Wen Yu-Rong, Shi Jian, Wang Ya-Fei, Lin Yang-Yang, Hu Zheng-Yu, Lin You-Tian, Wang Xue-Qiang, Wang Yu-Ling
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Aging Neurosci. 2022 Jun 21;14:921069. doi: 10.3389/fnagi.2022.921069. eCollection 2022.
Aging is a significant risk factor in chronic pain development with extensive disability and greater health care costs. Mind-body exercise (MBE) has been scientifically proven to affect the pain intensity and physical health.
To assess the effects of MBE modes (Tai Chi, yoga, and qigong) for treating chronic pain among middle-aged and old people, compared with nonactive and active treatment, as well as function, quality of life, and adverse events.
We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Scientific Journals Full-Text Database (VIP) till March 2022. No restrictions were chartered within the year and language of publication. We included randomized controlled trials of MBE treatment in middle-aged and elderly people with chronic pain. The overall certainty of evidence was evaluated by using the GRADE approach.
A total of 17 studies ( = 1,332) were included in this review. There was low-certainty evidence indicating that MBE had a moderate effect on reducing pain compared with the nonactive and active control group (standard mean difference (SMD): -0.64, 95% confidence interval (CI): -0.86 to -0.42, < 0.001). Very-low-certainty evidence showed that the pooled SMD for the functional improvement was -0.75 (95% CI: -1.13 to -0.37, < 0.001). Low-certainty evidence presented that no influence was observed in physical component summary (SMD: 0.23, 95% CI: -0.16 to 0.62, = 0.24) and mental component summary (SMD: -0.01, 95% CI -0.39 to 0.36, = 0.95).
Our results indicated that MBE was an effective treatment for reducing symptoms of middle-aged and elderly people with chronic pain compared with nonactive and active control groups. TC and qigong had obvious benefits for knee osteoarthritis in self-reported function, but the efficacy of chronic low back pain was uncertain. No significant benefit of MBE on quality of life in older adults with chronic pain was found. More high-quality RCTs should be conducted to explore the efficacy and mechanism of MBE on chronic pain in middle-aged and elderly people from various dimensions, such as affective and cognitive dimensions.
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316591, identifier CRD42022316591.
衰老在慢性疼痛的发展中是一个重要的风险因素，会导致广泛的残疾和更高的医疗保健成本。身心锻炼（MBE）已被科学证明会影响疼痛强度和身体健康。
评估MBE模式（太极拳、瑜伽和气功）治疗中老年慢性疼痛的效果，并与非主动和主动治疗进行比较，同时评估其对功能、生活质量和不良事件的影响。
我们检索了截至2022年3月的PubMed、Embase、Web of Science、Cochrane图书馆、中国知网（CNKI）、万方数据库和中文科技期刊全文数据库（维普）。对发表年份和语言没有限制。我们纳入了针对中老年慢性疼痛患者进行MBE治疗的随机对照试验。采用GRADE方法评估证据的总体确定性。
本综述共纳入17项研究（n = 1332）。低确定性证据表明，与非主动和主动对照组相比，MBE在减轻疼痛方面有中等效果（标准化均数差（SMD）：-0.64，95%置信区间（CI）：-0.86至-0.42，P < 0.001）。极低确定性证据显示，功能改善的合并SMD为-0.75（95%CI：-1.13至-0.37，P < 0.001）。低确定性证据表明，在生理成分总分（SMD：0.23，95%CI：-0.16至0.62，P = 0.24）和心理成分总分（SMD：-0.01，95%CI -0.39至0.36，P = 0.95）方面未观察到影响。
我们的结果表明，与非主动和主动对照组相比，MBE是治疗中老年慢性疼痛症状的有效方法。太极拳和气功在自我报告的功能方面对膝骨关节炎有明显益处，但对慢性下腰痛的疗效尚不确定。未发现MBE对患有慢性疼痛的老年人的生活质量有显著益处。应开展更多高质量的随机对照试验，从情感和认知等多个维度探索MBE对中老年慢性疼痛的疗效和机制。
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316591，标识符CRD42022316591 。
