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Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials

BACKGROUND: This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi. METHODS: Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sin...

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Autores principales: Yang, Guo-Yan, Hunter, Jennifer, Bu, Fan-Long, Hao, Wen-Li, Zhang, Han, Wayne, Peter M., Liu, Jian-Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719113/
https://www.ncbi.nlm.nih.gov/pubmed/36463306
http://dx.doi.org/10.1186/s13643-022-02100-5
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author Yang, Guo-Yan
Hunter, Jennifer
Bu, Fan-Long
Hao, Wen-Li
Zhang, Han
Wayne, Peter M.
Liu, Jian-Ping
author_facet Yang, Guo-Yan
Hunter, Jennifer
Bu, Fan-Long
Hao, Wen-Li
Zhang, Han
Wayne, Peter M.
Liu, Jian-Ping
author_sort Yang, Guo-Yan
collection PubMed
description BACKGROUND: This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi. METHODS: Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan 2010 and Dec 2020 in any language. Effect estimates were extracted from the most recent, comprehensive, highest-quality SR for each population, condition, and outcome. SR quality was appraised with AMSTAR 2 and overall certainty of effect estimates with the GRADE method. RESULTS: Of the 210 included SRs, 193 only included randomized controlled trials, one only included non-randomized studies of interventions, and 16 included both. Common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%), and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found; however, multiple proxy-outcomes/risks factors were evaluated. One hundred and fourteen effect estimates were extracted from 37 SRs (2 high, 6 moderate, 18 low, and 11 critically low quality), representing 59,306 adults. Compared to active and/or inactive controls, 66 of the 114 effect estimates reported clinically important benefits from Tai Chi, 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight of the 114 effect estimates (7.0%) were rated as high, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low certainty evidence due to concerns with risk of bias (92/114, 80.7%), imprecision (43/114, 37.7%), inconsistency (37/114, 32.5%), and publication bias (3/114, 2.6%). SR quality was often limited by the search strategies, language bias, inadequate consideration of clinical, methodological, and statistical heterogeneity, poor reporting standards, and/or no registered SR protocol. CONCLUSIONS: The findings suggest Tai Chi has multidimensional effects, including physical, psychological and quality of life benefits for a wide range of conditions, as well as multimorbidity. Clinically important benefits were most consistently reported for Parkinson’s disease, falls risk, knee osteoarthritis, low back pain, cerebrovascular, and cardiovascular diseases including hypertension. For most conditions, higher-quality SRs with rigorous primary studies are required. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021225708. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13643-022-02100-5.
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spelling pubmed-97191132022-12-04 Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials Yang, Guo-Yan Hunter, Jennifer Bu, Fan-Long Hao, Wen-Li Zhang, Han Wayne, Peter M. Liu, Jian-Ping Syst Rev Research BACKGROUND: This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi. METHODS: Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan 2010 and Dec 2020 in any language. Effect estimates were extracted from the most recent, comprehensive, highest-quality SR for each population, condition, and outcome. SR quality was appraised with AMSTAR 2 and overall certainty of effect estimates with the GRADE method. RESULTS: Of the 210 included SRs, 193 only included randomized controlled trials, one only included non-randomized studies of interventions, and 16 included both. Common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%), and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found; however, multiple proxy-outcomes/risks factors were evaluated. One hundred and fourteen effect estimates were extracted from 37 SRs (2 high, 6 moderate, 18 low, and 11 critically low quality), representing 59,306 adults. Compared to active and/or inactive controls, 66 of the 114 effect estimates reported clinically important benefits from Tai Chi, 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight of the 114 effect estimates (7.0%) were rated as high, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low certainty evidence due to concerns with risk of bias (92/114, 80.7%), imprecision (43/114, 37.7%), inconsistency (37/114, 32.5%), and publication bias (3/114, 2.6%). SR quality was often limited by the search strategies, language bias, inadequate consideration of clinical, methodological, and statistical heterogeneity, poor reporting standards, and/or no registered SR protocol. CONCLUSIONS: The findings suggest Tai Chi has multidimensional effects, including physical, psychological and quality of life benefits for a wide range of conditions, as well as multimorbidity. Clinically important benefits were most consistently reported for Parkinson’s disease, falls risk, knee osteoarthritis, low back pain, cerebrovascular, and cardiovascular diseases including hypertension. For most conditions, higher-quality SRs with rigorous primary studies are required. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021225708. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13643-022-02100-5. BioMed Central 2022-12-03 /pmc/articles/PMC9719113/ /pubmed/36463306 http://dx.doi.org/10.1186/s13643-022-02100-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Yang, Guo-Yan
Hunter, Jennifer
Bu, Fan-Long
Hao, Wen-Li
Zhang, Han
Wayne, Peter M.
Liu, Jian-Ping
Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials
title Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials
title_full Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials
title_fullStr Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials
title_full_unstemmed Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials
title_short Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials
title_sort determining the safety and effectiveness of tai chi: a critical overview of 210 systematic reviews of controlled clinical trials
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719113/
https://www.ncbi.nlm.nih.gov/pubmed/36463306
http://dx.doi.org/10.1186/s13643-022-02100-5
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