Optimal exercise parameters of tai chi for balance performance in older adults: A meta‐analysis

Abstract

Background Tai chi is considered a safe and low‐cost treatment for improving balance ability among an older population. However, there is no existing evidence on the optimal exercise parameters of tai chi for improving balance in older adults. Objectives To investigate the optimal parameters of a tai chi intervention to improve balance performance of older adults. Design Systematic review and meta‐analysis of randomized controlled trials (RCTs). Setting PubMed, Embase, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Periodical and China Biology Medicine were searched from inception until November 30, 2020. Participants Adults aged 60 years and over. Measurements Two reviewers independently extracted the data and assessed the quality of the included studies according to the Physiotherapy Evidence Database (PEDro) scale. Subgroup analyses and meta‐regressions were conducted to elucidate the impact of tai chi training programs on balance measures. Results Twenty‐six eligible RCTs were included in the meta‐analysis. Pooled results showed that tai chi has moderate effects for improving proactive balance (weighted mean standardized mean differences [SMDwm] = 0.61, 95% CI 0.33–0.89) and static steady‐state balance (SMDwm = 0.62, 95% CI 0.30–0.95) and small effects for improving dynamic steady‐state balance (SMDwm = 0.38, 95% CI 0.03–0.73) and balance test batteries (SMDwm = 0.47, 95% CI 0.13–0.81) in adults over 60 years of age. The practice frequency could predict the effects of tai chi on static steady‐state balance, and the 24‐form simplified Yang style tai chi (45–60 min/session, more than four sessions per week and at least 8 weeks) was the most optimal. Conclusions Tai chi is effective at improving the balance ability of adults over 60 years of age. A medium duration and high frequency of 24‐form tai chi may be the optimal program for improving balance, but this evidence should be recommended with caution due to limitations of the methodology and small sample sizes.

Effects and parameters of community-based exercise on motor symptoms in Parkinson’s disease: a meta-analysis

“…Heterogeneity was so ubiquitous that even if we performed a subgroup analysis or tried to exclude a single study, the heterogeneity could not be significantly changed. The higher heterogeneity is consistent with the results of other exercise interventions [ 58 ]. This suggests that the improvement of motor symptoms in PD by exercise is affected by multiple factors.…”

Comment on “Optimal exercise parameters of tai chi for balance performance in older adults: A meta‐analysis”

“…To the Editor: A recent study by Wang et al searched the available databases and conducted a systematic review and meta-analysis to investigate the optimal parameters of a tai chi intervention to improve balance performance of older adults, which was published in the recent issue of Journal of the American Geriatrics Society. 1 They came to the conclusion that "Tai chi is effective at improving the balance ability of adults over 60 years of age and a medium duration and high frequency of 24-form tai chi may be the optimal program for improving balance." Although the results are of great importance, we would like to underline some issues as to registration of the studies, quality assessment, and data analysis that we feel ought to be considered when interpreting these findings.…”

Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly

“…A recent study speculated that an intervention lasting 6 months to 1 year might lead to further improvements in cognitive functions (Lim et al, 2019 ). The effect size of Tai Chi on static steady-state balance in older adults was positively correlated with exercise frequency in a meta-analysis (Wang L. C. et al, 2021 ). Dose-response analyses are needed to optimize the intervention of Tai Chi on MCI.…”