Abstract
Objective Tai Chi shows potential as a safe and cost-effective intervention to improve bone mineral density (BMD). However, the various effects caused by different training durations and frequencies have not been evaluated. This updated systematic review aims to explore the effectiveness of Tai Chi in attenuating bone mineral density loss based on different training durations and frequencies. Methods We conducted an extensive database search in Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database on randomized controlled trials that examined Tai Chi for BMD improvement. Two reviewers independently performed data screening and extraction. Study quality was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Results A total of 23 randomized controlled trials involving 1582 patients were identified. The aggregated results have shown significant benefits in favor of Tai Chi on BMD improvement in the lumbar spine (SMD = 0.36, 95% [0.13, 0.59], P=0.002), femoral neck (SMD = 0.40, 95% [0.16, 0.63], P=0.0009), femoral trochanter (SMD = 0.43, 95% CI [0.20, 0.66], P=0.0002), and Ward's triangle (SMD = 0.31, 95% [0.15, 0.48], P=0.002). Such favorable benefits in Tai Chi can only be seen when compared with the nonexercise group, and Tai Chi showed no significant improvement in BMD change when compared with other exercises group. Subgroup analyses showed various effects of BMD improvement based on different training durations and frequencies of Tai Chi. Tai Chi is effective in attenuating BMD loss with an intervention frequency of >4 days/week in the lumbar spine, with an intervention frequency of >4 days/week or an intervention duration of >10 months in the femoral neck, and with an intervention duration of >10 months or a frequency of ≤4 days/week in Ward's triangle. Conclusions The results demonstrated that Tai Chi may have benefits in attenuating BMD loss. Different training durations and frequencies may result in variable effectiveness. Researchers should focus more on the training durations and frequencies of Tai Chi so that a more definitive claim can be made regarding the beneficial effects for BMD improvement.
Highlights
Data Sources and Search Strategies. e following databases were searched using a computer: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database (CBM), China Knowledge Resource Integrated Database (CNKI), Wanfang Data, and China Science and Technology Journal Database (VIP). e primary search terms used were “Taiji,” “Bone mineral density,” “Bone health,” “Bone metabolism,” “Osteoporosis.” e retrieval time was from the establishment of the database to May 2020, and only studies published in English or Chinese were included
Main Results and Analysis. is systematic review and meta-analysis, which was based on 23 randomized controlled trials (RCTs) involving 1582 participants, found that Tai Chi may have a positive effect on bone mineral density (BMD) improvement in the lumbar spine, the femoral neck, the femoral trochanter, and Ward’s triangle
Our study showed benefits in improving BMD in the four parts mentioned above in favor of Tai Chi compared with the nonexercise group
Summary
E following databases were searched using a computer: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database (CBM), China Knowledge Resource Integrated Database (CNKI), Wanfang Data, and China Science and Technology Journal Database (VIP). E primary search terms used were “Taiji,” “Bone mineral density,” “Bone health,” “Bone metabolism,” “Osteoporosis.” e retrieval time was from the establishment of the database to May 2020, and only studies published in English or Chinese were included. Relevant systematic reviews and the references to the included articles were searched to supplement other potentially relevant literature. Criteria for Considering Studies for is Review. Studies should meet the following inclusion criteria (PICO format): (1) Participants: individuals without serious complications. E age, gender, case source, nationality, disease duration, or race of subjects was not restricted. Other Tai Chi exercises like Tai Chi push hands or Tai Chi ball were excluded. (3) Control: any type of control group, including usual care, conventional Western medicine, no exercise, and any kind of exercise, was acceptable. (4) Outcomes: the primary outcomes were dual-energy X-ray absorptiometry measures of BMD of the spine, the femoral neck, the femoral tuberosity, and Ward’s triangle. (5) Study type: RCTs
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