太极拳对老年人平衡功能影响的系统评价

发布时间：2018-02-25 05:14

本文关键词： 太极拳老年人平衡功能系统评价　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过系统评价探索太极拳运动对老年人平衡功能的影响,以期得到太极拳改善老年人平衡功能的最佳方案,进而预防或减少老年人跌倒的发生。研究方法检索万方数据知识服务平台(WanFang);清华同方知网数据库(CNKI);中文科技期刊数据库(维普);中国生物医学数据库(CBMdisc);Pubmed数据库;EMbase数据库;Web of Science数据库;Cochrane Library数据库中的临床试验文献,检索时间均从各个数据库收录起始时间至2016年3月底。严格对纳入文献的质量进行独立评价,应用RevMan 5.3系统评价软件进行Meta分析。异质性检验使用Q值统计量检验法和卡方检验法。多个同类研究间具有同质性,选用固定效应模型进行统计量合并;反之则进行亚组分析或敏感性分析,消除异质性的来源后,应用固定效应模型进行分析;如无法消除异质性,则采用随机效应模型进行分析。二分类变量用相对危险度(RR)来表示,连续性变量使用均数差(MD)或标准化均数差(SMD)来分析。两种类型资料均计算95%可信区间,如不能进行Meta分析则进行描述性分析。对纳入文献较多的结局指标(不小于5篇)按照发表时间排序后进行累积Meta分析,应用相关图示来表明,分析太极拳对老年人平衡功能影响的动态变化趋势,进一步对其疗效进行评价。结果1纳入研究特征共纳入59项研究,试验地点来自8个国家,31篇英文文献和28篇中文文献。包括随机对照试验26项和非随机对照试验33项,其中非随机对照研究包括非随机对照试验5项,队列研究17项,自身前后对照试验11项。试验组的干预措施为太极拳,对照组的干预措施包括空白对照和其他运动疗法,其中其他运动疗法包括瑜伽,气功,健步走,交谊舞,认知活动训练,标准化平衡训练以及其他低运动量干预等,不同研究的干预措施存在差异性。纳入研究的干预措施的练习周期为5天～15年,每次练习时间为30分钟～90分钟,练习频率为每天2次～每周1次,总的练习时间为6小时～2994小时.2效果分析随机对照研究显示,与空白对照组比较,太极拳对老年人Berg平衡量表(Berg Balance Scale,BBS)得分的影响差异无统计学意义,与其他运动疗法比较,差异亦无统计学意义;与空白组或其他运动疗法比较,太极拳对老年人跌倒次数的减少差异有明显的统计学意义;与空白组比较,太极拳干预时间分别为38～80个小时和180～336小时时,太极拳对老年人闭眼单足站立时间(One-leg standing,OLS)的提升差异均有统计学意义;太极拳干预时间为20～48小时,太极拳对老年人睁眼单足站立时间的影响差异无统计学意义,干预时间为64～80小时太极拳对老年人睁眼单足站立时间的影响差异有统计学意义;与其他运动疗法比较,干预时间为20～48小时和64～80小时,太极拳对老年人睁眼单足站立时间影响差异无统计学意义;与空白组或其他运动疗法比较,太极拳对老年人起立行走试验(Timed up and go,TUG)得分差异均无统计学意义;与空白组相比,太极拳对老年人功能性伸展测试(Functional reach test,FRT)得分差异无统计学意义;与其他运动疗法比较,差异有统计学意义;与空白组或其他运动疗法比较,太极拳组老年人跌倒恐惧(Fear of fall,FOF)的例数较少,跌倒恐惧较低,差异均有统计学意义。非随机对照研究结果显示,与空白对照组相比,太极拳对老年人闭眼单足站立时间影响的差异有统计学意义;与空白对照组相比,太极拳对老年人起立行走试验得分影响的差异有统计学意义。队列研究的结果显示,与空白对照组相比,太极拳对老年人闭眼单足站立时间影响的差异有统计学意义;太极拳对老年人平衡木行走得分的差异无统计学意义;太极拳对老年人Romberg试验得分影响的差异有统计学意义。自身前后对照试验的结果显示,太极拳锻炼后,干预时间为48～64小时,老年人的闭眼单足站立时间与试验前差异无统计学意义,干预时间为96～288小时,老年人的闭眼单足站立时间与试验前差异有统计学意义;老年人的睁眼单足站立时间与试验前比较差异无统计学意义;起立行走试验得分与实验前比较差异有统计学意义;平衡木行走得分与实验前比较差异有统计学意义;功能性伸展测试干预时间为7.5小时,与试验前比较差异无统计学意义,干预时间为36～54小时差异有统计学意义;跌倒恐惧得分试验前后差异无统计学意义。结论1太极拳一定程度上可以改善老年人的平衡功能。其中,太极拳对老年人的静态平衡功能有明显的改善作用,对老年人的动态平衡功能的具体改善效果尚无法明确。2太极拳可减少老年人跌倒次数,减少或降低老年人跌倒恐惧,间接地提高老年人的平衡功能。3太极拳干预效果的发挥需要一定的时间周期。就本研究所得结果而言,太极拳的总体的干预时间在80小时以上,其对平衡功能的改善作用可呈现稳定性。4太极拳与其他运动疗法相比,仅部分结局指标有统计学意义,与其他疗法相比效果是否有优势暂未明确。
[Abstract]:Objective to explore the effect of Taijiquan Exercise on the balance function of the aged in the evaluation system, in order to get the best scheme of Taijiquan to improve the balance function of the elderly, in order to prevent or reduce the occurrence of falls in elderly people. The method of retrieval of Wanfang Data knowledge service platform (WanFang); Tongfang database (CNKI); Chinese technology journal database (VIP); Chinese biomedical databases (CBMdisc); Pubmed database; EMbase Web database; of Science database; clinical trial literature Cochrane Library database. The retrieval time was collected from each database starting time to the end of March 2016. The strict independent evaluation of the literature quality evaluation software application system Meta RevMan 5.3 analysis. Heterogeneity test Q value method test statistics and chi square test. A number of similar studies with homogeneity, with fixed effect model Type of statistics combined; and vice versa for subgroup analysis and sensitivity analysis, eliminate the sources of heterogeneity, were analyzed by fixed effect model; if cannot eliminate the heterogeneity, the random effects model analysis. Two classification variables with relative risk (RR) to represent the continuous variables using the mean difference (MD) or standardized mean difference (SMD). To analyze the two types of data were calculated as the 95% confidence interval, can carry out Meta analysis. Descriptive analysis of outcome measures included literature more (not less than 5) of the cumulative Meta analysis according to the published time after sorting, the application of analysis the dynamic changes of the balance function of the aged tendency of the effect of Taijiquan, further to evaluate its efficacy. Results of the 1 included studies characteristics of 59 studies were included, the test sites from 8 countries, 31 in English and 28 articles in Chinese The literature. Including 26 randomized controlled trials and non randomized controlled trials of 33 items, including non randomised controlled trials including 5 non randomized controlled trials, 17 cohort study, self control test 11. Experimental group interventions for Taijiquan, intervention in the control group including blank control and other exercise therapy, including other sports therapy include yoga, Qigong, walking, dancing, cognitive training, balance training standard and other low amount of exercise intervention, different interventions are different. The intervention measures included in the study of practice for a period of 5 days to 15 years, each exercise time is 30 minutes to 90 minutes of exercise the frequency of 2 times a day to 1 times a week, randomized controlled study showed that the total exercise time for 6 hours to 2994 hours of.2, compared with the blank control group, Tai Chi for the elderly Berg balance scale (Berg Balance Scale, BBS) there was no significant difference in the effect of score, compared to other active treatments, there were no significant differences; compared with the control group or other exercise therapy, there was statistically significant difference in reduction of Taijiquan on the elderly fall times; compared with the control group, Tai Chi intervention time was 38~80 hours and 180~336 hours, Tai Chi for the elderly one leg standing time (One-leg standing, OLS) to enhance the statistically significant difference; Taijiquan intervention time is 20~48 hours, Tai Chi for the elderly and single foot standing time effect was no statistically significant difference was statistically significant, the intervention time was 64~80 hours Taijiquan single eyes foot standing time effect on elderly differences; compared with other exercise therapy, intervention time was 20~48 hours and 64~80 hours, Tai Chi for the elderly eyes standing on one foot There was no significant effect of time difference; compared with the control group or other exercise therapy, Tai Chi for the elderly to walk test (Timed up and go, TUG) scores were not statistically significant; compared with the control group, Tai Chi for the elderly function extension test (Functional reach test, FRT) score was not statistically significant compared with other differences; exercise therapy, the difference was statistically significant; compared with the control group or other exercise therapy, fear fall Taijiquan group elderly (Fear of fall, FOF) of the small number of cases, the fear of falling is low, the differences were statistically significant. Non randomized controlled study showed that compared with the control group. There were statistically significant differences in Tai Chi for the elderly one leg stance of time; compared with the control group, there was statistical significance of Tai Chi for the elderly to walk test scores. The effects of differences in cohort study The results show that, compared with the control group, there were statistically significant differences in Tai Chi for the elderly one leg standing time of Taijiquan; no statistical significance of differences in elderly balance beam walking scores; the effect of Taijiquan on the elderly Romberg test score difference was statistically significant. Self control test the results showed that Taijiquan exercise after intervention for 48~64 hours, the elderly one leg standing time and before the test there was no significant difference between the intervention time of 96~288 hours, the elderly one leg standing time and test before the difference was statistically significant; one foot standing time and before the experiment there was no significant difference the eyes of the aged; stand up and walk test scores before the experiment there was significant difference; the balance beam walking scores and the difference was statistically significant; function Stretch test intervention for 7.5 hours, compared with before the test there was no significant difference between the intervention time was statistically significant differences before and after the fall of 36~54 hours; fear test score difference was not statistically significant. Conclusion 1 Taijiquan to a certain extent, can improve the balance function of the elderly. Among them, have a significant role in improving the static balance function Tai Chi for the elderly, the dynamic balance function of the elderly is not clear the specific effect of.2 Taijiquan can reduce the elderly number of falls, reduce the fear of falls in elderly people and indirectly improve the elderly people's balance function.3 Taijiquan intervention effect requires a certain period of time. For this study the results of the overall intervention time of Taijiquan in more than 80 hours, the effect on improving the balance function can present stability of.4 with other Taijiquan exercise therapy In comparison, only partial outcome indicators were statistically significant, and whether the effectiveness of the results compared with other treatments was not clear.

【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：G852.1

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