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 |