The Effects of Tai Chi on Depression, Anxiety, and Psychological Well-Being: A Systematic Review and Meta-Analysis
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Tai chi, also called taiji or tai chi chuan, is a form of mind–body exercise that originated from China. It combines Chinese martial arts and meditative movements that promote balance and healing of the mind and body, involving a series of slowly performed, dance-like postures that flow into one another. As it comprises mental concentration, physical balance, muscle relaxation, and relaxed breathing, tai chi shows great potential for becoming widely integrated into the prevention and rehabilitation of a number of medical and psychological conditions.
A growing body of clinical research has begun to evaluate the efficacy of tai chi as a therapy for a variety of health issues. A systematic review and meta-analysis were carried out on randomized controlled trials (RCTs) and quasi-experimental (Q-E) trials that studied the effects of tai chi on psychological well-being.
Drawn from English and Chinese databases, 37 RCTs and 5 Q-E studies published up to May 31, 2013 were included in the systematic review. The methodological quality of the RCTs was evaluated based on the following criteria: adequate sequence generation, allocation concealment, blinding, completeness of outcome data, selective reporting, and other potential biases. Statistical analyses were performed using Review Manager version 5.0.
The studies in this review demonstrated that tai chi interventions have beneficial effects for various populations on a range of psychological well-being measures, including depression, anxiety, general stress management, and exercise self-efficacy. Meta-analysis was performed on three RCTs that used depression as an outcome measure (ES = −5.97; 95 % CI −7.06 to −4.87), with I 2 = 0 %.
In spite of the positive outcomes, the studies to date generally had significant methodological limitations. More RCTs with rigorous research design are needed to establish the efficacy of tai chi in improving psychological well-being and its potential to be used in interventions for populations with various clinical conditions.
KeywordsTai chi Taiji Depression Anxiety Psychological well-being Meta-analysis
Research was partly funded by the following two projects: US Centers for Disease Control and Prevention (grant number 5R01DP000339) and The Ministry of Science and Technology of the People's Republic of China (grant number 2011DFA30960).
Conflicts of Interest
The authors declare that they have no competing interests and no financial benefits to the authors. Each author's contribution to this manuscript is as follows: HB and GF obtained funding from the US Centers for Disease Control and Prevention for the study. WW obtained funding from the Ministry of Science and Technology of the People's Republic of China for the study. AY designed the study. FW and EL conducted the research. FW conducted the meta-analysis. EL, FW, and AY wrote the first draft of the manuscript. FW, EL, TW, and AY participated in the revision of the subsequent drafts. All authors read and approved the final manuscript. Thank you for Jenny K.M. Man from Massachusetts General Hospital, Boston, MA, USA, for her help in conducting the research.
- 4.Yeh GY, Wood MJ, Lorell BH, Stevenson LW, Eisenberg DM, Wayne PM, 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;117:541–8. doi: 10.1016/j.amjmed.2004.04.016.PubMedCrossRefGoogle Scholar
- 13.Galantino ML, Shepard K, Krafft L, LaPerriere A, Ducette J, Sorbello A, et al. The effect of group aerobic exercise and t'ai chi on functional outcomes and quality of life for persons living with acquired immunodeficiency syndrome. J Altern Complement Med. 2005;11:1085–92. doi: 10.1089/acm.2005.11.1085.PubMedCrossRefGoogle Scholar
- 15.Wang CW, Chan CLW, Ho RTH, Tsang H, Chan CHY, Ng SM. The effect of qigong on depressive and anxiety symptoms: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2013. doi: 10.1155/2013/716094, 2013.
- 24.Han Q, Huang X, Li L, Chen L. The effect of shadow boxing exercise on the long-term quality of life in middle-aged and elderly patients with primary hypertension. Chin J Mod Nurs. 2010;16:1617–9.Google Scholar
- 25.Jin X. The comparison study of body-building among health qigong, tai chi and yangko to the elderly. (Master's thesis). Available from CNKI Dissertations and Theses (No. G852.6); 2010.Google Scholar
- 29.Li F, McAuley E, Harmer P, Duncan TE, Chaumeton NR. Tai chi enhances self-efficacy and exercise behavior in older adults. J Aging Phys Act. 2001;9:161–71.Google Scholar
- 30.Li W, Huang X, Bai M. Impact of Tai Chi exercise on the quality of life of women with osteoporosis in perimenopausal period. J Qilu Nurs. 2010;16:16–7.Google Scholar
- 31.Mao H, Yuan L, Luo M. The influence of taiji practice to depression and anxiety of female college students. New West. 2008;8:232–9.Google Scholar
- 38.Winsmann F. The effect of tai chi chuan meditation on dissociation in a group of veterans. (Doctoral dissertation). Available from ProQuest Dissertations and Theses (UMI No. 3184477; 2005.)Google Scholar
- 40.Lu G. The effect of Tai Chi prescription on college students' health. Martial Art Sci. 2008;5(1):56–8.Google Scholar
- 41.Liao G. The effect of Tai Chi to depression and quality of life of the aged with empty nest. J Community Health. 2012;10(17):5–6.Google Scholar
- 43.Li X. Influence of middle-age women's anxiety by Taiji practice. J Sports Adult Educ. 2012;28(2):36-7-48.Google Scholar
- 44.Li C, Feng H, Xiao S, Huang H. The influence of Tai Ji Quan on the therapeutic effect for irritable bowel syndrome. J Pract Med Tech. 2008;15(11):1384–6.Google Scholar
- 45.Li Z. The effect of Taiji to depression and anxiety of chronic obstructive pulmonary disease. Chin J Aesthet Med. 2011;20(6):129–30.Google Scholar
- 46.Li X, Song W. The effect of Taiji to the emotion of freshmen. Acad. 2011;24:37.Google Scholar
- 47.Wang C. Exercise on health and mood state of the university student's health care class. (Master's thesis). Available from CNKI Dissertations and Theses (No.G807.4); 2006.Google Scholar
- 50.Redwine LS, Tsuang M, Rusiewicz A, Pandzic I, Cammarata S, Rutledge T, et al. A pilot study exploring the effects of a 12-week t'ai chi intervention on somatic symptoms of depression in patients with heart failure. Psychoneuroendocrinology. 2012;37(8):1171–80. doi: 10.1016/j.psyneuen.2011.12.007.CrossRefGoogle Scholar
- 52.Yang K. How to write a systematic review. Beijing: People's Medical Publishing House; 2010.Google Scholar
- 53.Yang X. Experimental study of the effect of Taijiquan on psychological health of college students. J Tianjin Inst Phys Educ. 2003;18(1):63–6.Google Scholar