Abstract
PURPOSE: To systematically evaluate the effects of Tai Chi on bone mineral density (BMD) in lumbar spine, femoral greater trochanter, Ward's triangle, femoral neck, and calcaneus among middle-aged and older adults through a meta-analysis. METHODS: A comprehensive literature search was conducted across multiple databases, including CNKI, PubMed, Embase, Web of Science, and Cochrane Library, to identify randomized controlled trials (RCTs) investigating the impact of Tai Chi on BMD in middle-aged and older populations. The literature search covered the period from the establishment of each database to February 25, 2025. EndNote 20 was employed for literature management. The methodological quality of included studies was evaluated using the PEDro (Physiotherapy Evidence Database) scale. Heterogeneity analysis, bias assessment, and sensitivity analysis were performed on extracted data using RevMan 5.4 and Stata SE 15.0 software. RESULTS: 1. Seventeen randomized controlled trials (RCTs) with a total sample size of 1,253 participants (intervention group: n=675; control group: n=578) were included in the final analysis. The methodological quality of the included studies, as assessed by standardized evaluation criteria, demonstrated overall high robustness. The meta-analysis revealed statistically significant improvements in bone mineral density (BMD) at multiple skeletal sites following Tai Chi intervention: lumbar spine (WMD = 0.07, 95% CI: 0.04-0.11, p < 0.00001), greater trochanter (WMD = 0.04, 95% CI: 0.02-0.06, p < 0.00001), Ward's triangle (WMD = 0.03, 95% CI: 0.01-0.05, p = 0.007), femoral neck (WMD = 0.03, 95% CI: 0.02-0.05, p < 0.0001), and calcaneus (WMD = 5.52, 95% CI: 3.87-7.27, p < 0.00001). CONCLUSION: Regular Tai Chi practice demonstrates significant improvements in bone mineral density (BMD) among middle-aged and older adults, particularly at the lumbar spine. Our meta-analysis suggests Tai Chi may serve as a viable non-pharmacological intervention for mitigating osteoporosis in aging populations. Notably, individuals aged ≥60 years exhibit more pronounced BMD enhancements when adhering to a structured regimen of ≥3 sessions/week over ≥6 months. However, rigorously designed randomized controlled trials (RCTs) are required to validate these observed benefits and systematically explore optimal Tai Chi exercise regimens for skeletal health promotion.