Skip to main content
Top
Published in: International Journal of Behavioral Medicine 4/2014

01-08-2014

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

Authors: Fang Wang, Eun-Kyoung Othelia Lee, Taixiang Wu, Herbert Benson, Gregory Fricchione, Weidong Wang, Albert S. Yeung

Published in: International Journal of Behavioral Medicine | Issue 4/2014

Login to get access

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.
Literature
3.
go back to reference Hartman CA, Manos TM, Winter C, Hartman DM, Li B, Smith JC. Effects of t'ai chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc. 2000;48:1553–9.PubMed Hartman CA, Manos TM, Winter C, Hartman DM, Li B, Smith JC. Effects of t'ai chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc. 2000;48:1553–9.PubMed
4.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
6.
7.
go back to reference Orr R, Tsang T, Lam P, Comino E, Singh MF. Mobility impairment in type 2 diabetes: association with muscle power and effect of tai chi intervention. Diabetes Care. 2006;29:2120–2. doi:10.2337/dc06-1130.PubMedCrossRef Orr R, Tsang T, Lam P, Comino E, Singh MF. Mobility impairment in type 2 diabetes: association with muscle power and effect of tai chi intervention. Diabetes Care. 2006;29:2120–2. doi:10.​2337/​dc06-1130.PubMedCrossRef
9.
go back to reference Mustian KM, Katula JA, Gill DL, Roscoe JA, Lang D, Murphy K. Tai chi chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors. Support Care Cancer. 2004;12:871–6. doi:10.1007/s00520-004-0682-6.PubMedCrossRef Mustian KM, Katula JA, Gill DL, Roscoe JA, Lang D, Murphy K. Tai chi chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors. Support Care Cancer. 2004;12:871–6. doi:10.​1007/​s00520-004-0682-6.PubMedCrossRef
10.
go back to reference Wang C, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, et al. Tai chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Care Res. 2009;61:1545–53. doi:10.1002/art.24832.CrossRef Wang C, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, et al. Tai chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Care Res. 2009;61:1545–53. doi:10.​1002/​art.​24832.CrossRef
13.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
15.
go back to reference 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. 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.
16.
go back to reference Wang WC, Zhang AL, Rasmussen B, Lin L, Dunning T, Kang S, et al. The effect of tai chi on psychosocial well-being: a systematic review of randomized controlled trials. J Acupunct Meridian Stud. 2009;2:171–81. doi:10.1002/art.24832.PubMedCrossRef Wang WC, Zhang AL, Rasmussen B, Lin L, Dunning T, Kang S, et al. The effect of tai chi on psychosocial well-being: a systematic review of randomized controlled trials. J Acupunct Meridian Stud. 2009;2:171–81. doi:10.​1002/​art.​24832.PubMedCrossRef
17.
19.
go back to reference Chou K. Effect of tai chi on depressive symptoms amongst Chinese older patients with major depression: the role of social support. Med Sport Sci. 2008;52:146–54. doi:10.1159/000134295.CrossRef Chou K. Effect of tai chi on depressive symptoms amongst Chinese older patients with major depression: the role of social support. Med Sport Sci. 2008;52:146–54. doi:10.​1159/​000134295.CrossRef
20.
go back to reference Chou K, Lee PWH, Yu ECS, Macfarlane D, Cheng Y, Chan SSC, et al. Effect of tai chi on depressive symptoms amongst Chinese older patients with depressive disorders: a randomized clinical trial. Int J Geriatr Psychiatr. 2004;19:1105–7. doi:10.1002/gps.1178.CrossRef Chou K, Lee PWH, Yu ECS, Macfarlane D, Cheng Y, Chan SSC, et al. Effect of tai chi on depressive symptoms amongst Chinese older patients with depressive disorders: a randomized clinical trial. Int J Geriatr Psychiatr. 2004;19:1105–7. doi:10.​1002/​gps.​1178.CrossRef
22.
go back to reference Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J. Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or tai chi classes. Arthritis Rheum. 2007;57:407–14. doi:10.1002/art.22621.PubMedCrossRef Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J. Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or tai chi classes. Arthritis Rheum. 2007;57:407–14. doi:10.​1002/​art.​22621.PubMedCrossRef
24.
go back to reference 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. 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.
25.
go back to reference 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. 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.
29.
go back to reference 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. 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.
30.
go back to reference 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. 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.
31.
go back to reference 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. 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.
32.
34.
go back to reference Wolf SL, Sattin RW, Kutner M, O'Grady M, Greenspan AI, Gregor RJ. Intense Tai Chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc. 2003;51:1693–701.PubMedCrossRef Wolf SL, Sattin RW, Kutner M, O'Grady M, Greenspan AI, Gregor RJ. Intense Tai Chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc. 2003;51:1693–701.PubMedCrossRef
35.
go back to reference Tsai J, Wang W, Chan P, Lin L, Wang C, Tomlinson B, et al. The beneficial effects of tai chi chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. J Altern Complement Med. 2003;9:747–54. doi:10.1089/107555303322524599.PubMedCrossRef Tsai J, Wang W, Chan P, Lin L, Wang C, Tomlinson B, et al. The beneficial effects of tai chi chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. J Altern Complement Med. 2003;9:747–54. doi:10.​1089/​1075553033225245​99.PubMedCrossRef
36.
go back to reference Tsang T, Orr R, Lam P, Comino E, Singh MF. Health benefits of tai chi for older patients with type 2 diabetes: the ''move it for diabetes study''-a randomized controlled trial. Clin Interv Aging. 2007;2:429–39.PubMedCentralPubMed Tsang T, Orr R, Lam P, Comino E, Singh MF. Health benefits of tai chi for older patients with type 2 diabetes: the ''move it for diabetes study''-a randomized controlled trial. Clin Interv Aging. 2007;2:429–39.PubMedCentralPubMed
38.
go back to reference 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.) 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.)
40.
go back to reference Lu G. The effect of Tai Chi prescription on college students' health. Martial Art Sci. 2008;5(1):56–8. Lu G. The effect of Tai Chi prescription on college students' health. Martial Art Sci. 2008;5(1):56–8.
41.
go back to reference 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. 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.
43.
go back to reference Li X. Influence of middle-age women's anxiety by Taiji practice. J Sports Adult Educ. 2012;28(2):36-7-48. Li X. Influence of middle-age women's anxiety by Taiji practice. J Sports Adult Educ. 2012;28(2):36-7-48.
44.
go back to reference 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. 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.
45.
go back to reference Li Z. The effect of Taiji to depression and anxiety of chronic obstructive pulmonary disease. Chin J Aesthet Med. 2011;20(6):129–30. Li Z. The effect of Taiji to depression and anxiety of chronic obstructive pulmonary disease. Chin J Aesthet Med. 2011;20(6):129–30.
46.
go back to reference Li X, Song W. The effect of Taiji to the emotion of freshmen. Acad. 2011;24:37. Li X, Song W. The effect of Taiji to the emotion of freshmen. Acad. 2011;24:37.
47.
go back to reference 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. 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.
48.
go back to reference Yeung A, Lepoutre V, Wayne P, Yeh G, Slipp LE, Fava M, et al. Tai chi treatment for depression in Chinese Americans: a pilot study. Am J Phys Med Rehabil. 2012;91(10):863–70.PubMedCrossRef Yeung A, Lepoutre V, Wayne P, Yeh G, Slipp LE, Fava M, et al. Tai chi treatment for depression in Chinese Americans: a pilot study. Am J Phys Med Rehabil. 2012;91(10):863–70.PubMedCrossRef
49.
go back to reference Nedeljkovic M, Ausfeld-Hafter B, Streitberger K, Seiler R, Wirtz PH. Taiji practice attenuates psychobiological stress reactivity—a randomized controlled trial in healthy subjects. J Cancer Surviv. 2012;6(2):146–54. doi:10.1007/s11764-011-0205-7.CrossRef Nedeljkovic M, Ausfeld-Hafter B, Streitberger K, Seiler R, Wirtz PH. Taiji practice attenuates psychobiological stress reactivity—a randomized controlled trial in healthy subjects. J Cancer Surviv. 2012;6(2):146–54. doi:10.​1007/​s11764-011-0205-7.CrossRef
50.
go back to reference 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.CrossRef 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.CrossRef
52.
go back to reference Yang K. How to write a systematic review. Beijing: People's Medical Publishing House; 2010. Yang K. How to write a systematic review. Beijing: People's Medical Publishing House; 2010.
53.
go back to reference 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. 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.
Metadata
Title
The Effects of Tai Chi on Depression, Anxiety, and Psychological Well-Being: A Systematic Review and Meta-Analysis
Authors
Fang Wang
Eun-Kyoung Othelia Lee
Taixiang Wu
Herbert Benson
Gregory Fricchione
Weidong Wang
Albert S. Yeung
Publication date
01-08-2014
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 4/2014
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-013-9351-9

Other articles of this Issue 4/2014

International Journal of Behavioral Medicine 4/2014 Go to the issue