運用太極拳於停經後骨質疏鬆婦女之成效探討－－系統性文獻回顧

Effects of Tai Chi in Postmenopausal Women with Osteoporosis: A Systematic Review

背景：太極拳是近年來常用於骨質疏鬆症患者的運動介入方案，但目前仍缺乏以停經後骨質疏鬆婦女為族群之系統性文獻探討。目的：本文是回顧以太極拳為介入措施於停經後骨質疏鬆婦女之臨床實驗性研究，對於研究方法、太極拳法及其成效品質做評價，期以利太極拳運動訓練的推廣。方法：以系統文獻回顧法搜尋1980年1月～2013年7月年間發表於14個電子資料庫，關鍵字含太極拳、骨質疏鬆、停經後婦女等字彙群組，搜尋共2,458篇文獻，排除重複性及未符合篩選標準文獻，最後剩下4篇等級較高的隨機控制實驗性研究，並針對文中相同的變項（平衡感、肌力、生活品質）進行整理與分析。結果：4篇研究中，有3篇太極拳對於停經後骨質疏鬆婦女生活品質之生理層面項目較有顯著性成效，但心理成效研究結果較不一致，在平衡感評估，雖使用不同測量工具但都有其成效。肌力只有一篇有顯著性成效，故較難整體評價太極拳對於平衡感與肌力之影響。結論：太極拳對停經後骨質疏鬆婦女於生活品質、平衡感與肌力之影響仍待商確，但其研究操作手法仍可提供未來介入之參考。另建議使用多元化工具測量同一項量以提供更完善的成效評價，增加研究的信效度。

Background: Tai chi has been increasingly applied in osteoporosis patients. However, systematic reviews of the efficacy of this practice have been few and of limited scope. Purpose: This study reviews previous experimental research work using tai chi as an intervention in postmenopausal women with osteoporosis and to appraise the reported research designs used, tai chi methods used, and outcomes. Method: A systematic review method was used to search 14 databases for articles published between January 1980 and July 2013. Searched keywords included: ＂tai chi,＂ ＂osteoporosis,＂ and ＂postmenopausal women＂. The 2,458 articles initially identified were reduced to 4 valid articles based on considerations of criteria and repeatability. The 4 valid articles used either a randomized clinical trial (RCT) or a controlled clinical trial (CCT). They were further analyzed and synthesized in terms of common variables such as balance, muscle strength, and quality of life. Result: Three of the 4 studies identified significant pretest/posttest differences in physiological aspects of quality of life in participants but did not obtain consistent results in terms of the psychological aspects. While reports identified a significant and positive tai chi effect on balance, they all used different measurements to do so. Only one of the four studies identified significant improvement in muscle strength. Therefore, this review could not identify clear support for the effectiveness of tai chi on balance or muscle strength. Conclusions: This review did not definitively support the positive effects of tai chi on balance, muscle strength, and quality of life in postmenopausal women with osteoporosis. The designs used in the tai chi interventions may be referenced for future studies. We suggest that future studies use data triangulation rather than a single-item tool to validate the research in order to cross-verify the same information. This may strengthen the research and increase the credibility and the validity of related findings.