The Efficacy of Traditional Chinese Medical Exercise for Parkinson’s Disease: A Systematic Review and Meta-analysis

Abstract

Background and ObjectiveSeveral studies assessed the efficacy of traditional Chinese medical exercise in the management of Parkinson’s disease (PD), but its role remained controversial. Therefore, the purpose of this systematic review is to evaluate the evidence on the effect of traditional Chinese medical exercise for PD.MethodsSeven English and Chinese electronic databases, up to October 2014, were searched to identify relevant studies. The PEDro scale was employed to assess the methodological quality of eligible studies. Meta-analysis was performed by RevMan 5.1 software.ResultsFifteen trials were included in the review. Tai Chi and Qigong were used as assisting pharmacological treatments of PD in the previous studies. Tai Chi plus medication showed greater improvements in motor function (standardized mean difference, SMD, -0.57; 95% confidence intervals, CI, -1.11 to -0.04), Berg balance scale (BBS, SMD, -1.22; 95% CI -1.65 to -0.80), and time up and go test (SMD, -1.06; 95% CI -1.44 to -0.68). Compared with other therapy plus medication, Tai Chi plus medication also showed greater gains in motor function (SMD, -0.78; 95% CI -1.46 to -0.10), BBS (SMD, -0.99; 95% CI -1.44 to -0.54), and functional reach test (SMD, -0.77; 95% CI -1.51 to -0.03). However, Tai Chi plus medication did not showed better improvements in gait or quality of life. There was not sufficient evidence to support or refute the effect of Qigong plus medication for PD.ConclusionsIn the previous studies, Tai Chi and Qigong were used as assisting pharmacological treatments of PD. The current systematic review showed positive evidence of Tai Chi plus medication for PD of mild-to-moderate severity. So Tai Chi plus medication should be recommended for PD management, especially in improving motor function and balance. Qigong plus medication also showed potential gains in the management of PD. However, more high quality studies with long follow-up are warrant to confirm the current findings.

The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson's disease: A systematic review and meta-analysis

“…Another 2014 meta-analysis focused only on motor outcomes and included 8 trials [13]. A 2015 review that evaluated both Tai Chi and Qigong included 13 RCTs, however, 4 of these were published in Chinese and thus are not included in our review [14]. Finally, one 2016 review including meta-analytic methods employed broader inclusion criteria, synthesizing results from multiple mind-body modalities, including yoga and dance in addition to Tai Chi [12].…”

“…This concern is reinforced by limitations in methodological quality and by the heterogeneity of both TCQ interventions and controls. Third, we did not distinguish outcomes that were assessed on and off-medication, as has been done in prior reviews [7, 14]. Fourth, there were too few studies to compare the effects of TCQ on subgroups of PD patients, such as early vs. later disease progression or tremor dominant vs. postural instability and gait difficulty.…”

“…The evidence for TCQ’s effects on PD motor symptoms have been evaluated in a growing number of trials, with prior meta-analyses and systematic reviews generally showing positive support for clinical measures of balance [12–14]. Mixed or inconclusive results for other motor outcomes (e.g., gait, mobility, and falls) have typically been reported, in large part due to the few numbers of studies assessing these outcomes [12–14].…”

“…Mixed or inconclusive results for other motor outcomes (e.g., gait, mobility, and falls) have typically been reported, in large part due to the few numbers of studies assessing these outcomes [12–14]. Even less attention has been devoted to systematically evaluating the effects of TCQ on non-motor outcomes [12], and no meta-analyses to date have evaluated key issues such as depression and cognitive function, which have been shown to be strongly linked to overall quality of life [15].…”

Proceedings of the Iii International Scientific and Practical Conference “Psychological Health of the Person: Life Resource and Life Potential”

“…Leading to movement control impairment, motor symptoms are considered cardinal in PD. Consequently, they are the primary focus (Li, Dong, Cheng, & Le, 2016;Glickman-Simon, Karp, & Sethi, 2015;Yang, Qiu, Hao, Lv, Jiao, & Teng, 2015;Yang, Hao, Tian, Gong, Zhang, Shi, Zhao, 2015).…”