The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson's disease: A systematic review and meta-analysis.
Author: Song R1, Grabowska W2, Park M3, Osypiuk K4, Vergara-Diaz GP5, Bonato P6, Hausdorff JM7, Fox M8, Sudarsky LR9, Macklin E10, Wayne PM11
Affiliation:
1College of Nursing, Chungnam National University, South Korea. Electronic address: songry@cnu.ac.kr.
2Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, USA. Electronic address: wgrabowska@coa.edu.
3Department of Nursing, Woosong College, South Korea. Electronic address: mkpark@wsi.ac.kr.
4Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, USA. Electronic address: kosypiuk@partners.org.
5Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, USA. Electronic address: gvergaradiaz@partners.org.
6Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, USA. Electronic address: pbonato@partners.org.
7Sackler Faculty of Medicine, Tel Aviv University, Center for the Study of Movement, Cognition, and Mobility at Tel Aviv Sourasky Medical Center, Tel Aviv-Yafo, Israel. Electronic address: Jeff.hausdorff@gmail.com.
8Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, USA. Electronic address: Mfox3@bidmc.harvard.edu.
9Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, USA. Electronic address: lsudarsky@partners.org.
10Harvard Medical School, Massachusetts General Hospital, USA. Electronic address: emacklin@mgh.harvard.org.
11Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, USA. Electronic address: pwayne@partners.org.
Conference/Journal: Parkinsonism Relat Disord.
Date published: 2017 May 25
Other:
Pages: S1353-8020(17)30185-2 , Special Notes: doi: 10.1016/j.parkreldis.2017.05.019. [Epub ahead of print] , Word Count: 247
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 = -0.341, 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]). I2 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.
Copyright © 2017 Elsevier Ltd. All rights reserved.
KEYWORDS: Meta analysis; Motor activity; Parkinson disease; Quality of life; Tai Chi
PMID: 28602515 DOI: 10.1016/j.parkreldis.2017.05.019
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