[Show abstract][Hide abstract] ABSTRACT: Whether Tai Chi benefits patients with osteoarthritis remains controversial. We performed a meta-analysis to assess the effectiveness of Tai Chi exercise for pain, stiffness, and physical function in patients with osteoarthritis.
A computerized search of PubMed and Embase (up to Sept 2012) was performed to identify relevant studies. The outcome measures were pain, stiffness, and physical function. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the Jadad score. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and pooled using a random effects model. The change in outcomes from baseline was compared to the minimum clinically important difference.
A total of seven randomized controlled trials involving 348 patients with osteoarthritis met the inclusion criteria. The mean Jadad score was 3.6. The pooled SMD was -0.45 (95% CI -0.70--0.20, P = 0.0005) for pain, -0.31 (95% CI -0.60--0.02, P = 0.04) for stiffness, and -0.61 (95% CI -0.85--0.37, P<0.00001) for physical function. A change of 32.2-36.4% in the outcomes was greater than the minimum clinically important difference.
Twelve-week Tai Chi is beneficial for improving arthritic symptoms and physical function in patients with osteoarthritis and should be included in rehabilitation programs. However, the evidence may be limited by potential biases; thus, larger scale randomized controlled trials are needed to confirm the current findings and investigate the long-term effects of Tai Chi.
[Show abstract][Hide abstract] ABSTRACT: Although unsupported upper extremity exercise (UUEE) is recommended in the guidelines for pulmonary rehabilitation (PR), it is controversial whether UUEE improves dyspnea in patients with COPD. The present study conducted a meta-analysis of randomized controlled trials to clarify whether UUEE could improve dyspnea in COPD patients.
A computerized search through PubMed and Embase (up to Mar 2012) was performed to obtain sample studies. Methodological quality was assessed using the PEDro scale. Weighted mean differences (WMDs), and 95% confidence intervals (CIs) were calculated and heterogeneity was assessed with the I(2) test. The overall effect sizes were compared with the minimum clinically important difference (MCID).
240 patients from 7 studies were included in this meta-analysis. The mean PEDro score was 7.0 (SD = 1.7). The results indicated UUEE relieved dyspnea and arm fatigue during activities of daily living (ADL) (WMD = -0.58, -0.55 scores; 95% CI = -1.13 to -0.02, -1.08 to -0.01), however, the overall treatment effects were lower than the MCID of 1 unit for the Borg scale. There was no statistical significance for dyspnea and arm fatigue during intervention (WMD = -0.34, 0.24 scores; 95% CI = -0.78 to 0.09, -0.33 to 0.81).
UUEE can relieve dyspnea and arm fatigue in patients with COPD during ADL and should be included in the PR program, however, there is currently a lack of clinical evidence to support UUEE relieving dyspnea and arm fatigue. Further study is urgent to investigate these effects of UUEE.
Preview · Article · Aug 2012 · Respiratory medicine