Written by Helen Cooke and the CAM-Cancer Consortium.
Updated June 16, 2016

Tai Chi

Does it work?

Three systematic reviews including meta-analyses, four randomised controlled trials and three non-randomised controlled trials were reviewed for this summary. The controlled trials are described in Table 1. There is preliminary evidence that Tai Chi (and Tai Chi/Qigong) may be a helpful supportive care intervention in terms of handgrip dynamometer strength and increased joint mobility. The evidence for health-related quality of life is mixed.

It is, due to the challenges of applying blinding, problematic to test the efficacy of Tai chi. The studies included in this summary, therefore, relate to the effectiveness of Tai chi, rather than the efficacy.

Systematic reviews

Three systematic reviews including meta-analyses of Tai chi for cancer have been published: one assessing Tai Chi in relieving treatment-related side effects and quality of life in women with breast cancer7, one of improving quality of life in breast cancer patients17,and one of Qigong and Tai Chi (combined as one body of evidence) on the health-related outcomes of cancer patients.8

The first systematic review (2015) analysed the available randomized controlled trials (RCTs) on the effects of Tai Chi Chuan (TCC) in relieving treatment-related side effects and quality of life in women with breast cancer7. Nine trials (total sample size n=322) were examined. Compared with control therapies, the pooled results suggested that TCC showed significant effects in improving handgrip dynamometer strength, limb elbow flexion (elbow extension, abduction, and horizontal adduction). No significant differences were observed in pain, interleukin-6, insulin-like growth factor, BMI, physical well-being, social or emotional well-being, or general health-related quality of life. Again, these findings need to be interpreted with caution due to the small sample sizes of the included studies and their methodological limitations (including short follow-up periods).

The second systematic review assessed the effects of tai chi on quality of life as well as other physical outcomes.17 Five RCTs involving 407 patients were included in the meta-analysis. No convincingly positive effects were reported for physical, emotional and functional well-being, body mass index, bone mineral density, and muscle strength.

A 2014 systematic review and meta-analysis evaluated the treatment effects of qigong/tai chi on the health-related outcomes of cancer patients.8 Thirteen trials with a total sample size n=592 met the author’s inclusion criteria for the qualitative synthesis, 9 thereof with a total sample size n= 499 for the meta-analysis. The researchers combined qigong and tai chi as one body of evidence. The primary outcome for this review was changes in quality of life (QOL) and other physical and psychological effects in cancer patients. The secondary outcome for this review was adverse events of the qigong/tai chi intervention. Qigong or tai chi interventions were shown to have positive effects on cancer-specific quality of life measured by FACTG within 12-week’s follow-up as well as fatigue, immune function and cortisol levels. No serious adverse events were reported in the studies. These findings need to be interpreted with caution due to the the small sample sizes of included RCTs identified and high risk of bias in included trials.  

Clinical trials

Four RCTs and three non-randomised controlled trials have been published that are not included in any of the above reviews. These trials are described in Table 1.

One recent randomised controlled trial (feasibility study) found significant reductionsin systolic blood pressure and levels of cortisolin senior female cancer survivors9.Qualitative analyses indicated that the TCC group felt they received mental and physical benefits, whereas HEC group reported on social support benefits and information received.10 The authors acknowledge that the outcomes limited to one-week post intervention. Other limitations include a small, heterogeneous sample (n=63) of senior cancer survivors.

Two RCTs reported that regular TCC appears to enhanceimmune function(peripheral blood mononuclear cell function) innon-small cell lung cancer patients11 and immune and inflammatory markers12 in breast cancer patients with insomnia. The short intervention time (16 weeks) may not have been long enough to see significant change in immune and inflammatory markers.

Three non-randomised controlled trials exploring the benefits of a tai chi/qigong combination intervention (TC qigong) reported improved balance performance13, improved joint mobility and reduced problems14 and higher blood flow velocity, lower arterial resistance, higher palmer skin temperature and better aerobic capacity then the control group receiving usual care15 in nasopharyngeal cancer survivors. The lack of randomisation and subject self-selection bias affects the reliability of the results.

Citation Helen Cooke, CAM-Cancer Consortium. Tai Chi [online document]. http://ws.cam-cancer.org/The-Summaries/Mind-body-interventions/Tai-Chi. June 16, 2016.



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