Recent CME posting by Medscape (a CME site for US physicians) lists a study published in the British Journal of Sports Medicine. The authors are:
Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MS Ed
18, 2011 — T'ai chi may benefit the elderly population in fall prevention,
psychological health, and general well-being, according to the results of an
overview of systematic reviews (SRs) reported Online First May 16 in the British Journal of Sports Medicine. The practice combines deep breathing and relaxation with
slow and gentle movements and is based on the Confucian and Buddhist belief
that health is controlled by 2 opposing life forces, yin and yang.
...SRs have assessed the effectiveness of t'ai chi for many conditions
including hypertension, osteoarthritis and fall prevention; however, their
conclusions have been contradictory," write Myeong Soo Lee, from the Brain
Disease Research Centre, Korea Institute of Oriental Medicine in Daejeon, South
Korea, and Edzard Ernst, from Complementary Medicine, Peninsula Medical School,
University of Exeter in Exeter, United Kingdom. "...Ill health is viewed
as an imbalance between yin and yang, and t'ai chi can reportedly rebalance
such energy disturbances. Regardless of these assumptions, the slow movements
between different postures that are normally held for short periods of time
represent physical stimuli, which affect the cardiovascular and muscular
reviewers' goal was to assess critically SRs of t'ai chi in any benefits
regarding medical conditions or clinical symptoms, based on a search of
English, Chinese, and Korean electronic databases. Predefined inclusion
criteria were met by 35 SRs, from which data were extracted for the overview.
conditions included in these SRs were cancer, aging, Parkinson's disease,
musculoskeletal pain, osteoarthritis, rheumatoid arthritis, cardiovascular
disease, osteoporosis, type 2 diabetes, and other chronic conditions. Outcomes
studied in these SRs included muscle strength and flexibility, improvements in
aerobic capacity, cardiovascular disease risk factors, lowering of resting
blood pressure, bone mineral density, psychological health, fall prevention,
and improvement of balance.
conclusions reached in these SRs were contradictory in several cases. Overall,
the evidence was relatively clear supporting the efficacy of t'ai chi in older
people for fall prevention, improvements in psychological health, and general
health benefits. In contrast, t'ai chi seemed to be ineffective for symptomatic
treatment of cancer and rheumatoid arthritis.
of this overview include high risk for bias in many of the SRs reviewed,
inability to ensure that all relevant articles were identified, and risk of
diluting the results of high-quality studies by including low-quality data.
overview showed that t'ai chi, which combines deep breathing and relaxation
with slow and gentle movements, may exert exercise-based general benefits for
fall prevention and improvement of balance in older people as well as some
meditative effects for improving psychological health," the study authors
conclude. "We recommend t'ai chi for older people for its various physical
and psychological benefits. However, t'ai chi may not effectively treat inflammatory
diseases and cardiorespiratory disorders."
Dr. Lee was supported by KIOM.
Coauthor Edzard Ernst has disclosed no relevant financial relationships.
Br J Sports Med. Published online May 16, 2011. Abstract
The National Council on Aging’s Fall Prevention
Web site provides a number of resources useful for the development of fall
chi combines deep breathing and relaxation with slow gentle movements and has
been claimed to be of benefit for a variety of conditions ranging from fall
prevention in older people to cardiovascular disease such as hypertension.
Different SRs have been performed to examine its efficacy.
This is a review of SRs on t'ai chi to gather information on
the types of conditions for which t'ai chi may be beneficial and to review the
evidence for efficacy for different conditions.
- The investigators conducted
electronic searches in July 2010 in the databases of MEDLINE, EMBASE,
AMED, CINAHL, the Cochrane library, 6 Korean Medical Databases, and a
Chinese database without restrictions.
- To be included, SRs had to
specifically address t'ai chi as an intervention and include evidence from
at least 2 clinical trials.
- The researchers assessed the
quality of the primary trials using the Overview Quality Assessment
- The search generated 55
articles, of which 35 met inclusion criteria.
- The SRs were published between
2002 and 2010.
- First authors originated from
the United States (n = 10), the United Kingdom (n = 9), Korea (n = 9),
France (n = 2), Australia (n = 2), the Netherlands (n = 2), Canada (n =
1), New Zealand (n = 1), Singapore (n = 1), and Sweden (n = 1).
- SRs were based on 2 to 47
- 10 reviews incorporated a
- The quality of the SRs varied.
- 17 had minimal bias, 11 had
major flaws, and the remaining had moderate flaws.
- The following conditions were
examined: cancer, general healthcare in older adults, Parkinson's disease,
musculoskeletal disorders, muscle strength, aerobic capacity, blood
pressure, osteoporosis, diabetes, balance, and other chronic conditions.
- 7 SRs concluded that data were
insufficient to draw conclusions, 8 concluded that t'ai chi did not have a
beneficial effect, and 20 reported that t'ai chi may be effective.
- Of 9 high-quality SRs, 1 SR
arrived at a positive conclusion, and 5 arrived at a negative conclusion.
In 3 SRs, no clear conclusions were drawn.
- A clear consensus was found
that t'ai chi improved the general health of older persons, improved
psychological health, and prevented falls.
- Of 4 SRs that investigated fall
prevention, 3 showed a positive effect.
- For psychological health, 4 of
5 SRs showed a positive effect.
- All 3 SRs evaluating
psychological health in older persons found a positive effect.
- The evidence for rheumatoid
arthritis and cancer was clearly negative in 2 SRs.
- There was contradiction about
the role of t'ai chi for improving cardiovascular function and aerobic
capacity, and improving balance.
- The authors concluded that, at
the present time, positive effects of t'ai chi were only shown for fall
prevention and improvement of psychological health in older people.
- The benefits of t'ai chi have
been investigated for many conditions including neurologic,
cardiovascular, orthopaedic, and psychological conditions, but the quality
of evidence varies.
- Evidence for benefit of t'ai
chi is shown for psychological health and fall prevention in older people
but not for cardiovascular disease, cancer, or rheumatoid arthritis.