Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review

Abstract

Background. Tai chi (TC) has received increased attention in stroke rehabilitation, yet services are greatly underutilized. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview. Methods. Eight databases were searched: PubMed, Cochrane Library, Embase, Web of Science, CNKI, SinoMed, Chongqing VIP, and Wanfang Data. SRs/MAs of TC on balance function in stroke patients were included. Literature selection, data extraction, and assessment of the review quality were performed by two independent reviewers. Methodological quality was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and evidence quality by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results. Nine SRs/MAs were included in this study. For methodological quality, what resulted in unsatisfactory methodological quality was noncompliance with critical item 4 (using a comprehensive literature search strategy) and critical item 7 (providing the list of excluded research literature). For reporting quality, what resulted in unsatisfactory reporting quality was inadequate reporting of Q1 (protocol and registration), Q8 (search), Q15 (risk of bias across studies), Q16 (additional analyses), Q22 (risk of bias across studies), Q23 (additional analysis), and Q27 (funding). For GRADE, the evidence quality was high in 0, moderate in 3, low in 11, and very low in 6. Risk of bias was the most common factor leading to downgrading of evidence, followed by inconsistency, imprecision, publication bias, and indirectness. Conclusions. TC may have beneficial effects on balance function in stroke survivors; however, this finding is limited by the generally low methodology, reporting quality, and evidence quality for published SRs/MAs.

Reliability of Evidence to Guide Decision-Making in the Use of Acupuncture for Postpartum Depression

“…In this context, a critical evaluation of different SRs/MAs and a summary of the scientific nature of the evidence is necessary ( 25 ). Furthermore, an overview can highlight deficiencies that need to be improved to guide future high-quality RCTs or SRs/MAs ( 26 ).…”

“…In this context, a critical evaluation of different SRs/MAs and a summary of the scientific nature of the evidence is necessary (25). Furthermore, an overview can highlight deficiencies that need to be improved to guide future high-quality RCTs or SRs/MAs (26). A total of six SR/MAs were included in this study, all of which were published in the past 5 years, suggesting that more researchers are beginning to study acupuncture as an alternative therapy for PPD.…”

The Effect and Safety of Xuefu Zhuoyue Prescription for Coronary Heart Disease: An Overview of Systematic Reviews and Meta-Analyses

“…Over the past 10 years, there have been a number of systematic reviews (SRs)/meta-analyses (MAs) that focused on assessing the potential benefits of XFZY for the health management of patients with CHD. However, the methods and quality of the evidence for their work have not been assessed, which may mislead clinicians in actual decision-making [ 14 ]. The overview is a new research methodology for assessing the quality of multiple SRs/MAs in an effort to resolve the inconsistencies in the evidence and identify key gaps in the use of the evidence [ 15 ].…”

Concepts and Application of Tai Ji in Stroke Rehabilitation: A Narrative Review

“…It is a safe form of gentle physical exercise integrating meditation and breathing components to promote relaxation and tranquility of the mind besides improving postural stability, postural control, movement coordination, strength, and flexibility. Up to date, a substantial number of studies and reviews conducted on the clinical use of Tai Ji in stroke rehabilitation, and most of the studies reported Tai Ji to yield positive results ( 10 – 13 ). As different styles of Tai Ji may have different focus which may affect the rehabilitation outcomes, not all these studies present specify the style used.…”

“…Tai Ji had been reported to improve postural stability and physical function ( 10 , 11 , 13 – 16 ), cardiorespiratory function ( 17 , 18 ), and mental health ( 11 , 13 , 15 , 18 – 20 ), which is beneficial when incorporated into stroke rehabilitation. This article is the first to review and explain the effects of Tai Ji on functional recovery in stroke patients, linking it to current approaches, concepts and therapies such as Bobath and proprioceptive neuromuscular facilitation techniques.…”