Table 2 Summary of the included systematic reviews on Tai Chi interventions.

Wang Xinzheng (2022), China

Up to August 26, 2022

Type 2 diabetes

19 RCTs, involving 1220 participants

Various Tai Chi forms

Exercise protocols

FBG

HbA1c

TG

HDL-C

Moderate

FBG: MD = −0.79, 95% CI (−1.73, −0.68), p < 0.0001.

HbA1c: MD = −1.10, 95% CI (−1.78, −0.43), p = 0.001.

TG: MD = −0.23, 95% CI (−0.32, −0.15), p < 0.0001.

HDL-C: MD = 0.15, 95% CI (0.11, 0.20), p < 0.0001.

Tai Chi improves FBG, HbA1c, TG, and HDL-C in T2DM, effective for prevention and treatment.

Unclear

Gowri Raman (2013), USA

Up to July 31, 2013

Several chronic conditions

11 studies (9 RCTs and 2 non-randomized studies), involving 994 participants

Various Tai Chi forms

Education and resistance training

Sleep Quality

Moderate to High

PSQI: ES = 0.89, 95% CI (0.28, 1.50), p < 0.05

Tai Chi enhances sleep quality and serves as a therapy for insomnia.

Potentially Effective

Yuanyuan Guan (2020), China

Up to December 2019

Hypertension

13 RCTs, involving 1,461 participants

Various Tai Chi forms

No intervention or standard activities

SBP

DBP

TC

TG

HDL-C

LDL-C

BMI

WC

Moderate

SBP: WMD = − 6.58, 95% CI (− 8.14, − 5.02), p = 0.005

DBP: SMD = − 0.57, 95% CI (− 0.77, − 0.37), p < 0.0001

TG: WMD = − 0.19, 95% CI (− 0.22, − 0.16), p < 0.00001

LDL: WMD = − 12.55, 95% CI (− 15.96, − 9.14), p < 0.00001

WC: WMD = − 0.37, 95% CI (− 0.63, − 0.10), p = 0.006

TC: SMD = − 0.29, 95% CI (− 0.73, 0.15), p = 0.20

HDL: SMD = 0.59, 95% CI (− 0.12, 1.29), p = 0.10

BMI: SMD = − 0.11, 95% CI (− 0.75, 0.52), p = 0.73

Tai Chi effectively treats hypertension, with effects varying by training style.

Unclear

Romy Lauche (2017), Australia

Up to December 2019

Stroke risk factors

21 RCTs, involving 1,604 participants

Tai Chi forms and Qigong

Routine therapy

SBP, DBP, BMI, FBG

High

SBP: MD = − 15.55, 95% CI (− 21.16, − 9.95), p < 0.001

DBP: MD = − 10.66, 95% CI (− 14.90, − 6.43), p < 0.001

FBG: MD = − 8.88, 95% CI (− 16.73, − 1.03), p = 0.03

BMI: MD = − 1.65, 95% CI (− 3.11, − 0.20), p = 0.03

Tai Chi and Qigong reduce stroke risk factors but lack conclusive evidence.

Unclear

Jiawei Qin (2019), China

Up to December 2019

Low back pain

10 RCTs, involving 959 participants

Various Tai Chi forms

Waitlist or active interventions

Pain

Physical Functioning

Moderate

Pain: WMD = −1.27, 95% CI (−1.50, −1.04), p < 0.00001.

Physical Functioning (SF-36): WMD = 3.30, 95% CI (1.92, 4.68), p < 0.00001.

Tai Chi reduces pain and improves function in LBP patients.

Potentially Effective

Rhayun Song (2017), South Korea

Up to August 30, 2016

Parkinson’s disease

21 studies (15 RCTs, 6 non-RCTs), involving 823 participants

Tai Chi and Qigong

Respiratory and physical exercises

Depression

Moderate

Depression: ES = −0.457, 95% CI (−0.795, −0.118), p = 0.008.

Tai Chi and Qigong improve motor, non-motor functions, and QoL in Parkinson’s patients.

Unclear

Chengyao Guo (2020), China

Up to August 28, 2018

Chronic Obstructive Pulmonary Disease

16 RCTs, involving 1,096 participants

Various Tai Chi forms

Active exercise and non-exercise care

6MWD, Anxiety, Depression

High

6MWD: MD = 30.78, 95% CI (15.15–46.42), p < 0.001

HAD : MD = −1.04, 95% CI (−1.58 to −0.51), p < 0.001.

Tai Chi complements pulmonary rehab, enhancing physical and mental health in COPD.

Potentially Effective

Chia-Yu Huang (2022), Taiwan

Up to August 28, 2018

Sarcopenia and frailty

11 RCTs, involving 1,676 participants

Various Tai Chi forms

Breathing exercises and therapies

DBP

Depression

Moderate

DBP: WMD = −7.00, 95% CI (−7.35 to −6.65), p < 0.00001.

Depression: SMD = −1.37, 95% CI (−1.91 to −0.83), p < 0.00001.

Tai Chi reduces falls, fear of falling, and blood pressure in frail elderly.

Potentially Effective

Xin Liu (2021), China

Up to September 2019

Chronic Obstructive Pulmonary Disease

23 RCTs, involving 1,663 participants

Various Tai Chi forms

Low, moderate, and high-intensity exercises

6MWD

Moderate

6MWD: MD = 40.83, 95% CI (32.47–49.19), p < 0.00001.

Tai Chi reduces dyspnea and enhances QoL in COPD patients.

Potentially Effective

Ying-li Yang (2018), China

Up to April 2017

Coronary disease

5 studies (2 RCTs and 3 N-RCTs), involving 291 participants

Various Tai Chi forms

No intervention or standard activities

VO_2max

High

VO2max: MD = 4.71, 95% CI (3.58–5.84), p < 0.00001.

Tai Chi improves cardiorespiratory fitness in coronary disease rehabilitation.

Unclear

Xiaomeng Ren (2017), China

Up to September 16, 2017

Heart failure

11 RCTs, involving 656 participants

Various Tai Chi forms

Usual care or aerobic exercise

6MWD

RHR

High

6MWD: WMD = 65.29 m, 95% CI (32.55–98.04), p < 0.00001

RHR: WMD = −2.52 bpm, 95% CI (−3.49 to −1.55), p < 0.00001

Tai Chi improves heart function and QoL in heart failure; long-term effects unclear.

Potentially Effective

Yi-Wen Chen (2016), Canada

Up to December 30, 2014

Several chronic conditions

33 RCTs, involving 1,584 participants

Various Tai Chi forms

Waitlist and education programs

6MWD

Pain

Depression

Moderate

6MWD: SMD = 1.58, 95% CI (0.70–2.45), p = 0.0004

Pain: SMD = 0.53, 95% CI (0.32–0.75), p < 0.0001.

Depression: SMD = 0.56, 95% CI (0.07–1.05), p = 0.03

Tai Chi improves physical performance and reduces symptoms in cancer, OA, HF, and COPD.

Potentially Effective

Chenjie Shu (2021), China

Up to April 1, 2020

Chronic inflammation

9 RCTs, involving 571 participants

Various Tai Chi forms

Health education and drug therapy

IL-6

Moderate

IL-6 (Interleukin-6): SMD = −2.17, 95% CI (−3.69 to −0.64), p = 0.005

Tai Chi reduces TNF-alpha, IL-6, and CRP, benefiting inflammatory diseases.

Potentially Effective

Xiao-Chao Luo (2020), China

Up to December 31, 2018

Breast cancer

15 RCTs, involving 885 participants.

Various Tai Chi forms

Standard therapy and rehabilitation

Pain

Anxiety

Fatigue

Moderate

Pain: SMD = 0.30, 95% CI (0.08–0.51), p = 0.007.

Anxiety: MD = −4.25, 95% CI (−5.87 to −2.63), p < 0.00001.

Fatigue: SMD = −1.11, 95% CI (−1.53 to −0.69), p < 0.00001.

Tai Chi alleviates pain, anxiety, and fatigue in breast cancer patients.

Unclear

Amanda Hall (2017), UK and Australia

Up to November 2015

Musculoskeletal pain

15 RCTs, involving 946 participants

Various Tai Chi forms

Waitlist control

Pain

Moderate

Pain: SMD = −0.66, 95% CI (−0.85 to −0.48), p < 0.0001.

Tai Chi outperforms no treatment for pain and disability in musculoskeletal conditions.

Potentially Effective

Jun-Hong Yan (2013), China

Up to September 2012

Osteoarthritis

7 RCTs, involving 348 participants

Various Tai Chi forms

Light exercise or routine care

Pain

Moderate

Pain: SMD = −0.45, 95% CI (−0.70 to −0.20), p = 0.0005

Tai Chi reduces pain, stiffness, and improves function in OA patients.

Unclear

Yingchun Zeng (2014), China

Up to June 30, 2013

Cancer

13 RCTs, involving 592 participants

Various Tai Chi forms

Psychosocial support or no intervention

Fatigue

Depression

Anxiety

High

Depression: SMD = −0.69, 95% CI (−1.51 to 0.14), p = 0.10.

Anxiety: SMD = −0.93, 95% CI (−1.80 to −0.06), p = 0.04.

Fatigue: SMD = −0.93, 95% CI (−1.80 to −0.06), p = 0.04.

Tai Chi and Qigong improve cancer-specific QoL, reduce fatigue, and lower cortisol.

Unclear

Jun-Hong Yan (2014), China

Up to September 2013

Breast cancer

5 RCTs, involving 407 participants

Various Tai Chi forms

Rehabilitation and spiritual activities

Emotional well-being

Physical well-being

Functional Well-being

Social Well-being

BMI

Moderate

Physical Well-being: SMD = 0.10, 95% CI (−0.35 to 0.54), p = 0.67.

Emotional Well-being: SMD = 0.24, 95% CI (0.02 to 0.45), p = 0.03.

Functional Well-being: SMD = 0.23, 95% CI (−0.03 to 0.49), p = 0.09.

Social Well-being: SMD = 0.03, 95% CI (−0.18 to 0.25), p = 0.77.

BMI (Body Mass Index): WMD = 0.67, 95% CI (−0.13 to 1.47), p = 0.10.

Tai Chi improves emotional well-being in breast cancer survivors, evidence limited.

Unclear

Guohua Zheng (2015), China

Up to September 2013

Healthy adults

20 studies (2 RCTs, 8 NRCTs, 7 Cohort studies, 3 SCTs), involving 1,868 participants

Various Tai Chi forms

Non-intervention

SBP

DBP

RHR

VO_2max

High

SBP: SMD = −0.93, 95% CI (−1.30 to −0.56), p < 0.00001.

DBP: SMD = −0.54, 95% CI (−0.90 to −0.18), p < 0.00001.

RHR: SMD = −0.72, 95% CI (−1.27 to −0.18), p = 0.01.

VO2peak: SMD = 1.33, 95% CI (0.97 to 1.70), p < 0.00001.

Tai Chi enhances cardiorespiratory fitness in healthy adults, but evidence quality is low.

Potentially Effective

Lizhou Liu (2020), New Zealand and China

Up to June 2019

Breast cancer

16 RCTs, involving 1,268 participants.

Various Tai Chi forms

Supportive care or rehabilitation

Fatigue

Sleeping quality

Depression

BMI

Moderate to high

Fatigue: SMD = −0.91, 95% CI (−1.30 to −0.53), p < 0.00001.

Depression: SMD = 0.22, 95% CI (−0.05 to 0.49), p > 0.05.

BMI: MD = −0.58, 95% CI (−2.18 to 1.01), p > 0.05.

Sleep Quality: MD = 0.26, 95% CI (−1.28 to 1.80), p > 0.05.

Tai Chi improves QoL and fatigue when combined with conventional therapy.

Potentially Effective

Xiaosha Ni (2019), China

Up to June 2019

Cancer survivors

22 RCTs, involving 1,410 participants

Various Tai Chi forms

Usual care and psychological therapy

Sleep quality

Moderate

Sleep Quality: SMD = −0.37, 95% CI (−0.72 to −0.02), p = 0.04.

Tai Chi enhances QoL, limb function, and reduces fatigue in cancer survivors.

Unclear