School of Physical Education, Yanshan University, Qinhuangdao, China.
Sports Rehabilitation Center, China Institute of Sport Science, Beijing, China.
PLoS One. 2024 Jul 9;19(7):e0306518. doi: 10.1371/journal.pone.0306518. eCollection 2024.
OBJECTIVE: To evaluate the effects of Tai Chi in the treatment of patients with chronic low back pain by Meta-analysis and to investigate its influencing factors. METHODS: The study searched eight databases (PubMed, Embase, The Cochrane Library, Web of Science, China Knowledge Network, Wanfang, VIP, and CBM) from inception to October 2023. Two investigators independently selected 10 eligible randomized controlled trials (RCT) against inclusion and exclusion criteria, followed by data extraction and study quality assessment by ROB 2. The outcomes of interest were pain intensity and disability. The studies were combined using meta-analysis when statistical pooling of data was possible. The quality of the evidence was assessed using the GRADE approach. RESULTS: 10 randomized controlled studies with a total sample of 886 cases were included, of which 4 (40%) were assessed as low risk of bias. The effect size of Tai Chi for chronic low back pain was [Weighted Mean Difference (WMD) with 95% Confidence Interval (CI) = -1.09 (-1.26, -0.92), p < 0.01], all achieving large effect sizes and statistically significant; the effect size for disability was [Standard Mean Difference (SMD) with 95% CI = -1.75 (-2.02, -1.48), p < 0.01], and the combined effect sizes of physical health and mental health for quality of life were [WMD (95% CI) = 4.18 (3.41, 4.95), p < 0.01; WMD (95% CI) = 3.23 (2.42, 4.04), p < 0.01] respectively. The incidence of adverse reactions was low. Meta regression and subgroup analysis showed that there was no significant effect on intervention measures (Tai Chi alone, Tai Chi as additional therapy, water Tai Chi), Tai Chi school (Chen and Yang) and the number of total intervention sessions (> 30 and ≤ 30). The evidence quality evaluation showed that the evidence of pain, physical health of quality of life and mental health score was medium quality, while the evidence of disability and adverse reactions was low quality. CONCLUSIONS: Tai Chi has an obvious effect of in relieving chronic low back pain. Tai Chi alone and Tai Chi as supplementary therapy have good effects. Tai Chi in water have not been verified. Chen style Tai Chi and Yang's Tai Chi, intervention more than 30 times or less than 30 times had no significant difference in the effect of intervention on CLBP.
目的：采用 Meta 分析评价太极拳治疗慢性下腰痛的疗效，并探讨其影响因素。
方法：本研究检索了PubMed、Embase、The Cochrane Library、Web of Science、中国知网、万方、维普和 CBM 数据库，检索时间为建库至 2023 年 10 月。由 2 名研究者按照纳入和排除标准独立筛选出 10 篇合格的随机对照试验（RCT），然后提取数据并使用 ROB 2 进行研究质量评估。当数据可以进行统计学合并时，使用荟萃分析来合并研究结果。使用 GRADE 方法评估证据质量。
结果：共纳入 10 项 RCT，总计 886 例患者，其中 4 项（40%）被评估为低偏倚风险。太极拳治疗慢性下腰痛的效果大小为 [加权均数差（WMD），95%置信区间（CI）=-1.09（-1.26，-0.92），p<0.01]，均达到大效应量且具有统计学意义；残疾的效果大小为 [标准均数差（SMD），95%CI=-1.75（-2.02，-1.48），p<0.01]，生活质量的身体和精神健康的综合效果大小为 [WMD（95%CI）=4.18（3.41，4.95），p<0.01；WMD（95%CI）=3.23（2.42，4.04），p<0.01]。不良反应发生率较低。Meta 回归和亚组分析表明，干预措施（单独太极拳、太极拳作为附加治疗、水中太极拳）、太极拳流派（陈式和杨式）和总干预次数（>30 次和≤30 次）对疗效无显著影响。证据质量评估显示，疼痛、生活质量的身体和精神健康评分的证据质量为中等质量，而残疾和不良反应的证据质量为低质量。
结论：太极拳对慢性下腰痛有明显的缓解作用。单独的太极拳和作为附加治疗的太极拳都有很好的效果。水中的太极拳还没有得到验证。陈式和杨式太极拳、干预次数超过 30 次或少于 30 次对慢性下腰痛的干预效果没有显著差异。
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