跌倒发生率：p=0.001）。由于漏斗图显示不对称，结果可能受发表偏倚影响。按样本量、偏倚风险和合并症进行的敏感性分析对主要结果无重大影响。
太极拳对预防老年人跌倒有效。预防效果可能随运动频率增加而增强，且杨式太极拳似乎比孙式太极拳更有效。
