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
1Lifestyle (Mind⁻Body Movement) Research Center, College of Sports Science, Shenzhen University, Shenzhen 518060, China.
2Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea.
3Department of Health, Exercise Science and Recreation Management School of Applied Sciences, The University of Mississippi, Oxford, MS 36877, USA.
4Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB T2S 3G3, Canada.
5Departments of Oncology and Community Health Sciences, Cunning School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
6Department of Martial Arts, Shanghai University of Sport, Shanghai 200438, China.
7Department of Physical Education, Wuhan University of Technology, Wuhan 430070, China.
8Lifestyle (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