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The Beneficial Effects of Traditional Chinese Exercises for Adults with Low Back Pain: A Meta-Analysis of Randomized Controlled Trials

Lifestyle (Mind–Body Movement) Research Center, College of Sports Science, Shenzhen University, Shenzhen 518060, China
Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea
Department of Health, Exercise Science and Recreation Management School of Applied Sciences, The University of Mississippi, Oxford, MS 36877, USA
Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB T2S 3G3, Canada
Departments of Oncology and Community Health Sciences, Cunning School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
Department of Martial Arts, Shanghai University of Sport, Shanghai 200438, China
Department of Physical Education, Wuhan University of Technology, Wuhan 430070, China
Author to whom correspondence should be addressed.
Medicina 2019, 55(5), 118;
Received: 12 March 2019 / Revised: 24 April 2019 / Accepted: 24 April 2019 / Published: 29 April 2019
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge’s g = −0.64, 95% CI −0.90 to −0.37, p < 0.001), Roland–Morris Disability Questionnaire (RMDQ) (Hedge’s g = −0.41, 95% CI −0.79 to −0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge’s g = −0.96, 95% CI −1.42 to −0.50, p < 0.001), and cognitive function (Hedge’s g = −0.62, 95% CI −0.85 to −0.39, p < 0.001). In a meta-regression analysis, age (β = 0.01, p = 0.02) and total exercise time (β = −0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge’s g = −0.87, 95% CI −1.38 to −0.36, p < 0.001) and Qigong (Hedge’s g = −0.54, 95% CI −0.86 to −0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1–2 times/week (Hedge’s g = −0.53, 95% CI −0.98 to −0.07, p = 0.02) and 3–4 times/week (Hedge’s g = −0.78, 95% CI −1.15 to −0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge’s g = −0.54, 95% CI −1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status. View Full-Text
Keywords: Tai Chi; mindfulness; Qigong; disability; randomized controlled trial Tai Chi; mindfulness; Qigong; disability; randomized controlled trial

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Zhang, Y.; Loprinzi, P.D.; Yang, L.; Liu, J.; Liu, S.; Zou, L. The Beneficial Effects of Traditional Chinese Exercises for Adults with Low Back Pain: A Meta-Analysis of Randomized Controlled Trials. Medicina 2019, 55, 118.

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