Abstract
Qigong and Tai Chi are mind-body exercises that may provide therapeutic benefits for individuals with chronic low back pain (CLBP), yet their efficacy remains uncertain. This systematic review and meta-analysis assessed their effects on pain and disability in individuals with CLBP. Randomized controlled trials (RCTs) evaluating Qigong or Tai Chi for CLBP were included. A systematic search was conducted in MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Physiotherapy Evidence Database (PEDro), and the Cochrane Library up to September 2023. Pain and disability were the primary outcomes. Risk of bias (RoB) was assessed independently by two reviewers using Cochrane's RoB 2 tool. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess the certainty of the evidence. Eight RCTs (n = 729 adults, age range 31.5-73 years, intervention duration 4-24 weeks) were included. Meta-analysis was performed using a random-effects model, with heterogeneity quantified via I² statistics. Eight RCTs (n = 729 participants) were included. Qigong and Tai Chi significantly reduced pain intensity (standardized mean difference (SMD) = -1.07, 95%CI: -1.64 to -0.49, I² = 93%) and disability (SMD = -0.77, 95%CI: -1.39 to -0.15, I² = 93%) compared to control groups. Subgroup analyses suggested greater effect sizes against passive controls (SMD = -1.17, 95%CI: -1.91 to -0.43, I² = 90%) than against active controls (SMD = -0.98, 95%CI: -1.95 to -0.01, I² = 95%). Limitations include substantial heterogeneity among studies and imprecision in effect estimates. The certainty of evidence was rated moderate to high. Qigong and Tai Chi appear effective in reducing pain and disability in individuals with CLBP. However, substantial heterogeneity and the lack of direct comparisons with structured exercise programs necessitate further high-quality RCTs to confirm their long-term effectiveness.