Qigong and tai chi

Who this is about

adults with essential hypertension

Practical note

The pooled analysis covered 49 randomised trials, 24 of tai chi and 25 of qigong styles such as Baduanjin, Yijinjing, Wuqinxi and Liuzijue, mostly added to medication or health education. Graded low for risk of bias and heterogeneity.

Safety note

Trials added these practices to usual care rather than replacing prescribed treatment. NCCIH summarises tai chi as appearing safe, with adverse events in trials similar to control groups and the related ones minor, such as musculoskeletal aches; people who are pregnant or living with a health condition are advised to talk with a health professional before starting.

Sources

• Supports “the addition of Chinese traditional exercises showed significant effects in regulating the systolic blood pressure and diastolic blood pressure in hypertensive patients” (Abstract) Ma J, Ma L, Lu S, Sun Y, Bao H. 2023. Evidence-Based Complementary and Alternative Medicine. The Effect of Traditional Chinese Exercises on Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis. CC BY; credit Ma et al., Evidence-Based Complementary and Alternative Medicine 2023
• Context “Although the results show that traditional Chinese exercise are effective, the clinical evidence will be affected by the low quality of most randomized controlled trials.” (Abstract) Ma J, Ma L, Lu S, Sun Y, Bao H. 2023. Evidence-Based Complementary and Alternative Medicine. The Effect of Traditional Chinese Exercises on Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis. CC BY; credit Ma et al., Evidence-Based Complementary and Alternative Medicine 2023
• Context “However, the authors said the studies were of poor quality and had many differences among them, warranting more research to confirm the conclusions.” (High Blood Pressure) National Center for Complementary and Integrative Health. NCCIH. Tai Chi: What You Need To Know. public domain; credit NCCIH

Who this is about

middle-aged and older adults

Practical note

The meta-analysis pooled 12 randomised trials with 731 participants; programmes longer than 24 weeks showed larger effects than 12-week ones. Graded low for risk of bias and very high heterogeneity.

Safety note

NCCIH summarises tai chi as appearing safe, with adverse events in trials similar to control groups and the related ones minor, such as musculoskeletal aches; people who are pregnant or living with a health condition are advised to talk with a health professional before starting.

Sources

• Supports “The study suggests that Tai Chi can be an alternative therapy for reducing depression in middle-aged and older adults.” (Abstract, Conclusion) Zeng L, Zhao X, Yu Y, Hu T, Li C, Wu M, Yang F. 2023. BMC Complementary Medicine and Therapies. Effects of Tai Chi on depression of middle-aged and older adults: an updated systematic review and meta-analysis. CC BY 4.0; credit Zeng et al., BMC Complementary Medicine and Therapies 2023
• Context “It should be noted that there may be lower-quality studies in the RCT literature analyzed, which may limit the general applicability and credibility of the conclusions.” (Abstract, Conclusion) Zeng L, Zhao X, Yu Y, Hu T, Li C, Wu M, Yang F. 2023. BMC Complementary Medicine and Therapies. Effects of Tai Chi on depression of middle-aged and older adults: an updated systematic review and meta-analysis. CC BY 4.0; credit Zeng et al., BMC Complementary Medicine and Therapies 2023
• Context “A 2020 review of 13 studies (869 participants) found that tai chi had a small positive effect on the quality of life and depressive symptoms of older adults with chronic conditions who lived in community settings.” (Does tai chi improve the quality of life of older adults?) National Center for Complementary and Integrative Health. NCCIH. Tai Chi: What You Need To Know. public domain; credit NCCIH

Who this is about

older adults

Practical note

The review pooled 15 randomised trials with 1,074 participants, measuring sleep with the Pittsburgh Sleep Quality Index; the Wuqinxi subgroup showed no clear effect. Graded low for risk of bias and heterogeneity.

Safety note

NCCIH describes qigong as appearing to be a safe form of activity; some movements may need to be avoided or modified in pregnancy.

Sources

• Supports “Qigong, particularly Baduanjin, may effectively improve sleep quality in older adults.” (Abstract, Conclusion) Xiong X, Zhang L, Zhang E. 2025. Frontiers in Public Health. The effects of Qigong exercise on sleep quality in older adults: a systematic review and meta-analysis. CC BY; credit Xiong et al., Frontiers in Public Health 2025
• Context “However, the overall certainty of the evidence was rated as moderate to low due to the high heterogeneity and risk of bias in some studies.” (Abstract, Results) Xiong X, Zhang L, Zhang E. 2025. Frontiers in Public Health. The effects of Qigong exercise on sleep quality in older adults: a systematic review and meta-analysis. CC BY; credit Xiong et al., Frontiers in Public Health 2025

Who this is about

community-dwelling older adults

Practical note

The duration and frequency of tai chi sessions varied across the trials in the Cochrane review. Graded moderate overall: high certainty for the number of people who fell, low certainty for the rate of falls.

Safety note

NCCIH summarises tai chi as appearing safe, with adverse events in trials similar to control groups and the related ones minor, such as musculoskeletal aches; people who are pregnant or living with a health condition are advised to talk with a health professional before starting.

Sources

• Supports “as well as reducing the number of people who experience falls by 20% (RR 0.80, 95% CI 0.70 to 0.91; 2677 participants, 8 studies; high-certainty evidence)” (Abstract, Main results) Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. 2019. Cochrane Database of Systematic Reviews. Exercise for preventing falls in older people living in the community. publisher copyright; metadata and short quotes only; Courtesy of the U.S. National Library of Medicine
• Supports “Tai chi may be beneficial in improving balance and preventing falls in older adults and people with Parkinson’s disease.” (Does tai chi help prevent falls?) National Center for Complementary and Integrative Health. NCCIH. Tai Chi: What You Need To Know. public domain; credit NCCIH
• Context “Tai Chi may reduce the rate of falls by 19% (RaR 0.81, 95% CI 0.67 to 0.99; 2655 participants, 7 studies; low-certainty evidence)” (Abstract, Main results) Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. 2019. Cochrane Database of Systematic Reviews. Exercise for preventing falls in older people living in the community. publisher copyright; metadata and short quotes only; Courtesy of the U.S. National Library of Medicine

Who this is about

older adults

Practical note

Qigong styles studied in trials include Baduanjin, Yijinjing, Wuqinxi and Liuzijue.

Safety note

NCCIH describes qigong as appearing to be a safe form of activity; some movements may need to be avoided or modified in pregnancy.

Sources

• Supports “A 2019 survey of reviews found sufficient evidence to support qigong for balance training and fall prevention.” (Can qigong help prevent falls?) National Center for Complementary and Integrative Health. NCCIH. Qigong: What You Need To Know. public domain; credit NCCIH
• Context “Liuzijue is a fitness Qigong that affects the movement of different zang-fu organs, meridians, and collaterals, Qi and blood” (Introduction) Ma J, Ma L, Lu S, Sun Y, Bao H. 2023. Evidence-Based Complementary and Alternative Medicine. The Effect of Traditional Chinese Exercises on Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis. CC BY; credit Ma et al., Evidence-Based Complementary and Alternative Medicine 2023
• Context “It involves using exercises to optimize energy within the body, mind, and spirit, with the goal of improving and maintaining health and well-being.” (What is qigong and how does it work?) National Center for Complementary and Integrative Health. NCCIH. Qigong: What You Need To Know. public domain; credit NCCIH