Paper
Thursday, 20 July 2006
This presentation is part of : Using Evidence to Enhance Patient Care
Tai Chi Exercise for Pain Reduction in Older Adults: A Meta-Analysis Approach
Asphodel Yang, RN, MSN, Patti Hamilton, RN, PhD, and Gail C. Davis, EdD. College of Nursing, Texas Woman's University, Denton, TX, USA
Learning Objective #1: Discuss the use of meta-analysis in evidence-based practice
Learning Objective #2: Discuss the use of tai chi chuan exercise for pain reduction in older adults
The American Geriatrics Society (2002) and many researchers have suggested regular physical activity should be part of the comprehensive pain management program for all older adults.  Studies have shown Tai Chi Chuan (TCC) has the potential to reduce suffering associated with poor health, and evidence has supported its use with frail, community-dwelling elder adults.  The majority of the published studies examining the efficacy of TCC in pain reduction have small sample size.  A meta-analysis involves the integration of several studies with small or large sample size, enabling the investigator to summarize the research result into useful clinical information.  Thus, the purpose of this paper is to present a systematic review of the effectiveness of TCC for pain management in older adults and a meta-analysis to estimate the extent to which TCC reduces pain intensity. A broad computerized literature search was conducted using an interactive online information system, EBSCOhost Database. A total of eight studies that investigated tai chi and pain and met the inclusion criteria were included in this meta-analysis. Quality assessment on each of the eight studies was performed using the Quality Index (Downs and Black, 1998). Explicit information about sample characteristics, intervention, outcome measures, results, and statistical methods was recorded using standardized abstracting forms. Only outcomes measure such as pain intensity was assessed.  Comprehensive Meta Analysis Program (Biostate, 1999) was used to analysis statistical data extracted from retrieved articles and to conduct meta-analysis. Effect sizes, 95% confidence intervals (CI) and p-values were calculated for each of studies as well as fixed and random combine effects. The studies reviewed and the results from the meta-analyses generally support the effectiveness of TCC in pain reduction for older adults. However, quality of studies requires further improvement in treating confounding factors, addressing compliance, randomizing the assignment and concealment of allocations.

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