Abstract
Background Tai chi (TC) has received increased attention in stroke rehabilitation, yet services are greatly underutilized. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview. Methods Eight databases were searched: PubMed, Cochrane Library, Embase, Web of Science, CNKI, SinoMed, Chongqing VIP, and Wanfang Data. SRs/MAs of TC on balance function in stroke patients were included. Literature selection, data extraction, and assessment of the review quality were performed by two independent reviewers. Methodological quality was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and evidence quality by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results Nine SRs/MAs were included in this study. For methodological quality, what resulted in unsatisfactory methodological quality was noncompliance with critical item 4 (using a comprehensive literature search strategy) and critical item 7 (providing the list of excluded research literature). For reporting quality, what resulted in unsatisfactory reporting quality was inadequate reporting of Q1 (protocol and registration), Q8 (search), Q15 (risk of bias across studies), Q16 (additional analyses), Q22 (risk of bias across studies), Q23 (additional analysis), and Q27 (funding). For GRADE, the evidence quality was high in 0, moderate in 3, low in 11, and very low in 6. Risk of bias was the most common factor leading to downgrading of evidence, followed by inconsistency, imprecision, publication bias, and indirectness. Conclusions TC may have beneficial effects on balance function in stroke survivors; however, this finding is limited by the generally low methodology, reporting quality, and evidence quality for published SRs/MAs.
Highlights
Tai chi (TC) may be beneficial for balance function in stroke survivors in the short term, but further random control trails (RCTs) with large sample sizes and long-term follow-up are needed to confirm this conclusion
TC was beneficial on ADL, balance, Lyu
China 7 (629) TC and TC+conventional rehabilitation therapy (CRT) CRT Cochrane criteria. These findings indicated that TC was superior to the CRT in the improvement of balance function, gait speed, and quality of life
Summary
A common and frequently occurring disease among elderly people, is considered to be the second most common cause of death and the third most common cause of disability worldwide [1].Stroke is a major global health challenge with a global incidence of 76-119 per 100,000 populations each year [2]. Various rehabilitation methods have been applied to improve balance functional training in stroke survivors [8], with limited efficacy [9]. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview. SRs/MAs of TC on balance function in stroke patients were included. TC may have beneficial effects on balance function in stroke survivors; this finding is limited by the generally low methodology, reporting quality, and evidence quality for published SRs/MAs
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