The Effects of Tai Chi on Depression, Anxiety, and Psychological Well-Being: A Systematic Review and Meta-Analysis

Abstract

Background

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.

Purpose

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.

Method

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.

Results

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 %.

Conclusion

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.

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Acknowledgments

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.

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Correspondence to Weidong Wang.

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Weidong Wang and Albert S Yeung are co-senior authors

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Wang, F., Lee, EK.O., Wu, T. et al. The Effects of Tai Chi on Depression, Anxiety, and Psychological Well-Being: A Systematic Review and Meta-Analysis. Int.J. Behav. Med. 21, 605–617 (2014). https://doi.org/10.1007/s12529-013-9351-9

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Keywords

  • Tai chi
  • Taiji
  • Depression
  • Anxiety
  • Psychological well-being
  • Meta-analysis