The report is a product of the VA/HSR Evidence Synthesis Program.

Evidence Map of Tai Chi and Qigong: Update from 2014–2024

Takeaway: This evidence map shows that the evidence base for tai chi and qigong has grown stronger since the last review in 2014 but remains sparse for many conditions. Of 25 systematic reviews published between 2014 and 2024, two showed high certainty and 16 showed moderate certainty of benefit for a range of adult health conditions. More high-quality research is needed to expand the evidence base, especially for health conditions of interest to VA.

Tai chi and qigong are widely practiced complementary and integrative health interventions for certain adult health conditions and for well-being. Interest in tai chi and qigong among Veterans has been growing and is expected to further increase as VA continues to expand access to these services. Despite the overall popularity of tai chi and qigong, past evidence syntheses have found limited or inconclusive support for their effectiveness.

In response to a request from VA’s Office of Patient Centered Care and Cultural Transformation, HSR’s Evidence Synthesis Program (ESP) Center in Los Angeles conducted a systematic review to update a previous evidence map on the effects of tai chi or qigong on adult health conditions. To identify relevant articles, the ESP team searched five databases for systematic reviews published January 2014 to March 2024 that examined the effects of tai chi or qigong on adult health conditions.

Summary of Findings

• Of 1,052 potentially relevant identified citations, 25 publications were included in this review.
• The reviews assessed the effectiveness of tai chi or qigong across 21 health conditions: breast cancer, cancer, chronic low back pain, chronic mechanical neck pain, chronic obstructive pulmonary disease, depression, diabetes, falls prevention, fibromyalgia, frailty in older adults, heart failure, hypertension, insomnia, knee osteoarthritis, mild cognitive impairment (cognitive function), osteoporosis, Parkinson’s disease (cognitive function), post-stroke, rheumatoid arthritis, sarcopenia, and schizophrenia.
• Findings suggest that there is stronger evidence for the potential benefit of tai chi or qigong for some adult health conditions since the last synthesis of literature in 2014.
• Two reviews reported high certainty of evidence for tai chi and qigong’s potential benefit for hypertension and osteoporosis.
• Sixteen reviews reported moderate certainty of evidence for tai chi and qigong’s potential benefit for certain conditions, including chronic low back pain, diabetes, depression, falls prevention, and knee osteoarthritis.
• Evidence points to improvement in some well-being and prevention metrics as indicated in the research outcomes: improvements in functional gains, bone mineral density, physical and mental health and disease-specific measures of quality of life.
• Most reviews reported no serious adverse events.
• Every review compared tai chi or qigong with another active therapy. An active therapy is defined as a therapy intended to have an intervention-specific effect that is not sham or placebo.

Implications

Evidence for tai chi and qigong’s benefit for a few conditions is strong but remains relatively sparce for others. More high-quality randomized controlled trials are needed to build the evidence base on the effect of tai chi and qigong on a wider range of adult health conditions.

Limitations

As is the case in every systematic review, some potentially eligible evidence might not have been identified. Also, the ESP team did not independently reevaluate the primary studies included in eligible systematic reviews, and for the health conditions that had more than one eligible review, the investigators mapped only the review they deemed most informative. In general, this was the most recent review or the review with the greatest number of included studies. Lastly, the interpretation of the effect of tai chi or qigong for some health conditions might be limited by certain patient characteristics in some instances. For example, many osteoporosis studies were conducted in China and focused on Asian women, whose bone turnover is different than that of some other ethnicities, including Caucasian, Hispanic, and African American.

Future Research

The most critical research need is for more high-quality primary studies about the effects of tai chi or qigong on a wider range of conditions and general well-being. Moreover, it is critical to examine the effect of different styles of tai chi or qigong, as well as the effect of duration of practice and the long-term effects of tai chi and qigong. In addition, for conditions of priority to VA that currently do not have at least moderate-certainty evidence that supports use of tai chi or qigong, studies that address the limitations of existing research are needed.

Mak S, Allen J, De Vries G, Begashaw M, Beroes-Severin J, Miake-Lye I, Shekelle P. Evidence Map of Tai Chi and Qigong: Update from 2014–2024. Washington, DC: Evidence Synthesis Program, Health Systems Research, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #05-226; 2025.

To view the full report, go to vaww.hsrd.research.va.gov/publications/esp/tai-chi.cfm . (This report is available via intranet only.)

How can VA leadership work with the ESP? Nominations for systematic review topics may be submitted to the program at any time. When you submit a topic nomination form, ESP Coordinating Center staff will work with you to determine the appropriate research approach and ESP product to address your questions of interest. Topics are selected and assigned to an ESP Center based on program capacity and alignment with VA national goals.

This Management Brief is provided to inform you about recent HSR findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR Resource Center charged with disseminating important HSR findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.

This report is a product of VA/HSR's Evidence Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers; and to disseminate these reports throughout VA.

See all reports online.