Abstract
BackgroundRecently, several studies assessed the effectiveness of Tai Chi for Parkinson's disease (PD), but the role of Tai Chi in the management of PD remained controversial. Therefore, the purpose of this systematic review is to evaluate the evidence on the efficacy of Tai Chi for PD.MethodsSix English and Chinese electronic databases, up to April 2014, were searched to identify relevant studies. The risk of bias in eligible studies was assessed by Cochrane Collaboration's tools. The primary outcomes were motor function, balance and gait in individuals with PD. Standardized mean difference (SMD) and 95% confidence intervals (CI) of random-effect model were calculated. And heterogeneity was assessed based on the I2statistic.Results7 randomized controlled trials and 1 non-randomized controlled trial were eligible. The aggregated results suggested that Tai Chi showed beneficial effects in improving motor function (SMD, −0.57; 95% CI −1.11 to −0.04; p = 0.03), balance (SMD, 1.22; 95% CI 0.80 to 1.65; p<0.00001) and functional mobility (SMD, 1.06; 95% CI 0.68 to 1.44; p<0.00001) in patients with PD, but not in improving gait velocity (SMD, −0.02; 95% CI −0.58 to 0.54; p = 0.94), step length (SMD, −0.00; 95% CI −0.57 to 0.56; p = 0.99), or gait endurance (SMD, 0.53; 95% CI −0.07 to 1.12; p = 0.08). Comparing with other active therapies, however, Tai Chi only showed better effects in improving balance (SMD, 0.74; 95% CI 0.38 to 1.10; p<0.0001).ConclusionTai Chi should be a valid complementary and alternative therapy for PD, especially in improving motor function and balance. However, more studies with long follow-up are warrant to confirm the current finding of Tai Chi for PD.
Highlights
Parkinson’s disease (PD), a common neurodegenerative disorder, has long been recognized by its cardinal clinical symptoms such as bradykinesia, rigidity, rest tremor, balance disruption and gait impairment [1]
A previous research has substantiated that Tai Chi can improve balance, kinesthetic sense and strength, it may be prescribed as a sensorimotor agility program for patients with PD [8]
Study Selection The eligible studies must meet the following criteria: (1) study design: randomized controlled trials (RCTs) and non-randomized controlled trials; (2) types of participants: participants were diagnosed with PD; (3) types of interventions: Tai Chi compared with placebo, no intervention and any other therapies; Tai Chi combined with conventional drugs compared with conventional drugs or other therapies combined with conventional drugs (4) types of outcomes: motor function, balance and gait; (5) the paper was available in either English or Chinese
Summary
Parkinson’s disease (PD), a common neurodegenerative disorder, has long been recognized by its cardinal clinical symptoms such as bradykinesia, rigidity, rest tremor, balance disruption and gait impairment [1]. These are important determinants of motor function disability and lower quality of life. In China, PD prevalence is estimated as 1.70% in people aged more than 65 years old [4]. Recent studies reported that Tai Chi might be safe and effective for patients with PD [7]. Li et al reported that Tai chi training appeared to reduce balance impairment in patients with mild-to-moderate PD, with additional benefits of improved functional capacity and reduced falls.
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