Health Care Professional Information

Common Name

Tai Chi Chuan, Taiji, Tai Chi Quan

Clinical Summary

Tai Chi is an exercise program that uses a sequence of precise body movements, meditation, and synchronized breathing to improve health and well-being. Tai chi movements are designed to express the yin and yang components that are fundamental to traditional Chinese medicine in a balanced and harmonious form. Like most moderate physical activities, tai chi can improve stamina, muscle tone, agility, and flexibility. The practice of breathing exercises may serve a meditative function to reduce stress.
Recent reviews of clinical trials show that tai chi practice has many benefits that include improved quality of life, alleviation of pain, and improved flexibility and strength (1) (2). A clinical study showed that tai chi is effective in slowing bone loss in early postmenopausal women (3) and improved physical functioning in older women with osteoarthritis (4). There is also evidence that tai chi improves range of motion in the lower limbs in patients with rheumatoid arthritis (5). But a systematic review found the evidence insufficient to establish this (12). Studies also showed that tai chi exercises improved aerobic capacity in sedentary adults (2), reduced hypertension and lipid profile in hypertensive individuals (6), and improved sleep in elderly individuals (7). Tai chi also improves the quality of life in patients with chronic heart failure (9) (14).
Patients with fibromyalgia reported significant improvements in symptom management and quality of life following a tai chi exercise program (8) (13). In patients with Parkinson's disease, Tai chi training improved balance and reduced risk of falls (15).

Preliminary data suggest benefits of tai chi in improving the quality of life in breast cancer survivors (10) and neuropsychological functioning in cancer survivors (16). A randomized controlled trial showed that aerobic exercise maintained erythrocyte levels during radiation treatment in breast cancer patients (11).
Tai chi can be practiced by people of all age groups as the movements are gentle.

Purported Uses
  • Arthritis
  • Balance
  • Fibromyalgia
  • Hypertension
  • Osteoporosis
  • Pain
  • Strength and stamina
Mechanism of Action

Practitioners of traditional Chinese Medicine believe that disease results when the flow of Qi (internal energy) is blocked and when there is disharmony between the yin and yang forces. Tai chi exercises are thought to result in balancing these forces and promoting the flow of Qi to improve health.
But the precise mechanisms underlying such effects are not known.

Contraindications

Patients who suffer from musculoskeletal injuries should consult a physician before starting tai chi.

Literature Summary and Critique

Mustian KM, et al. Tai chi chuan, health-related quality of life and self-esteem: A randomized trial with breast cancer survivors. Support Care Cancer 2004;12:871-6.
In this randomized study, 21 breast cancer patients received 12 weeks of tai chi chuan or psychosocial support. The patients had completed cancer treatment within the last 30 months. Health-related quality of life and self-esteem were assessed at baseline, 6 weeks, and 12 weeks. Researchers found that patients in the tai chi group reported significant improvements in health-related quality of life and self esteem whereas those in the psychosocial group reported lowered self-esteem. However, more studies with larger sample size are needed to confirm these observations.

Tsai CJ, et al. The beneficial effects of tai chi chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. JACM 2003;9(5):747-754.
Seventy-six individuals with stage I hypertension were randomized into 2 groups. One group practiced tai chi for 3 times a week. Each session included a 10-minute warm-up, 30-minute tai chi exercise, and a 10-minute cool-down. The control group maintained a sedentary lifestyle. After 12 weeks, there was significant decrease in blood pressure, total serum cholesterol level, and anxiety levels in the tai chi group as compared to those in the control group. Although the study indicates effectiveness of tai chi in treating mild hypertension, it is unclear how tai chi compares with other physical activity programs.

Han A, et al. Tai chi for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2004;3:CD004849.
This review included four trials involving 206 participants with rheumatoid arthritis. Results of the trials indicate that tai chi exercises did not have any clinical or statistically significant effect on day-to-day activities or on the swollen joints. The exercise program did, however, significantly improve the lower extremity range of motion, in particular the ankle range of motion. Researchers also found that the exercises did not aggravate arthritic symptoms. These conclusions suggest that tai chi can be used to improve movement and thereby, the quality of life in patients with rheumatoid arthritis.

Yeh GY, et al. Effects of Tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: A randomized controlled trial. Am J Med 2004;117:541-48.Thirty patients with chronic stable heart failure were randomly assigned to receive standard care or tai chi exercises in addition to standard care. The exercises were practiced for one hour, twice a week, for 12 weeks. At 12 weeks, patients in the tai chi group reported improved quality of life compared to those in the control group. Researchers also found a decrease in the levels of serum B-type natriuretic peptide, which is suggestive of improved cardiac filling pressures. Since this study involved only thirty patients, trials involving more patients are needed to validate these observations.

References
  1. Klein PJ and Adams WD. Comprehensive therapeutic benefits of Taiji: a critical review. Am J Phys Med Rehabil 2004; 83(9):735-745.
  2. Taylor-Piliae RE and Froelicher ES. J Cardiovasc Nurs 2004; 19(1):48-57. Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis.
  3. Chan K, et al. Arch Phys Med Rehabil 2004; 85(5):717-722 A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women.
  4. Song R, et al. Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial. J Rheumatol 2003; 30(9):2039-2044.
  5. Han A, Robinson et al. Tai chi for treating rheumatoid arthritis. Cochrane Database Syst Rev 2004;(3):CD004849.
  6. Tsai JC, et al. The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. J Altern Complement Med 2003; 9(5):747-754.
  7. Li F, et al. Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomized controlled trial. J Am Geriatr Soc 2004; 52(6):892-900.
  8. Taggart HM, et al. Effects of T'ai Chi exercise on fibromyalgia symptoms and health-related quality of life. Orthop Nurs 2003; 22(5):353-360
  9. Yeh GY, et al. Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: A randomized controlled trial. Am J Med 2004; 117:541-48.
  10. Mustian KM, et al. Tai chi chuan, health-related quality of life and self-esteem: A randomized trial with breast cancer survivors. Support Care Cancer 2004;12:871-6.
  11. Drouin JS, Young TJ, Beeler J, et al. Random control clinical trial on the effects of aerobic exercise training on erythrocyte levels during radiation treatment for breast cancer. Cancer 2006.
  12. Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatology (Oxford). 2007;46(11):1648-51.
  13. Wang C, Schmid CH, Rones R, et al. A Randomized Trial of Tai Chi for Fibromyalgia. N Engl J Med 2010; 363:743-754.
  14. Yeh GY, McCarthy EP, Wayne PM, Stevenson LW. Tai Chi Exercise in Patients With Chronic Heart Failure: A Randomized Clinical Trial. Arch Intern Med. 2011;171(8):750-757.
  15. Fuzhong Li, Peter Harmer, Kathleen Fitzgerald, et al. Tai Chi and Postural Stability in Patients with Parkinson's Disease. N Engl J Med 2012; 366:511-519.
  16. Reid-Arndt SA1, Matsuda S, Cox CR. Tai Chi effects on neuropsychological, emotional, and physical functioning following cancer treatment: a pilot study. Complement Ther Clin Pract. 2012 Feb;18(1):26-30.

Consumer Information

How It Works

Bottom Line: Tai Chi exercises are effective in relieving pain, improving flexibility and strength, and reducing stress in some patients.

Tai Chi combines body movements, meditation and breathing exercises to improve health and well-being. The movements are designed to express the yin and yang components, the basic elements of Chinese medicine in a balanced form. Practitioners of Traditional Chinese Medicine believe that disease results when the flow of Qi (internal energy) is blocked and when there is disharmony between the yin and yang forces. Tai chi exercises are thought to result in balancing the forces of yin and yang and promoting the flow of Qi to improve health. Tai chi can improve stamina, muscle tone, agility, flexibility, and reduce stress. Studies have shown that tai chi practice has many benefits that include improved quality of life, reduction of pain, improved flexibility and strength. The breathing exercises can help improve respiratory function. It has also been shown to slow bone loss in early postmenopausal women and improved physical functioning in older women with osteoarthritis. There is also evidence that tai chi improves the range of motion in the lower limbs in patients with rheumatoid arthritis, and reduces risk of falls in patients with Parkinson's disease. One recent study showed that it improved the quality of life in patients with fibromyalgia. Studies also showed that the exercises reduced high blood pressure in patients with hypertension and also helped improve sleep in elderly individuals. Tai chi also improves the quality of life in patients with chronic heart failure. Tai chi can be practiced by people of all age groups as the movements are gentle and it puts minimal stress on the body. Currently, there are no studies that demonstrate the effects of tai chi in cancer treatment. However, aerobic exercise has been shown to benefit breast cancer patients.

Purported Uses
  • Pain
    This use is supported by clinical trials.
  • Muscle strength
    Some studies show that tai chi can improve muscle strength.
  • Arthritis
    Clinical trials suggest that tai chi can reduce pain in patients with osteoarthritis and rheumatoid arthritis.
  • Anxiety
    Several studies have shown that tai chi is effective in reducing anxiety levels.
  • Hypertension
    One clinical trial supports use of tai chi in lowering high blood pressure. More studies are needed.
  • Fibromyalgia
    Tai chi was shown effective in managing symptoms and in improving quality of life in patients with fibromyalgia in two clinical trials.
Research Evidence

Bone density:
In a clinical trial, 132 healthy women after menopause were assigned to tai chi or no exercise groups. Tai chi exercises were practiced for 45 minutes every day, 5 days a week for 12 months. Women in the tai chi group had slower rate of bone loss compared to those in the control group.

Hypertension:
In another study, 76 patients with hypertension were asked to practice tai chi exercises for 3 times a week for 12 weeks or no exercise. After 12 weeks, there was a decrease in blood pressure, total serum cholesterol, and anxiety in patients in the tai chi group compared to those who did not exercise.

Rheumatoid arthritis:
Four clinical trials that included 206 patients were reviewed in this study. Researchers found that tai chi improves the range of motion in the ankle without increasing the arthritic symptoms.

Do Not Take If
  • Consult your doctor before starting tai chi if you are suffering from musculoskeletal injuries.
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