Effect of Tai Chi on muscle strength, physical endurance, postural balance and flexibility: a systematic review and meta-analysis

Abstract

ObjectiveTo investigate the impact of Tai Chi training on muscle strength, physical endurance, postural balance and flexibility, as measured by tests commonly used in health-related fitness or competitive sports contexts.DesignSystematic review and meta-analysis.Data sourcesThe following databases were searched up to 31 July 2020: CINAHL, Cochrane Library, MEDLINE via PubMed and SPORTDiscus.Eligibility criteria for studiesInclusion: (1) Randomised controlled trials published in German or English; (2) Tai Chi used as an intervention to improve physical performance; (3) Test methods commonly used in health-related fitness or competitive sports and (4) Participants aged ≥16 years (irrespective of health status). Exclusion: (1) Studies not focusing on Tai Chi or including Tai Chi mixed with other interventions and (2) Modified or less than eight Tai Chi movements.ResultsOut of 3817 records, 31 studies were included in the review, 21 of them in the meta-analysis. Significant improvements in handgrip strength (2.34 kg, 95% CI 1.53 to 3.14), walking distance during 6 min (43.37 m, 95% CI 29.12 to 57.63), standing time in single-leg-stance with open eyes (6.41 s, 95% CI 4.58 to 8.24) and thoracolumbar spine flexibility (2.33 cm, 95% CI 0.11 to 4.55) were observed.ConclusionTai Chi training seems to moderately improve physical fitness when evaluated by tests used in health-related fitness or competitive sports. Moreover, thoracolumbar spine flexibility seems to be a factor in the improvement of postural balance. Further research is needed, including younger healthy participants performing a widely used, standardised form (eg, Peking-style routine) with high-intensity movements (eg, use of lower stances).

Thoracolumbar Rotation During Tai Chi Movements—A Biomechanical Analysis of the Entire Peking Style Routine

“…According to Kasukawa et al (2010) and Ishikawa et al (2017), spinal mobility and sagittal spinal shape are causal factors with respect to displacement of the center of gravity, which results in balance impairment. This relation supports the hypothesis that enhancing thoracolumbal spine flexibility leads to an improvement in postural balance ability (Wehner et al, 2021).…”

“…its effects on individuals with chronic obstructive pulmonary disease (COPD) (Chen et al, 2016;Wang et al, 2019), type 2 diabetes mellitus (Zhou et al, 2019), coronary heart disease (Liu et al, 2018) or its ability to improve balance and mobility in individuals with Parkinson disease (Hackney and Earhart, 2008). A meta-analysis examining the effect of Tai Chi training on muscle strength, physical endurance, postural balance and thoracolumbal spine flexibility revealed significant enhancement of the standing time in single-leg-stance with open eyes and of thoracolumbal spine flexibility (Wehner et al, 2021). When analyzing the large heterogeneity via univariate meta-regression analysis regarding thoracolumbal spine flexibility, 91.4% of the between study heterogeneity could be explained by the existence of a balance impairment (Wehner et al, 2021).…”

“…A meta-analysis examining the effect of Tai Chi training on muscle strength, physical endurance, postural balance and thoracolumbal spine flexibility revealed significant enhancement of the standing time in single-leg-stance with open eyes and of thoracolumbal spine flexibility (Wehner et al, 2021). When analyzing the large heterogeneity via univariate meta-regression analysis regarding thoracolumbal spine flexibility, 91.4% of the between study heterogeneity could be explained by the existence of a balance impairment (Wehner et al, 2021). This is most apparent in the study of Zhang et al (2006), who investigated the influence of Tai Chi on balance-impaired participants with a higher risk of falling (defined by a one leg standing time between 5 and 20 s).…”

Effectiveness of a Hybrid Exercise Program on the Physical Abilities of Frail Elderly and Explainable Artificial-Intelligence-Based Clinical Assistance

“…Studies have shown that Tai Chi training improves health-related biomarkers, and for a better body balance, Tai Chi gait recruits more lower limb muscles than conventional gait [ 20 , 21 ]. Therefore, Tai Chi may be an economic and effective exercise program for improving balance [ 22 ], strength [ 23 ], and aerobic endurance [ 24 , 25 ], as demonstrated by the fact that after one year of Tai Chi training, the maximum oxygen uptake of the elderly increased by 18.7%, and even the risk of falls in the frail elderly reduced by 47.5% [ 26 ].…”

Comparative Study of the Effects of Tai Chi and Square Dance on Immune Function, Physical Health, and Life Satisfaction in Urban Empty-Nest Older Adults

“…Tai Chi exercise is a traditional Chinese physical exercise characterized by meditation and low-to-moderate intensity activity, and it is practiced worldwide by older adults. In addition to improving muscle strength ( Manson et al, 2013b ; Wehner et al, 2021 ), balance ( Wehner et al, 2021 ), body mass index ( Manson et al, 2013a , b ), and systolic blood pressure (SBP) ( Manson et al, 2013a ), research has also found Tai Chi exercise to have favorable effects on immunity ( Yeh et al, 2006 ; Ho et al, 2013 )as well as physical and mental health in older adults ( Holly and Helen, 2012 ; Zheng et al, 2017 ). Square dance is considered an expansion of line dancing and was introduced in 2004, to China ( Li, 2011 ).…”