The effectiveness of Tai chi in improving bone mineral density in postmenopausal women

Abstract

Topic overview: Bone mineral density (BMD) is known to decrease as a person grows older. However, women experience more bone loss due to an impairment to the normal bone turnover cycle caused by estrogen deficiency. If bone loss is not improved, this could lead to osteoporosis. Tai Chi, which is a therapeutic exercise, has many health benefits and may also be beneficial in improving BMD of postmenopausal women (Yang et al. 2020). The research question: Is Tai Chi effective in improving bone mineral density in postmenopausal women? PICO elements: The population studied comprised postmenopausal women. The intervention under review was Tai Chi practice while the comparison was no Tai Chi practice. The expected outcome was an improvement in BMD. Method: The key elements of the PICO question were utilised in order to create alternative terms. These were then combined with the use of Boolean Operators. Limiters were also used for a more precise search. The terms created were then searched in the following databases; EBSCO, PubMed and Scopus. To eliminate articles which were not relevant, the PRISMA 2009 checklist was made use of. To evaluate the eligibility of the articles, an inclusion and exclusion criteria was applied (Table 2.4). The critical appraisal of the literature was guided with the use of the Critical Appraisal Skills Programme (CASP) tool. Results: In total, this study included one meta-analysis and five randomised controlled trials (RCTs). The meta-analysis and one of the RCTs found that Tai Chi does not improve BMD, while another RCT concluded that Tai Chi improves BMD. The other three RCTs found that Tai Chi did not improve BMD but it did however slow bone loss. Conclusion: From this study, a definite conclusion cannot be presented. However, the results show that although BMD may not be improved, it can be maintained. More research should be carried out for a more clear answer to the PICO question. Implications and recommendations: Tai Chi practice by postmenopausal women would provide many health benefits. This includes either improving BMD or slowing the rate of bone loss. This leads to a decrease in the risk of developing osteoporosis. Postmenopausal women should also be made aware of the risk factors which lead to faster bone loss and those at a higher risk should be encouraged to take a bone density screening test regularly. Further research should be done in this area, with a larger sample size in order to have a better understanding of the role of Tai Chi in improving BMD in postmenopausal women.