Table 2.
Characteristics of systematic reviews included in the evidence synthesis
| Review ID | Populations (no.) Conditions |
Main outcomes * (Other outcomes) |
Tai Chi (TC) minutes/session, frequency/week, follow-up Comparisons |
Search date No. databases No. studies (Languages) |
Funding | SR analysis AMSTAR 2 quality rating |
|---|---|---|---|---|---|---|
| Buto 2020 [60] | Older adults (n = 2063; TC = 1728) Prefrail and frail | Functional capacity, QoL |
20–60 min 1–5 times/week, 15–96 weeks TC vs Ucare, HEd, PT, Ex, other |
Sep 2019 6 databases (Eng.) 15 RCTs (Tai Chi: 9 RCTs) (Eng. Chin.) |
Uni |
No meta-analysis Moderate (†Low) |
| Cheng 2019 [61] |
Adults (n = 657) Fibromyalgia |
Fibromyalgia impact (fatigue, pain, sleep quality, depression, QoL) |
55–120 min 1–3 times/week, 10–24 weeks TC vs Ucare, Ex |
May 2019 3 databases (Eng.) 6 RCTs (Eng.) |
Uni |
Meta-analysis Low (†Critically low) |
| Choo 2020 [62] |
Older adults (n = 869) Chronic diseases |
NI (QoL, mental health, physical function, AE) |
40–90 min 1–4 times/week, 10–24 weeks TC vs noRx, Ucare, HEd, Pharm, Ex, other, waitlist |
NI 7 databases (Eng. Chin.) 13 RCTs (Eng. Chin.) |
NI | Meta-analysis Critically low |
| Cocchiara 2020 [63] |
Adults (n = 467) Workplace wellness of healthcare workers |
NI (work-related stress, physical and mental health, improvement in attention and/or productivity) |
8–12 weeks NI |
Mar, 2019 4 databases (Eng.) 1 SR, 3 RCTs, 1 NRSI, 1 case report (Eng.) |
NI |
No meta-analysis Critically low |
| Cui 2019 [64] |
Adults, older adults (n = 1794) Healthy, chronic diseases |
Serious and non-serious adverse events |
30–60 min 1–5 times/week, 12–48 weeks TC vs active or inactive intervention |
Feb 2016 3 databases (Eng.) 24 RCTs (Eng.) |
Gov | Meta-analysis Critically low |
| Dong 2020 [65] |
Adults, older adults (n = 1608) with or without hypertension |
Systolic and diastolic BP |
30–120 min 1–7 times/week, 8–24 weeks TC vs noRx, Ex |
Jan 2019 6 databases (Eng. Chin.), 24 RCTs (Eng. Chin.) |
Gov | Meta-analysis Critically low |
| Gu 2017 [66] |
Adults, older adults (n = 918) Chronic heart failure |
6MWD, QoL (B-type natriuretic peptide, LVEF, BP, VO2peak) |
15–60 min 2–7 times/week, 4–24 weeks TC vs Ucare, Ex, Pharm |
Jun 2016 6 databases (Eng. Chin.) 13 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Low (†Critically low) |
| Guo 2020 [67] |
Adults, older adults (n = 1508) COPD |
Lung function tests (6MWD, QoL) |
30–60 min 2–5 times/week, 8–48 weeks TC vs noRx, Ex |
Aug 2018 9 databases (Eng. Chin.) 16 RCTs (Eng. Chin.) |
Gov | Meta-analysis Low |
| Hall 2017 [68] |
Adults, older adults (n = 1012) Musculoskeletal chronic pain |
Pain (disability, stiffness, QoL) |
40–60 min 2 times/week, 6–20 weeks TC vs Ucare, HEd, waitlist |
Nov 2015 7 databases (Eng.) 15 RCTs (Eng.) |
NI |
Meta-analysis Low (†Critically low) |
| Ho 2013 [69] | Adolescents, adults, older adults (n = 939) Healthy, HIV | NI (any symptoms of infections, biomedical indicators of immunity) |
30–60 min 1–5 times/week, 5–576 weeks TC vs Ucare, HEd, Ex, waitlist |
Jan 2011 14 databases (Eng. Chin.) 7 RCTs, 9 NRSIs (Eng. Chin.) |
NI |
No meta-analysis Low (†Critically low) |
| Hu 2020 [70] |
Older adults (n = 986) Knee osteoarthritis |
Pain, stiffness, physical function, mental health, self-efficacy, AE |
30–60 min 1–4 times/week, 5–52 weeks TC vs noRx, Ucare, HEd, PT, waitlist |
Jun 2020 9 databases (Eng. Chin.) 16 RCTs (Eng. Chin.) |
No |
Meta-analysis Low (†Critically low) |
| Huang 2017 [73] |
Older adults (n = 3824) Chronic diseases |
No. of people who fell (falls incidence) |
1–5 times/week, 16–96 weeks TC vs noRx, PT, Ex, waitlist |
Feb 2016 3 databases (Eng.) 18 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Low (†Critically low) |
| Huang 2019 [72] |
Adults, older adults (n = 132) Vestibular balance disorders |
Balance, gait, neuromuscular function, trunk stability (symptom severity/relief/impact, AE) |
45–90 min 1–5 times/week, 3–18 weeks TC vs noRx, vestibular training/education, Ex; TC individualized vs TC standardized |
Dec 2016 4 (English) 3 RCTs, I NRSI (English) |
NI |
No meta-analysis Low (†Critically low) |
| Huang 2020 [71] |
Adults, older adults (n = 3842) Falls |
Falls rate (Balance—single leg standing, Berg balance scale, time-up-and-go) |
30–90 min 1–7 times/week, 8–48 weeks TC vs ADL, PT, HEd, Ex, other |
Aug 2019 6 databases (Eng. Chin.) 20 RCTs (Eng. Chin.) |
Gov | Meta-analysis Critically low |
| Jiang 2018 [74] |
Older adults (n = 290) Stable angina |
NI (VO2max, maximum heart rate) |
12–48 weeks TC vs noRx, Ex |
1999–2015 10 databases (Eng. Chin.) 5 RCTs (Eng. Chin.) |
NI |
Meta-analysis Low (†Critically low) |
| Kruisbrink 2020 [75] |
Older adults (NI) Falls |
Fear of falling |
30–60 min 2–7 times/week, 8–24 weeks TC vs noRx, Ucare |
Jul 2005–Jul 2019 5 databases (Eng.) 62 RCTs / 38 Tai Chi (Eng.) |
Uni |
Meta-analysis Low (†Critically low) |
| Liu F 2020 [76] |
Adults (n = 772; TC = 179) Substance abuse disorders |
Depression, anxiety (AE) |
45–60 min 3–4 times/week, 45–60 weeks TC vs usual care |
Jan 2019 (English Chinese) 1 RCT, 6 NRSIs (English, Chinese) | Uni |
Meta-analysis Critically low |
| Liu LZ 2020 [77] |
Adults, older adults (n = 1268) Breast cancer |
Fatigue, sleep quality, QoL |
30–120 min 2–3 times/week, 10–24 weeks TC vs Ucare, Psych, sham QiGongEx; TC + Rehab vs Dance + Rehab |
Jun 2019 8 databases (Eng. Chin.) 16 RCTs (Eng. Chin.) |
n.f.p | Meta-analysis Critically low |
| Liu WJ 2020 [78] |
Older adults (n = 798) Osteoarthritis |
NI (Pain, stiffness & function, time-up-and-go, 6MWD, other) |
8–48 weeks TC vs Ucare, HEd, other |
Jan 2019 6 databases (Eng. Chin.) 15 RCTs (Eng. Chin.) |
NI | Meta-analysis Critically low |
| Luo 2020 [79] |
Female adults (n = 885) Breast cancer |
Quality of life (fatigue, BMI, laboratory blood tests) |
20–120 min 3–7 times/week, 12–24 weeks TC vs Psych; TC + Ucare vs Ucare; TC + Rehab vs Rehab |
Feb 2020 11 databases (Eng. Chin. Japanese Korean Tai) 15 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Moderate (†Low) |
| Lyu 2018 [81] |
Adults, older adults (n = 1293) Stroke survivors |
NI (ADL, motor function, balance, mental health, AE) |
20–48 weeks TC vs Rehab |
Oct 2017 7 databases (Eng. Chin.) 21 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Moderate (†Low) |
| Lyu 2020 [80] |
Adults, older adults (n = 723) Stroke survivors |
NI (mental health, sleep quality, cognitive impairment) |
6–48 weeks TC vs Ucare, Rehab; TC + Rehab vs Rehab |
Jul 2020 7 databases (Eng. Chin.) 11 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Moderate (†Low) |
| Mudano 2019 [82] |
Adults, older adults (n = 345) Rheumatoid arthritis |
NI (pain, disease activity, physical function, AE) |
7–60 min 1–2 times/week, 8–12 weeks TC vs Ucare, HEd, Ex; TC + HEd + other vs TCM; TC + HEd class vs HEd brochure |
Sep 2018 5 databases (Eng.) 2 RCTs, 5 NRSIs (Eng. Chin.) |
NI | Meta-analysis High |
| Ni 2019 [83] |
Adults, older adults (n = 1410) Cancer |
QoL (limb function, fatigue, sleep quality, laboratory blood tests, AE) |
20–60 min 3–5 times/week, 12–24 weeks TC vs Ucare, Rehab, HEd, Psych, Ex, sham Qigong |
Apr 2018 7 databases (Eng. Chin.) 22 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Low (†Critically low) |
| Pan 2016 [84] |
Adults, older adults (n = 445) Hyperlipidaemia |
Lipid measures—cholesterol, triglycerides, LDL-C, HDL-C (AE) |
40–60 min 3–7 times/week, 12–48 weeks TC vs Ucare, Ex, waitlist |
Jun 2015 6 databases (Eng. Chin.) 6 RCTs (Eng.) |
NI |
Meta-analysis Low (†Critically low) |
| Qin 2019 [85] |
Adults, older adults (n = 959) Back pain |
Pain, disability (AE) |
40–60 min 1–6 times/week, 2–28 weeks TC vs noRx; TC + HEd vs HEd; TC + massage vs massage; TC + PT vs PT |
Mar 2019 6 databases (Eng. Chin.) 10 RCTs (Eng. Chin.) |
NI |
Meta-analysis Low (†Critically low) |
| Si 2020 [86] |
Adults, older adults (n = 1858) Healthy, chronic diseases |
Sleep quality assessed with Pittsburgh Sleep Quality Index (AE) |
5–120 min 1–5 times/week, 8–36 weeks TC vs noEx, ADL, HEd, Psych, Ex, Rehab, other, waitlist, sham Qigong |
Aug 2019 6 databases (Eng. Chin.) 25 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Low (†Critically low) |
| Song 2018 [87] |
Adults, older adults (n = 373) Cancer |
Cancer related fatigue |
30–60 min 2–7 times/week, 4–12 weeks TC vs Ucare, HEd, Psych, Ex, sham Qigong |
Apr 2017 9 databases (Eng. Chin.) 6 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Low (†Critically low) |
| Su 2020 [88] |
Adults, older adults (n = 762) Healthy, osteoarthritis |
Knee strength |
2–7 times/week, 12–72 weeks TC vs noEx, ADL, HEd, Ex |
NI 7 databases (Eng. Chin.) 12 RCTs (Eng. Chin.) |
Gov | Meta-analysis Critically low |
| Taylor 2017 [89] |
Adults (n = 193) Multiple sclerosis |
Balance, gait, flexibility, strength, fatigue, QoL, symptoms, perception of disease, mood (AE) |
40–90 min TC vs noRx, Ucare, TC + meditation |
Aug 2016 12 databases (Eng.) 3 RCTs, 5 NRSIs (Eng.) |
NI |
No meta-analysis Low (†Critically low) |
| Taylor-Piliae 2020 [90] |
Adults, older adults (n = 1853) Hypertension, chronic heart failure |
Quality of life, mental health (AE) |
30 min, 6–52 weeks TC vs noRx, Ucare, PT, Rehab, Ex TC + HEd vs noRx; TC + Rehab vs Rehab; TC + Ex vs Ex |
Jul 2009–Jul 2019 10 databases (Eng.) 13 RCTs, 2 NRSIs (Eng.) |
No | Meta-analysis Critically low |
| Wang 2010 [93] |
Adults, older adults (n = 3817) Healthy, chronic diseases, depression, frail |
NI (Stress, anxiety, depression, self-esteem, mood, AE) |
30–120 min 1–4 times/week, 10–24 weeks TC vs ADL, HEd, Ex, Psych, waitlist |
Mar 2009 11 databases (Eng. Chin.) 17 RCTs, 7 CCS, 16 CS (Eng.) |
NI | Meta-analysis Critically low |
| Wang 2017 [92] |
Adults, older adults (n = 344) Females, perimenopause |
QoL, 8 domains assessed by SF-36 (BMD) |
30–90 min 3–7 times/week, 20–36 weeks TC vs Ucare, placebo |
Jan 2014 4 databases (Eng. Chin.) 5 RCTs (Eng. Chin.) |
Gov | Meta-analysis Critically low |
| Wang 2020 [91] |
Older adults (n = 1170) Healthy, chronic diseases |
Quality of life |
15–90 min 2–5 times/week, 4–24 weeks TC vs Ucare, ADL, Ex |
Dec 2019 6 databases (Eng. Chin.) 10 RCTs (Eng. Chin.) |
NI | Meta-analysis Critically low |
| Wayne 2014 [94] |
Older adults (n = 2553) Cognitive impairment |
Global cognitive function, executive function (other cognitive tests, AE) |
20–60 min 1–4 times/week, 10–48 weeks TC vs noRx, HEd, Ex |
Mar 2013 4 databases (Eng.) 11 RCTs, 5 NRSIs, 4 CS (Eng.) |
NI | Meta-analysis Critically low |
| Webster 2016 [95] | Adolescents (n = 9263) | Physical flexibility, depression, anxiety, interpersonal (other physical/mental health) | NI |
Feb 2013 11 (Eng. Chin.) 12RCTs, 18NRSIs, 19CS (Eng. Chin.) |
NI |
No meta-analysis Critically low |
| Wu 2020 [96] |
Adults, older adults (n = 615) Myocardial infarction |
6-min walk distance, left ventricular ejection fraction (AE) |
5–60 min 3–5 times/week, 12–44 weeks TC + HEd + Pharm vs HEd + Pharm; TC + HEd + Ex vs HEd + ADL; TC + HEd + Ex vs HEd + Ex; TC + Ex + Rehab vs + Ex + Rehab |
Jan 1976–May 2019 6 databases (Eng. Chin.) 7 RCTs (Chin.) |
NI |
Meta-analysis Low (†Critically low) |
| Xiang 2017 [97] |
Adults, older adults (n = 689) Fatigue no serious ailment, chronic disease |
Fatigue (vitality, depression, sleep, AE) |
40–60 min 1–7 times/week, 12–24 weeks TC vs noRx, Ucare, HEd, Ex, other, sham Qigong |
Apr 2016 7 databases (Eng. Chin.) 10 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Moderate (†Low) |
| Yin 2014 [98] | Adults, older adults (n = 2765 TC = 1435) Anxiety, depression and/or chronic diseases | Depression, anxiety (AE) |
30–120 min 1–5 times/week, 4–48 weeks TC vs noRx, Ex, sham/other |
April 2013 (English) 25 RCTs (English) |
NI |
Meta-analysis Low |
| Yu 2019 [99] |
University students (n = 325) Depression or symptoms |
Depression |
60 min 2–3 times/week, 7–18 weeks TC vs noRx, Ex |
Oct 2016 8 databases (Eng. Chin.) 12 RCTs (Eng. Chin.) |
Gov |
Meta-analysis Critically low |
| Yu 2018 [100] |
Older adults (n = 556) Parkinson’s disease |
Motor manifestations, balance, walking ability, QoL |
45–60 min 2–10 times/week, 4–24 weeks TC vs noRx, Ex; TC + Ucare vs Ucare; TC + Ucare vs Ex + Ucare |
Dec 2018 6 (English Chinese) 7 RCTs (English, Chinese, Korean) |
Gov | Meta-analysis Critically low |
| Zhang 2019 [101] |
Adults, older adults (n = 857) Osteoporosis, or osteopenia |
Osteoporosis-related fractures (BMD, pain, QoL, biochemical markers) |
30–120 min 1–6 times/week, 16–48 weeks TC vs noRx, Ucare; TC + Ucare vs Ucare |
Sep 2017 7 databases (Eng. Chin.) 15 RCTs (Eng. Chin.) |
NI |
Meta-analysis Moderate (†Low) |
| Zhang 2020 [102] |
Older adults (n = 1068) Mild cognitive impairment |
Global cognitive function assessed by MMSE (delayed recall test, digit span test) |
5–50 min 3–4 times/week, 12–52 weeks TC vs Ucare, ADL, HEd, Psych, Ex |
Feb 2020 9 databases (Eng. Chin.) 7 RCTs (Eng.) |
NI |
Meta-analysis Low (†Critically low) |
| Zheng 2015 [103] |
Adults, older adults (n = 2393) Stroke (prevention) |
Incidence of fatal & nonfatal stroke (stroke risk factors (body weight, BP, lipids, glucose), AE) |
30–120 min 3–21 times/week, 4–96 weeks TC vs noRx; TC + Ucare vs Ucare |
Oct 2013 6 databases (Eng. Chin.) 23 RCTs, 11 NRSIs, 2 CS (Chin.) |
NI |
Meta-analysis Low (†Critically low) |
| Zheng 2016 [104] |
Adults, older adults (n = 483) Schizophrenia, in hospital or other residential care |
Positive and negative symptoms assessed by PANSS (social, cognitive, behavioural, stress, discontinuation rate, AE) |
45–60 min 2–7 times/week, 12–24 weeks TC + (Pharm + / − Ucare) vs Pharm + (noEx, Ucare, HEd, Ex, or waitlist) |
Aug 2016 9 databases (Eng. Chin.) 6 RCTs (Eng. Chin.) |
Uni |
Meta-analysis Moderate (†Low) |
| Zhong 2020 [105] |
Adults, older adults (n = 2937) Essential hypertension |
Systolic and diastolic BP (AE) |
30–120 min 3–14 times/week, 6–240 weeks TC vs noRx, HEd, Ex, other activities; TC + HEd vs HEd; TC + Pharm vs Pharm; TC + HEd vs Pharm + HEd; TC + HEd + Pharm vs Ex + HEd + Pharm; TC + HEd vs Qigong + HEd |
Jan 2020 9 databases (Eng. Chin.) 28 RCTs (Eng. Chin.) |
Gov | Meta-analysis High |
| Zhou 2019 [106] |
Adults, older adults (n = 1235) Type 2 diabetes |
Fasting glucose, glycosylated haemoglobin (HbA1c), fasting insulin, insulin resistance, BMI, BP |
15–120 min 2–14 times/week, 4–24 weeks TC vs Ucare, Ucare + TCM, HEd, sham exercise |
Mar 2018 7 databases (Eng. Chin.) 23 RCTs (Eng. Chin.) |
NI | Meta-analysis Critically low |
NI no information, Age groups adolescents 10–18 years, adults 25–59 years, older adults ≥ 60 years, AE adverse effects, 6MWD 6-min walk distance/test, BMD bone mineral density, BMI body mass index, BP blood pressure, COPD chronic obstructive pulmonary disease, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, LVEF cardiac left ventricular ejection fraction, MMSE Mini-Mental State Examination, PANSS positive and negative syndrome scale, QoL quality of life, ADL routine activities of daily living/ routine lifestyle, Ex exercise (any type, including stretching), HEd health education or other educational interventions, noRx no treatment, control, Pharm pharmaceutical drugs / medication, Psych psychological interventions, counselling, support, PT physical therapy/physiotherapy, Rehab rehabilitation programs, TC Tai Chi intervention, TCM traditional Chinese herbal medicine, Ucare usual care, conventional treatment, standard medical care
*reported as NI if no clear statement about primary outcome(s) of interest
Sensitivity analysis shows different rating
For AMSTAR-2 quality rating refer to Additional File 5