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 older than 55. Data Sources: Seven databases (Scopus, PubMed, Web of Science, SPORTDiscus, Cochrane Library, Wanfang, 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. Physiotherapy Evidence Database 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% confidence interval [95% CI], −0.9 to −0.2; P=.002; I ² =0%; n=162), dorsiflexion (SMD=−0.75; 95% CI, −1.11 to −0.39; P<.001; I ² =0%; n=162), nondominant or left knee flexion (SMD=−0.71; 95% CI, −1.10 to −0.41; P<.001; I ² =25.1%; n=266), dominant or right knee flexion (SMD=−0.82; 95% CI, −1.06 to −0.58; P<.001; I ² =33.8%; n=464). Conclusions: There is moderate to strong evidence that suggests that Tai Chi is an effective intervention to maintain and improve lower limb proprioception in adults older than 55. More robust multicenter studies including oldest-old participants, with longer follow-ups and validated outcome measures, are needed before a definitive conclusion is drawn.