Yang Ying-Li, Wang Ya-Hong, Wang Shuo-Ren, Shi Pu-Song, Wang Can
First Clinical Medical School, Beijing University of Chinese Medicine, Beijing, China.
Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Front Physiol. 2018 Jan 4;8:1091. doi: 10.3389/fphys.2017.01091. eCollection 2017.
Tai Chi that originated in China as a martial art is an aerobic exercise with low-to-moderate intensity and may play a role in cardiac rehabilitation. To systematically review the effect of Tai Chi on cardiorespiratory fitness for coronary disease rehabilitation. We performed a search for Chinese and English studies in the following databases: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database. The search strategy included terms relating to or describing Tai Chi and coronary disease, and there were no exclusion criteria for other types of diseases or disorders. Further, bibliographies of the related published systematic reviews were also reviewed. The searches, data extraction, and risk of bias (ROB) assessments were conducted by two independent investigators. Differences were resolved by consensus. RevMan 5.3.0 was used to analyze the study results. We used quantitative synthesis if the included studies were sufficiently homogeneous and performed subgroup analyses for studies with different control groups. To minimize bias in our findings, we used GRADEpro to grade the available evidence. Five studies were enrolled-two randomized controlled trials (RCTs) and three nonrandomized controlled trials (N-RCTs)-that included 291 patients. All patients had coronary disease. ROB assessments showed a relatively high selection and detection bias. Meta-analyses showed that compared to other types of low- or moderate-intensity exercise, Tai Chi could significantly improve VOmax [MD = 4.71, 95% CI (3.58, 5.84), < 0.00001], but it seemed less effective at improving VOmax as compared to high-intensity exercise. This difference, however, was not statistically significant [MD = -1.10, 95% CI (-2.46, 0.26), = 0.11]. The GRADEpro showed a low level of the available evidence. Compared to no exercise or other types of exercise with low-to-moderate intensity, Tai Chi seems a good choice for coronary disease rehabilitation in improving cardiorespiratory fitness. However, owing to the poor methodology quality, more clinical trials with large sample size, strict randomization, and clear description about detection and reporting processes are needed to further verify the evidence.
太极拳起源于中国，最初是一种武术，是一种中低强度的有氧运动，可能在心脏康复中发挥作用。为了系统评价太极拳对冠心病康复中心肺适能的影响。我们在以下数据库中检索中英文研究：PubMed、EMBASE、Cochrane对照试验中心注册库、中国生物医学文献数据库、中国知网、万方数据和中国科技期刊数据库。检索策略包括与太极拳和冠心病相关或描述它们的术语，对其他类型的疾病或病症没有排除标准。此外，还对相关已发表系统评价的参考文献进行了审查。检索、数据提取和偏倚风险（ROB）评估由两名独立研究人员进行。分歧通过协商解决。使用RevMan 5.3.0分析研究结果。如果纳入的研究足够同质，我们使用定量合成，并对不同对照组的研究进行亚组分析。为了尽量减少我们研究结果中的偏倚，我们使用GRADEpro对现有证据进行分级。共纳入五项研究，其中两项随机对照试验（RCT）和三项非随机对照试验（N-RCT），包括291例患者。所有患者均患有冠心病。ROB评估显示存在相对较高的选择和检测偏倚。荟萃分析表明，与其他类型的中低强度运动相比，太极拳可显著提高最大摄氧量[MD = 4.71，95%CI（3.58，5.84），P < 0.00001]，但与高强度运动相比，在提高最大摄氧量方面似乎效果较差。然而，这种差异无统计学意义[MD = -1.10，95%CI（-2.46，0.26），P = 0.11]。GRADEpro显示现有证据质量较低。与不运动或其他中低强度运动相比，太极拳似乎是冠心病康复中改善心肺适能的一个不错选择。然而，由于方法学质量较差，需要更多大样本、严格随机化以及对检测和报告过程有清晰描述的临床试验来进一步验证该证据。
