太极拳预防老年人跌倒和改善平衡能力：随机对照试验的系统评价和荟萃分析。

BACKGROUND AND OBJECTIVE: As the population ages, the health of older adults is becoming a public health concern. Falls are a significant threat to their health due to weakened balance. This study aims to investigate the beneficial effects of Tai Chi on fall prevention and balance improvement in older adults. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials related to Tai Chi, falls, and balance ability, searching PubMed, Embase, and Cochrane Library databases from their establishment until December 31, 2022. Two independent reviewers performed the search, screening of results, extraction of relevant data, and assessment of study quality. This study followed the PRISMA guidelines for systematic review and meta-analysis. RESULTS: Totally 24 RCTs were included for meta-analysis, and the results showed that Tai Chi can effectively reduce the risk of falls in older adults (RR: 0.76, 95% CI: 0.71 to 0.82) and decrease the number of falls (MD [95% CI]: -0.26 [-0.39, -0.13]). Tai Chi can also improve the balance ability of older adults, such as the timed up and go test (MD [95% CI]: -0.69 [-1.09, -0.29]) and the functional reach test (MD [95% CI]: 2.69 [1.14, 4.24]), as well as other balance tests such as single-leg balance test, Berg balance scale, and gait speed ( < 0.05). Subgroup analysis showed that Tai Chi is effective for both healthy older adults and those at high risk of falls ( < 0.001), and its effectiveness increases with the duration and frequency of exercise. In addition, the effect of Yang-style Tai Chi is better than that of Sun-style Tai Chi. CONCLUSION: Tai Chi is an effective exercise for preventing falls and improving balance ability in older adults, whether they are healthy or at high risk of falling. The effectiveness of Tai Chi increases with exercise time and frequency. Yang-style Tai Chi is more effective than Sun-style Tai Chi. SYSTEMATIC REVIEW REGISTRATION: https://clinicaltrials.gov/, identifier CRD42022354594.

背景与目的：随着人口老龄化，老年人的健康成为公共卫生关注的焦点。由于平衡能力下降，老年人跌倒的风险很大。本研究旨在探讨太极拳对预防老年人跌倒和改善平衡能力的有益作用。

方法：我们对与太极拳、跌倒和平衡能力相关的随机对照试验进行了系统评价和荟萃分析，检索了 PubMed、Embase 和 Cochrane Library 数据库，检索时间截至 2022 年 12 月 31 日。两名独立的审查员进行了搜索、结果筛选、相关数据提取和研究质量评估。本研究遵循 PRISMA 系统评价和荟萃分析指南。

结果：共纳入 24 项 RCT 进行荟萃分析，结果表明，太极拳可有效降低老年人跌倒风险（RR：0.76，95%CI：0.71 至 0.82）和跌倒次数（MD [95%CI]：-0.26 [-0.39，-0.13]）。太极拳还可以改善老年人的平衡能力，如计时起立行走测试（MD [95%CI]：-0.69 [-1.09，-0.29]）和功能性伸展测试（MD [95%CI]：2.69 [1.14，4.24]），以及单腿平衡测试、伯格平衡量表和步态速度等其他平衡测试（ < 0.05）。亚组分析表明，太极拳对健康老年人和高跌倒风险老年人均有效（ < 0.001），且随着运动时间和频率的增加而增加。此外，杨式太极拳的效果优于孙式太极拳。

结论：太极拳是预防老年人跌倒和改善平衡能力的有效运动，无论他们是否健康或有高跌倒风险。太极拳的效果随着运动时间和频率的增加而增加。杨式太极拳比孙式太极拳更有效。

系统评价注册：https://clinicaltrials.gov/，标识符 CRD42022354594。