Effects of Baduanjin exercise for knee osteoarthritis: A systematic review and meta-analysis

Author: Zeng ZP1, Liu YB2, Fang J3, Liu Y4, Luo J5, Yang M6
Affiliation: <sup>1</sup>Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China. <sup>2</sup>2nd Department of Limb Orthopedic and Reconstructive Surgery, Tianjin Hospital, Tianjin, 300211 China. <sup>3</sup>Department of Dermatology, The Third Affiliated Hospital of Guangxi Medical University, 13 Dancun Road, Nanning, 530031, Guangxi, China. <sup>4</sup>School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, WHO Collaborating Centre for Traditional Medicine, Bundoora, Vic., Australia. <sup>5</sup>Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China. Electronic address: cam0232@sina.com. <sup>6</sup>Department of Dermatology, The Third Affiliated Hospital of Guangxi Medical University, 13 Dancun Road, Nanning, 530031, Guangxi, China; Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, Yunnan, China. Electronic address: ymcomcn@hotmail.com.
Conference/Journal: Complement Ther Med.
Date published: 2020 Jan
Other: Volume ID: 48 , Pages: 102279 , Special Notes: doi: 10.1016/j.ctim.2019.102279. Epub 2019 Dec 16. , Word Count: 384


OBJECTIVES: Baduanjin is a Chinese form of low-intensity aerobic exercise that consists of eight movements. It is one of the most common forms of Chinese Qigong exercise, which originated during the Song dynasty and has a history of more than 1000 years. The aim of this research was to assess the efficacy of Baduanjin exercise for knee osteoarthritis (KOA).

METHODS: A literature search was conducted of 10 databases (Web of Science, AMED, Scopus, CINAHL, MEDLINE, EMBASE, KoreaMed Synapse, Oriental Medicine Advanced Searching Integrated System, Chinese Wan Fang and China National Knowledge Infrastructure) from their inception to June 2019. We included eligible randomised controlled trials (RCTs) in which Baduanjin was employed either alone or as an adjuvant treatment for baseline interventions in patients with KOA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS) and response rate were used as important outcomes in this research. Risk of bias was assessed using the Cochrane Collaboration tool. Two reviewers independently selected studies, extracted data and assessed risk of bias. Meta-analysis was applied to quantitative data.

RESULTS: Seven RCTs totalling 424 participants were included. Overall, only three studies (43 %) reported adequate random sequence generation, allocation concealment, blinding of outcome assessment and accounting for incomplete outcome data. The results showed a statistically significant mean difference (MD) between Baduanjin exercise and waiting list control on three domains of WOMAC scores [MD=-4.40 (95 % CI: -7.16, -1.64), p < 0.01 in pain; MD=-1.34 (95 % CI: -1.64, -1.04), p < 0.01 in stiffness; MD=-2.44 (95 % CI: -4.33,-0.55), p < 0.01 in physical function] and the response rate [RR = 1.18 (95 % CI: 1.01, 1.37), p = 0.04]. Moreover, when used alone, Baduanjin exercise demonstrated a statistically significant improvement on three domains of WOMAC scores [MD=-1.69 (95 % CI: -2.03, -1.35), p < 0.01 in pain; MD=-0.86 (95 % CI: -1.13, -0.58), p < 0.01 in stiffness; MD=-2.23 (95 % CI: -3.65,-0.82), p < 0.01 in physical function] compared to health education. Furthermore, Baduanjin exercise plus NSAID therapies significantly improved total WOMAC score [MD=-10.26 (95 % CI: -13.41, -7.11), p < 0.01] and reduced VAS [MD=-1.65 (95 % CI: -1.83,-1.48), p < 0.01] compared to NSAID therapies alone.

CONCLUSION: The existing weak evidence suggests that Baduanjin exercise may have favourable effects for KOA patients. However, further rigorously designed RCTs are warranted before it can be recommended.

Copyright © 2019. Published by Elsevier Ltd.

KEYWORDS: Baduanjin exercise; Knee osteoarthritis; Systematic review

PMID: 31987253 DOI: 10.1016/j.ctim.2019.102279