BACKGROUND: Tai Chi has been shown to improve the bone mineral density of the middle-aged and elderly patients, and the quality is poor, so a systematic assessment is required. OBJECTIVE(S): To evaluate the effect of Tai Chi on bone mineral density in the middle-aged and elderly, thereby providing accurate and reliable reference for the prevention and treatment of osteoporosis, and providing the reference of evidence-based medicine for making exercise prescription. METHOD(S): Databases of Wanfang, CNKI, CBM, Cochrane Library, PubMed and Embase were searched from inception to September 2018 to identify the randomized controlled trials or clinical controlled trials concerning the effect of Tai Chi on bone mineral density in the middle-aged and elderly. The quality of the included randomized controlled trials and clinical controlled trials was evaluated by Cochrane system and criteria made by Slim. RevMan 5.3 software and State 13.0 software were used for meta-analysis. RESULTS AND CONCLUSION(S): Tai Chi could significantly improve the bone mineral density of the lumbar vertebrae (MD 0.09, 95%CI 0.06 to 0.12, p < 0.00001), femoral neck (MD 0.09, 95%CI 0.06 to 0.13, p < 0.00001), large trochanter (MD 0.06, 95%CI 0.03 to 0.10, p < 0.00001) and Ward's triangle (MD 0.07, 95%CI 0.06 to 0.09, p < 0.0002) in the middle-aged and elderly. At the same time, Tai Chi could significantly increase the bone mineral density of calcaneus, such as speed of sound and broadband ultrasound attenuation (p < 0.05). These results indicate that Tai Chi can significantly improve the bone mineral density in the middle-aged and elderly patients, and possesses the good roles in the prevention and treatment of middle-aged and elderly osteoporosis.

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