May 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.

"Several ...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 systems."

The 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.

Medical 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.

The 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.

Limitations 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.

"Our 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