Abstract：
OBJECTIVE: There exists a deficiency in a distinct understanding of the intervention effects of Traditional Chinese Medicine (TCM) exercise therapies (Tai Chi, Yi Jin Jing, Ba Duan Jin, Liu Zi Jue, Qigong, Wu Qin Xi etc.) on cognitive function and its moderating variables in the elderly. This study aims to systematically evaluate the effects of TCM exercise therapies on the cognitive function of the elderly and further propose the best exercise intervention programme to delay the cognitive decline of the elderly.
METHODS: PubMed, EBSCO host, Web of Science, EMbase, China National Knowledge Infrastructure and Wan Fang databases were searched for the effects of TCM exercise therapies on the cognitive function in older adults until July 2022. A meta-analysis of the included literature was performed using Stata 12.0 software, with a subgroup analysis of seven moderating variables: subject type, intervention content, intervention duration, intervention frequency, intervention period, study type and sample size. A random effects model was used to combine the overall effect sizes and to test for heterogeneity and publication bias across studies.
RESULTS: A total of 20 publications with 1975 subjects were included. The TCM exercise therapies delayed cognitive decline in older adults (d = 0.83; 95 % CI [0.62-1.04]; P < 0.001). Subgroup analysis found that intervention content, intervention duration, intervention frequency, and intervention period were significant moderating variables influencing the effectiveness of the intervention. Among them, the Ba Duan Jin intervention (d = 0.85; 95 % CI [0.65-1.06]; P < 0.001), the duration of each exercise session of 60 min or more (d = 0.86; 95 % CI [0.71-1.00]; P < 0.001), the frequency of exercise of more than 5 times per week (d = 0.80; 95 % CI [0.64-0.96]; P < 0.001) and exercise cycles of 6-9 months (d = 0.96; 95 % CI [0.80-1.12]; P < 0.001) produced the largest effect sizes.
CONCLUSIONS: TCM exercise therapies can effectively improve the cognitive function of the elderly. The best effect on the cognitive function of the elderly was achieved by choosing Ba Duan Jin and exercising at least five times a week for at least 60 min each time for a total of 6-9 months. The effect size of the TCM exercise therapy interventions on the cognitive function in older adults may be overestimated because of publication bias. In addition, large-sample, multicenter, high-quality randomised controlled trials should be conducted to validate this result.
METHODS: PubMed, EBSCO host, Web of Science, EMbase, China National Knowledge Infrastructure and Wan Fang databases were searched for the effects of TCM exercise therapies on the cognitive function in older adults until July 2022. A meta-analysis of the included literature was performed using Stata 12.0 software, with a subgroup analysis of seven moderating variables: subject type, intervention content, intervention duration, intervention frequency, intervention period, study type and sample size. A random effects model was used to combine the overall effect sizes and to test for heterogeneity and publication bias across studies.
RESULTS: A total of 20 publications with 1975 subjects were included. The TCM exercise therapies delayed cognitive decline in older adults (d = 0.83; 95 % CI [0.62-1.04]; P < 0.001). Subgroup analysis found that intervention content, intervention duration, intervention frequency, and intervention period were significant moderating variables influencing the effectiveness of the intervention. Among them, the Ba Duan Jin intervention (d = 0.85; 95 % CI [0.65-1.06]; P < 0.001), the duration of each exercise session of 60 min or more (d = 0.86; 95 % CI [0.71-1.00]; P < 0.001), the frequency of exercise of more than 5 times per week (d = 0.80; 95 % CI [0.64-0.96]; P < 0.001) and exercise cycles of 6-9 months (d = 0.96; 95 % CI [0.80-1.12]; P < 0.001) produced the largest effect sizes.
CONCLUSIONS: TCM exercise therapies can effectively improve the cognitive function of the elderly. The best effect on the cognitive function of the elderly was achieved by choosing Ba Duan Jin and exercising at least five times a week for at least 60 min each time for a total of 6-9 months. The effect size of the TCM exercise therapy interventions on the cognitive function in older adults may be overestimated because of publication bias. In addition, large-sample, multicenter, high-quality randomised controlled trials should be conducted to validate this result.
摘要：
目的：对中医（TCM）运动疗法的干预效果缺乏清晰的理解（太极拳，易进静,八段金,刘子觉,气功,吴琴Xi等。)关于老年人认知功能及其调节变量的研究。本研究旨在系统评价中医运动疗法对老年人认知功能的影响，进一步提出延缓老年人认知功能下降的最佳运动干预方案。
方法：PubMed，EBSCO主机，WebofScience,EMBase,直到2022年7月，我们搜索了中国国家知识基础设施和万方数据库，以了解中医运动疗法对老年人认知功能的影响。使用Stata12.0软件对纳入的文献进行荟萃分析，对七个调节变量进行亚组分析：主题类型，干预内容,干预持续时间，干预频率,干预期,研究类型和样本量。使用随机效应模型来组合总体效应大小，并测试研究中的异质性和发表偏倚。
结果：共纳入20篇出版物，其中1975篇受试者。中医运动疗法可延缓老年人认知功能下降(d=0.83;95%CI[0.62-1.04];P<0.001)。亚组分析发现，干预内容，干预持续时间，干预频率,干预期是影响干预效果的显著调节变量。其中,八段锦干预(d=0.85；95%CI[0.65-1.06]；P<0.001)，每次运动时间为60分钟或以上(d=0.86;95%CI[0.71-1.00];P<0.001),每周5次以上的运动频率(d=0.80;95%CI[0.64-0.96];P<0.001)和6-9个月的运动周期(d=0.96;95%CI[0.80-1.12];P<0.001)产生的效应最大。
结论：中医运动疗法能有效改善老年人的认知功能。选择八段锦，每周至少锻炼5次，每次至少60min，共6-9个月，对老年人认知功能的效果最佳。由于发表偏倚，中医运动疗法干预对老年人认知功能的影响可能被高估。此外,大样本,多中心，应进行高质量的随机对照试验来验证这一结果.
方法：PubMed，EBSCO主机，WebofScience,EMBase,直到2022年7月，我们搜索了中国国家知识基础设施和万方数据库，以了解中医运动疗法对老年人认知功能的影响。使用Stata12.0软件对纳入的文献进行荟萃分析，对七个调节变量进行亚组分析：主题类型，干预内容,干预持续时间，干预频率,干预期,研究类型和样本量。使用随机效应模型来组合总体效应大小，并测试研究中的异质性和发表偏倚。
结果：共纳入20篇出版物，其中1975篇受试者。中医运动疗法可延缓老年人认知功能下降(d=0.83;95%CI[0.62-1.04];P<0.001)。亚组分析发现，干预内容，干预持续时间，干预频率,干预期是影响干预效果的显著调节变量。其中,八段锦干预(d=0.85；95%CI[0.65-1.06]；P<0.001)，每次运动时间为60分钟或以上(d=0.86;95%CI[0.71-1.00];P<0.001),每周5次以上的运动频率(d=0.80;95%CI[0.64-0.96];P<0.001)和6-9个月的运动周期(d=0.96;95%CI[0.80-1.12];P<0.001)产生的效应最大。
结论：中医运动疗法能有效改善老年人的认知功能。选择八段锦，每周至少锻炼5次，每次至少60min，共6-9个月，对老年人认知功能的效果最佳。由于发表偏倚，中医运动疗法干预对老年人认知功能的影响可能被高估。此外,大样本,多中心，应进行高质量的随机对照试验来验证这一结果.
