大学生太极拳活动的心理健康效益：基于ICF的系统综述

doi:10.3969/j.issn.1006-9771.2023.01.007

摘要/Abstract

摘要：

目的运用《国际功能、残疾和健康分类》(ICF)构建大学生参与太极拳活动的心理健康效益及架构，系统综述太极拳运动对大学生焦虑、抑郁及睡眠质量的改善效果。

方法采用主题检索方式，检索Web of Science、PubMed、Medline、Scopus、中国知网、万方数据库建库至2022年11月10日公开发表的大学生参与太极拳运动及其在焦虑、抑郁、睡眠质量健康结局的相关文献，进行系统综述。

结果纳入10篇文献，均来自中国和美国，包括10项随机对照试验和960例参与者(16.4~40岁)，主要来源于体育与健康领域期刊，发表时间集中于2016年至2021年。物理治疗证据数据库量表评分平均为6.3分。大学生主要心理健康问题表现为抑郁、焦虑、高压力和低睡眠质量。采取的太极拳运动方式以二十四式简化太极拳为主，也包括陈氏太极拳。干预方案为每周1~6次，每次45~90 min (60 min居多)，持续4~18周。太极拳对大学生焦虑、抑郁、睡眠质量的健康效益在ICF中主要体现在情感功能(b152)、心理运动功能(b147)、能量和驱力功能(b130)和睡眠功能(b134)。太极拳练习能改善焦虑，缓解抑郁，减轻压力。加入二十四式太极拳理课程的太极拳锻炼，对改善轻度和中度抑郁症患者的抑郁水平相比单一的太极拳练习效果更显著。太极拳有助于提高睡眠质量，缩短入睡时间，降低睡眠障碍和日间功能障碍。

结论本研究基于ICF构建了大学生参与太极拳活动的健康效益的PICO架构。大学生从事的太极拳活动主要为二十四式简化太极拳，干预方案为每次45~90 min (60 min居多)，每周1~6次，持续4~18周。太极拳活动心理健康效益主要表现为改善大学生焦虑、抑郁状态，提升睡眠质量。

关键词: 太极拳, 大学生, 焦虑, 抑郁, 睡眠质量, 系统综述

Abstract:

Objective To construct the mental health benefits of physical activity of Tai Chi and framework for college students based on International Classification of Functioning, Disability, and Health (ICF), and to systematically review the effect of physical activity of Tai Chi on anxiety, depression and sleep quality of college students.

Methods Relevant literatures about the health outcomes on anxiety, depression and sleep quality of college students participating in physical activity of Tai Chi were retrieved from databases of Web of Science, PubMed, Medline, Scopus, CNKI, Wanfang data, from the establishment to November 10th, 2022, and screened and reviewed.

Results Ten randomized controlled trials were included finally, from China and U.S.， involving 960 participants (aged 16.4 to 40 years). The main sources were from journals about physical activity and health, with publication dates from 2016 to 2021. The quality of the included literatures was evaluated using the Physical Therapy Evidence Database (PEDro) scale with a mean score of 6.3. The main mental health problems of college students mainly focused on depression, anxiety, high stress, and poor sleep quality. The physical activity of Tai Chi included 24 simplified Tai Chi and Chen style Tai Chi. The frequency of physical activity of Tai Chi was mainly 1 to 6 times a week, 45 to 90 minutes (60 minutes mostly) a time, for 4 to 18 weeks. The health benefits of Tai Chi on anxiety, depression, and sleep quality for college students in the ICF were mainly in the affective function (b152), psychomotor function (b147), energy and drive function (b130), and sleep function (b134). The beneficial outcomes of physical activity of Tai Chi involved reducing anxiety, alleviating depressive symptoms and reducing stress. Compared with physical activity of Tai Chi, physical activity of Tai Chi with the addition of a twenty-four-pattern Taijiquan theory course was more effective in improving depression levels in patients with mild and moderate depression. Tai Chi also can help to improve sleep quality, shorten the time to sleep, and reduce sleep disturbances and daytime dysfunction.

Conclusion A PICO framework of Tai Chi for the health benefits of college students has been constructed using ICF. Tai Chi engaged in by college students are mainly 24 simplified Tai Chi. The frequency of physical activity of Tai Chi is 45 to 90 minutes (60 minutes mostly) a time, 1 to 6 times a week, for 4 to 18 weeks. The physical activities of Tai Chi can benefit in reducing anxiety and depression of college students and improving the quality of sleep.

Key words: Tai Chi, college student, anxiety, depression, sleep quality, systematic review

中图分类号:

崔家宝, 林舰, 刘育成, 王鹏, 曾洪发. 大学生太极拳活动的心理健康效益：基于ICF的系统综述[J]. 《中国康复理论与实践》, 2023, 29(1): 48-54.

CUI Jiabao, LIN Jian, LIU Yucheng, WANG Peng, ZENG Hongfa. Mental health benefits of Tai Chi for college students: a systematic review using ICF[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 48-54.

图/表 4

表1

图1

表2

纳入研究基本特征"

纳入研究	国家	样本特征	健康和功能状况	干预方式	干预场所	干预方案	比较	心理健康效益
华正春等^[23] (2021)	中国	大二学生210例	身体健康	二十四式简化太极拳	大学课堂	每次80 min，每周1次，12周	太极拳能改善抑郁和焦虑	太极拳改善焦虑和抑郁效果显著
Zhang等^[24](2018)	中国	大一、大二学生共64例， (18.41±2.01)岁	有低于阈值的抑郁症状	二十四式简化太极拳	大学课堂	每次90 min，每周2次，8周	太极拳活动能降低抑郁状态和重度抑郁症发生率；减轻压力	太极拳能缓解抑郁症状并降低压力水平
胡平^[25] (2018)	中国	大一、大二、大三学生共60例	轻度和重度焦虑	二十四式简化太极拳	课外活动	每次65 min，每周> 4次，18周	二十四式太极拳可改善轻度焦虑	参与太极拳活动能减轻焦虑
李小芳等^[26] (2017)	中国	大一、大二学生共58例，(20.5±0.96)岁	轻度和中度抑郁	二十四式简化太极拳	课外活动	每次60 min，每周3次，12周	参与太极拳活动能改善抑郁	参与太极拳活动降低了抑郁水平
毛雪晨^[27] (2018)	中国	男大学生72例，(20.33±1.38)岁	身体健康	太极拳	大学课堂	每次60 min，每周2次，8周	参加太极拳活动能有效降低状态焦虑	参与太极拳活动降低了特质焦虑和状态焦虑
朱景芳等^[28] (2019)	中国	本科生125例，(19.15±0.87)岁	身体健康	二十四式简化太极拳	课外活动	每次60 min，每周5次，4周	参加太极拳活动能有效缓解抑郁	参与太极拳活动减轻抑郁情绪和压力
王磊^[29] (2021)	中国	女本科生60例	身体健康	太极拳活动	大学课堂	每次60~90 min，每周3~4次，16周	太极拳组的抑郁、焦虑等心理指标均显著改善	太极拳能显著减轻焦虑和抑郁
谢小婷等^[30] (2020)	中国	女大学生 104例	正常压力和高压力学生	二十四式简化太极拳	课外活动	每次60 min，每周5次，6周	参与太极拳活动能降低焦虑、抑郁和压力评分	参与太极拳活动能降低焦虑、抑郁和压力水平
沈鹤军等^[31] (2018)	中国	本科生132例，18~25岁	身体健康	二十四式太极拳	课外活动	每次45 min，每周5~6次，8周	太极拳组入睡时间、睡眠障碍和日间功能障碍显著改善	太极拳活动能改善睡眠质量
Caldwell等^[32](2016)	美国	大学生75例，18~40岁	轻、中度焦虑及轻度抑郁	陈氏太极拳	课外活动	每次60 min，每周2次，10周	太极拳对焦虑的影响较小，能改善睡眠质量	参与太极拳活动4周焦虑水平降低，睡眠改善

表2

表3

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纳入研究	资格标准	随机分配	分配隐藏	基线相似性	评定者施盲	被试流失率≤15%	意向治疗分析	组间统计比较	报告点测量和变异测量	总分
华正春等^[23](2021)	√	√	√			√	√	√	√	6
Zhang等^[24](2018)	√	√	√	√	√		√	√	√	7
胡平^[25](2018)	√	√				√	√	√	√	5
李小芳等^[26](2017)	√	√	√			√	√	√	√	6
毛雪晨^[27](2018)	√	√	√	√		√	√	√	√	7
朱景芳等^[28](2019)	√	√	√			√	√	√		5
王磊^[29](2021)	√	√	√	√		√	√	√		6
谢小婷等^[30](2020)	√	√	√	√	√	√	√	√	√	8
沈鹤军等^[31](2018)	√	√	√	√		√	√	√		6
Caldwell等^[32](2016)	√	√	√	√	√	√		√	√	7