Tai Chi (Tai Ji)

Purported Benefits, Side Effects & More

Tai Chi (Tai Ji)

Purported Benefits, Side Effects & More
Tai chi (Tai ji)

Common Names

  • Tai Chi Chuan
  • Taijiquan

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

What is it?

Regular tai chi practice can improve posture, movement control, and ability to walk. The gradual weight shift in lower and upper limbs and slow foot movements like forward heel-to-toe and backward toe-to-heel also improve flexibility, stamina, and muscle tone. Moves from wide to narrow stances while turning also expands the types of situations under which the body experiences support.

The coordinated breathing used in tai chi helps to improve lung function, increase awareness, and reduce stress.

Taken together, these physical and mental aspects of tai chi work to improve balance and mobility while reducing fall risk. It also reduces markers of inflammation linked to many chronic diseases.

What are the potential uses and benefits?
  • Balance and fall risk
    Several studies show that tai chi improves balance which may also help reduce fall risk.
  • Fatigue
    Clinical trials suggest that tai chi can help reduce fatigue in cancer patients.
  • Pain
    Tai chi can help with several types of pain including knee pain, low back pain, and fibromyalgia.
  • Physical functioning
    Tai chi can improve muscle strength, flexibility, stamina, and posture in a variety of populations including cancer patients.
  • Sleep
    Tai chi can improve sleep, including among cancer patients. One study found it had similar effects to cognitive behavioral therapy, the non-drug gold standard treatment for insomnia.
  • Inflammation
    Tai chi reduces markers of inflammation linked with many chronic diseases and disturbed sleep.
  • Immune functioning
    In a randomized trial of older adults, tai chi appeared to boost immune response to the shingles vaccine and the shingles virus.
What else do I need to know?

What Is It:

Based on Chinese philosophy and traditional medicine, tai chi is a movement therapy that seeks to harmonize the Yin and Yang vital forces and promote the flow of energy in the body known as Qi to improve health. It coordinates a series of prescribed movements with meditation and breathing exercises.

Clinical trials of tai chi have been conducted in elderly, frail, and disabled patients, and those with chronic conditions such as fibromyalgia, arthritis, Parkinson’s disease, heart disease, and cancer. These studies show that tai chi can improve sleep, strength, stamina, flexibility, balance, limb function, immune function, blood pressure, mental outlook, and awareness. It can also help reduce stress, fall risk, inflammation, and bone loss.

Tai chi can be practiced by people of all age groups as the movements are gentle with little stress on the body. Like other mind-body approaches, benefits increase with regular practice.

Is It Safe:

  • Tai chi is generally considered to be safe.
  • Patients with muscle and bone injuries should consult their physician before starting tai chi practice. 

Who Can Provide this Service:

Experienced tai chi instructors.

Where Can I Get Treatment:

Many hospitals, cancer centers, and community and senior centers offer tai chi classes. The Integrative Medicine Service at MSK offers tai chi and other exercise and mind-body modalities in our online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.

For Healthcare Professionals

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. Based on Chinese philosophy and traditional medicine theory, tai chi exercises are thought to harmonize Yin and Yang vital forces and promote the flow of Qi, or internal energy. Coordinated breathing with these exercises also serve a meditative function to increase awareness and reduce stress.

Tai chi can help improve

  • Balance
  • Mobility
  • Stamina

It can also help reduce

  • Pain
  • Fatigue
  • Fall risk

Effects on pain, mobility, balance, and fall risk
Clinical trials show that tai chi practice reduces pain (9) (26) (27) (51) (53), improves flexibility, strength, balance, and mobility (1) (2) (5) (6) (7) (8) (11) (56) (62), and reduces fall and fracture risks (3) (4) (12) (54) (55). It also improved fitness and mental health among ethnically diverse participants (10), and significantly improved function and balance even as a tailored sitting program for subacute stroke survivors (64).

Effects on fatigue, sleep, and inflammation
Tai chi reduced cancer-related fatigue (40) (52) (56) (65), improved sleep (21) (50) (65), and was noninferior to cognitive behavioral therapy (50). Other studies suggest it can also reverse markers of inflammation (20) (23) (37) (49) (59) (62) and boost immune response (60).

Studied in multiple patient populations 
Tai chi may reduce risk factors for chronic diseases (18) (19) and is a useful tool in chronic illness management (58) including patients with cancer (50) (56) (59), COPD (14) (15), cardiovascular disease (16) (17) (24) (25), neurological diseases like Parkinson’s (28) (29) (31) (62) and multiple sclerosis (30), and in sedentary adults (2).

Oncology guidelines recommend tai chi
Current oncology guidelines recommend tai chi as adjunctive therapy in cancer patients to reduce fatigue, improve sleep, and as exercise therapy (66) (67) (69) and for anxiety and depression (68).

Clinical trials are continuing to evaluate tai chi for patients with cancer.

The Integrative Medicine Service at MSK offers tai chi as part our online program, Integrative Medicine at Home, as well as other classes and therapies to support the recovery and well-being of cancer patients everywhere.

Purported Uses and Benefits
  • Balance
  • Fatigue
  • Fall risk
  • Inflammation
  • Mobility
  • Pain
  • Sleep
Mechanism of Action

Specific features that characterize the tai chi protocol include weight shifting and ankle sway, which move center of gravity toward the limits of stability (28). Alternating narrow and wide stances continually change the base of support, increase support-leg standing and trailing-leg swing time, and encourage torso rotation with an upright posture. Forward heel-to-toe and backward toe-to-heel steps strengthen dorsiflexion and plantar flexion, respectively.

Regular tai chi practice also incorporates semi-squatting positions and abdominal breathing producing lower extremity muscle co-contractions that affect neuromuscular coordination, gait, and postural control, as well as bone mineral density by producing stress changes in the lumbar spine and femur (61) (63). Improved mobility is related to increased flexibility and balance (6), and are also the mechanisms by which tai chi practice helps prevent falls (41).

In patients with Parkinson’s disease, fMRI studies associated improved balance score with visual network changes, the reduced connections of which have been shown in PD patients with frozen gait (62). Tai chi particularly appears to alleviate bradykinetic movements by improving gait characteristics such as maximum excursion, while reducing deviation in movement and markedly increasing gait velocity and stride length (28). Reduced markers of inflammation and improvements in amino acid, energy, and neurotransmitter metabolism were also attributed to long-term effects on Parkinson’s severity and balance scores (62).

Other studies evaluating biomarker changes suggest the physical aspects of tai chi mediate reductions in both decreased fat mass and IL-2 levels along with increased fat-free mass and IL-6, while the meditative component may also contribute to anti-inflammatory effects (42). Declining pro-inflammatory cytokine IL-2 levels further result in increased bone formation and metabolism levels (43). Other anti-inflammatory effects include increased superoxide dismutase activity with reduced IL-1β (44).

Adverse Reactions
  • Tai chi is generally considered to be safe (19) (57), can be practiced by people of all age groups, and has a good adherence rate (17) (22) as the movements are gentle with low risk for injury.
  • Patients with musculoskeletal injuries should consult their physicians before starting a tai chi program.
Practitioners and Treatments

Tai chi classes are offered in many hospitals, cancer centers, and community and senior centers, generally by experienced instructors. The Integrative Medicine Service at MSK offers tai chi and other exercise and mind-body modalities in our online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.

Dosage (OneMSK Only)
  1. Klein PJ, Adams WD. Comprehensive therapeutic benefits of Taiji: a critical review. Am J Phys Med Rehabil. Sep 2004;83(9):735-745.
  2. Taylor-Piliae RE, Froelicher ES. Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis. J Cardiovasc Nurs. Jan-Feb 2004;19(1):48-57.
  3. Chan K, Qin L, Lau M, et al. A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Arch Phys Med Rehabil. May 2004;85(5):717-722.
  4. Wayne PM, Kiel DP, Buring JE, et al. Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial. BMC Complement Altern Med. 2012;12:7.
  5. Song R, Lee EO, Lam P, 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. Sep 2003;30(9):2039-2044.
  6. Maris SA, Quintanilla D, Taetzsch A, et al. The combined effects of tai chi, resistance training, and diet on physical function and body composition in obese older women. J Aging Res. 2014;2014:657851.
  7. Han A, Robinson V, Judd M, et al. Tai chi for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2004(3):Cd004849.
  8. Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatology (Oxford). Nov 2007;46(11):1648-1651.
  9. Tsai PF, Chang JY, Beck C, et al. A supplemental report to a randomized cluster trial of a 20-week Sun-style Tai Chi for osteoarthritic knee pain in elders with cognitive impairment. Complement Ther Med. Aug 2015;23(4):570-576.
  10. Dogra S, Shah S, Patel M, et al. Effectiveness of a Tai Chi intervention for improving functional fitness and general health among ethnically diverse older adults with self-reported arthritis living in low-income neighborhoods: a cohort study. J Geriatr Phys Ther. Apr-Jun 2015;38(2):71-77.
  11. Zeng R, Lin J, Wu S, et al. A randomized controlled trial: preoperative home-based combined Tai Chi and Strength Training (TCST) to improve balance and aerobic capacity in patients with total hip arthroplasty (THA). Arch Gerontol Geriatr. Mar-Apr 2015;60(2):265-271.
  12. Hwang HF, Chen SJ, Lee-Hsieh J, et al. Effects of Home-Based Tai Chi and Lower Extremity Training and Self-Practice on Falls and Functional Outcomes in Older Fallers from the Emergency Department-A Randomized Controlled Trial. J Am Geriatr Soc. Mar 2016;64(3):518-525.
  13. Day L, Hill KD, Stathakis VZ, et al. Impact of tai-chi on falls among preclinically disabled older people. A randomized controlled trial. J Am Med Dir Assoc. May 1 2015;16(5):420-426.
  14. Chan AW, Lee A, Lee DT, et al. The sustaining effects of Tai chi Qigong on physiological health for COPD patients: a randomized controlled trial. Complement Ther Med. Dec 2013;21(6):585-594.
  15. Ngai SP, Jones AY, Tam WW. Tai Chi for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2016(6):Cd009953.
  16. Yeh GY, Wood MJ, Lorell BH, 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. Oct 15 2004;117(8):541-548.
  17. Yeh GY, McCarthy EP, Wayne PM, et al. Tai chi exercise in patients with chronic heart failure: a randomized clinical trial. Arch Intern Med. Apr 25 2011;171(8):750-757.
  18. Sun J, Buys N. Community-Based Mind-Body Meditative Tai Chi Program and Its Effects on Improvement of Blood Pressure, Weight, Renal Function, Serum Lipoprotein, and Quality of Life in Chinese Adults With Hypertension. Am J Cardiol. Oct 1 2015;116(7):1076-1081.
  19. Campo RA, Light KC, O’Connor K, et al. Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial. J Cancer Surviv. Mar 2015;9(1):115-125.
  20. Irwin MR, Olmstead R, Breen EC, et al. Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial. Biol Psychiatry. Nov 15 2015;78(10):721-729.
  21. Li F, Fisher KJ, Harmer P, et al. Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomized controlled trial. J Am Geriatr Soc. Jun 2004;52(6):892-900.
  22. Manor B, Lough M, Gagnon MM, et al. Functional benefits of tai chi training in senior housing facilities. J Am Geriatr Soc. Aug 2014;62(8):1484-1489.
  23. Carroll JE, Seeman TE, Olmstead R, et al. Improved sleep quality in older adults with insomnia reduces biomarkers of disease risk: pilot results from a randomized controlled comparative efficacy trial. Psychoneuroendocrinology. May 2015;55:184-192.
  24. Kim H, Kim YL, Lee SM. Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients. Int J Rehabil Res. Jun 2015;38(2):156-161.
  25. Nery RM, Zanini M, de Lima JB, et al. Tai Chi Chuan improves functional capacity after myocardial infarction: A randomized clinical trial. Am Heart J. Jun 2015;169(6):854-860.
  26. Taggart HM, Arslanian CL, Bae S, et al. Effects of T’ai Chi exercise on fibromyalgia symptoms and health-related quality of life. Orthop Nurs. Sep-Oct 2003;22(5):353-360.
  27. Wang C, Schmid CH, Rones R, et al. A randomized trial of tai chi for fibromyalgia. N Engl J Med. Aug 19 2010;363(8):743-754.
  28. Li F, Harmer P, Fitzgerald K, et al. Tai chi and postural stability in patients with Parkinson’s disease. N Engl J Med. Feb 9 2012;366(6):511-519.
  29. Zhang TY, Hu Y, Nie ZY, et al. Effects of Tai Chi and Multimodal Exercise Training on Movement and Balance Function in Mild to Moderate Idiopathic Parkinson Disease. Am J Phys Med Rehabil. Oct 2015;94(10 Suppl 1):921-929.
  30. Azimzadeh E, Hosseini MA, Nourozi K, et al. Effect of Tai Chi Chuan on balance in women with multiple sclerosis. Complement Ther Clin Pract. Feb 2015;21(1):57-60.
  31. Li F, Harmer P. Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008-2011. Prev Chronic Dis. 2015;12:E120.
  32. Lauche R, Stumpe C, Fehr J, et al. The Effects of Tai Chi and Neck Exercises in the Treatment of Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. J Pain. Jun 23 2016.
  33. Bao X, Jin K. The beneficial effect of Tai Chi on self-concept in adolescents. Int J Psychol. Mar 2015;50(2):101-105.
  34. Zheng G, Lan X, Li M, et al. Effectiveness of Tai Chi on Physical and Psychological Health of College Students: Results of a Randomized Controlled Trial. PLoS One. 2015;10(7):e0132605.
  35. Black LI, Clarke TC, Barnes PM, et al. Use of complementary health approaches among children aged 4-17 years in the United States: National Health Interview Survey, 2007-2012. Natl Health Stat Report. Feb 10 2015(78):1-19.
  36. Mustian KM, Katula JA, Gill DL, et al. Tai Chi Chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors. Support Care Cancer. Dec 2004;12(12):871-876.
  37. Sprod LK, Janelsins MC, Palesh OG, et al. Health-related quality of life and biomarkers in breast cancer survivors participating in tai chi chuan. J Cancer Surviv. Jun 2012;6(2):146-154.
  38. Reid-Arndt SA, Matsuda S, Cox CR. Tai Chi effects on neuropsychological, emotional, and physical functioning following cancer treatment: a pilot study. Complement Ther Clin Pract. Feb 2012;18(1):26-30.
  39. Campo RA, O’Connor K, Light KC, et al. Feasibility and acceptability of a Tai Chi Chih randomized controlled trial in senior female cancer survivors. Integr Cancer Ther. Nov 2013;12(6):464-474.
  40. Larkey LK, Roe DJ, Weihs KL, et al. Randomized controlled trial of Qigong/Tai Chi Easy on cancer-related fatigue in breast cancer survivors. Ann Behav Med. Apr 2015;49(2):165-176.
  41. Winters-Stone K. Tai Ji Quan for the aging cancer survivor: Mitigating the accelerated development of disability, falls, and cardiovascular disease from cancer treatment. J Sport Health Sci. Mar 1 2014;3(1):52-57.
  42. Janelsins MC, Davis PG, Wideman L, et al. Effects of Tai Chi Chuan on insulin and cytokine levels in a randomized controlled pilot study on breast cancer survivors. Clin Breast Cancer. Jun 2011;11(3):161-170.
  43. Peppone LJ, Mustian KM, Janelsins MC, et al. Effects of a structured weight-bearing exercise program on bone metabolism among breast cancer survivors: a feasibility trial. Clin Breast Cancer. Jun 2010;10(3):224-229.
  44. Mendoza-Nunez VM, Hernandez-Monjaraz B, Santiago-Osorio E, et al. Tai Chi exercise increases SOD activity and total antioxidant status in saliva and is linked to an improvement of periodontal disease in the elderly. Oxid Med Cell Longev. 2014;2014:603853.
  45. Galantino ML, Callens ML, Cardena GJ, et al. Tai chi for well-being of breast cancer survivors with aromatase inhibitor-associated arthralgias: a feasibility study. Altern Ther Health Med. Nov-Dec 2013;19(6):38-44.
  46. Salmoirago-Blotcher E, Wayne P, Bock BC, et al. Design and methods of the Gentle Cardiac Rehabilitation Study—A behavioral study of tai chi exercise for patients not attending cardiac rehabilitation. Contemp Clin Trials. Jul 2015;43:243-251.
  47. Tao J, Rao T, Lin L, et al. Evaluation of Tai Chi Yunshou exercises on community-based stroke patients with balance dysfunction: a study protocol of a cluster randomized controlled trial. BMC Complement Altern Med. 2015;15:31.
  48. Yang Y, Hao YL, Tian WJ, et al. The effectiveness of Tai Chi for patients with Parkinson’s disease: study protocol for a randomized controlled trial. Trials. 2015;16:111.
  49. Irwin MR, Olmstead R, Breen EC, et al. Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial. Biol Psychiatry. 2015 Nov 15;78(10):721-9.
  50. Irwin MR, Olmstead R, Carrillo C, et al. Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. J Clin Oncol. 2017 Aug 10;35(23):2656-2665.
  51. Wang C, Schmid CH, Fielding RA, et al. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. BMJ. Mar 21 2018;360:k851.
  52. Wayne PM, Lee MS, Novakowski J, et al. Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. J Cancer Surviv. Apr 2018;12(2):256-267.
  53. Qin J, Zhang Y, Wu L, et al. Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). Sep 2019;98(37):e17099.
  54. Gallant MP, Tartaglia M, Hardman S, et al. Using Tai Chi to Reduce Fall Risk Factors Among Older Adults: An Evaluation of a Community-Based Implementation. J Appl Gerontol. Jul 2019;38(7):983-998.
  55. Chewning B, Hallisy KM, Mahoney JE, et al. Disseminating Tai Chi in the Community: Promoting Home Practice and Improving Balance. Gerontologist. May 15 2020;60(4):765-775.
  56. Ni X, Chan RJ, Yates P, et al. The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis. Support Care Cancer. Oct 2019;27(10):3701-3716.
  57. Cui H, Wang Q, Pedersen M, et al. The safety of tai chi: A meta-analysis of adverse events in randomized controlled trials. Contemp Clin Trials. Jul 2019;82:85-92.
  58. Zou L, Xiao T, Cao C, et al. Tai Chi for Chronic Illness Management: Synthesizing Current Evidence from Meta-Analyses of Randomized Controlled Trials. Am J Med. 2021 Feb;134(2):194-205.e12
  59. Irwin MR, Olmstead R, Breen EC, et al. Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial. J Natl Cancer Inst Monogr. Nov 2014;2014(50):295-301.
  60. Irwin MR, Olmstead R, Oxman MN. Augmenting immune responses to varicella zoster virus in older adults: a randomized, controlled trial of Tai Chi. J Am Geriatr Soc. Apr 2007;55(4):511-517.
  61. Wayne PM, Gow BJ, Hou F, et al. Tai Chi training’s effect on lower extremity muscle co-contraction during single- and dual-task gait: Cross-sectional and randomized trial studies. PLoS One. 2021;16(1):e0242963.
  62. Li G, Huang P, Cui SS, et al. Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson’s disease patients. Transl Neurodegener. Feb 7 2022;11(1):6.
  63. Cheng L, Chang S, He B, et al. Effects of Tai Chi and brisk walking on the bone mineral density of perimenopausal women: A randomized controlled trial. Front Public Health. 2022;10:948890.
  64. Zhao J, Chau JPC, Chan AWK, et al. Tailored Sitting Tai Chi Program for Subacute Stroke Survivors: A Randomized Controlled Trial. Stroke. Jul 2022;53(7):2192-2203.
  65. Yao LQ, Kwok SWH, Tan JB, et al. The effect of an evidence-based Tai chi intervention on the fatigue-sleep disturbance-depression symptom cluster in breast cancer patients: A preliminary randomised controlled trial. Eur J Oncol Nurs. Sep 28 2022;61:102202.
  66. National Comprehensive Cancer Network. NCCN Guidelines: Cancer-Related Fatigue.
  67. National Comprehensive Cancer Network. NCCN Guidelines: Survivorship.
  68. Carlson LE, Ismaila N, Addington EL, et al. Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol. 2023 Aug 15:JCO2300857.
  69. Bower JE, Lacchetti C, Alici Y, et al. Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update. J Clin Oncol. 2024 May 16:JCO2400541.
Email your questions and comments to [email protected].

Last Updated