College of Nursing, Chungnam National University, Daejeon, Republic of Korea.
Department of Nursing, Woosuk University, Wanju, Republic of Korea.
PLoS One. 2022 Nov 17;17(11):e0277541. doi: 10.1371/journal.pone.0277541. eCollection 2022.
BACKGROUND: Stroke survivors often experience impaired mobility and physical functions. Tai Chi and Qigong have been shown to have physical and psychological benefits for stroke patients. PURPOSE: To summarize the evidence on Tai Chi and Qigong for improving mobility in stroke survivors, specifically the ability to walk, dynamic balance, and activities of daily living (ADL). METHODS: Independent searches of 16 electronic databases in English, Korean, and Chinese from their inception until December 2021 were conducted by two research teams. Methodological quality was assessed using Cochrane's risk of bias tool 2.0. Comprehensive Meta-Analysis 3.0 software was used to calculate effect sizes with subgroup analysis and to assess heterogeneity and publication bias. RESULTS: The meta-analysis included 27 randomized trials (18 with Tai Chi and 9 with Qigong) on stroke survivors (N = 1,919). None of the studies were considered at high risk of bias, about 70% had some concerns, and 30% were considered low risk. Meta-analysis of 27 randomized controlled trials with random-effects models indicated that Tai Chi and Qigong effectively improved mobility, specifically on the ability to walk (Hedges'g = 0.81), dynamic balance (Hedges'g = 1.04), and ADL (Hedges'g = 0.43). The effects of Tai Chi and Qigong were significant for short-term and long-term programs (Hedges'g 0.91 vs. 0.75), and when compared with active controls and no treatment group (Hedges'g 0.81 vs. 0.73). CONCLUSION: Tai Chi and Qigong performed for 12 weeks or less were effective in improving the mobility of stroke survivors. Further studies are warranted to assess whether Tai Chi and Qigong work best as an adjunct to rehabilitation, an effective alternative to rehabilitation or as a maintenance strategy, and whether the results could be further optimized by assessing different schools of Tai Chi and Qigong, different types of stroke patients, and different points in the post-stroke recovery process. PROSPERO REGISTRATION NUMBER: This study has been registered on the UK National Institute for Health Research (http://www.crd.york.ac.uk/PROSPERO) PROSPERO registration number: CRD42020220277.
背景：中风幸存者常经历活动能力和身体机能受损。太极和气功对中风患者具有身心益处。 目的：总结太极和气功改善中风幸存者活动能力的证据，具体为行走能力、动态平衡和日常生活活动（ADL）。 方法：由两个研究小组独立检索了 16 个英文、韩文和中文电子数据库，检索时间从建库至 2021 年 12 月。使用 Cochrane 偏倚风险工具 2.0 评估方法学质量。使用 Comprehensive Meta-Analysis 3.0 软件计算效应大小，进行亚组分析，并评估异质性和发表偏倚。 结果：纳入的 27 项随机试验（18 项为太极，9 项为气功）涉及中风幸存者（N=1919）。无研究被认为具有高偏倚风险，约 70%的研究存在一定程度的关注，30%的研究被认为具有低风险。采用随机效应模型对 27 项随机对照试验进行的荟萃分析表明，太极和气功可有效改善活动能力，特别是行走能力（Hedges'g=0.81）、动态平衡（Hedges'g=1.04）和 ADL（Hedges'g=0.43）。短期和长期方案的太极和气功效果显著（Hedges'g 0.91 与 0.75），与积极对照和无治疗组相比（Hedges'g 0.81 与 0.73）也是如此。 结论：持续 12 周或更短时间的太极和气功运动对改善中风幸存者的活动能力有效。有必要进一步研究以评估太极和气功是否作为康复的辅助手段、替代康复的有效方法或作为维持策略效果最佳，以及通过评估不同的太极和气功流派、不同类型的中风患者以及中风后恢复过程中的不同阶段，是否可以进一步优化结果。 PROSPERO 注册号：本研究已在英国国家卫生与保健优化研究所（http://www.crd.york.ac.uk/PROSPERO）注册，PROSPERO 注册号：CRD42020220277。
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