The Effects of Tai Chi on Lower Limb Proprioception in Adults Aged Over 55: A Systematic Review and Meta-Analysis.

OBJECTIVE: To summarize and critically evaluate the effects of Tai Chi on lower limb proprioception in adults aged over 55. DATA SOURCES: Seven databases (Scopus, PubMed, Web of Science, SPORTDiscus, Cochrane Library, Wanfang, and CNKI) were searched from inception until April 14, 2018. STUDY SELECTION: Eleven randomized controlled trials were included for meta-analysis. DATA EXTRACTION: Two independent reviewers screened potentially relevant studies based on the inclusion criteria, extracted data, and assessed methodological quality of the eligible studies using the Physiotherapy Evidence Database (PEDro). DATA SYNTHESIS: The pooled effect size (standardized mean difference, SMD) was calculated while the random-effects model was selected. PEDro scores ranged from 5 to 8 points (mean = 6.7). The study results showed that Tai Chi had significantly positive effects on lower limb joint proprioception. Effect sizes were moderate to large, including ankle plantar flexion (SMD = -0.55, 95% CI -0.9 to -0.2, p = 0.002, I2 = 0%, N = 162), dorsiflexion (SMD = -0.75, 95% CI -1.11 to -0.39, p < 0.001, I2 =0%, N = 162), non-dominant/left knee flexion (SMD = -0.71, 95% CI -1.10 to - 0.41, p< 0.001, I2 = 25.1%, N = 266), dominant/right knee-flexion (SMD = -0.82, 95% CI -1.06 to - 0.58, p < 0.001, I2 = 33.8%, N = 464). CONCLUSIONS: There is moderate to strong evidence suggests that Tai Chi is an effective intervention to maintain and improve lower limb proprioception in adults aged over 55. More robust multi-center studies including oldest-old participants, with longer follow-ups and validated outcome measures are needed before a definitive conclusion is drawn.