Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Sep;98(37):e17099.
doi: 10.1097/MD.0000000000017099.

Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials

Jiawei Qin  1   2 , Yi Zhang  2 , Lijian Wu  2 , Zexiang He  2 , Jia Huang  1 , Jing Tao  1 , Lidian Chen  1   3
Affiliations
Meta-Analysis

Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials

Jiawei Qin et al. Medicine (Baltimore). 2019 Sep.

Abstract

Background: This is the first systematic review evaluating and statistically synthesis the current studies regarding the effects of Tai Chi on pain and disability in patients with low back pain (LBP).

Methods: Seven electronic databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and VIP information from inception to early March 2019 were searched. The Physiotherapy Evidence Database (PEDro) Scale was used to assess quality of all included randomized controlled trials (RCTs). The pooled effect size (weight mean difference, WMD) and 95% confidence interval (CI) were calculated to determine the effect of Tai Chi on pain and disability among LBP patients based on random effects model.

Results: The aggregated results of the meta-analysis suggested that Tai Chi significantly decreased pain (WMD = -1.27, 95%CI -1.50 to -1.04, P < .00001, I = 74%) and improve function disability, Oswestry disability index (ODI) subitems: pain intensity (WMD = -1.70, 95% CI -2.63 to -0.76, P = .0004, I = 89%); personal care (WMD = -1.93, 95% CI -2.86 to -1.00, P < .0001, I = 90%); lifting (WMD = -1.69, 95% CI -2.22 to -1.15, P < .0001, I = 66%); walking (WMD = -2.05, 95% CI -3.05 to -1.06, P < .0001, I = 88%); standing (WMD = -1.70, 95% CI -2.51 to -0.89, P < .0001, I = 84%); sleeping (WMD = -2.98, 95% CI -3.73 to -2.22, P < .00001, I = 80%); social life (WMD = -2.06, 95% CI -2.77 to -1.35, P < 0.00001, I = 80%) and traveling (WMD = -2.20, 95% CI -3.21 to -1.19, P < .0001, I = 90%), Japanese Orthopedic Association (JOA) score (WMD = 7.22, 95% CI 5.59-8.86, P < .00001, I = 0%), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) physical functioning (WMD = 3.30, 95% CI 1.92-4.68, P < .00001), and Roland-Morris Disability Questionnaire (RMDQ) (WMD = -2.19, 95% CI -2.56 to -1.82, P < .00001).

Conclusion: We drew a cautious conclusion that Tai Chi alone or as additional therapy with routine physical therapy may decrease pain and improve function disability for patients with LBP. Further trials are needed to be conducted with our suggestions mentioned in the systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of literature selection.
Figure 2
Figure 2
Forest plot of effect of Tai Chi for pain.
Figure 3
Figure 3
Forest plot of subgroup analysis of Tai Chi for pain.
Figure 4
Figure 4
Forest plot of effect of Tai Chi for disability (ODI subitems). ODI = Oswestry disability index.
Figure 5
Figure 5
Forest plot of effect of Tai Chi for disability (JOA score, SF-36 PF, RMDQ). JOA = Japanese Orthopedic Association, RMDQ = Roland-Morris Disability Questionnaire, SF-36 = Medical Outcomes Study Questionnaire Short Form 36 Health Survey.
Figure 6
Figure 6
Funnel plot of Tai Chi for pain.
See this image and copyright information in PMC

References

    1. Dionne CE, Dunn KM, Croft PR, et al. A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine (Phila Pa 1976) 2008;33:95–103. - PubMed
    1. Uthman OA. Global, regional, national incidence, prevalence and years lived with disability for 310 acute and chronic diseases and injuries 1990-2015: a systematic analysis for the Global Burden of Disease Study. Lancet 2015;388:1545–602. - PMC - PubMed
    1. Buchbinder R, van Tulder M, Oberg B, et al. Low back pain: a call for action. Lancet 2018;391:2384–8. - PubMed
    1. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet 2018;391:2356–67. - PubMed
    1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet 2017;389:736–47. - PubMed

MeSH terms