The Beneficial Effects of Traditional Chinese Exercises for Adults with Low Back Pain: A Meta-Analysis of Randomized Controlled Trials

Author: Zhang Y1,2, Loprinzi PD3, Yang L4,5, Liu J6, Liu S7, Zou L8
Affiliation: <sup>1</sup>Lifestyle (Mind⁻Body Movement) Research Center, College of Sports Science, Shenzhen University, Shenzhen 518060, China. <sup>2</sup>Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea. <sup>3</sup>Department of Health, Exercise Science and Recreation Management School of Applied Sciences, The University of Mississippi, Oxford, MS 36877, USA. <sup>4</sup>Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB T2S 3G3, Canada. <sup>5</sup>Departments of Oncology and Community Health Sciences, Cunning School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada. <sup>6</sup>Department of Martial Arts, Shanghai University of Sport, Shanghai 200438, China. <sup>7</sup>Department of Physical Education, Wuhan University of Technology, Wuhan 430070, China. <sup>8</sup>Lifestyle (Mind⁻Body Movement) Research Center, College of Sports Science, Shenzhen University, Shenzhen 518060, China.
Conference/Journal: Medicina (Kaunas).
Date published: 2019 Apr 29
Other: Volume ID: 55 , Issue ID: 5 , Special Notes: doi: 10.3390/medicina55050118. , Word Count: 313

Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge's g = -0.64, 95% CI -0.90 to -0.37, p < 0.001), Roland-Morris Disability Questionnaire (RMDQ) (Hedge's g = -0.41, 95% CI -0.79 to -0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge's g = -0.96, 95% CI -1.42 to -0.50, p < 0.001), and cognitive function (Hedge's g = -0.62, 95% CI -0.85 to -0.39, p < 0.001). In a meta-regression analysis, age (β = 0.01, p = 0.02) and total exercise time (β = -0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge's g = -0.87, 95% CI -1.38 to -0.36, p < 0.001) and Qigong (Hedge's g = -0.54, 95% CI -0.86 to -0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1-2 times/week (Hedge's g = -0.53, 95% CI -0.98 to -0.07, p = 0.02) and 3-4 times/week (Hedge's g = -0.78, 95% CI -1.15 to -0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge's g = -0.54, 95% CI -1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status.

KEYWORDS: Qigong; Tai Chi; disability; mindfulness; randomized controlled trial

PMID: 31036791 DOI: 10.3390/medicina55050118