Tai chi

March 22, 2017


Tai chi

Natural Standard Bottom Line Monograph, Copyright © 2013 ( Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Martial arts, meditation, mind-body technique, Qi gong, Simplified Tai-Chi Exercise Program (STEP), Sun-style Tai Chi, t'ai chi chih, t'ai chi chuan, tai chi chih, tai chi guan, tai chi quan, taijiquan, tele-exercise program, visual imagery, visualization, yang tai chi.


  • Tai chi is a system of movements and positions believed to have developed in 12th Century China. Tai chi techniques aim to address the body and mind as an interconnected system and are traditionally believed to have mental and physical health benefits to improve posture, balance, flexibility, and strength.

  • Many styles of tai chi have developed since the original set of 13 postures. The modern practice of tai chi often includes sequences of slow movements coordinated with deep breathing and mental attention. Specific forms or poses may last from five to 30 minutes. Tai chi is taught in classes or can be practiced alone. Classes often include fewer than 20 people. Instructors guide pupils through movements, encouraging them to keep their bodies stable and upright while shifting weight. A high level of concentration is usually involved, and sessions are intensely focused and quiet. Exercises can also be practiced alone daily for 15 to 20 minutes, often in the morning.


  • In traditional Chinese medicine, illness may be viewed as the result of imbalance between two opposing life forces: yin and yang. The practice of tai chi aims to reestablish balance creating harmony between body and mind and between the individual and the outside world. It is said that in the 13th Century, Taoist priest Chang San Fang observed a crane fighting with a snake and compared their movements to yin and yang. Some techniques of tai chi were based on movements mimicking these animals.

  • In modern times, tai chi is a physical exercise that, when practiced regularly, may increase muscle strength. Preliminary scientific evidence suggests that better cardiovascular health, coordination, and balance may occur from regular tai chi practice.

Scientific Evidence


These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.


Aging (quality of life in the elderly)

There is good evidence from several studies indicating that tai chi, if practiced regularly, may help improve quality of life in the elderly. Beyond improved balance and the preventive effects against falls, it appears that the practice may improve overall physical functioning and sense of well-being.


Sleep disorders

Tai chi may lead to improved sleep quality in older adults with sleep disorders. More studies are needed before definitive recommendations can be made.


Balance and strength maintenance

Early research suggests that tai chi practice may improve balance and maintain strength. These benefits may be similar to other forms of exercise. Additional research is necessary before a firm conclusion can be reached.


Body fat reducer (body fat redistribution in the elderly)

There is not enough scientific evidence to recommend the use of tai chi to change body fat distribution in the elderly.


Bone density improvement (in menopausal women and the elderly)

The data are mixed as to whether tai chi is beneficial for bone health in menopausal women and in the elderly. Although some early results are promising, others report that the beneficial effects of tai chi on musculoskeletal health are modest and may not translate into better clinical outcomes.


Brain injury

Based on a small study, tai chi may provide short-term benefits after traumatic brain injury; however, long-term studies are needed.


Breast cancer

Tai chi chuan has been studied in breast cancer patients to improve functional capacity (specifically aerobic capacity, muscular strength, and flexibility). Larger studies are needed to make a firm recommendation.


Cardiovascular disease

There is evidence that suggests that tai chi decreases blood pressure and cholesterol as well as enhances quality of life in patients with chronic heart failure. Most studies have used elderly Chinese patients as their population. Additional research is needed before a firm conclusion can be drawn.


Cardiovascular rehabilitation

Tai chi, as a complement to existing exercise interventions, can be utilized for low and intermediate risk patients. Although promising, more study is needed to make a firm recommendation.


Chickenpox, shingles (varicella zoster)

A small trial showed that treatment with tai chi might increase immunity to the virus that causes shingles. This may suggest the use of tai chi in the prevention of chickenpox and shingles, but further well-designed large studies must be done before a recommendation can be made.


Chronic pain

There is a lack of scientific evidence to conclude that tai chi is effective for chronic pain conditions. Further research is needed in this area.


Cochleovestibular impairment (vestibulopathy)

Early scientific evidence suggests that tai chi may be helpful as an adjunct treatment to regular vestibular rehabilitation regimes. Tai chi may improve body stability and footfall stability. More studies are needed.



Preliminary research suggests that tai chi may alleviate depression, anger, and fatigue. Better studies are needed before conclusions can be drawn.



Tai chi has been suggested as a possible therapy for improving body composition and improving blood sugar regulation in diabetics. Early results are mixed, and additional study is needed. Tai chi is not recommended over current standard of care for diabetes control.


Exercise capacity

Several studies suggest that tai chi is a form of aerobic exercise that can improve aerobic capacity. In particular, benefit has been reported with the classical Yang style.


Fall prevention (elderly)

Several studies have examined the effects of regular tai chi practice on balance and falling risk in the elderly. Results are not consistent, and many studies have been poorly designed. It is not clear if tai chi is safer or more effective than other forms of exercise in older individuals. Better research is needed before a recommendation can be made.



Tai chi may aid quality of life in fibromyalgia patients, but additional study is needed to make a strong recommendation.


High blood pressure

Early study shows that tai chi may help patients with high blood pressure to reduce blood pressure, cholesterol, and anxiety.


Immune stimulant

Tai chi may increase the body's immune response in older adults and in individuals with HIV. For example, patients receiving varicella vaccines and who practiced tai chi showed increased immune responses. Although early study is promising, more study is needed.


Lung function (after lung removal)

Tai chi practice may help improve lung function, activity capacity, and quality of life of patients after lobectomy (lung removal usually due to cancer). More study is needed in this area.



Women but not men may experience improved mood as a result of tai chi practice. Additional research is needed in this area.



A small trial in women with osteoarthritis reported that treatment with tai chi significantly decreased pain and stiffness compared with a sedentary lifestyle. Women in the tai chi group also reported fewer perceptions of difficulties in physical functioning. More well-designed studies are needed before a recommendation can be made.



Preliminary research suggests that tai chi may be beneficial in delaying early bone loss in postmenopausal women. Additional evidence and long-term follow-up is needed to confirm these results.


Parkinson's disease

Community-based fitness programs, which include tai chi classes, may improve balance in Parkinson's patients and motivate patients to participate in routine exercise.


Quality of life (HIV)

Tai chi has been studied in individuals living with various stages of HIV. Preliminary study shows that tai chi may be helpful for stress and improving quality of life, but additional research is needed before a recommendation can be made.


Rheumatoid arthritis

There is not enough scientific evidence showing that tai chi reduces rheumatoid arthritis symptoms, although tai chi may help improve range of motion of the lower extremities.



Tai chi may reduce stress in various populations of people, including HIV patients and children.


Stroke recovery

Tai chi may benefit social and general functioning in stroke rehab patients but may not be as effective as physiotherapy for balance and speed of walking.


Tension headaches

Early study suggests that tai chi practice may be effective in reducing tension headache impact and may also be effective in improving perceptions of some aspects of physical and mental health.


Well-being/fitness/physical functioning/breathing in the elderly

Several studies suggest that tai chi may improve heart and lung fitness, muscle strength, handgrip strength, flexibility, gait, coordination, and sleep and may decrease the risk of osteoporosis. It is not clear if these benefits are different from other forms of exercise. Nearly all of the studies that exist in these areas compare tai chi programs with a sedentary lifestyle, not with another form of exercise. Tai chi has been found to be of low to moderate intensity in the cardiovascular studies thus far, which makes tai chi a candidate for certain rehabilitation programs. Additional research is needed before a recommendation can be made.


*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).


The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Ankylosing spondylitis, anxiety, asthma, attention deficit hyperactivity disorder (ADHD), bronchitis, cancer, chronic lung conditions, circulation problems, congestive heart failure, coronary artery disease, dementia, emphysema, fibromyalgia, gastritis, gout, hemiplegia, hemophilia, improving concentration, increasing energy, kidney disorders, low back pain, lowering heart rate, multiple sclerosis (MS), neurasthenia, peripheral vascular disease, repetitive strain injuries, schizophrenia, self-esteem, substance abuse, tension, tuberculosis.


Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

  • Adverse effects of tai chi are rarely reported and may include sore muscles or sprains. Tai chi should be avoided by people with severe osteoporosis or joint problems, acute back pain, sprains, or fractures. Advancing too quickly while studying tai chi may increase the risk of injury.

  • Tai chi instructors sometimes recommend that practice be avoided during active infections, right after a meal, or when very tired. Some believe that visualization of energy flow below the waist during menstruation may increase menstrual bleeding. Straining downwards or holding low postures should be avoided during pregnancy and by people with inguinal hernias. Some tai chi practitioners believe that practicing for too long or using too much intention may direct the flow of chi (qi) inappropriately, possibly resulting in physical or emotional illness.

  • Tai chi should not be used as a substitute for more proven therapies for potentially serious conditions. Individuals should consult a qualified healthcare professional if they experience dizziness, shortness of breath, chest pain, headache, or severe pain while practicing tai chi.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (


Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to Selected references are listed below.

  1. Abbott RB, Hui KK, Hays RD, et al. A Randomized Controlled Trial of Tai Chi for Tension Headaches. Evid Based Complement Alternat Med 2007 Mar;4(1):107-113. View Abstract

  2. Forbes D, Forbes S, Morgan DG, et al. Physical activity programs for persons with dementia. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006489. View Abstract

  3. Galantino ML, Shepard K, Krafft L, et al. The effect of group aerobic exercise and t'ai chi on functional outcomes and quality of life for persons living with acquired immunodeficiency syndrome. J Altern Complement Med 2005 Dec;11(6):1085-92. View Abstract

  4. Gemmell C, Leathem JM. A study investigating the effects of Tai Chi Chuan: individuals with traumatic brain injury compared to controls. Brain Inj 2006 Feb;20(2):151-6. View Abstract

  5. Irwin MR, Olmstead R, Motivala SJ. Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Tai Chi Chih. Sleep. 2008 Jul 1;31(7):1001-8. View Abstract

  6. 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 2007 Apr;55(4):511-7. View Abstract

  7. Lee MS, Pittler MH, Ernst E. Tai chi for osteoarthritis: a systematic review. Clin Rheumatol 2008 Feb;27(2):211-8. View Abstract

  8. Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatology (Oxford) 2007 Nov;46(11):1648-51. View Abstract

  9. Lee MS, Pittler MH, Ernst E. Is Tai Chi an effective adjunct in cancer care? A systematic review of controlled clinical trials. Support Care Cancer 2007 Jun;15(6):597-601. View Abstract

  10. Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2005;60(2):187-194. View Abstract

  11. Maciaszek J, Osiński W, Szeklicki R, et al. Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. Am J Chin Med 2007;35(1):1-9. View Abstract

  12. McCain NL, Gray DP, Elswick RK, et al. A randomized clinical trial of alternative stress management interventions in persons with HIV infection. J Consult Clin Psychol. 2008 Jun;76(3):431-41. View Abstract

  13. Taylor-Piliae RE. The effectiveness of Tai Chi exercise in improving aerobic capacity: an updated meta-analysis. Med Sport Sci. 2008;52:40-53. View Abstract

  14. Taylor-Piliae RE, Haskell WL, Stotts NA, et al. Improvement in balance, strength, and flexibility after 12 weeks of Tai chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. Altern Ther Health Med 2006 Mar-Apr;12(2):50-8. View Abstract

  15. Yeh GY, Wang C, Wayne PM, et al. The effect of tai chi exercise on blood pressure: a systematic review. Prev Cardiol. 2008 Spring;11(2):82-9. View Abstract

Copyright © 2013 Natural Standard (

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.


March 22, 2017