Overview

Tai Chi (Tai Chi Chuan, Taijiquan) is a traditional form of martial art used more for promoting health than for fighting. Its gentle, dance-like moves are said to strengthen and balance the body’s “energy.” The net results, according to tradition, include increased physical stamina, enhanced sense of well-being and comfort, and improved resistance to illness.

Tai Chi is said to have been invented by the Taoist monk Chang San-Feng sometime in the Middle Ages. (The exact dates and even the existence of this monk are disputed.) Various schools of Tai Chi developed over subsequent centuries, each with their own particular movements and postures, but all conforming to the same underlying principles.

In the 1950s, the Chinese government began to develop a series of standardized Tai Chi forms. One of these has become the most popular form of Tai Chi in the West, a 37-posture form abbreviated from a traditional approach to Tai Chi called the Yang Style.

How Is Tai Chi Used Today?

Tai Chi is an extremely popular form of exercise among older Asians in China and other Asian countries. In the US, it is gaining widespread use as a method of improving balance and preventing falls among seniors. The slow movements of Tai Chi provide a gentle framework for enhancing physical control and improving balance.

Tai Chi is also advertised to improve overall health and enhance immunity, but this has not been evaluated scientifically to any significant extent.

What Is the Scientific Evidence for Tai Chi?

Although there is some evidence that Tai Chi may offer medical benefits, in general this evidence is not strong. There are several reasons for this (including funding obstacles), but one is fundamental: Even with the best of intentions, it is difficult to properly ascertain the effectiveness of an exercise therapy like Tai Chi.

Only one form of study can truly prove that a treatment is effective: the double-blind, placebo-controlled trial. However, it isn’t possible to fit Tai Chi into a study design of this type. While it might be possible to design a placebo form of Tai Chi, it would be quite difficult to keep participants and researchers in the dark regarding who is practicing real Tai Chi and who is practicing fake Tai Chi!

Therefore, some compromise with the highest research standards is inevitable. Unfortunately, the compromise used in most studies is less than optimal. In these trials, Tai Chi was compared to no treatment. The problem with such studies is that a treatment—any treatment—frequently appears to be better than no treatment, due to a host of factors. (See Why Does This Database Rely on Double-blind Studies? for more information.) It would be better to compare Tai Chi to generic forms of exercise, such as daily walking, but thus far this method has not seen much use.

Given these caveats, the following is a summary of what science has found out about Tai Chi.

Most controlled trials of Tai Chi published in English have evaluated its potential benefits for improving balance in seniors. Falling is one of the most common causes of injury in seniors, leading to fractures, head injuries, and even death. Recovery from fall-related injuries may involve extensive immobilization in bed, which in turn increases the risk of osteoporosis, pneumonia, and depression. According to most (but not all) studies, Tai Chi can improve balance and decrease risk of falling.1,4,6,12 For example, in a 10-week study, 24 seniors practiced Tai Chi (one class weekly, plus daily home practice), while a control group of 22 volunteers did not change their activity.2 The results showed that people practicing Tai Chi experienced substantially improved balance (measured by the ability to stand on one leg) compared to the control group. Some studies failed to find benefit;1,8 however, this is typical of treatments for which all studies have been small in size. For statistical reasons, small studies commonly fail to identify benefit even when there is one.

Although there is some evidence that Tai Chi can improve balance and reduce the risk of falling, researchers conducting a 2008 review of 9 randomized controlled trials were unable to conclude that Tai Chi or Tai Chi-inspired exercises can effectively prevent fall-related harm in the elderly.15 This was largely due to the fact that the trials were too inconsistent in their methods and quality.

Besides balance, Tai Chi may mildly improve flexibility and cardiovascular health, presumably because it is a form of moderate exercise.3 However, one fairly large (207-participant) and long-term (1-year) study that compared Tai Chi to resistance exercise (weight lifting) found that while resistance exercises measurably improved one measure of cardiovascular risk (insulin sensitivity), Tai Chi did not affect any measures of cardiovascular risk.5 In a review of 26 published studies examining the effectiveness of Tai Chi for high blood pressure, 85% demonstrated a reduction in blood pressure. However, only 5 of these 26 studies were of acceptable quality.11

While there was no adequate control group, one study found that patients with congestive heart failure can benefit from Tai Chi.14 Two other studies found that Tai Chi may improve the quality of life in people with this heart condition.19,20

In two controlled studies, Tai Chi produced some benefit in bone density, suggesting the possibility that it might be helpful for preventing osteoporosis.8,9

A few studies provide inconsistent evidence for the usefulness of Tai Chi as a treatment for osteoarthritis,7,10 and a highly preliminary study suggests it may be beneficial for mild to moderate rheumatoid arthritis.13

In a small, randomized controlled trial of 66 patients, Tai Chi appeared to improve symptoms, function, and quality of life in patients with fibromyalgia.18

In one randomized study, a certain form of Tai Chi was more effective than health education after 25 weeks in subjects with moderate insomnia.16

A review of 7 studies found insufficient evidence to conclude whether or not Tai Chi improves quality of life or psychological or physical outcomes in patients with breast cancer.17

In a randomized trial of 95 patients with Parkinson's disease, Tai Chi improved symptoms, like balance, gait, and strength, compared to other forms of treatment (ie, resistance training, stretching).21

In a randomized trial involving 160 people with low back pain, Tai Chi was more effective in reducing pain and improving function than usual care.22

What Should You Expect in a Tai Chi Class?

A Tai Chi class consists of progressive training in the movements of a Tai Chi form. Each subsequent class adds more moves to your repertoire, until you finally know how to perform the entire series. The Tai Chi instructor will gently correct your movements, helping you to make your stances and transitions between them more precise, graceful, and balanced.

Expect to feel pretty awkward at first. Even if you were a world-class ballet dancer, you wouldn’t immediately be able to do Tai Chi as well as someone who has taught and practiced it for years. However, the intricate, often beautiful movements of Tai Chi have a strong intrinsic charm; they are pleasant to perform and as with all things, they respond to practice. If you can give yourself 15 minutes a day to practice at home, you’ll improve rapidly; soon you may wish to spend even more time at it.