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Complementary & Alternative Medicine
Index Of Alternative Therapies And Modalities
When deciding to begin a complementary therapy or to see a complementary practitioner, first speak with your primary health care provider.
Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.
Tai chi aims to address the body and mind as an interconnected system and to improve mental and physical health while benefiting posture, balance, flexibility and strength.
Tai chi includes sequences of slow movements coordinated with deep breathing and mental focus. Tai chi can be practiced alone or with a group of people in a class. Practitioners guide pupils through movements, encouraging them to keep their bodies stable and upright while shifting weight.
In traditional Chinese medicine, it is believed that illness is a result of imbalance between two opposing life forces, yin and yang. Tai chi aims to reestablish balance, create harmony between body and mind and connect an individual with the outside world. 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 tai chi movements are said to mimic those of the animals.
Preliminary evidence suggests that when practiced regularly, tai chi may increase muscle strength and improve cardiovascular health, coordination and balance. Additional studies are necessary before firm conclusions can be reached.
Scientists have studied tai chi for the following health problems:
Falls in the elderly, postural stability
Several studies have examined the effects of tai chi on balance and on the risk of falls in older people. Most studies have been poorly designed, and results are inconsistent. Further research is needed to determine if tai chi is safer or more effective than other forms of exercise in the elderly.
Balance and strength
Early data suggest that tai chi may improve balance and maintain physical strength. These benefits may be similar to those of other forms of exercise. Better research is necessary before a definitive conclusion can be reached.
Depression, anger, fatigue, anxiety
Preliminary scientific study reports that tai chi may help to alleviate depression, anxiety, confusion, anger, fatigue, mood disturbances and pain perception. Additional research is necessary before a clear conclusion can be reached.
Breathing, fitness, physical functioning and well-being in the elderly
Studies suggest that tai chi may improve cardiovascular health, muscle strength, handgrip strength, flexibility, gait, coordination and sleep and may decrease osteoporosis risk. It is not clear if any of these benefits are different from those offered through 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. Further research is needed before a clear conclusion can be drawn.
Chickenpox, shingles (varicella-zoster)
A small placebo-controlled trial showed 15-week treatment with tai chi may 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.
A small, randomized, controlled trial in women with osteoarthritis reported that 12-week 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.
Preliminary research suggests that tai chi may be beneficial in delaying early bone loss in postmenopausal women. Additional evidence and long-term follow-up are needed to confirm these results.
Several studies suggest that tai chi is a form of aerobic exercise that can improve aerobic capacity. In particular, a benefit has been reported with the classical Yang style.
There is evidence that suggests tai chi decreases blood pressure and cholesterol, as well as enhances quality of life, in patients with chronic heart failure. Additional research is needed before a firm conclusion can be drawn.
Aging (quality of life)
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.
Body fat composition
There is not enough scientific evidence to recommend the use of tai chi to change body fat distribution in 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.
Based on a small study, tai chi may provide short-term benefits after traumatic brain injury; however, long-term studies are needed.
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.
Tai chi, as a complement to existing exercise interventions, can be utilized for low- and intermediate-risk patients. Early data suggest tai chi may help reduce both systolic and diastolic blood pressure in cardiac rehab patients. Tai chi may help improve quality of life and walking distance in patients with chronic stable heart failure. Tai chi has also been studied for its effect on exercise tolerance in patients with moderate heart failure. Although promising, more study is needed to make a firm recommendation.
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.
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.
Ear disorders (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.
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.
Tai chi may increase the body's immune response in older adults. For example, patients receiving varicella vaccines and who practiced tai chi showed increased immune response. 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.
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 disease. Preliminary study shows it may be helpful for stress and improving quality of life, but additional research is needed before a recommendation can be made.
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 lead to improved sleep quality in older adults with sleep disorders. More studies are needed before definitive recommendations can be made.
Tai chi may reduce stress in various populations of people, including HIV patients.
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.
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.
Tai chi has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using tai chi for any use.
| Ankylosing spondylitis (a type of arthritis)|
Attention-deficit hyperactivity disorder
Chronic lung conditions
Congestive heart failure
Coronary artery disease
Heart attack recovery
| Hemiplegia (a form of paralysis)|
Low back pain
Low blood pressure
Lowered heart rate
Neurasthenia (a type of fatigue)
Peripheral vascular disease
Recovery from head trauma
Repetitive strain injuries
Sore muscles, sprains and electrical sensations have been reported rarely with tai chi. People with severe osteoporosis, joint problems, acute back pain, sprains or fractures should consult their health care provider before considering tai chi. Straining downward or holding low postures should be avoided by pregnant women, by people with an inguinal hernia and by those recovering from abdominal surgery.
Practitioners may recommend that tai chi be avoided by those with active infections, those who have just eaten and those who are very tired. Some tai chi practitioners have said that visualization of energy flow below the waist during menstruation increases menstrual bleeding. Some tai chi practitioners believe that practicing tai chi for too long or using too much intention may direct the flow of chi (qi) inappropriately, possibly resulting in physical or emotional illness. These assertions do not fall within the Western framework of medical concepts and have not been evaluated scientifically.
Tai chi should not be used as a substitute for more proven therapies for potentially severe medical conditions. Consult a qualified health care provider if you experience dizziness, shortness of breath, chest pain, headache or severe pain related to tai chi.
Tai chi has been recommended for many conditions. Numerous anecdotes and preliminary scientific studies report health benefits of tai chi. However, effectiveness and safety of tai chi have not been proven over other forms of exercise.
The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.
- Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
- National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research
Selected Scientific Studies: Tai Chi
Natural Standard has reviewed all of the currently available medical literature to prepare the professional monograph from which this version was created.
Some of the more recent studies are listed below:
- 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.
- Adler P, Good M, Roberts B. The effects of tai chi on older adults with chronic arthritis pain. J Nurs Schol 2000;32(4):377.
- Breslin KT, Reed MR, Malone SB. An holistic approach to substance abuse treatment. J Psychoactive Drugs 2003;Apr-Jun, 35(2):247-251.
- Chan K, Quin 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 2003;85(5):717-722.
- Chan SP, Luk TC, Hong Y. Kinematic and electromyographic analysis of the push movement in tai chi. Br J Sports Med 2003;Aug, 37(4):339-344.
- Chao YF, Chen SY, Lan C, Lai JS. The cardiorespiratory response and energy expenditure of tai-chi-qui-gong. Am J Chin Med 2002;30(4):451-461.
- Fontana JA, Colella C, Baas LS, et al. T'ai chi chih as an intervention for heart failure. Nurs Clin North Am 2000;35(4):1031-1046.
- Hartman CA, Manos TM, Winter C, et al. Effects of t'ai chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc 2000;48(12):1553-1559.
- Hass CJ, Gregor RJ, Waddell DE, et al. The influence of Tai Chi training on the center of pressure trajectory during gait initiation in older adults. Arch Phys Med Rehabil 2004;85(10):1593-1598.
- Hernandez-Reif M, Field TM, Thimas E. Attention deficit hyperactivity disorder: benefits from tai chi. J Bodywork Mov Ther 2001;5(2):120-123.
- Hong Y, Li JX, Robinson PD. Balance control, flexibility, and cardiorespiratory fitness among older tai chi practitioners. Br J Sports Med 2000;34(1):29-34.
- Humphrey R. Tai chi in cardiac rehabilitation. J Cardiopulm Rehabil 2003;Mar-Apr, 23(2):97-99. Comment in: J Cardiopulm Rehabil 2003;Mar-Apr, 23(2):90-96.
- Irwin MR, Pike JL, Cole JC, Oxman MN. Effects of a behavioral intervention, tai chi chih, on varicella-zoster virus specific immunity and health functioning in older adults. Psychosom Med 2003;Sep-Oct, 65(5):824-830.
- 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):511-517.
- Jerosch J, Wustner P. Effect of a sensorimotor training program on patients with subacromial pain syndrome [Article in German]. Unfallchirurg 2002;Jan, 105(1):36-43.
- Jones AY, Dean E, Scudds RJ. Effectiveness of community-based Tai Chi program and implications for public health initiatives. Arch Phys Med Rehabil 2005;86(4):619-625.
- Lan C, Lai JS, Chen SY, et al. Tai chi chuan to improve muscular strength and endurance in elderly individuals: a pilot study. Arch Phys Med Rehabil 2000;81(5):604-607.
- Lan C, Chen SY, Lai JS, Wong MK. Heart rate responses and oxygen consumption during tai chi chuan practice. Am J Chin Med 2001;29(3-4):403-410.
- Lee EO, Song R, Bae SC. Effects of 12-week tai chi exercise on pain, balance, muscle strength, and physical functioning in older patients with osteoarthritis: randomized trial. Arthritis Rheum 2001;44(9):S393.
- Lee MS, Pittler MH, Ernst E. Tai chi for osteoarthritis: a systematic review. Clin Rheumatol 2007;Sep 14. [Epub ahead of print]
- Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatology (Oxford) 2007;Nov, 46(11):1648-1651.
- 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.
- Li F, McAuley E, Harmer P, et al. Tai chi enhances self-efficacy and exercise behavior in older adults. J Aging Phys Act 2001;9:161-171.
- 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.
- 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 2004;52(6):892-900.
- Li F, Harmer P, Chaumeton NR, et al. Tai chi as a means to enhance self-esteem: a randomized controlled trial. J Appl Gerontol 2002;21(1):70-89.
- Li F, Harmer P, McAuley E, et al. An evaluation of the effects of tai chi exercise on physical function among older persons: a randomized controlled trial. Ann Behav Med 2001;23(2):139-146.
- Li F, Harmer P, McAuley E, et al. Tai chi, self-efficacy, and physical function in the elderly. Prev Sci 2001;2(4):229-239.
- Lin YC, Wong AM, Chou SW, et al. The effects of tai chi chuan on postural stability in the elderly: preliminary report. Changgeng Yi Xue Za Zhi 2000;23(4):197-204.
- 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.
- Mak MK, Ng PL. Mediolateral sway in single-leg stance is the best discriminator of balance performance for tai-chi practitioners. Arch Phys Med Rehabil 2003;May, 84(5):683-686.
- Nowalk MP, Prendergast JM, Bayles CM, et al. A randomized trial of exercise programs among older individuals living in two long-term care facilities: the FallsFREE program. J Am Geriatr Soc 2001;Jul, 49(7):859-865.
- Qin L, Au S, Choy W, et al. Regular tai chi chuan exercise may retard bone loss in postmenopausal women: a case-control study. Arch Phys Med Rehabil 2002;Oct, 83(10):1355-1359. Comment in: Arch Phys Med Rehabil 2003;Apr, 84(4):621. Author reply, 621-623.
- Song R, Lee EO, Lam P, Bae SC. 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 2003;Sep, 30(9):2039-2044.
- Taggart HM. Effects of tai chi exercise on balance, functional mobility, and fear of falling among older women. Appl Nurs Res 2002;Nov, 15(4):235-242.
- Taylor-Piliae RE, Froelicher ES. Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis. J Cardiovasc Nurs 2003;19(1):48-57.
- Tsai JC, Wang WH, Chan P, et al. The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. J Altern Complement Med 2003;9(5):747-754.
- Voukelatos A, Cumming RG, Lord SR, et al. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc 2007;Aug, 55(8):1185-1191.
- Wang JS, Lan C, Chen SY, Wong MK. Tai chi chuan training is associated with enhanced endothelium-dependent dilation in skin vasculature of healthy older men. J Am Geriatr Soc 2002;Jun, 50(6):1024-1030. Comment in: J Am Geriatr Soc 2002;Jun, 50(6):1159-1160.
- Wang JS, Lan C, Wong MK. Tai chi chuan training to enhance microcirculatory function in healthy elderly men. Arch Phys Med Rehabil 2001;Sep, 82(9):1176-1180.
- Wolf SL, Sattin RW, Kutner M, et al. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003;51(12):1693-1701.
- Wolf SL, Sattin RW, O'Grady M, et al. A study design to investigate the effect of intense tai chi in reducing falls among older adults transitioning to frailty. Control Clin Trials 2001;22(6):689-704.
- Wong AM, Lin YC, Chou SW, et al. Coordination exercise and postural stability in elderly people: effect of tai chi chuan. Arch Phys Med Rehabil 2001;82(5):608-612.
- Wu G. Evaluation of the effectiveness of tai chi for improving balance and preventing falls in the older population: a review. J Am Geriatr Soc 2002;50(4):746-754.
- 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 2004;117(8):541-548.
- Yeung D, Ng G, Wong R, et al. Rehabilitation of patients with rheumatoid arthritis by tai chi chuen training. Arthritis Rheum 2001;44(9):S210.
- Zwick D, Rochelle A, Choksi A, et al. Evaluation and treatment of balance in the elderly: a review of the efficacy of the Berg Balance Test and tai chi quan. Neuro Rehab 2000;15(1):49-56.
Last updated May 07, 2008
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