太极拳运动对老年人平衡功能和跌倒预防效果的Meta分析_《中国循证医学杂志》

作者：

赵媛 ¹ ,  王燕 ¹ , 徐旭东 ¹ , 刘雅莉 ²

1. 天津中医药大学（天津 300193）；2. 兰州大学循证医学中心（兰州 730000）;

关键词：

太极拳平衡功能老年系统评价 Meta分析随机对照试验

DOI：

10.7507/1672-2531.20130058

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价太极拳运动对老年人平衡功能和跌倒预防效果的影响。
方法　计算机检索PubMed、Web of Science、The Cochrane Library（2012年第8期）、EMbase、CBM、CNKI、VIP和WanFang Data等数据库中有关太极拳运动对老年人平衡功能和预防跌倒的随机对照试验（RCT），检索时限均为2000～2012年，并追溯纳入研究的参考文献。按照纳入和排除标准筛选文献、提取资料并评价纳入研究的方法学质量后，采用RevMan 5.1软件进行Meta分析。
结果　共纳入6个RCT，合计2 796例患者。Meta分析结果显示：太极拳组在降低老年人跌倒的发生率［RR=0.82，95%CI（0.73，0.92），P=0.000 6］、减少起立行走时间［MD=0.71，95%CI（0.29，1.12），P=0.000 9］、增加功能性伸展距离［MD=0.78，95%CI（0.33，1.23），P=0.000 7］和Berg平衡量表得分［MD=2.45，95%CI（1.47，3.43），P lt;0.000 01］方面均明显优于对照组，其差异均有统计学意义。
结论　太极拳运动可降低老年人跌倒的发生，提高平衡功能。

引用本文： 赵媛,王燕,徐旭东,刘雅莉. 太极拳运动对老年人平衡功能和跌倒预防效果的Meta分析. 中国循证医学杂志, 2013, 13(3): 339-345. doi: 10.7507/1672-2531.20130058 复制

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2.	Neyens JC, Dijcks BP, Twisk J, et al. A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomisedcontrolled trial (RCT). Age Ageing, 2009, 38(2): 194-199.
3.	Greenspan AI, Wolf SL, Kelley ME, et al. Tai chi and perceived health status in older adults who are transitionally frail: a randomized controlled trial. Phys Ther, 2007, 87(5): 525-535.
4.	Brian F, Stephen S, Tatyana K, et al. Tai Chi and Low Impact Exercise: Effects on the Physical Functioning and Psychological Well-Being of Older People. J Appl Gerontol, 2007, 26(5): 433-453.
5.	Chyu MC, James CR, Sawyer SF, et al. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal womenwith osteopaenia: a randomized clinical study. Clin Rehabil, 2010, 24(12): 1080-1090.
6.	Higgins PT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
7.	Lelard T, Doutrellot PL, David P, et al. Effects of a 12-Week Tai Chi Chuan Program Versus a Balance Training Program on Postural Control and Walking Ability in Older People. Arch Phys Med Rehabil, 2010, 91(1): 9-14.
8.	Woo J, Hong A, Lau E, et al. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing, 2007, 36(3): 262-268.
9.	Maciaszek J, Osiński W, Szeklicki R, et al. Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. Am J Chin Med, 2007, 35(1): 1-9.
10.	Li F, Harmer P, Fisher KJ, et al. Tai Chi: Improving Functional Balance and Predicting Subsequent Falls in Older Persons. Med Sci Sports Exerc, 2004, 36(12): 2046-2052.
11.	Tousignant M, Corriveau H, Roy PM, et al. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial. Disabil Rehabil, 2012, 34(3): 196–201.
12.	Taylor D, Hale L, Schluter P, et al. Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial. J Am Geriatr Soc, 2012, 60(5): 841-848.
13.	Faber MJ, Bosscher RJ, Chin A Paw MJ, et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabil, 2006, 87(7): 885-896.
14.	Wolf SL, O’Grady M, Easley KA, et al. The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults. J Gerontol A Biol Sci Med Sci, 2006, 61(2): 184-189.
15.	Voukelatos A, Cumming RG, Lord SR, et al. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc, 2007, 55(8): 1185-1191.
16.	Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci, 2005, 60(2): 187-194.
17.	Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ, 2004, 328(7441): 680.
18.	Wolfson L, Whipple R, Derby C, et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc, 1996, 44(5): 498-506.
19.	Lajoie Y, Gallagher SP. Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Cofidence(ABC) scale for comparing fallers. Arch Gerontol Geriatr, 2004, 38(1): 11-26.
20.	Christou EA, Yang Y, Rosengren KS. Taiji training improves knee extensor strength and force control in older adults. J Gerontol A Biol Sci Med Sci, 2003, 58(8): 763-766.
21.	Duncan PW, Studenski S, Chandler J, et al. Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol, 1992, 47(3): M93-98.

1. Rose DJ. Preventing falls among older adults: no "one size suits all" intervention strategy. J Rehabil Res Dev, 2008, 45(8): 1153-1166.
2. Neyens JC, Dijcks BP, Twisk J, et al. A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomisedcontrolled trial (RCT). Age Ageing, 2009, 38(2): 194-199.
3. Greenspan AI, Wolf SL, Kelley ME, et al. Tai chi and perceived health status in older adults who are transitionally frail: a randomized controlled trial. Phys Ther, 2007, 87(5): 525-535.
4. Brian F, Stephen S, Tatyana K, et al. Tai Chi and Low Impact Exercise: Effects on the Physical Functioning and Psychological Well-Being of Older People. J Appl Gerontol, 2007, 26(5): 433-453.
5. Chyu MC, James CR, Sawyer SF, et al. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal womenwith osteopaenia: a randomized clinical study. Clin Rehabil, 2010, 24(12): 1080-1090.
6. Higgins PT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
7. Lelard T, Doutrellot PL, David P, et al. Effects of a 12-Week Tai Chi Chuan Program Versus a Balance Training Program on Postural Control and Walking Ability in Older People. Arch Phys Med Rehabil, 2010, 91(1): 9-14.
8. Woo J, Hong A, Lau E, et al. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing, 2007, 36(3): 262-268.
9. Maciaszek J, Osiński W, Szeklicki R, et al. Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. Am J Chin Med, 2007, 35(1): 1-9.
10. Li F, Harmer P, Fisher KJ, et al. Tai Chi: Improving Functional Balance and Predicting Subsequent Falls in Older Persons. Med Sci Sports Exerc, 2004, 36(12): 2046-2052.
11. Tousignant M, Corriveau H, Roy PM, et al. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial. Disabil Rehabil, 2012, 34(3): 196–201.
12. Taylor D, Hale L, Schluter P, et al. Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial. J Am Geriatr Soc, 2012, 60(5): 841-848.
13. Faber MJ, Bosscher RJ, Chin A Paw MJ, et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabil, 2006, 87(7): 885-896.
14. Wolf SL, O’Grady M, Easley KA, et al. The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults. J Gerontol A Biol Sci Med Sci, 2006, 61(2): 184-189.
15. Voukelatos A, Cumming RG, Lord SR, et al. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc, 2007, 55(8): 1185-1191.
16. Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci, 2005, 60(2): 187-194.
17. Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ, 2004, 328(7441): 680.
18. Wolfson L, Whipple R, Derby C, et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc, 1996, 44(5): 498-506.
19. Lajoie Y, Gallagher SP. Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Cofidence(ABC) scale for comparing fallers. Arch Gerontol Geriatr, 2004, 38(1): 11-26.
20. Christou EA, Yang Y, Rosengren KS. Taiji training improves knee extensor strength and force control in older adults. J Gerontol A Biol Sci Med Sci, 2003, 58(8): 763-766.
21. Duncan PW, Studenski S, Chandler J, et al. Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol, 1992, 47(3): M93-98.

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《中国循证医学杂志》

太极拳运动对老年人平衡功能和跌倒预防效果的Meta分析

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