• Tianzhao Tian, Yingfeng Cai, Jianpeng Zhou, Baoxin Liu, Liye Chen, Min Shi, and Haodong Liang.
• Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China.
• Medicine (Baltimore). 2020 Jan 1; 99 (1): e18549.

BackgroundPhysical therapy have an important role in preventing and managing osteoporosis (OP). A number of randomized controlled studies have indicated that eight-section brocade (ESB) could increase bone mass and alleviate pain, particularly in older women. However, there is no systematic review evaluating safety and efficacy of ESB.MethodsRelevant studies involving eight-section brocade in middle-aged and elderly individuals with osteoporosis were systematically identified from electronic databases, including EMBASE, PubMed, the Cochrane Library Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodicals Database, Chinese BioMedical Database, and Wanfang Data. Inclusion criteria are randomised controlled trials of eight-section brocade that examine function and bone metabolism in middle-aged and elderly individuals with OP. The primary outcome measures will be bone mineral density (BMD), balance capacity, pain score, and adverse event including fracture during exercise. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Begg and Egger tests will be used to assess funnel plot symmetries. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.ResultsThis paper will systematically review the existing evidence, assessing the safety and effect of eight-section brocade in middle-aged and elderly individuals with OP.ConclusionThe results of this review may help to establish a better approach to prevention of osteoporosis and osteoporotic fractures in high-risk groups and to provide reliableevidence for its further application.Ethics And DisseminationOur aim is to publish this systematic review in a peer-reviewed journal. Our findings will provide information about the safety of ESB exercises and their effect on BMD of middle-aged and elderly individuals. This review will not require ethical approval as there are no issues about participant privacy.

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