Song R, Grabowska W, Park M, Osypiuk K, Vergara-Diaz GP, Bonato P, Hausdorff JM, Fox M, Sudarsky LR, Macklin E, Wayne PM.

Parkinsonism Relat Disord. 2017 May 25.

Highlights

• Mind-body exercises like Tai Chi and Qigong (TCQ) show promise for addressing motor and non-motor symptoms in Parkinson’s disease.
• Meta-analyses support that TCQ training leads to clinically meaningful improvements in multiple domains of motor function and fall risk.
• Our findings also suggest that TCQ training leads to improvements in mood and quality of life.

Abstract

Purpose To systematically evaluate and quantify the effects of Tai Chi/Qigong (TCQ) on motor (UPDRS III, balance, falls, Timed-Up-and-Go, and 6-Minute Walk) and non-motor (depression and cognition) function, and quality of life (QOL) in patients with Parkinson’s disease (PD).

Methods A systematic search in 7 electronic databases targeted clinical studies evaluating TCQ for individuals with PD published through August 2016. Meta-analysis was used to estimate effect sizes (Hedges’s g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed by two raters.

Results Our search identified 21 studies, 15 of which were RCTs with a total of 735 subjects. For RCTs, comparison groups included no treatment (n = 7, 47%) and active interventions (n = 8, 53%). Duration of TCQ ranged from 2 to 6 months. Methodological bias was low in 6 studies, moderate in 7, and high in 2. Fixed-effect models showed that TCQ was associated with significant improvement on most motor outcomes (UPDRS III [ES = −0.444, p < 0.001], balance [ES = 0.544, p < 0.001], Timed-Up-and-Go [ES = −0.341, p = 0.005], 6 MW [ES = −0.293, p = 0.06], falls [ES = −0.403, p = 0.004], as well as depression [ES = −0.457, p = 0.008] and QOL [ES = −0.393, p < 0.001], but not cognition [ES = −0.225, p = 0.477]). I2 indicated limited heterogeneity. Funnel plots suggested some degree of publication bias.

Conclusion Evidence to date supports a potential benefit of TCQ for improving motor function, depression and QOL for individuals with PD, and validates the need for additional large-scale trials.