Lei Honghui, Ma Zhen, Tian Kexin, Liu Ke, Wang Jiaying, Zhu Xiangyu, Mi Baohong, Chen Ying, Yang Qihao, Jiang Huili
Department of Rehabilitation, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
Department of Encephalopathy, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Front Aging Neurosci. 2022 Aug 29;14:936027. doi: 10.3389/fnagi.2022.936027. eCollection 2022.
BACKGROUND: Tai Chi can show improvement in balance and motor ability of elderly patients with PD. However, there were few reports on differences in outcomes associated with different types of Tai Chi on improving exercise capacity in elderly patients with PD. We compared the improvement of motor function in Parkinson's patients with different types of Tai Chi, for finding an optimal intervention. METHODS: The following databases were searched from the beginning of the establishment of each database to 10 January 2022: PubMed, EMBASE, The Cochrane Library, CNKI, Wanfang Database, and VIP Database. Randomized controlled trials incorporating different types of Tai Chi for PD were included. The outcome measures were UPDRSIII and BBS. NMA was conducted using Stata 15.0 based on a frequentist framework. RESULTS: A total of twenty trials were eligible, including 996 participants. In conventional meta-analysis, as for the UPDRSIII scale, 24-form simplified Tai Chi (SMD = -1.272, 95% CI [-2.036, -0.508], < 0.05, I > 50%), Tai Chi exercise program (SMD = -0.839, 95% CI [-1.828, 0.151], > 0.05, I > 50%), 8-form simplified Yang style Tai Chi (SMD = -0.325, 95% CI [-1.362, 0.713], > 0.05, I > 50%), and 8-form simplified Chen style Tai Chi (SMD = -0.28, 95% CI [-0.97, 0.42], > 0.05, I > 50%) were statistically more efficient than the control group. For BBS outcome, 24-form simplified Tai Chi (MD = 3.979, 95% CI [3.364, 4.595], < 0.05, I <50%), Tai Chi exercise program (MD = 5.00, 95% CI [2.07, 7.93], > 0.05, I > 50%), and 8-form simplified Chen style Tai Chi (MD = 1.25, 95% CI [0.52, 1.98], < 0.05, I > 50%) were better than the control group. In the network meta-analysis, the results of UPDRSIII were as follows: 24-form > TCEP > 8-form YS > 8-form CS > control. The ranking probability of BBS was as follows: TCEP > 24-form > 8-form CS > control. CONCLUSION: Among the four treatments studied, 24-form Tai Chi and Tai Chi exercise programs have shown better efficacy than other types. Our study provides new insights into exercise therapy for PD and may contribute to the formulation of a clinical exercise prescription. SYSTEMATIC REVIEW REGISTRATION: Identifier: CRD42021285005.
背景：太极拳可改善老年帕金森病（PD）患者的平衡能力和运动能力。然而，关于不同类型太极拳对改善老年PD患者运动能力的效果差异的报道较少。我们比较了不同类型太极拳对帕金森病患者运动功能的改善情况，以寻找最佳干预措施。 方法：检索了以下数据库，检索时间从各数据库建库开始至2022年1月10日：PubMed、EMBASE、Cochrane图书馆、中国知网、万方数据库和维普数据库。纳入了纳入不同类型太极拳治疗PD的随机对照试验。结局指标为统一帕金森病评定量表第三部分（UPDRSIII）和伯格平衡量表（BBS）。基于频率学派框架，使用Stata 15.0进行网络荟萃分析（NMA）。 结果：共有20项试验符合条件，包括996名参与者。在传统荟萃分析中，对于UPDRSIII量表，24式简化太极拳（标准化均数差[SMD]=-1.272，95%置信区间[-2.036，-0.508]，P<0.05，I²>50%）、太极拳锻炼方案（SMD=-0.839，95%置信区间[-1.828，0.151]，P>0.05，I²>50%）、8式简化杨式太极拳（SMD=-0.325，95%置信区间[-1.362，0.713]，P>0.05，I²>50%）和8式简化陈式太极拳（SMD=-0.28，95%置信区间[-0.97，0.42]，P>0.05，I²>50%）在统计学上比对照组更有效。对于BBS结局，24式简化太极拳（平均差[MD]=3.979，95%置信区间[3.364，4.595]，P<0.05，I²<50%）、太极拳锻炼方案（MD=5.00，95%置信区间[2.07，7.93]，P>0.05，I²>50%）和8式简化陈式太极拳（MD=1.25，95%置信区间[0.52，1.98]，P<0.05，I²>50%）比对照组更好。在网络荟萃分析中，UPDRSIII的结果如下：24式>太极拳锻炼方案>8式杨式>8式陈式>对照组。BBS的排序概率如下：太极拳锻炼方案>24式>8式陈式>对照组。 结论：在所研究的四种治疗方法中，24式太极拳和太极拳锻炼方案显示出比其他类型更好的疗效。我们的研究为PD的运动疗法提供了新的见解，并可能有助于制定临床运动处方。 系统评价注册：标识符：CRD42021285005。
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