The effectiveness of traditional Chinese medicine-based exercise on physical performance, balance and muscle strength among older adults: a systematic review with meta-analysis

Author: Cenyi Wang1, Jiling Liang2, Yuhao Si3, Zeyun Li4, Aming Lu5
1 School of Physical Education and Sports Science, Soochow University, Suzhou, China.
2 Graduate School, Wuhan Sports University, Wuhan, China.
3 The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
4 Department of Rehabilitation Medicine, Xiangtan Central Hospital, Xiangtan, China.
5 School of Physical Education and Sports Science, Soochow University, Suzhou, China.
Conference/Journal: Aging Clin Exp Res
Date published: 2021 Aug 22
Other: Special Notes: doi: 10.1007/s40520-021-01964-2. , Word Count: 356

Traditional Chinese medicine (TCM) based exercises have been widely used in the prevention and treatment of balance, cardiopulmonary, and other related diseases in older adults. However, there seems to be no consensus on the improvement and comparison of physical performance, balance, and muscle strength in the elderly population.

To systematically examine the impact of different TCM-based exercises on physical performance, balance, and muscle strength outcomes in the elderly.

We searched PubMed, EMBASE, Scopus, and Cochrane Center, CNKI and Wan Fang between their date of inception and March 2021. This meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCT) or controlled clinical trials (CCT) were considered in TCM-based exercises (Tai Chi, Ba Duan Jin, Qigong). The overall mean difference (MD) or standardized mean difference (SMD), and its 95% confidence interval (CI) were calculated.

Main results:
A total of 27 studies with 2580 older adults met the inclusion criteria. The pooled analysis indicated that Tai Chi could be more effective in Times up and go (TUG) (MD = - 2.62, 95% CI - 4.00 to - 1.24, P = 0.0002), 5 times sit-stand (MD = - 1.89; 95%CI - 3.38 to - 0.40; P = 0.01), and handgrip strength outcomes (SMD = 0.69; 95%CI 0.52-0.86; P < 0.0001) compared to Ba Duan Jin and Qigong. The older adults performing Qigong could have a better benefit in Single-bed balance (SLB) with eyes closed compared to Tai Chi and Ba Duan Jin (MD = 3.42; 95%CI 1.55 to 5.29; P = 0.0003). Tai Chi also had benefits in terms of balance outcomes compared to those in the control group: Berg Balance scale (BBS) (MD = 1.41; 95% CI 0.03-2.85; P = 0.05), Functional reach test (FRT) (MD = 1.57; 95%CI 1.22-1.93; P < 0.0001). The Tai Chi study meta-analysis demonstrated significant effects on lower limb strength: knee extension (SMD = 0.56; 95%CI 0.26-0.86; P = 0.0003), ankle dorsiflexion (SMD = 0.67; 95%CI 0.02-1.31; P = 0.04) compared to the controls.

This systematic review reveals that TCM-based exercises can effectively improve physical performance outcomes, balance outcomes, and muscle strength in the elderly population. While there is limited evidence on the efficacy of other TCM-based lifestyle interventions, more high-quality clinical trials on this topic are warranted.

Keywords: Ba Duan Jin; Balance; Muscle strength; Physical performance; Qigong; Systematic review; Tai Chi; Traditional Chinese medicine.

PMID: 34420189 DOI: 10.1007/s40520-021-01964-2