Traditional Chinese Eight Brocade Exercise Prescription for Ankylosing Spondylitis: A Quantitative Synthesis

Abstract

Introduction: The aim of this research was to assess the safety and effectiveness of traditional Chinese Eight Brocade exercise for ankylosing spondylitis (AS). Methods: A literature search was conducted using twelve databases (Web of Science, EBSCO, AMED, SCOPUS, CINAHL, MEDLINE, EMBASE, DBPIA, KoreaMed Synapse, Oriental Medicine Advanced Searching Integrated System, Chinese Wan Fang, and China National Knowledge Infrastructure) from inception to June 2019. We only included randomized controlled trials (RCTs) regarding traditional Chinese Eight Brocade exercise for AS. For statistical analysis, we adopted a quantitative analysis using the RevMan 5.3 statistical software. Results: Five eligible RCTs involving 308 participants were included in the systematic review. The meta-analysis showed superior effects of traditional Chinese Eight Brocade exercise plus NSAIDs therapy on response rate, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), inflammatory indicators, and bone mineral density when compared with NSAIDs therapy alone (p < 0.05). Moreover, when used alone, traditional Chinese Eight Brocade exercise significantly improved fatigue, intensity of morning stiffness domains, and duration of morning stiffness domains of BASDAI scores in comparison to waiting list controls (p < 0.05). Conclusion: Traditional Chinese Eight Brocade exercise could improve physical function and reduce disease activity and inflammatory indicators in AS patients. However, the level of evidence was low because of the high risk of bias. Further rigorously designed RCTs are warranted before it can be recommended.

Comment on: Traditional Chinese Eight Brocade Exercise Prescription for Ankylosing Spondylitis: A Quantitative Synthesis

“…Dear Editor, I came across the article accidentally entitled "Traditional Chinese Eight Brocade Exercise Prescription for Ankylosing Spondylitis: A Quantitative Synthesis," which was published online on May 28, 2020, in Complementary Medicine Research [1]. There are some viewpoints to be discussed.…”

“…This article claims to include a total of 5 RCTs, including original references 11–15 [in ref. 1]. There are problems with some of these RCTs.…”

“…An interesting result showed in the original article that “Only one study [ref. 11] suggests that Eight Brocade exercise plus drug therapy exerted a positive effect on bone mineral density compared with drug therapy alone” [1]. This result is groundless.…”

“…The observation indicators in this study included ESR and CRP only [3]. It is questionable whether the authors can explain the source of BASFI, BASDAI, and the response rate shown in original Table 1 and the related Results section [1]. The original text of reference 12 accompanied by an English abstract can be found in online supplementary material 2.…”