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Phys Ther. 2017 Feb 1;97(2):227-238. doi: 10.2522/ptj.20160246.

Effectiveness of Tai Chi for Chronic Musculoskeletal Pain Conditions: Updated Systematic Review and Meta-Analysis.

Abstract

Background:

Tai chi is recommended for musculoskeletal conditions; however, the evidence for its clinical effectiveness is uncertain.

Purpose:

The aim of this study was to determine whether tai chi is beneficial for clinical outcomes in people with musculoskeletal pain.

Data Sources:

Seven databases were searched: Embase, PEDro, AMED, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Central Register of Controlled Trials.

Study Selection:

Randomized controlled trials of tai chi for people with a chronic musculoskeletal condition were included.

Data Extraction:

Two reviewers extracted data and rated risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were calculated for individual trials and pooled effect sizes were calculated using a random-effects model.

Data Synthesis:

Fifteen studies were identified; these studies included people with osteoarthritis (80%), back pain (13%), and headache (7%). Using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach, moderate-quality evidence was found that tai chi was more effective than no treatment or usual care at short term on pain (SMD=-0.66 [95% CI=-0.85, -0.48]) and disability (SMD=-0.66 [95% CI=-0.85, -0.46]). The evidence for other outcomes was of low or very low quality and there was little information regarding long-term effects. Thus, although the number of publications in this area has increased, the rigor has not, hindering physical therapists' ability to provide reliable recommendations for clinical practice.

Limitations:

The evidence provided in this review is limited by trials with small sample sizes, low methodological quality, and lack of long-term assessment.

Conclusions:

In order for tai chi to be recommended as an effective intervention, more high-quality trials with large sample sizes assessing tai chi versus other evidence-based treatments at short term and at long term are needed.

PMID:
27634919
DOI:
10.2522/ptj.20160246
[Indexed for MEDLINE]

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