title: Taichi exercise for self-rated sleep quality in older people: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Self-reported sleep disorders are common in older adults, resulting in serious consequences. Non-pharmacological measures are important complementary interventions, among which Taichi exercise is a popular alternative. Some experiments have been performed; however, the effect of Taichi exercise in improving sleep quality in older people has yet to be validated by systematic review. Using systematic review and meta-analysis, this study aimed to examine the efficacy of Taichi exercise in promoting self-reported sleep quality in older adults.
  
  
  METHODS
  Systematic review and meta-analysis of randomized controlled studies.
  
  
  METHODS
  4 English databases: Pubmed, Cochrane Library, Web of Science and CINAHL, and 4 Chinese databases: CBMdisc, CNKI, VIP, and Wanfang database were searched through December 2013.
  
  
  METHODS
  Two reviewers independently selected eligible trials, conducted critical appraisal of the methodological quality by using the quality appraisal criteria for randomized controlled studies recommended by Cochrane Handbook. A standardized data form was used to extract information. Meta-analysis was performed.
  
  
  RESULTS
  Five randomized controlled studies met inclusion criteria. All suffered from some methodological flaws. The results of this study showed that Taichi has large beneficial effect on sleep quality in older people, as indicated by decreases in the global Pittsburgh Sleep Quality Index score [standardized mean difference=-0.87, 95% confidence intervals (95% confidence interval) (-1.25, -0.49)], as well as its sub-domains of subjective sleep quality [standardized mean difference=-0.83, 95% confidence interval (-1.08, -0.57)], sleep latency [standardized mean difference=-0.75, 95% confidence interval (-1.42, -0.07)], sleep duration [standardized mean difference=-0.55, 95% confidence interval (-0.90, -0.21)], habitual sleep efficiency [standardized mean difference=-0.49, 95% confidence interval (-0.74, -0.23)], sleep disturbance [standardized mean difference=-0.44, 95% confidence interval (-0.69, -0.19)], and daytime dysfunction [standardized mean difference=-0.34, 95% confidence interval (-0.59, -0.09)]. Daytime sleepiness improvement was also observed.
  
  
  CONCLUSIONS
  Weak evidence shows that Taichi exercise has a beneficial effect in improving self-rated sleep quality for older adults, suggesting that Taichi could be an effective alternative and complementary approach to existing therapies for older people with sleep problems. More rigorous experimental studies are required.
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Shizheng
authors.initials: S
authors.lastname: Du
authors.affiliation: Shanghai Health Education Institute, Shanghai, China.
authors.forename: Jianshu
authors.initials: J
authors.lastname: Dong
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Zhang
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Shengji
authors.initials: S
authors.lastname: Jin
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China. Electronic address: xgh_88@126.com.
authors.forename: Guihua
authors.initials: G
authors.lastname: Xu
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Zengxia
authors.initials: Z
authors.lastname: Liu
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Chen
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Yin
authors.affiliation: School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Zhiling
authors.initials: Z
authors.lastname: Sun
mesh_terms: D000368:Aged; D006801:Humans; D012890:Sleep; D026302:Tai Ji
keywords: Elderly; Eta-analysis; Sleep quality; Systematic review; Tai Ji