Effects of Tai Chi on health related quality of life in patients with chronic conditions: A systematic review of randomized controlled trials

Objectives: To determine the effects of Tai Chi practice on health related quality of life in patients with various chronic medical conditions. Background: One of the characters of chronic illness is life-long condition with the deterioration in health related quality of life. Tai Chi has become a popular mind-body exercise and self-management strategy for patients with chronic conditions regarding its various physical and psychological effects. Methods: Eight databases (the Cochrane Library, PubMed, Medline, EBSCO, Web of science and three Chinese databases: CNKI, Wanfang data and VIP) were searched (up to December 2013) for relevant studies. Studies including participants with chronic conditions were selected. All studies were randomized controlled trials reporting the effects of Tai Chi on health related quality of life. Two independent reviewers extracted trial data and assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Results: Of the 2021 papers which were screened, 21 studies including 1200 patients met the eligibility criteria. Most studies (18 of 21 studies) found significant improvements on health related quality of life for participants with chronic conditions in Tai Chi group. No evidence was observed to suggest that Tai Chi was more effective than other types of exercise. And objective measures were not always consistent with self-reported quality of life measures. Conclusions: Tai Chi appears to be safe and has positive effects on health related quality of life in patients with chronic conditions, especially for patients with disorders in Cardio-cerebrovascular and respiratory systems, and musculoskeletal system. However, as the delivery mood of Tai Chi provides multiply benefits, which part of the group provides the most benefit in improving quality of life is unclear. Due to the design limitations of previous studies, more larger and well-designed RCTs are needed to confirm the effects. And qualitative researches are warranted to explore how Tai Chi may work exactly from patients' own perspectives. (C) 2014 Elsevier Ltd. All rights reserved.