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Article pour les cliniciens

Le tai-chi pour le risque de chutes: une méta-analyse.



  • Lomas-Vega R
  • Obrero-Gaitan E
  • Molina-Ortega FJ
  • Del-Pino-Casado R
J Am Geriatr Soc. 2017 Sep;65(9):2037-2043. doi: 10.1111/jgs.15008. Epub 2017 Jul 24. (Review)
PMID: 28736853
Lire le résumé Lire résumé des données probantes
Disciplines
  • Médecine familiale (MF)/Médecine générale (MG)
    Relevance - 6/7
    Intérêt médiatique  - 5/7
  • Médecine interne générale - Soins primaires
    Relevance - 6/7
    Intérêt médiatique  - 5/7
  • - Gériatrie
    Relevance - 6/7
    Intérêt médiatique  - 5/7
  • Santé publique
    Relevance - 5/7
    Intérêt médiatique  - 6/7
  • Médecine interne (voir sous-spécialités ci-dessous)
    Relevance - 4/7
    Intérêt médiatique  - 4/7

Résumé (en anglais)

OBJECTIVES: To analyze the effectiveness of tai chi for falls prevention.

DESIGN: Systematic review and meta-analysis.

SETTING: Pubmed, Scopus, CINHAL, and Physiotherapy Evidence Database (PEDro) were searched to May 26, 2016.

PARTICIPANTS: Older adult population and at-risk adults.

INTERVENTION: Randomized controlled trials analyzing the effect of tai chi versus other treatments on risk of falls.

MEASUREMENTS: The incidence rate ratio (IRR) for falls incidence and hazard ratio (HR) for time to first fall.

RESULTS: The search strategy identified 891 potentially eligible studies, of which 10 met the inclusion criteria. There was high-quality evidence of a medium protective effect for fall incidence over the short term (IRR = 0.57; 95% CI = 0.46, 0.70) and a small protective effect over the long term (IRR = 0.87; 95% CI = 0.77, 0.98). Regarding injurious falls, we found very low-quality evidence of a medium protective effect over the short term (IRR = 0.50; 95% CI = 0.33, 0.74) and a small effect over the long term (IRR = 0.72; 95% CI = 0.54, 0.95). There was no effect on time to first fall, with moderate quality of evidence (HR = 0.98; 95% CI = 0.69, 1.37).

CONCLUSION: In at-risk adults and older adults, tai chi practice may reduce the rate of falls and injury-related falls over the short term (<12 months) by approximately 43% and 50%, respectively. Tai chi practice may not influence time to first fall in these populations. Due to the low quality of evidence, more studies investigating the effects of tai chi on injurious falls and time to first fall are required.


Commentaires cliniques (en anglais)

Internal Medicine

This is a meta-analysis on the efficacy of Tai Chi in the prevention of falls. No consideration is given to the type of condition of patients included in the reviewed trials, neither to the type of control interventions, which limits the relevance of this analysis.

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