Journal
PARKINSONISM & RELATED DISORDERS
Volume 41, Issue -, Pages 3-13Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2017.05.019
Keywords
Meta analysis; Tai Chi; Parkinson disease; Motor activity; Quality of life
Categories
Funding
- Davis Phinney Foundation for Parkinson's
- Osher Center for Integrative Medicine
- National Center for Complementary and Integrative Health, National Institutes of Health [K24 AT009282]
- Basic Science Research Program through the National Research Foundation of Korea [2013R-1A-1A-2065536]
- National Research Foundation of Korea [31Z20150213567] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Purpose: To systematically evaluate and quantify the effects of Tai Chi/Qigong (TCQ) on motor (UPDRS III, balance, falls, Timed-Up-and-Go, and 6-Minute Walk) and non-motor (depression and cognition) function, and quality of life (QOL) in patients with Parkinson's disease (PD). Methods: A systematic search in 7 electronic databases targeted clinical studies evaluating TCQ for individuals with PD published through August 2016. Meta-analysis was used to estimate effect sizes (Hedges's g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed by two raters. Results: Our search identified 21 studies, 15 of which were RCTs with a total of 735 subjects. For RCTs, comparison groups included no treatment (n = 7, 47%) and active interventions (n = 8, 53%). Duration of TCQ ranged from 2 to 6 months. Methodological bias was low in 6 studies, moderate in 7, and high in 2. Fixed-effect models showed that TCQ was associated with significant improvement on most motor outcomes (UPDRS III [ES = -0.444, p < 0.001], balance [ES = 0.544, p < 0.001], Timed-Up-and-Go [ES = 0341, p = 0.005], 6 MW [ES = -0.293, p = 0.06], falls [ES = -0.403, p = 0.004], as well as depression [ES = -0.457, p = 0.008] and QOL [ES = -0.393, p < 0.001], but not cognition [ES = -0.225, p = 0.477]). I-2 indicated limited heterogeneity. Funnel plots suggested some degree of publication bias. Conclusion: Evidence to date supports a potential benefit of TCQ for improving motor function, depression and QOL for individuals with PD, and validates the need for additional large-scale trials. (C) 2017 Elsevier Ltd. All rights reserved.
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