- Tai Chi Chuan
For Patients & Caregivers
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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 obtained from this modality increase with regular practice.
How It Works
Tai chi practice can improve posture, movement control, and ability to walk, in part due to the gradual weight shift that occurs with the lower and upper limbs. Slow foot movements such as forward heel-to-toe and backward toe-to-heel motions also improve flexibility, stamina, and muscle tone. The practice of moving from wide to narrow stances as well as turning in the movements expands the number of situations under which the body experiences support. The coordinated breathing used along with the exercises helps to improve lung function. Taken together, these details within the exercises are the mechanisms that serve to improve balance while reducing risk of falls. Tai chi has also been shown to reduce inflammation that is linked with many chronic diseases, including heart disease and cancer.
Balance and fall risk
Several studies show that tai chi improves balance which may also help to reduce fall risk.
Clinical trials suggest that tai chi can help reduce fatigue in cancer patients.
A randomized trial showed that tai chi was as good or even better than aerobic exercise to reduce fibromyalgia symptoms.
In a randomized trial of older adults, tai chi appeared to boost immune response to the shingles vaccine and the shingles virus.
Several studies show that tai chi reduces markers of inflammation that are linked with many chronic diseases and dysregulated sleep.
This use is supported by clinical trials.
Several studies show that tai chi can improve muscle strength, flexibility, stamina, and stable posture in a variety of populations including cancer patients.
Several studies indicate that tai chi improves sleep, including among cancer patients.
Is It Safe
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 a new online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.
For Healthcare Professionals
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 the Yin and Yang vital forces and promote the flow of Qi, or internal energy, to improve health. Like most moderate physical activities, tai chi can improve stamina, muscle tone, agility, and flexibility. The coordinated breathing along with the exercises may serve a meditative function to increase awareness and reduce stress.
Clinical trials show that tai chi has many benefits including reduced pain and improved flexibility and strength (1) (2) (9) (53). Tai chi may also help reduce bone loss (3) and fracture-related risks (4), and improve physical function (5). Along with resistance training and diet, tai chi improved mobility in obese older women (6). In addition, tai chi benefits patients with fibromyalgia (26) (27) (51), improved range of motion in arthritis patients (7) (8), and improved fitness and mental health among ethnically diverse participants (10). In patients with end-stage hip osteoarthritis, a combined tai chi/strength training program improved balance and aerobic capacity (11). For older adults with previous fall-related emergency visits, those who were given a tai chi intervention were less likely to experience subsequent falls than those given lower-extremity training (12). Tai chi in both community and home practice settings also appear to reduce fall risk and improve physical and executive function among older adults (54) (55). It also reversed markers of inflammation and improved sleep in elderly individuals and patients with insomnia (20) (21) (22) (23) (49) (58) (59). Other studies suggest that tai chi can boost immune response to the shingles vaccine and even to the shingles virus itself in a randomized trial of older adults (60).
In cancer patients, tai chi improves QoL (36) (37), neuropsychological functioning (38), limb function (56), and cancer-related fatigue and sleep (40) (52) (56), and was noninferior to cognitive behavioral therapy (50) (58). It may also reduce risk factors for other chronic diseases (18) (19) and has shown benefits in patients with COPD (14) (15), cardiovascular disease (16) (17) (24) (25), neurological diseases like Parkinson’s (28) (29) (31) and multiple sclerosis (30), and in sedentary adults (2).
A large review of 45 meta-analyses concluded the level of evidence to be moderate to support tai chi in improving physical and mental health outcomes among patients with cancer, neurological disorders, metabolic diseases, cardiopulmonary diseases, musculoskeletal diseases, and cognitive-psychological disorders (61).
Tai chi can be practiced by people of all age groups and has been found to have a good adherence rate (17) (22) as the movements are gentle and there is a low risk for injury. In a meta-analysis of RCTs to assess safety, tai chi was found to be generally safe, with significantly fewer adverse events than with controls among patients with heart failure (57).
The Integrative Medicine Service at MSK offers tai chi and other exercise and mind-body modalities in a new online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.
Mechanism of Action
Improved postural control and walking ability are due to specific features that characterize the tai chi protocol, in which weight shifting and ankle sway move one’s 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 rotation of the torso with an upright posture. Forward heel-to-toe and backward toe-to-heel steps strengthen dorsiflexion and plantar flexion, respectively. Improvements in mobility are attributed to the increased flexibility and balance that may occur with regular tai chi practice (6), and are also the mechanisms by which this modality helps to prevent falls (41). Tai chi particularly appears to alleviate bradykinetic movements associated with Parkinson’s disease by improving gait characteristics such as maximum excursion, while reducing deviation in movement (eg, reaching forward to take objects from a cabinet; transitioning from seated-to-standing / standing-to-seated positions) and markedly increasing gait velocity and stride length (28).
Several studies evaluating biomarker changes with tai chi indicate that the physical aspects of this exercise 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). Tai chi may also improve health-related QoL by regulating other inflammatory responses and biomarkers (37).
- Tai chi is generally considered to be safe (19). Adverse events have not yet been reported in studies of tai chi for patients with COPD (15), Parkinson’s disease (29), or cancer (39) (45). Additional studies are further evaluating safety in patients with cardiovascular (46) (47) and Parkinson’s disease (48).
- It is advisable that patients with musculoskeletal injuries 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 a new online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.