A Comprehensive Review of Health Benefits of Qigong and Tai Chi.
Research examining psychological and physiological benefits of Qigong and Tai Chi is growing rapidly. The many practices described as Qigong or Tai Chi have similar theoretical roots, proposed mechanisms of action and expected benefits.
Research trials and reviews, however, treat them as separate targets of examination. This review examines the evidence for achieving outcomes from randomized controlled trials (RCTs) of both.
A substantial body of published research has examined the health benefits of Tai Chi (also called Taiji) a traditional Chinese wellness practice. In addition, a strong body of research is also emerging for Qigong, an even more ancient traditional Chinese wellness practice that has similar characteristics to Tai Chi. Qigong and Tai Chi have been proposed, along with Yoga and Pranayama from India, to constitute a unique category or type of exercise referred to currently as meditative movement.1 These two forms of meditative movement, Qigong and Tai Chi, are close relatives having shared theoretical roots, common operational components, and similar links to the wellness and health promoting aspects of traditional Chinese medicine. They are nearly identical in practical application in the health enhancement context and share much overlap in what traditional Chinese medicine describes as the “three regulations”: body focus (posture and movement), breath focus, and mind focus (meditative components).
Due to the similarity of Qigong and Tai Chi, this review of the state of the science for these forms of meditative movement will investigate the benefits of both forms together. In presenting evidence for a variety of health benefits, many of which are attributable to both practices, we will point to the magnitude of the combined literature and suggest under what circumstances Qigong and Tai Chi may be considered as potentially equivalent interventions, with recommendations for standards and further research to clarify this potential.
Research Question 1: What health benefits are evidenced from RCTs of Qigong and Tai Chi?
Research Question 2: In examining the Qigong and Tai Chi practices incorporated in research, and the evidence for health benefits commensurate with each, what claims can be made for equivalence of these two forms of practice/exercise that have typically been considered to be separate and different?
Both Qigong and Tai Chi sessions incorporate a wide range of physical movements, including slow, meditative, flowing, dance-like motions. In addition, they both can include sitting or standing meditation postures as well as either gentle or vigorous body shaking. Most importantly, both incorporate the purposeful regulation of both breath and mind coordinated with the regulation of the body. Qigong and Tai Chi are both based on theoretical principles that are inherent to traditional Chinese medicine (TCM).1 In the ancient teachings of health-oriented Qigong and Tai Chi, the instructions for attaining the state of enhanced Qi capacity and function point to the purposeful coordination of body, breath and mind (paraphrased here): “Mind the body and the breath, and then clear the mind to distill the Heavenly elixir within.” This combination of self-awareness with self-correction of the posture and movement of the body, the flow of breath, and stilling of the mind, are thought to comprise a state which activates the natural self-regulatory (self-healing) capacity, stimulating the balanced release of endogenous neurohormones and a wide array of natural health recovery mechanisms which are evoked by the intentful integration of body and mind.
Therefore Qigong and Tai Chi, in the health promotion and wellness context, are operationally equivalent.
Qigong
Qigong exercises consist of a series of orchestrated practices including body posture/movement, breath practice, and meditation, all designed to enhance Qi function (that is, drawing upon natural forces to optimize and balance energy within) through the attainment of deeply focused and relaxed states. From the perspective of Western thought and science, Qigong practices activate naturally occurring physiological and psychological mechanisms of self-repair and health recovery.
A key underlying philosophy of the practice is that any form of Qigong has an effect on the cultivation of balance and harmony of Qi, positively influencing the human energy complex (Qi channels/pathways) which functions as a holistic, coherent and mutually interactive system.
Tai chi
Tai Chi, the exercise, is named after this concept and was originally developed both as a martial art (Tai Chi Chuan or taijiquan) and as a form of meditative movement. The practice of Tai Chi as meditative movement is expected to elicit functional balance internally for healing, stress neutralization, longevity, and personal tranquility. This form of Tai Chi is the focus of this review.
Table 1
Randomized Controlled Trials Testing Health Benefits of Qigong and Tai Chi
| Source | No. of Subjects/Mean Age Sex (Male/Femal e) | Exercise Duration (minutes × days per week) | Exercise Group | Control group | Reported Outcomes * P<.05 |
|---|---|---|---|---|---|
| Audette Jin Newcomer Stein Duncan & Frontera, 2006 USA | 27 Sedentary women 71.4 years 0/27 | 12 weeks (60 minutes × 3 days) | Tai Chi 10 movement Yang (n=11) | Brisk Walking (n=8); Usual Care (UC) later recruited and not randomized (n=8) | Cardiopulmonary: VO2 max ↑ in TC more than BW and UC*; heart rate variability, high frequency ↑ and low frequency ↓ in TC only* no between Falls and Balance: Strength, hand grip and knee extension ↑ TC only* and left knee extension ↑ in TC more than BW *; flexibility, only toe touch flexibility ↑ in TC more than BW*; and balance, only non-dominant one leg stance (OLS) with eyes closed ↑ in TC more than BW* |
| Barrow Bedford Ives O’Toole & Channer, 2007 UK | 52 Older adults history chronic heart failure 69.5 years 42/10 | 16 weeks (55 minutes × 2 days) | TC with Chi Kung (n=25) | Usual Care (n=27) | Cardiopulmonary: Incremental shuttle walk ↑ in TC more than UC ns Patient Reported Outcomes: Perceived symptoms of heart failure ↓ in TC more than UC* Psychological: Depression (SCL-90-R) ↓ in TC more than UC ns; anxiety ↓ in both groups ns |
| Brismee Paige Chyu Boatright Hagar McCaleb Quintela Feng Zu Shen, 2007 USA | 41 History of knee osteoarthritis 70 years 7/34 | 12 week TC and 6 week no training (40 minutes × 3 days/6 weeks group training and 6 weeks home training; and 6 weeks detraining) | TC Yang 24-form simplified (n=18) | 6 weeks of Health Lecture followed by no activity same as exercise group (n=13) | Physical Function: WOMAC ↑ in TC more than HL* with ↓ for detraining period Patient Reported Outcomes: Pain ↓ in TC more than HL*; adverse outcomes ns |
| Burini Farabollini Ianucci, Rimatori Riccardi Capecci Provinciali & Ceravolo, 2006 Italy | 26 History of Parkinson’s disease 65 years 9/17 | 7 weeks each of Aerobics (45 min × 3 days) and Qigong (50 min × 3 days) 20 sessions each with 8 weeks between sessions | Qigong (QG) (n=11) | Aerobic Training (AT) sessions (n=11) | Cardiopulmonary: 6-minute walk and Borg scale for breathlessness ↑ and spirometry and cardiopulmonary exercise test ↓ for AT more than QG* Patient Reported Outcomes: Parkinson’s Disease Questionnaire ns for both; Unified Parkinson’s Disease Rating Scale ns; Brown’s Disability Scale ns Psychological: Beck Depression Inventory ns |
| Chan Qin Lau Woo Au Choy Wingyee Lee & Lee, 2004 Hong Kong | 132 History of post-menopausal and sedentary 54 years 0/132 | 12 months (45 min 5 × days) | Tai Chi Chuan Yang Style (n=54) | UC (n=54) | Bone Density: Fractures (1 strong>TC and 3 UC) BMD measured by Dual energy x-ray absorptiometry in femoral neck, ↓ in TC less than UC ns and trochanter ↓ both ns; peripheral quantitative computed tomography of distal and ultradistal tibia ↓ less in TC than UC* |
| Channer Barrow Barrow Osborne & Ives 1996 UK | 126 History of MI 58.5 years ?/? | 8 weeks (2 days × 3 weeks, then 1 day × 5 weeks) | TC Wu Chian-Ch’uan (n=38) | Aerobic Exercise (n=41) or Cardiac Support Group (n=41) discussed risk factor modification and problems in rehab. | Cardiopulmonary: Immediate SBP and DBP ↓ TC and AE ns and HR ↑ in AE more than TC *; Over time, SBP ↓ both ns and DBP and resting HR↓ in TC more than AE *; SG too small for comparison |
| Chen Yeh & Lee 2006 Taiwan | 87 History of BMD T ≥ −2.5 45 years 0/87 | 12 week (studied for 2 weeks, then 3 days/week) | QG Baduanjin (n=44) | NQqigong (n=43) | Bone Density: BMD maintained in QG and ↓ in NQ*; Immune/Inflammation: Interleukin-6↓ in QG and ↑ in NQ* |
| Cheung Lo Fong Chan Wong Wong Lam Lau Karlberg 2005 Hong Kong | 88 Older adults in community, history of hypertension 54.5 years 37/51 | 16 wk (120 min × 2 days × 4 weeks then monthly and encouraged to practice 60 min in AM and 15 min in PM × 7 days) | QG Guolin (n=37) | Exercise (n=39) | Cardiopulmonary: BP, HR, waist circumference, BMI, Total cholesterol, renin and 24 hour urinary protein excretion ↓ QGandEns; ECGQGandEnc/ns QOL: SF-36 ↓ E ns Psychological: Beck Anxiety Inventory ↓ and Beck Depression Inventory ↑ QG and E ns |
| Choi Moon & Song 2005 South Korea | 59 Living in care facility, ambulatory with history of at least 1 fall risk factor 77.8 years 15/44 | 12 weeks (35 min × 3 days) | Tai Chi Sun-style (n=29) | UC(n=30) | Falls and Balance: Falls ns, but falls efficacy forTC↑ and ↓UC*; knee and ankle strength, OLS eyes open, and Toe reach ↑ and 6 meter walk ↓ more thanUC*; OLS eyes open nc Self-efficacy: Falls efficacy forTC↑ and ↓UC* |
| Chou Lee Yu Macfarlane Cheng Chan & Chi 2004 Hong Kong | 14 Community dwelling Chinese, history of depression from a psycho- geriatric clinic 72.6 years 7/7 | 3 months(45 min × 3 days) | Tai Chi Yang Style18 form (n=7) | Waitlist (n=7) | Psychological: Center for Epidemiological Studies Depression Scale ↓TCmore than W* |
| Elder, Ritenbaugh Mist Aickin Schneider Zwickey & Elmer 2007 USA | 92 History of completing 12 week wt loss intervention and loss of at least 3.5 kg 47.1 years 13/79 | 24 weeks (10 hours overall with 28 min qigong sessions) | Qigong Emie Zhen Gong (n=22) | TapasAcupressureTechnique (n=27) andSelf-DirectedSupport (n=24) | Cardiopulmonary: Wt loss maintenance forTATand ↑ QG andSDS* |
| Faber Bosscher Chin Paw & vanWieringe n 2006 Netherlands | 238 Frail (51%) or pre-frail (48.9%) older adults living in care facility 85 years 50/188 | 20 week (60 min exercise and 30 min social time × day × 4 weeks for socializatio n, then × 2 days for 16 weeks) | Tai Chi (balance exercises inspired byTC) (n=90) | FunctionalWalking (n=66) orUC(92) | Falls and Balance: Falls lower forTCmore than FW andUCns; When FW andTCcombined, Fall risk↓ and physical function (6 meter walk, Timed chair stand, TUG, and FICSIT-4) ↑ compared toUCin pre-frail*, frail ns, alsoTCcompared to FW ns Patient Reported Outcomes: Performance Oriented Mobility Assessment ↑ forTCand FW and exercise groups combined more thanUC*and pre-frail*, frail ns; Groningen Activity Restriction Scale ↓ for FW more than control*TCvsUCns |
| Fransen Nairn Winstanley Lam & Edmons 2007 Austrailia | 152 Older adults, history of chronic symptomatic hip or knee osteoarthritis 70.8 years 40/112 | 12 week (60 min × 2 days) | TCfor Arthritis by Dr. Lam from Sun Style 24-forms (n=56) | Hydrotherapy (n=55) andWaitList control (n=41) | Physical Function: WOMAC: Pain and function ↓TCand H ns with treatment effect for physical function moderate*; pain score ↓ for H compared toWL*,TCns; Physical performance: TUG, 50-foot walk, and stair climb ↓ more for H thanWL*; and timed stair climb for ↓TCand H ns QOL: SF-12 Physical ↑ H more thanWL*andTCmore thanWLborderline*; SF-12 Mental ns Patient Reported Outcomes: Pain and function ↓TCandHns Psychological: Depression Anxiety Stress 21 ↓ H*andTCns |
| Galantino Shepard Krafft Laperriere Ducette Sorbello Barnish Condoluci & Farrar 2005 USA | 38 History of long term care of HIV/AIDS Between 20 and 60 38/0 | 8 weeks (60 minx 2 days) | TC(n=13) | AerobicExercise (n=13) andUC(n=12) | Physical Function: FR, SR, Sit Up, and Physical Performance Test all improved more thanUC*andTCcompared to AE nc QOL: Medical Outcomes Short Form-HIV improvedTCand AE more than control*; Spiritual Well Being improvedTCAE andUCns Psychological: Profile of Mood States improvedTCand AE more than control* |
| Gatts and Woollacott 2006 USA | 19 Balance impaired seniors 68–92 years 2/17 | 3 weeks (90 min × 5 days) | Tai Chi Twelve Classical Tai Chi Postures (n=11) | TC Based and axial mobility program; same group practicedTCafter control time (n=8) | Falls and Balance: TUG ↓ more forTCthan control*; FR↑ forTCand control; OLS and tandem stance both legs ↑ moreTCthan control*; tibialis anterior more ↑ forTCthan control*; gastrocnemius ↑ onlyTCafter control time* |
| Gemmell & Leathem 2006 New Zealand | 18 History of traumatic brain injury symptoms 45.7 years 9/9 | 6 weeks (45 min × 2 days) | TCChen Style (n=9) | WaitlistUC(n=9) | QOL: SF-36 and Rosenberg Self-Esteem Scale no different ns except role emotional ↑TCmore thanUC* Psychological: Visual Analogue Mood Scales improvedTCmore thanUC*; Rosenberg Self-Esteem Scale nc, ns |
| Greenspan Wolf Kelley O’Grady 2007 USA | 269 Congregate independent living, transitionally frail with at least 1 fall in past year >70 years and 50% over 80 0/269 | 48 week (60 increasing to 90 min × 2 days) | TC6 simplified forms (n=103) | WellnessEducation (n=102) | Physical Function: Sickness Impact Profile for physical function and ambulation ↓ moreTChan WE* Patient Reported Outcomes: Sickness Impact Profile and physical and ambulation perceived health status ↓TCmore thanWE*and Self Reported Health ncTCandWEns |
| Hammond & Freeman 2006 UK | 133 History of fibromyalgia from a rheumatology outpatient department 48.53 years 13/120 | 10 weeks (45 min × 1 day) | Tai Chi for Arthritis (part of patientEducation group including fibromyalg ia informatio n, postural training, stretching and weights) (n=52) | RelaxationGroup (n=49) | Self-efficacy: Arthritis Self-Efficacy Scale ↑TCmore than RG at 4 months*at 8 months ns Patient Reported Outcomes: Fibromyalgia Impact Questionnaire ↓TCmore than RG*at 4 months*at 8 months ns Psychological: Anxiety and depressionTCand TG ns |
| Hart Kanner Gilboa-Mayo Haroeh-Peer Rozenthul-Sorokin Eldar 2004 Israel | 18 History of stroke, community- dwelling 54.77 years 16/2 | 12 weeks (60 min × 2 days) | TCC (n=9) | BalanceExercises (n=9) | Falls and Balance: BBS, OLS, Emory Fractional Ambulation Profile, Romberg, TUG improved inBE*, notTCC ns QOL: Duke Health Profile improvedTC*, notBEns |
| Hartman Manos Winter Hartman Li & Smith 2000 USA | 33 Community dwelling with lower extremity osteoarthritis 68 years 4/28 | 12 weeks (60 min × 2 days) | TC9 form Yang (n=18) | UsualCare with phone calls every 2 weeks to discuss issues related to Osteoarthritis (n=15) | Physical Function: OLS, 50-ft walk, and chair riseTCandUCns with small to moderate effect size forTConly QOL: Arthritis Impact Measurement Scale II(satisfaction with life) ↑ and tension ↓ more forTCthanUC*Pain and mood both ns Self-efficacy: Arthritis self-efficacy ↑TCmore thanUC* |
| Hass Gregor Waddell Oliver Smith Fleming Wolf 2004 USA | 28 Older adults transitioning to frailty 79.6 years ?/? | 48 weeks(60 min × 2 days) | Tai Chi 8 of 24 simplified forms (n=14) | WellnessEducation (n=14) | Falls and Balance: Center of pressure during S1 and S2 improved forTCmore thanWE*S3 for both ns |
| Irwin Olmstead & Oxman 2007 USA | 112 Healthy older adults 70 years 41/71 | 16 weeks (40 min × 3 days) | Tai Chi Chih (n=59) | HealthEducation (n=53) | QOL: SF-36 improved for physical functioning, bodily pain, vitality and mental health forTCmore thanHE*; Role emotional ↓ for HE more thanTC*; Role physical, general health, and social functioning both groups ns Psychological: Beck Depression Score ↑TCandHEns Immune/Inflammation: Varicella zoster virus-Responder cell frequency ↑TCmore thanHE* |
| Irwin Pike Cole & Oxman 2003 USA | 36 Healthy older adults 60 years 5/13 | 15 week (45 min × 3 days) | Tai chi Chih (n=14) | WaitList (n=17) | QOL: SF-36 only role-physical and physical functioning improved more forTCthanWL* Immune/Inflammation: Varicella zoster virus-cell-mediated immunity ↑ more forTCthanWL* |
| Jin 1992 Australia | 96 Tai Chi practitioners 36.2 years 48/48 | History ofTC46.4 mo males/34 months females 2 sessions of exposure to stress followed by respective treatment | Tai Chi Long form or Yang Style (n=24) | BriskWalking (n=24),TC Meditation (n=24), andNeutralReading (n=24) | Psychological: Profile of Mood States improved all treatments*with state anxiety ↓ inTCmore than reading*; BP and HR ↑ under stress forTCand BW more than M and NR*; Adrenaline ↓ more forTCthan M*; noradrenaline ↑ more forTCthan NR*; and salivary cortisol ↑ all groups* |
| Judge Lindser Underwook & Winsemius 1993 USA | 21 Sedentary women 68 years 0/21 | 6 months(20 min walking plus other exercise × 3 days forTCand no exercise for 12 weeks, then 30 min x1 day for FT) | Tai Chi simple with strength training and walking (n=12) | FlexibilityTraining (n=9) | Falls and Balance: OLS ↑ more forTCthan FT ns; knee extension ↑ more forTCthanFT*; and sitting leg press improvedTCandFTns |
| Kutner, Barnhart, Wolf, McNeely, & Xu 1997 USA | 130TCBalance training and control mostly women/Healthy older adults 76.2 years ?/? | 15 weeks (45 min total × 2 days TC and 1 day BT and ED) | TC10 modified forms from 108 (n=51) | BalanceTraining (n=39) andEducationControl (n=40) | QOL: SF-36 all groups nc Self-efficacy: Self confidence ↑ more forTCandBTthanEC* Psychological: Rosenberg self esteem ↑ moreTCthanBTorECns |
| Lansinger Larsson Persson & Carlsson 2007 Sweden | 122 History of long term nonspecific neck pain 43.8 years 36/86 | 3 month (1 hour × 1–2 days/week × 10–12 sessions) | Qigong Biyun (n=60) | ExerciseTherapy (n=62) | Physical Function: Grip strength and Cervical ROM ↑ both groups ns Patient Reported Outcomes: Neck pain and Neck Disability Index ↓ both groups ns |
| Lee Lee Kim & Choi 2004a AND Lee Lim & Lee 2004b Korea | 36 History of hypertension 53.4 years 14/22 | 8 wk (30 min × 2 days) | Qigong Shuxinping xuegong (n=17) | WaitList (n=19) | Cardiopulmonary: (2004a) BP ↓ more inQGthanWL*; HDL and APO-A1 ↑ more in QG thanWL*; high-density lipoprotein and Apolipoprotein A1 ↑ and total cholesterol ↓ inQGpre-post*; Triglycerides ↓ inQGand ↑ inWLns Self-efficacy: (2004b) Self efficacy and perceived benefits↑ inQGand ↓ inWL* Psychological: (2004b) Emotional state ↑ inQGand ↓ inWL* |
| Lee Lee Kim & Moon 2003a AND Lee Lee Choi & Chung 2003b Korea | 58 History of hypertension 56.2 years | 10 weeks (30 min × 3 days) | Qigong Shuxinping xuegong (n=29) | UC WaitList (n=29) | Cardiopulmonary: (2003a) HR ↓ more inQGthanWL*; Epinephrine and norepinephrine ↓ forQGand ↑ forWL*; cortisol ↓ for QG and ↑ forWLns Psychological: (2003a) Self report stress↓ QG more thanWL*; Epinephrine and norepinephrine ↓ for QG and ↑ forWL*; cortisol ↓ for QG and ↑ forWLns Cardiopulmonary: (2003b) BP and catecholamines ↓ for QG and ↑ forUC*; Ventilatory function ↑ more forQGthanUC* |
| Lee Y. K. Lee & Woo 2007a Hong Kong | 139 Resident of care facility, ambulatory, Chinese and 82.7 years 45/96 | 26 weeks (60 min × 3 days) | Tai Chi (n=66) | UC(n=73) | QOL: Health Related Quality of Life ↑TCmore thanUC* Psychological Symptoms: Self Esteem ↑TCmore thanUC* |
| Li Fisher Harmer & Shirai 2003 USA | 48 Older adults 68.88 years | 3 months (3 days/wk) | Tai Chi Yang 8- form easy Tai Chi (n=26) | StretchingControl (n=22) | Falls and Balance: OLS improvedTCmore thanSC* Physical Function: SF-12 physical, instrumental activities of daily living, 50-ft walk, and chair rise all improvedTCmore thanSC* Psychological: SF-12 mental ↑ moreTCthanSC* |
| Li Fisher Harmer Irbe Tearse & Weimer 2004 USA | 118 History of moderate sleep complaints and community dwelling adults 75.4 years 22/96 | 24 week (60 min × 3 days) | Tai chi Yang (n=62) | ExerciseControl (n=56) | Physical Function: OLS and SF-12 physical ↑; and chair rise and 50-ft walk ↓TCmore thanEC* Patient Reported Outcomes: Sleep duration and efficiency ↑ and sleep quality, latency, duration, and disturbances; Epworth Sleepiness Scale; and Pittsburg Sleep Quality Index ↓ more forTCthanEC*; Sleep dysfunction both and medication ↓TConly ns Psychological: SF-12 mental ↑ both ns |
| Li Harmer Fisher McAuley Chaumeton Eckstrom & Wilson 2005b AND Li Fisher Harmer & McAuley 2005a USA | 256 Sedentary 77.48 years 77/179 | 6 month (60 min × 2 days) | TCYang Style 24 forms (n=125) | StretchingControl (n=131) | Falls and Balance: (2005b) Fewer falls and fewer injurious falls forTCthanSC*; and BBS, Dyamic Gait Index, FR and OLS ↑ and 50 ft walk and TUG ↓ more forTCthanSC*all sustained at 6 month follow-up Falls and Balance: (2005a) Activities Specific Balance ↑ more forTCthanSC* Self-efficacy: (2005a) Falls Self-efficacy↑ (mediator) and fear of falling (SAFFE) ↓ more forTCthanSC* Psychological: Fear of falling (SAFFE) ↓ more forTCthanSC* |
| Li Harmer McAuley Duncan Duncan Chaumeton & Fisher 2001a USA | 49 Sedentary and community dwelling 72.8 years 9/85 | 6 month (60 min × 2 days) | Tai Chi Yang style 24 forms (n=49) | WaitList (n=45) | Physical Function: SF-20 (physical function) ↑ moreTCthanWL* |
| Li Harmer McAuley Fisher Duncan & Duncan 2001b AND Li Fisher Harmer & McAuley 2002 AND Li Harmer Chaumeton Duncan Duncan 2002 AND Li McAuley Harmer Duncan & Chaumeton 2001 USA | 94 Sedentary 72.8 years 9/85 | 6 month (60 min × 2 days) | Tai Chi Yang style 24 forms (n=49) | WaitList (n=45) | Physical Function: (2001b) SF-20 physical Function ↑ amongTCmore thanWLover time*r scores Self-efficacy: (2001b) Self-efficacy ↑ amongTCmore thanWLover time*r scores QOL: (2002) SF −20 (General Health Survey) ↑ more forTCthanWL*;TCwith lower levels of health perception, physical function, and high depression at baseline and Movement confidence ↑ = ↑ physical function* Psychological: (2002) Physical function self-esteem and Rosenberg self-esteem ↑ more forTCthanWL* Self-efficacy: (2001) Barrier and performance Self-efficacy ↑TCmore thanWL*; exercise adherence ↑TCthanWL*; and SE conditions related to adherence forTC |
| Maciaszek Osinski Szeklicki & Stemplewske 2007 Poland | 49 Sedentary, history of osteopenia or osteoporosis 60 to 82.1 years 49/0 | 18 week (45 min × 2 days) 3 month (20 min × 1 day) | Tai Chi 24 form (n=25) | UC(n=24) | Falls and Balance: Posturographic Platform (time ↓; % task performance and total length of path ↑ forTC*; and % task performance and total length of path ↑ more forTCthanUC* |
| Mannerkorpi & Arndorw 2004 Sweden | 36 History of Fibromyalgia 45 years 0/36 | Qigong with Body Awareness (n=19) | UC(n=17) | Physical Function: Chair stand and hand gripTCandUCns Patient Reported Outcomes: Body Awareness ↑TCmore thanUC*; fibromyalgia symptomsTCandUCns |
|
| Manzaneque Vera Maldonado Carranque et al. 2004 Spain | 29 Healthy young adults 18–21 14/15 | 1 month (30min × 5 days) | Qigong Eight Pieces of Brocade (low intensity) (n=16) | UC(n=13) | Immune/Inflammation: Leukocytes, eosoinophils, monocytes, and C3 levels ↓TCthanUC*; trend for neutrophils; and total lymphocytes, T lymphocytes, t helper lymphocytes, concentrations of complement C4 or immunoglobulins ns |
| McGibbon Krebs Parker Scarborough Wayne & Wolf 2005 USA | 36 History of vestibulopath y 59.5 years 16/20 | 10 weeks (70 min × 1 day) | Tai Chi Yang (n=19) | VestibularRehabilitation (n=12) | Falls and Balance: Gait speed ↑TCmore than VR*; step length ↑ forTCandVR*; stance duration ↓ VR*more thanTC; Step width ↑ VR andTCns: Mechanical energy expenditure (hip ↓TCmore than VR*; ankle ↑ more forTCthanVR*; knee and leg both ns); Peak trunk forward velocity ↑TCmore thanVR*; forward velocity range and peak or range of lateral trunk velocityTCand VR ns; Peak trunk angular velocity ↑ more for VR thanTC*; and trunk angular velocity in frontal plane and change in peak and rangeTCand VR ns; Trunk velocity peak and range positively correlated with change in leg mechanical energy expenditure forTC*andVRnegative relationship |
| McGibbon Krebs Wolf Wayne Scarborough & Parker 2004 USA | 26 History of Vestibulopath y 56.2 years 11/15 | 10 weeks (70 min × 1 day) | Tai Chi Yang (n=13) | VestibularRehabilitation (n=13) | Falls and Balance: Gaze stability ↑ more for VR thanTC*; Whole-body stability and foot fall stability ↑ more forTCthan VR*; Correlation between change in gaze stability and whole-body stability, and foot-fall stability and gaze stability for VR notTC*; Correlation between foot-fall stability and whole-body stability for VR andTC* |
| Motivala Sollers Thayer & Irwin 2006 USA | 32 out of 63 who completed RCT for Herpes Zoster risk in aging study 68.5 years 14/18 | 37 weekTC(? Min × 1 day) | TCC (n=19) | Passive-Rest and slow moving physical movement (n=19) | Cardiopulmonary: Pre-ejection period ↑ post task more forTCthanPR*; BP and HRTCandPRns |
| Mustian Katula Gill Roscoe Lang & Murphy 2004 AND Mustian Katula & Zhao 2006 USA | 21 History of breast cancer 52 years 0/21 | 12 week (60 min × 3 days) | Tai Chi Yang and Chi Kung (n=11) | PsychosocialSupport (n=10) | Cardiopulmonary: (2006) 6-minute walk ↑ forTCand ↓ forPS*; aerobic capacity ↑ forTCnd ↓ for PS ns Physical Function: (2006) Muscle strength (hand grip ↑ forTCand ↓ forPS*); and flexibility (abduction ↑TCand PS, flexion, extension, horizontal adduction and abduction ↑ more forTCthanPS*; and body fat mass ↓ forTCand ↑ forPSns QOL: (2004) Health Related Quality Of Life ↑ forTC*and ↓PSnsPsychological: (2004) Self esteem ↑ forTCand ↓ forPS* |
| Nowalk Prendergast Bayles D’Amico & Colvin 2001 USA | 110 Long term care residents 84 years 7/48 | 13 to 28 months (3 × week) | Tai Chi with behavioral component (n=38) | Physical therapy weight training (n=37) andEducationControl (n=35) | Falls and Balance: Falls No difference between groups |
| Pippa Manzoli Corti Congedo Romanazzi & Parruti 2007 Italy | 43 History of stable chronic atrial fibrillation 68 years 30/13 | 16 week (90 minutes × 2 days) | Qigong (n=22) | Wait-List control (n=21) | Cardiopulmonary: 6-minute walk ↑ forQGand ↓ forWL*; Ejection fraction, BMI, cholesterol ns |
| Sattin Easley Wolf Chen & Kutner 2005 USA | 217 Transitionally frail with history of 1 or more falls in past year (55 African Americans) 70–97 years 12/205 | 48 weeks (60–90 min × 2 days) | Tai Chi 6 of 24 Simplified (n=158) | WellnessEducation (n=153) | Falls and Balance: Activities Specific Balance ↑ more amongTCthanWE* Psychological: Falls Efficacy Scale ↓ more amongTCthanWE* |
| Shen Williams Chyu Paige Stephens Chauncey Prabhu Ferris & Yeh 2007 USA | 28 Sedentary from a senior living facility 79.1 years 7/21 | 24 week (40 min × 3 days) | TCYang Style Simplified 24 forms (n=14) | ResistanceTraining (n=14) | Bone Density: Sedentary older adults on bone metabolism (Serum Bone Specific alkaline phosphatase/Urinary Pyridinoline ↑ more forTCthanRTat 6 weeks*andTCreturned to baseline andRTless than baseline*; Parathyroid hormone ↑ more forTCthanRTat 12 weeks*; serum 1,25-vitamin D3TCandRTns; serum calcium ↑ more forTCthanRTat 12 weeks compared to 6 weeks*; urinary calcium ↓ forTC*notRT; serum and urinary PiTCandRTns |
| Song Lee Lam & Bae 2003 AND Song Lee Lam & Bae 2007 Korea | 72 History of osteoarthritis and no exercise for 1 year prior 63 years 0/72 | 12 week (60 min × 3 days for 2 weeks then × 1 day for 10 weeks) | Tai Chi Sun Style modified for arthritics (n=22) | UC(n=21) | Cardiopulmonary: (2003) BMI, 13 minute ergometerTCandUCns Falls and Balance: (2003) OLS, trunk flexion and sit ups ↑ more forTCthanUC*; Flexibility and knee strengthTCandUCns Patient Reported Outcomes: (2007) Pain and stiffness ↓ and perceived benefits ↑ more forTCthanUC*;TCperformed more health behaviors thanUC* |
| Stenlund Lindstrom Granlund & Burell 2005 Sweden | 95 History of coronary artery disease 77.5 years 66/29 | 12 weeks (60 min QG and 120 min of discussion on various themes) | Qigong (TCMedicinsk Qigong) (n=48) | UC(n=47) | Falls and Balance: Falls Efficacy Scale, tandem standing, OLS Left, Climb boxes LeftTCandUCns; OLS Right and climb boxes right ↑ more forTCthanUC*; and co-ordination ↓ more forUCthanTC*; and Self reported activity level ↑ forTCmore thanUC* Psychological: Fear of falling betweenTCandUCns |
| Thomas Hong Tomlinson Lau Lam Sanderson & Woot 2005 Hong Kong | 207 Healthy, community dwelling 68.8 years 113/94 | 12 months(60 min × 3 days) | Tai Chi Yang style 24 forms (n=64) | ResistanceTraining (n=65) orUC(n=78) | Cardiopulmonary: Energy expenditure ↑ forTCandRTmore thanUCns; Waist circumference and HR ↓ moreTCandRTthanUCns; Insulin sensitivity ↓ more forRTthanUC*and more forTCthanUCns; BMI, body fat, BP, Cholesterol, and glucoseTC,RT, andUCns |
| Tsai Wang Chan Lin Wang Tomlinson Hsieh Yang & Liu 2003 Taiwan | 76 Sedentary with pre- hypertension or Stage I 52 years 38/38 | 12 wk ( 50 min × 3 days) | Tai Chi Yang (n=37) | UC(n=39) | Cardiopulmonary: BP& total cholesterol ↓ forTC*and ↑ forUCns; BMI and HRTCandUCns; Triglyceride ↓TC*and ↑UC*; LDL ↓TC*and ↑UCns; High- density lipoprotein ↑TC*and ↓strong>UCns Psychological: Trait and State anxiety ↓TC*more thanUCns |
| Tsang H.W. Fung Chan Lee & Chan 2006 Hong Kong | 82 history of depression and chronic illness 82.4 years 16/66 | 16 weeks (30–45 min × 3 days) | Qigong Baduanjin (n=48) | NewspaperReading group with same intensity (n=34) | QOL: Personal Well Being ↑ forQGand ↓NR*; and General Health Questionnaire ↓QGand ↑NR*; and Self-concept ↓ moreTCthanNR* Self-efficacy: Chinese General Self-efficacy and Perceived Benefits Questionnaire ↑ more for QG thanNR* Psychological: Geriatric Depression Scale ↓ more forQGthanNR* |
| Tsang HW Mok Yeung & Chan 2003 Hong Kong | 50 History of chronic disease 74.6 years 26/24 | 12 week (60 min × 2 days) | Qigong Eight- Section Brocades (n=24) | BasicRehabilitation activities (n=26) | QOL: Physical health, activities of daily living psychological health and social relationships improved forQG*; Self-concept and WHOQOL-BREF QG andBRns Psychological: Geriatric Depression Scale ↓TCandBRns |
| Tsang T. Orr Lam Comino & Singh 2007 Australia | 38 Sedentary, community dwelling, type 2 diabetics 65.4 years 8/30 | 16 week (45 min × 2 days) | Tai Chi for diabetes (12 movement hybrid from Yang and Sun (n=17) | ShamExercise (seated calisthenics and stretching) (n=20) | Physical Function: 6-minute walk, habitual and maximal gait speed, muscle strength and peak power ↑TCmore thanSEns; Endurance ↓ more for SE thanTCns; and Habitual Physical Activity ↑TCand ↓SE* Falls and Balance: Balance index ↓TCand SE ns; OLS open ↑TCand ncSEns; OLS closed and tandem walk ↓TCand SE ns; Falls 0–2TCandSEns QOL: SF-36 (except Social Function ↑ forTCand ↓SE*) and Diabetes Integration Scale;TCandSEns |
| Voukelatos Cumming Lord & Rissel 2007 Australia | 702 Community dwelling 69 years 112/589 | 16 weeks (60 min × 1 day) | Tai Chi 38 Programs mostly Sun-style (83%) Yang (3%) (n=271) | Wait-List (n=256) | Falls and Balance: Sway on floor and foam mat, lateral stability, coordinated stability, and choice stepping reaction time improvedTCmore thanWL*; Maximal leaning balance range ↑TCmore thanWLns; Fall rates less forTC(n=347) thanWL(n=337)* |
| Wang Roubenoff Lau Kalish Schmid Tighiouart Rones & Hibberd 2005 USA | 20 Community dwelling with Rheumatoid Arthritic class I or II 49.5 years 5/15 | 12 week (60 min × 2 days) | Tai Chi Yang Style (n=10) | Stretching andWellnessEducation (n=10) | Physical Function: Chair stand and 50-ft walk ↑TCand WE ns; American College of Rheumatology 20 ↓TCmore than WE*; hand grip not reported; Health Assessment Questionnaire ↑ moreTCthan WE*; Erythrocyte sedimentation rate and C-Reactive protein ns QOL: SF-36 ↑ moreTCthan WE with only vitality* Patient Reported Outcomes: Pain ↓TCand ↑ WE ns Psychological: Center for Epidemiological Studies Depression Scale ↑ moreTCthan WE* Immune/Inflammation: ESR and C-Reactive protein ns (noteTChigher level at baseline) |
| Wennenberg Gunnarsson & Ahlstrom 2004 Sweden | 36 History of Muscular Dystrophy 33–80 years 19/17 | 12wk (Weekend immersion, then 45–50 min × 1 day for 4 weeks, then every other week for 8 weeks) | Qigong (n=16) | Wait-List control (n=15) | Cardiopulmonary: Forced vital capacity and expiratory volume ↓ QG andWLns Falls and Balance: BBS unchanged for QG and ↓WLns for intervention period; subgroup A QOL: SF-36 general health unchanged for QG and ↓WL*and other dimensions ns; Ways of Coping: positive reappraisal coping ↓ for QG and unchanged forWL*, Confrontative coping ↑ QG and ↓WLns, and other dimensions ns Psychological: Montgomery Asberg Depression Rating Scale QG andWLns |
| Winsmann 2006 USA | 47 Veterans 49.55 years 47/0 | 4 weeks (75 min × 2 days) | Tai Chi Chuan Yang Style (n=23) | UCincluded group therapy (n=24) | Patient Reported Outcomes: Dissociative Experiences and Symptom Checklist 90 ↓TCmore thanUCns |
| Wolf O’Grady Easley Guo Kressig & Kutner 2006 USA | 311 Transitionally frail with average of 5.6 comorbidities 80.9 years 20/291 | 48 weeks (60–90 min × 2 days) | Tai chi 6 of 24 simplified forms (n=158) | WellnessEducation (n=153) | Cardiopulmonary: BMI ↓TCand ↑WE*; SBP and HR ↓TCand ↑WE*; DBP ↓TCmore thanWE* Physical Function: Gait Speed and FR ↑TCandWEns; Chair stands ↓ 12.3%TCand ↑ 13.7% WE*; 360° turn and pick up object similar changeTCandWEns; and OLS nc |
| Wolf Sattin Kutner O’Grady Greenspan & Gregor 2003b USA | 311 Transitionally frail with average of 5.6 comorbidities 80.9 years 20/291 | 48 weeks (60–90 min × 2 days) | Tai chi 6 of 24 simplified forms (n=145) | WellnessEducation (n=141) | Falls and Balance: TClower risk for falls from month 4 to 12; RR fallsTCandWE0.75 (CI=0.52–1.08) ns |
| Wolf Barnhart Ellison Coogler & Gorak 1997a USA | 72 Sedentary 77.7 years 12/60 | 15 weeks (60 min × 2daysTCgroup) | Tai Chi 108 forms simplified to 10 forms (n=19) | BalanceTraining (n=16) andEducation Control (n=19) | Falls and Balance: Balance: Dispersion for OLS (eyes open), toes up (eyes open and closed), Center of Balance X with toes up (eyes open) and Center of Balance Y (OLS eyes open and closed) ↓ moreBTthanEDandTC*; Dispersion for toes up (eyes open), Center of Balance X OLS (eyes open and closed) and Toes up (eyes closed), and Center of Balance Y for toes up (eyes open and closed)TC,BT, andEDns; Psychological: Fear of falling ↓ more forTCthanBTandED* |
| Wolf Barnhart Kutner McNeelly Coogler & Xu 2003a USA | 200 Community dwellling 76.2 years 58/242 | 15 weeks (45 minutes weekly in class plus 15 min 2 × daily) | Tai Chi (n=72) | Balance Training (n=64) andEducation Control (n=64) | Cardiopulmonary: BP↓ more forTCthanBTandED*; 12-minute walk ↑ 0.01 mile forBTandEDand ↓ 0.02 forTC*; Body composition changes forTC,BTandEDns Physical Function: Left hand grip strength ↓ more inBTandEDthanstrong>TC*; Strength of hip, knee and ankle via Nicholas MMT 0116 muscle tester, lower extremity ROM changesTC,BTandEDns Falls and Balance: Intrusiveness↓ more forTCthanEDns; RR for falls inTC0.632 (CI 0.45– 0.89)*using FICSIT fall definition and forBTand other fall definitions ns Psychological: Fear of falling ↓ more forTCtBT andbsp;ED* |
| Woo Hong Lau & Lynn 2007 China | 180 Community dwelling 68.91 years 90/90 | 12 months (?min × 3 days) | Tai Chi Yang style 24 forms (n=30) | ResistanceTraining (n=29) andUC(n=29) | Falls and Balance: Muscle strength (grip strength and quadriceps) ns; Balance (SMART Balance Master, stance time, gait velocity, and bend reach); and falls forTC,RTandUCns Bone Density: Women: BMD loss at hip less forTCandRTthanUC*; BMD loss at spine less forTCandRTthannbsp;UCns; Men: no difference in % change in BMD |
| Yang Verkuilen Rosengren Grubisich Reed & Hsiao- Wecksler 2007a USA | 49 Healthy adults 80.4 years 10/39 | 6 months (60 min × 3 days) | Qigong (sitting and standing) and Taiji Chen style Essential 48 form (n=33) | Wait-List (n=16) | Falls and Balance: Sensory Organization Test vestibular ratios and Base of Support measures ↑ more forTCthanWL*↑; Sensory Organization Test visual ratios and feet opening angle forTCandWLnc |
| Yang Verkuilen Rosengren Mariani Reed Grubisich & Woods 2007b USA | 50 History of received flu immunization and sedentary 77.2 years 13/37 | 20 weeks (60 min × 3 days) | Qigong (sitting and standing) and Taiji Chen style Essential 48 form (n=27) | Wait-List (n=23) | Immune/Inflammation: Hemagglutination Inhibition assay ↑ 109% for QG compared to ~10% for ;WL* |
| Yeh Wood Lorell Stevenson Eisenberg Wayne et al. 2004 USA | 30 History chronic stable heart failure 64 years 19/11 | 12 weeks (60 min × 2 days) | Tai chi Yang-style 5 core movements (n=15) | UCincluding pharmacologi c therapy, dietary and exercise counseling (n=15) | Cardiopulmonary: Peak O2 uptake↑TCand ↓UCns; 6-minute walk ↑TCand ↓UC*; Serum B-type natriuretic peptide ↓TCand ↑UC*; Plasma norepinephrine ↑TCmore thanUCns; and no differences in incidence of arrhythmia between groups QOL: Minnesota Living with Heart Failure ↓TCand ↑UC* |
| Young Appel Jee & Miller 1999 USA | 62 History of BP between 130 and 159 and not taking medications for hypertension or insulin (45.2% black) 66.7 years 13/49 | 12 weeks (60 min × 2 days class with goal of 30–45 min/4–5 days/week) | TCYang Style 13 movements (n=31) | AerobicExercise class at 40 to 60% HR reserve (n=31) | Cardiopulmonary: BP↓TCandAE*; BMI ↑ slightlyTCandAEns; and time in moderate activity, weekly energy expenditure, and leisurely walking ↑ forAEmore thanTCns |
| Zhang Ishikawa- Takata Yamazaki Morita & Ohta 2006 China | 47 History of poor balance 70.4 years 25/22 | 8 weeks (60 min × 7 days) | TC simplified 24 forms Zhou (n=24) | UC(n=23) | Falls and Balance: OLS, trunk and flexion more TC than UC*; 10 minute walk ↓TC and UC ns Psychological Symptoms: Falls Efficacy Scale ↑ more TC than UC* |
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