The Effects of Tai Chi Exercise Among Adults With Chronic Heart Failure: An Overview of Systematic Review and Meta-Analysis

Abstract

Background: Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview.Methods: Both English and Chinese databases were searched for systematic reviews (SRs)/meta-analyses (MAs) on TC for CHF from their inception to June 2020. The methodological quality, reporting quality, and risk of bias of SRs/MAs were assessed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and Risk of Bias in Systematic reviews (ROBIS), respectively. The evidence quality of outcome measures was assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE).Results: Six SRs/MAs using a quantitative synthesis to assess various outcomes of TC in CHF were included in this overview. The methodological quality, reporting quality and risk of bias of the SRs/MAs and the evidence quality of the outcome measures are generally unsatisfactory. The limitations of the past SRs/MAs included the lack of either the protocol or registration, the list of excluded studies, and the computational details of meta-analysis were inadequately reported. The critical problems were that qualitative data synthesis relied on trials with small sample sizes and critical low quality.Conclusions: TC may be a promising complementary treatment for CHF. However, further rigorous and comprehensive SRs/MAs and RCTs are required to provide robust evidence for definitive conclusions.

Determining the safety and effectiveness of Tai Chi: A critical overview of 210 systematic reviews of controlled clinical trials

“…Due to the large number of SRs, most of which were screened using a partially blinded process to help reduce the risk of selective reporting bias, it is possible that some populations and outcomes were also missed. However, we are con dent that we have reported the important outcomes also highlighted in other SRs of SRs [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

“…Given the large number of SRs of Tai Chi, SRs of SRs (henceforth referred to as overviews) are increasingly being conducted [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Some have evaluated multiple interventions for a single condition [18][19][20][21][22][23][24][25][26], whilst others have focused only on Tai Chi interventions for either a single condition [7][8][9][10][11][12] or multiple conditions [13][14][15][16][17]. Limitations of the overviews evaluating only Tai Chi interventions [7][8][9][10][11][12][13][14][15]...…”

“…Some have evaluated multiple interventions for a single condition [18][19][20][21][22][23][24][25][26], whilst others have focused only on Tai Chi interventions for either a single condition [7][8][9][10][11][12] or multiple conditions [13][14][15][16][17]. Limitations of the overviews evaluating only Tai Chi interventions [7][8][9][10][11][12][13][14][15][16][17], were the potential for language bias [10][11][12][13][15][16][17], reporting bias in which the most favorable results were emphasised [16,17], and reporting multiple estimates of effects/results for the same or similar outcome and population, with limited or no discussion about con icting results or overlapping of the primary studies, nor for a meta-analysis that did not meet the criteria outlined in item 11 of AMSTAR 2. Following calibration exercises, ve reviewers (GYY, WLH, FLB, HZ, JH) extracted data into Research Electronic Data Capture (REDCap) [34] that was veri ed by two senior reviewers (GYY, JH).…”

Quality of the Evidence Supporting the Role of Acupuncture for Stable Angina Pectoris: An Umbrella Review of Systematic Reviews

“…We have registered this overview under the PROSPERO registry (CRD42020188107). The methodology followed the guidelines stated in the Cochrane Handbook, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist ( 15 ), and some high-quality methodological overviews ( 16 , 17 ).…”

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

“…Various rehabilitation methods have been applied to improve balance functional training in stroke survivors [ 8 ], however with limited efficacy [ 9 ]. As a traditional martial art widely practiced in China for centuries, tai chi (TC) is well known for its slow and graceful rhythm transformation [ 10 ]. Recently, in December 2020, the United Nations Education Scientific and Cultural Organization (UNESCO) announced that TC has been included in the representative list of the intangible cultural heritage of humanity.…”