What does the research show about tai chi and qigong?

Tai chi and qigong

In older adults, tai chi cut the rate of falls by about 19% to 43% in pooled trials and beat stretching in a large trial. It eased knee osteoarthritis about as much as physical therapy and lowered blood pressure. Mood and sleep improved against no program. Reported harms were minor aches, with no serious events tied to tai chi.

Add to Bio HackChecked 2026-11-13

Status: A practice, not a regulated product.
Also called: tai chi, tai chi chuan, taiji, taijiquan, tai ji quan, Yang style tai chi, Sun style tai chi, Tai Chi Chih, Tai Ji Quan: Moving for Better Balance, qigong, chi kung, Baduanjin, eight brocades, mind-body exercise
Practiced for: balance, falls, blood pressure, knee osteoarthritis, arthritis, fibromyalgia, joint pain, stress, anxiety, depression, mood, sleep, insomnia, cholesterol, flexibility, energy, qi, longevity

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help9

StrongShown to reduce the rate of falls in older adults by about 19% to 43% in pooled trials, and the number of people who fall by about 20%.
ModerateShown to lower blood pressure in people with hypertension by about 12 to 13 mm Hg systolic, in two meta-analyses, one of tai chi and one of Baduanjin qigong.
ModerateShown in two meta-analyses to lower LDL cholesterol and triglycerides in people with hypertension. HDL cholesterol results differed between them.
ModerateShown to ease knee osteoarthritis pain and stiffness and improve function in one meta-analysis of 16 trials. A small trial found more relief than wellness education and stretching.
ModerateShown to lower stress, anxiety and depression in pooled trials of tai chi and of qigong, against waiting list and varied controls, in trials with methodological limits.
ModerateShown in two trials of older adults with insomnia to improve sleep against no intervention or sleep education, by modest amounts on wrist-worn sleep measures.
LimitedOne trial of 670 adults at high risk of falling found a tai chi balance program cut falls 58% against stretching and 31% against a multimodal exercise program.
LimitedOne trial of 342 adults with prehypertension found a year of tai chi lowered office systolic pressure 2.4 mm Hg more than aerobic exercise of the same schedule.
LimitedOne trial of 226 adults with fibromyalgia found tai chi improved symptom scores more than aerobic exercise at 24 weeks, by 16.2 points when matched for time.

Reported risks1

LimitedReported adverse events in randomized trials were mostly minor muscle and joint aches, such as knee and back pain. Two thirds of trials did not report adverse events.How often is not known

What people practice it for, and what was found

Shown to help9

Strong

Falls in older adults

Shown to reduce the rate of falls in older adults by about 19% to 43% in pooled trials, and the number of people who fall by about 20%.

Compared with control interventions not thought to reduce falls [1]; other treatments [2]; control groups the source abstract does not describe [3]

The numbers and sources

Effect: In a Cochrane review, tai chi reduced the rate of falls by 19% (rate ratio 0.81, 95% CI 0.67 to 0.99, 7 trials, 2,655 participants, low certainty) and the number of people who fell by 20% (risk ratio 0.80, 95% CI 0.70 to 0.91, 8 trials, high certainty) [1]. Another meta-analysis found falls cut over the short term (incidence rate ratio 0.57, 95% CI 0.46 to 0.70) and less over the long term (0.87), with fewer injurious falls (0.50 short term). Time to first fall did not change (hazard ratio 0.98, 95% CI 0.69 to 1.37) [2]. A third found fewer fallers (risk ratio 0.80) and a lower fall rate (0.69, 95% CI 0.60 to 0.80), larger with more frequent practice [3].
Population: Community-dwelling adults aged 60 and over, mean age 76, 77% women [1]. Older and at-risk adults in 10 trials [2]. 3,824 older adults in 18 trials [3].
Sources: [1], [2], [3]
Caveats: Most trials had unclear or high risk of bias in at least one item [1]. Funnel plot asymmetry suggested publication bias [3]. The reviews share many trials.

Limited

Falls, against other exercise

One trial of 670 adults at high risk of falling found a tai chi balance program cut falls 58% against stretching and 31% against a multimodal exercise program.

Compared with stretching exercises [4]; multimodal exercise combining balance, aerobic, strength and flexibility work [4]

The numbers and sources

Effect: Over 6 months, there were 152 falls in 85 people with tai chi, 218 falls in 112 people with multimodal exercise and 363 falls in 127 people with stretching. The incidence rate ratio was 0.42 (95% CI 0.31 to 0.56) for tai chi against stretching and 0.69 (95% CI 0.52 to 0.94) against multimodal exercise [4].
Population: 670 community-dwelling adults aged 70 and over who had fallen in the past year or had impaired mobility, mean age 77.7, 65% women, in Oregon [4].
Sources: [4]
Caveats: One single-blind trial of a program tailored for balance, not classic tai chi forms [4].

Moderate

Blood pressure, against no exercise or usual care

Shown to lower blood pressure in people with hypertension by about 12 to 13 mm Hg systolic, in two meta-analyses, one of tai chi and one of Baduanjin qigong.

Compared with control groups the source abstract does not describe [5]; no intervention [6]; antihypertensive drugs alone [6]

The numbers and sources

Effect: Tai chi was associated with lower systolic pressure (WMD -12.47 mm Hg, 95% CI -16.00 to -8.94) and diastolic pressure (WMD -6.46 mm Hg, 95% CI -8.28 to -4.64) and better quality of life [5]. Baduanjin qigong lowered systolic pressure by 13.00 mm Hg (95% CI -21.24 to -4.77) and diastolic by 6.13 mm Hg against no intervention, and did not differ from antihypertensive drugs. Added to drugs, it lowered systolic pressure 7.49 mm Hg more than drugs alone [6].
Population: Adults with essential hypertension in trials from 15 databases [5]. Adults with hypertension in 8 trials [6].
Sources: [5], [6]
Caveats: The two reviews cover different practices, tai chi and Baduanjin qigong. Both searched Chinese databases, and neither abstract reports trial quality or heterogeneity [5][6].

Limited

Blood pressure, against aerobic exercise

One trial of 342 adults with prehypertension found a year of tai chi lowered office systolic pressure 2.4 mm Hg more than aerobic exercise of the same schedule.

Compared with aerobic exercise, four 60-minute supervised sessions a week [7]

The numbers and sources

Effect: At 12 months, office systolic pressure fell 7.01 mm Hg with tai chi and 4.61 mm Hg with aerobic exercise, a difference of -2.40 mm Hg (95% CI -4.39 to -0.41). Twenty-four hour ambulatory systolic pressure (-2.16 mm Hg) and nighttime systolic pressure (-4.08 mm Hg) were also lower with tai chi [7].
Population: 342 adults aged 18 to 65 with prehypertension at 2 hospitals in China, mean age 49, 51.5% women [7].
Sources: [7]
Caveats: One single-blinded trial. People with full hypertension were not included [7].

Moderate

Blood fats in hypertension

Shown in two meta-analyses to lower LDL cholesterol and triglycerides in people with hypertension. HDL cholesterol results differed between them.

Compared with control groups the source abstract does not describe [5]; no intervention [6]

The numbers and sources

Effect: Tai chi was associated with lower total cholesterol (WMD -0.49), triglycerides (WMD -0.49, 95% CI -0.92 to -0.07) and LDL cholesterol (WMD -0.86), and no significant effect on HDL cholesterol (P = 0.16) [5]. Baduanjin lowered triglycerides and LDL cholesterol and raised HDL cholesterol against no intervention [6].
Population: Adults with essential hypertension [5][6].
Sources: [5], [6]
Caveats: The first abstract gives no units, and its HDL interval does not contain its own point estimate [5]. The second gives no sizes for blood fats [6].

Moderate

Knee osteoarthritis, against no program or attention control

Shown to ease knee osteoarthritis pain and stiffness and improve function in one meta-analysis of 16 trials. A small trial found more relief than wellness education and stretching.

Compared with control groups the source abstract does not describe [8]; wellness education and stretching, as an attention control [9]

The numbers and sources

Effect: Tai chi improved pain (SMD -0.69, 95% CI -0.95 to -0.44), stiffness (SMD -0.59), physical function (SMD -0.92, 95% CI -1.16 to -0.69), dynamic balance (SMD 0.69) and physical and mental quality of life [8]. In 40 adults, WOMAC pain improved more with tai chi than with the attention control at 12 weeks (mean difference -118.80 mm, 95% CI -183.66 to -53.94), along with function, chair stand time and depression scores [9].
Population: 986 patients with knee osteoarthritis in 16 trials [8]. 40 adults with symptomatic knee osteoarthritis, mean age 65 [9].
Sources: [8], [9]
Caveats: Strength of evidence for the main outcomes was low or moderate [8]. Patients knew their group [9].

Limited

Fibromyalgia, against aerobic exercise

One trial of 226 adults with fibromyalgia found tai chi improved symptom scores more than aerobic exercise at 24 weeks, by 16.2 points when matched for time.

Compared with supervised aerobic exercise twice a week for 24 weeks [11]

The numbers and sources

Effect: Revised Fibromyalgia Impact Questionnaire scores improved 5.5 points more across the combined tai chi groups than with aerobic exercise (95% CI 0.6 to 10.4), and 16.2 points more when tai chi was given at the same dose (95% CI 8.7 to 23.6). Anxiety, self-efficacy and coping also improved more. Twenty-four weeks of tai chi improved scores more than 12 weeks [11].
Population: 226 adults with fibromyalgia, 151 in four tai chi groups and 75 in aerobic exercise [11].
Sources: [11]
Caveats: One single-blind trial. Attendance was higher in tai chi than in aerobic exercise, which may explain part of the difference [11].

Moderate

Stress, anxiety and depression

Shown to lower stress, anxiety and depression in pooled trials of tai chi and of qigong, against waiting list and varied controls, in trials with methodological limits.

Compared with varied control groups, including some nonrandomized studies [12]; waiting list [13]; lectures and structured movement alone [13]

The numbers and sources

Effect: Tai chi reduced stress (effect size 0.66, 95% CI 0.23 to 1.09), anxiety (0.66, 95% CI 0.29 to 1.03) and depression (0.56, 95% CI 0.31 to 0.80) and improved mood (0.45) [12]. In healthy adults, 1 to 3 months of qigong lowered anxiety (SMD -0.75, 95% CI -1.11 to -0.40, 4 trials) and stress (SMD -0.88, 95% CI -1.22 to -0.55, 3 trials) against waiting list [13].
Population: 3,817 participants in 40 studies, healthy and with chronic conditions [12]. Healthy adults in 7 trials [13].
Sources: [12], [13]
Caveats: The tai chi review pooled randomized and nonrandomized trials and noted inadequate controls [12]. The qigong review had few trials with methodological flaws [13].

Moderate

Insomnia, against no program or sleep education

Shown in two trials of older adults with insomnia to improve sleep against no intervention or sleep education, by modest amounts on wrist-worn sleep measures.

Compared with no intervention [14]; a sleep seminar education control [15]

The numbers and sources

Effect: After 12 weeks, sleep efficiency rose 3.4% (95% CI 1.6 to 5.1), wake time after sleep onset fell 13.3 minutes and awakenings fell by 2.2 against no intervention, measured by actigraphy and maintained at 24 months [14]. Against a sleep seminar, Tai Chi Chih improved self-rated sleep quality, fatigue and depressive symptoms, but not insomnia remission, and polysomnography did not change [15].
Population: 320 adults aged 60 and over with chronic insomnia in Hong Kong, 80% women [14]. 123 older adults with chronic insomnia in Los Angeles [15].
Sources: [14], [15]
Caveats: The authors describe the absolute improvements as modest [14].

Not shown to help2

Limited

Knee osteoarthritis, against physical therapy

One trial of 204 adults found tai chi and physical therapy eased knee osteoarthritis symptoms by similar amounts at 12 weeks, maintained to 52 weeks.

Compared with standard physical therapy twice a week for 6 weeks, then 6 weeks of monitored home exercise [10]

The numbers and sources

Effect: WOMAC scores fell 167 points with tai chi and 143 points with physical therapy at 12 weeks, a difference of 24 points (95% CI -10 to 58) that was not significant. Tai chi produced greater improvement in depression and in the physical component of quality of life [10].
Population: 204 adults with symptomatic knee osteoarthritis, mean age 60, 70% women [10].
Sources: [10]
Caveats: Patients knew their group. One urban academic hospital [10].

Moderate

Insomnia, against exercise or CBT

Not shown to improve sleep more than conventional exercise. In one trial, CBT for insomnia produced more remission and better sleep than Tai Chi Chih.

Compared with conventional exercise [14]; cognitive behavioral therapy for insomnia [15]

The numbers and sources

Effect: Sleep measures by actigraphy did not differ between tai chi and conventional exercise [14]. CBT performed better than Tai Chi Chih for clinician-rated remission of insomnia and showed greater, more sustained improvement in sleep quality, fatigue and depressive symptoms (all P < 0.01) [15].
Population: 210 older adults in the tai chi and exercise arms [14]. 123 older adults [15].
Sources: [14], [15]
Caveats: Two trials of older adults.

Protocols studied

The fall prevention trial used two 60-minute classes a week for 24 weeks of a balance-focused tai ji quan program [4]. In the prehypertension trial, four 60-minute supervised sessions a week ran for 12 months [7]. Knee osteoarthritis trials used tai chi twice a week for 12 weeks [10], including 60-minute sessions of 10 modified Yang style forms [9]. The fibromyalgia trial gave classic Yang style tai chi for 12 or 24 weeks, once or twice a week, and 24 weeks improved scores more than 12 [11]. Insomnia trials ran 12 weeks [14] and weekly 2-hour group sessions of Tai Chi Chih over 4 months [15]. Qigong trials in healthy adults ran 1 to 3 months [13]. In fall prevention, more frequent practice and Yang style went with larger effects than Sun style [3].

Risks

Reported risks1

LimitedHow often is not known

Minor muscle and joint aches

Reported adverse events in randomized trials were mostly minor muscle and joint aches, such as knee and back pain. Two thirds of trials did not report adverse events.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Of 153 randomized trials, 50 (33%) reported adverse events and 18 (12%) described an explicit monitoring protocol. Reported events were typically minor, expected and musculoskeletal, such as knee and back pain [16].
Population: 153 randomized trials, most in older adults [16].
Sources: [16]
Caveats: Reporting was poor and inconsistent, so no rate can be given [16].

Checked, no increase found1

Limited

Serious adverse events

No intervention-related serious adverse events were reported in a review of 153 randomized trials or in the knee osteoarthritis and fibromyalgia trials.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: No intervention-related serious adverse events appeared in 153 trials [16]. No serious adverse events occurred in the knee osteoarthritis trial against physical therapy [10], and none related to the interventions in the fibromyalgia trial [11].
Population: 153 trials [16]. 204 adults [10]. 226 adults [11].
Sources: [16], [10], [11]
Caveats: Only 12% of trials described how they monitored adverse events [16].

Claims tested and not found

That tai chi eases knee osteoarthritis more than physical therapy. Symptom scores did not differ significantly between the two at 12 weeks [10].
That tai chi delays the first fall. Pooled trials found no change in time to first fall (hazard ratio 0.98) even as the fall rate dropped [2].
That tai chi improves insomnia more than ordinary exercise or CBT. Sleep did not differ from conventional exercise [14], and CBT produced more remission [15].
That tai chi changes sleep measured in a sleep lab. Polysomnography measures did not change with Tai Chi Chih against a sleep seminar [15].

Sources

Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2019. https://doi.org/10.1002/14651858.CD012424.pub2
Lomas-Vega R, Obrero-Gaitán E, Molina-Ortega FJ, Del-Pino-Casado R. Tai Chi for Risk of Falls. A Meta-analysis. Journal of the American Geriatrics Society. 2017. https://doi.org/10.1111/jgs.15008
Huang ZG, Feng YH, Li YH, Lv CS. Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open. 2017. https://doi.org/10.1136/bmjopen-2016-013661
Li F, Harmer P, Fitzgerald K, et al. Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial. JAMA Internal Medicine. 2018. https://doi.org/10.1001/jamainternmed.2018.3915
Liang H, Luo S, Chen X, et al. Effects of Tai Chi exercise on cardiovascular disease risk factors and quality of life in adults with essential hypertension: A meta-analysis. Heart and Lung. 2020. https://doi.org/10.1016/j.hrtlng.2020.02.041
Xiong X, Wang P, Li S, et al. Effect of Baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials. Maturitas. 2015. https://doi.org/10.1016/j.maturitas.2015.01.002
Li X, Chang P, Wu M, et al. Effect of Tai Chi vs Aerobic Exercise on Blood Pressure in Patients With Prehypertension: A Randomized Clinical Trial. JAMA Network Open. 2024. https://doi.org/10.1001/jamanetworkopen.2023.54937
Hu L, Wang Y, Liu X, et al. Tai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis. Clinical Rehabilitation. 2021. https://doi.org/10.1177/0269215520954343
Wang C, Schmid CH, Hibberd PL, et al. Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis and Rheumatism. 2009. https://doi.org/10.1002/art.24832
Wang C, Schmid CH, Iversen MD, et al. Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial. Annals of Internal Medicine. 2016. https://doi.org/10.7326/M15-2143
Wang C, Schmid CH, Fielding RA, et al. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. BMJ. 2018. https://doi.org/10.1136/bmj.k851
Wang C, Bannuru R, Ramel J, et al. Tai Chi on psychological well-being: systematic review and meta-analysis. BMC Complementary and Alternative Medicine. 2010. https://doi.org/10.1186/1472-6882-10-23
Wang CW, Chan CH, Ho RT, et al. Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials. BMC Complementary and Alternative Medicine. 2014. https://doi.org/10.1186/1472-6882-14-8
Siu PM, Yu AP, Tam BT, et al. Effects of Tai Chi or Exercise on Sleep in Older Adults With Insomnia: A Randomized Clinical Trial. JAMA Network Open. 2021. https://doi.org/10.1001/jamanetworkopen.2020.37199
Irwin MR, Olmstead R, Carrillo C, et al. Cognitive behavioral therapy vs. Tai Chi for late life insomnia and inflammatory risk: a randomized controlled comparative efficacy trial. Sleep. 2014. https://doi.org/10.5665/sleep.4008
Wayne PM, Berkowitz DL, Litrownik DE, et al. What do we really know about the safety of tai chi?: A systematic review of adverse event reports in randomized trials. Archives of Physical Medicine and Rehabilitation. 2014. https://doi.org/10.1016/j.apmr.2014.05.005

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