背景

身体活动能力受损是指身体或一个或多个肢体的独立且有目的的身体运动受到限制。身体上的限制会对个人的身体和心理功能产生负面影响。坐式太极拳是传统太极拳的衍生形式，已发现可以增加所有关节的柔韧性，并增强进行体育锻炼的能力。然而，将太极拳放在身体活动能力受损的人的身体和心理社会健康结局上的证据是有限的。

目标

为了评判坐立太极拳对肢体活动障碍人士健康状况的影响的证据，并确定坐立太极拳干预措施的实施策略。

方法

从建库.到2020年1月，系统地对11个英语数据库和两个中文数据库进行了搜索。纳入以英语或汉语发表的随机对照试验和非随机对照试验。两名独立的评审员筛选了所有符合条件的研究，评估了偏倚风险，并提取了数据。使用Review Manager 5.4进行荟萃分析，并在不合适的荟萃分析的情况下进行叙述性综合。证据的确定性使用Grade指南工具进行评估。该研究已在PROSPERO中注册。

结果

检索1,446条记录，有11项研究符合纳入条件。荟萃分析报告表明，坐式太极拳对抑郁症状（SMD：-1.53，95％CI：-2.81至-0.21，2个研究；质量非常低），心率（MD：-5.72，95％） CI：-11.16至-0.29，2个研究；低质量）和生活质量的社会领域（MD：1.42，95％CI：0.66至2.19，3个研究；低质量）的影响有统计学意义。

结论

研究发现，坐式太极拳对身体活动不佳的人的抑郁症状，心率和生活质量的社交领域具有良好的作用。从非常低到低的证据不足以支持太极拳在动态坐姿平衡，握力和生活质量的生理和心理方面的有效性。仅有有限的证据表明对坐式太极拳干预的最佳实施策略。未来应设计更完善的研究，继续在该领域中开发高质量的证据。

Background

Impaired physical mobility refers to a limitation in independent and purposeful physical movement of the body or one or more extremities. Physical restrictions result in negative consequences on an individual's physical and psychosocial functions. Sitting Tai Chi, a derivative form of traditional Tai Chi, has been found to increase the flexibility of all joints involved and enhance the ability to perform physical activity. However, the evidence of sitting Tai Chi on physical and psychosocial health outcomes on individuals with impaired physical mobility is limited.

Objectives

To critically synthesise evidence that evaluates the effects of sitting Tai Chi on health outcomes among individuals with impaired physical mobility and to identify implementation strategies for the sitting Tai Chi intervention.

Methods

Searches were performed across 11 English and two Chinese databases systematically from inception to January 2020. Randomised controlled trials and non-randomised controlled trials, written in English or Chinese were included. Two independent reviewers screened all eligible studies, appraised risk of bias, and extracted the data. Meta-analyses were conducted using Review Manager 5.4 and narrative syntheses were performed where meta-analysis was inappropriate. The certainty of evidence was assessed using Grades of Recommendation, Assessment, Development and Evaluation profiler Guideline Development Tool. This study was registered in PROSPERO.

Results

A total of 1,446 records were generated and 11 studies were eligible for inclusion. Meta-analysis reported a statistically significant effect size favouring sitting Tai Chi on depressive symptoms (SMD: -1.53, 95% CI: -2.81 to -0.21, 2 studies; very low quality), heart rate (MD: -5.72, 95% CI: -11.16 to -0.29, 2 studies; low quality) and social domain of quality of life (MD: 1.42, 95% CI: 0.66 to 2.19, 3 studies; low quality).

Conclusions

Sitting Tai Chi was found to have favourable effects on depressive symptoms, heart rate, and social domain of quality of life of individuals with impaired physical mobility. Very low to low quality evidence does not support the effectiveness of sitting Tai Chi on dynamic sitting balance, handgrip strength, and the physical and psychological domains of quality of life. There was limited evidence to suggest the best implementation strategies for the sitting Tai Chi intervention. It is anticipated that more well-designed studies will continue developing high quality evidence in this field.

原文链接：

https://www.sciencedirect.com/science/article/pii/S0020748921000493

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