Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 3;11(1):260.
doi: 10.1186/s13643-022-02100-5.

Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials

Guo-Yan Yang #  1 , Jennifer Hunter #  2 , Fan-Long Bu  3 , Wen-Li Hao  4 , Han Zhang  5 , Peter M Wayne  6 , Jian-Ping Liu  7   8
Affiliations

Determining the safety and effectiveness of Tai Chi: a critical overview of 210 systematic reviews of controlled clinical trials

Guo-Yan Yang et al. Syst Rev. .

Abstract

Background: This overview summarizes the best available systematic review (SR) evidence on the health effects of Tai Chi.

Methods: Nine databases (PubMed, Cochrane Library, EMBASE, Medline, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan 2010 and Dec 2020 in any language. Effect estimates were extracted from the most recent, comprehensive, highest-quality SR for each population, condition, and outcome. SR quality was appraised with AMSTAR 2 and overall certainty of effect estimates with the GRADE method.

Results: Of the 210 included SRs, 193 only included randomized controlled trials, one only included non-randomized studies of interventions, and 16 included both. Common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%), and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found; however, multiple proxy-outcomes/risks factors were evaluated. One hundred and fourteen effect estimates were extracted from 37 SRs (2 high, 6 moderate, 18 low, and 11 critically low quality), representing 59,306 adults. Compared to active and/or inactive controls, 66 of the 114 effect estimates reported clinically important benefits from Tai Chi, 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight of the 114 effect estimates (7.0%) were rated as high, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low certainty evidence due to concerns with risk of bias (92/114, 80.7%), imprecision (43/114, 37.7%), inconsistency (37/114, 32.5%), and publication bias (3/114, 2.6%). SR quality was often limited by the search strategies, language bias, inadequate consideration of clinical, methodological, and statistical heterogeneity, poor reporting standards, and/or no registered SR protocol.

Conclusions: The findings suggest Tai Chi has multidimensional effects, including physical, psychological and quality of life benefits for a wide range of conditions, as well as multimorbidity. Clinically important benefits were most consistently reported for Parkinson's disease, falls risk, knee osteoarthritis, low back pain, cerebrovascular, and cardiovascular diseases including hypertension. For most conditions, higher-quality SRs with rigorous primary studies are required.

Systematic review registration: PROSPERO CRD42021225708.

Keywords: Overview; Prevention; Rehabilitation; Systematic review; Tai Chi; Treatment.

PubMed Disclaimer

Conflict of interest statement

GYY is an academic researcher at NICM Health Research Institute. As a medical research institute, NICM Health Research Institute receives research grants and donations from foundations, universities, government agencies, individuals, and industry. Sponsors and donors provide untied funding for work to advance the vision and mission of the Institute. This review was not undertaken as part of a contractual relationship with any donor or sponsor.

GYY is an academic researcher with interest in traditional, complementary, and integrative medicine. She has spoken at research workshops, seminars, and conferences for which registration and travel has been paid by the organizers.

JH is the director and beneficial share holder of Health Research Group and an academic general practitioner with a clinical interest in integrative medicine. JH has received payment for providing expert advice about traditional, complementary, and integrative medicine, including nutraceuticals, to industry, government bodies and non-government organizations, and spoken at workshops, seminars and conferences for which registration, travel and/or accommodation has been paid for by the organizers.

FLB, WLH, and HZ have no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work.

PW is the founder and sole owner of the Tree of Life Tai Chi Center. PW’s interests were reviewed and managed by the Brigham and Women’s Hospital and Partner’s HealthCare in accordance with their policies of conflict of interest. PW was supported by National Institutes of Health grant K24AT009282.

JPL is an academic researcher with interest in traditional, complementary, and integrative medicine. He has spoken at research workshops, seminars, and conferences for which registration and travel has been paid by the organizers.

Reviewers JH, WLH, FLB, and HZ were not Tai Chi investigators and were yet to publish a SR evaluating a Tai Chi intervention. JH directed the selection process of the SRs for the final synthesis and was involved in all aspects of rating both the quality of the SRs and the GRADE certainty in the evidence. Of the other four reviewers (GYY, WLH, FLB, and HZ) who were involved in screening, selecting, extracting data, and appraising the SRs and evidence certainty, only GYY was a Tai Chi investigator. GYY had conducted and published RCTs evaluating Tai Chi interventions but was yet to publish a SR evaluating a Tai Chi intervention before the completion of this overview.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Tang H, Gu L. Study on Tai Chi. Beijing: People’s Sport Publishing House of China; 2012. The history and development of Tai Chi.
    1. Wayne PM, Manor B, Novak V, Costa MD, Hausdorff JM, Goldberger AL, Ahn AC, Yeh GY, Peng CK, Lough M, et al. A systems biology approach to studying Tai Chi, physiological complexity and healthy aging: design and rationale of a pragmatic randomized controlled trial. Contemp Clin Trials. 2013;34(1):21–34. doi: 10.1016/j.cct.2012.09.006. - DOI - PMC - PubMed
    1. Gu L, Shen J. Chen style Tai Chi. Beijing: People’s Sports Publishing House of China; 2007.
    1. Wayne PM, Kaptchuk TJ. Challenges inherent to t’ai chi research: part II-defining the intervention and optimal study design. J Altern Complement Med. 2008;14(2):191–7. - PubMed
    1. Yang JY. A practical exploration on the reform of Taijiquan elective courses in universities based on the Chinese health physical education curriculum model. J Phys Educ. 2020;06:111–117.

Publication types