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Tai chi, also known as t’ai chi ch’uan, is an ancient Chinese martial art, recognized widely in modern times by its slow graceful gestures and flowing movements.  Tai chi is a form or expression of qi gong, and some even argue that research about the two should not be treated separately, but rather as a unified whole.  Key features of tai chi include mindfulness, use of imagery (tai chi moves are based on using images as learning strategy), structural alignment, flexibility, relaxation, rhythmic breathing, social support, and integration of body, mind, and spirit.[1]

Qi gong is a broader term.  It is often applied to practices of movement that have many similarities to tai chi, but it traditionally encompasses more than that.  Qi gong translates to “cultivation of vital energy.”  Working with that energy (qi or chi) can take many forms, including movements and other activities intended to improve chi flow.  External qi gong involves a practitioner directing the flow of chi; it perhaps is better classed as an energy medicine (biofield) therapy rather than as a movement-based one.

Tai chi and qi gong are said to work through a number of mechanisms.[2]  As with any types of movement, they can improve strength, range of motion, and overall physical function.  Benefits for fall prevention are likely due to improvements in strength and balance.  They also boost immunity[3] and reduce chronic inflammation.[4]  Both can also be considered forms of movement meditation; as such, they likely have benefit in terms of mindful awareness and the mind-body connection.  Tai chi is also known to have beneficial effects on brain function in neuroimaging studies.[5]

Tai chi and qi gong are often taught in a classroom format. As is the case for yoga, it is best for beginners to start in a class format to ensure safety and good technique. People can learn a variety of forms. They should start with the basics and then advance over time.

Three percent of Americans practice tai chi.[6]  It is particularly popular within elderly populations.  If conscientious about the risk of falls while engaging in tai chi, it can be tailored to almost anyone. In fact, wheelchair tai chi is popular at several VA facilities.[7]  Tai chi and qi gong are offered in 81% of VA facilities (not counting community care).

There are a number of studies of the health benefits of tai chi and qi gong.[4,8-10]  Remember, as is the case with many complementary approaches, these therapies are intended to benefit overall quality of life, not necessarily as a cure for any one problem or illness.

• Tai chi increases overall well-being and improves sleep.[4]
• For tai chi, some of the strongest evidence relates to the elderly, particularly for fall prevention (it reduces falls by 43-50%).[11,12] It also helps to reduce fear of falling.  Tai chi improves balance in people with a history of stroke.[13]
• Tai chi benefits mobility and balance and disease progression in people with Parkinson’s disease.[14] Tai chi improves osteoarthritis pain and is recommended by the American College of Rheumatology for osteoarthritis of the hip, hand, and knee.[15]  Data is limited regarding tai chi for rheumatoid arthritis[16] but promising for fibromyalgia.[17]
• Tai chi supports cardiac rehabilitation after myocardial infarction.[18,19] There is a small to medium treatment effect for improvements in BMI.[20]
• Tai chi improves cognitive function and has specifically been associated with a lower incidence of dementia in longitudinal studies.[21, 30, 32]. Research has also shown benefit in cognitive performance in Parkinson’s patients engaging in tai chi [35].
• Tai chi promotes general mental well-being.[22] It reduces the prevalence and severity of depression [22] and improves mental health and quality of life in patients with cardiovascular disease.[31]
• Preliminary research shows promise for preventing and treating osteoporosis.[23]
• It can also improve glucose management and hemoglobin A1c in type 2 diabetes.[24,25]
• A recent review found tai chi shows promise for reducing fatigue.[26]
• Another review noted more research is still needed regarding tai chi and its effects on chronic pain.[27]
• A 2018 study found that tai chi is equivalent to pulmonary rehabilitation when it comes to outcomes for patients with COPD.[28]
• A 2021 study showed tai chi improved cognitive performance, motor function, and well-being in older patients during the Covid 19 pandemic [37].
• Data is less clear for the benefits for tai chi related to chronic heart failure.
• Qi gong has not been studied as extensively, but it shows promise for helping people with cancer with managing their symptoms and improving physical ability, functional ability, insomnia, depression, anxiety, and balance.[29] More research is needed.

Tai chi and qi gong are considered safe when used under the guidance of a skilled teacher [36].  Both have enough of an aerobic component to merit the same cautions that would apply to other aerobic activities, though they can be tailored to different people’s needs.[10] Limited studies have assessed tai chi in pregnancy, but no adverse events were noted in these studies [33, 34].

• Many VA facilities have live virtual or in-person classes available. If they do not, look around for classes and teachers in your community.  Some health clubs have classes, as do many university settings.  You can find a certified instructor on the American Tai Chi and Qigong Association 
• Try taking some classes yourself, so that you can speak with more knowledge about them to others.
• While there is less research on other martial arts, it is reasonable to assume that they can have similar benefits to tai chi.

VA Whole Health and Related Sites

• • Evidence Map for Tai Chi: http://www.hsrd.research.va.gov/publications/esp/taichi-REPORT.pdf
    • Compilation of systematic review data by VA Health Services Research and Development (HSR&D)
    • Whole Health Veteran Handouts: https://www.va.gov/WHOLEHEALTH/veteran-handouts/index.asp
    • Introduction to Tai Chi and Qi Gong for Whole Health
  • Integrative Health Coordinating Center SharePoint on Tai Chi/Qi Gong:

  https://dvagov.sharepoint.com/sites/VHAOPCC/IHCC/SitePages/Tai-Chi---Qi-Gong.aspx

  • CIH Listservs. To be added, contact:
    • Tai Chi/Qi Gong listserv: VHAOPCC&CTTaiChiQiGong@va.gov
    • Other listservs: Frankenfield@va.gov
  • National CIH Subject Matter Experts, as of FY2020

  o   Tai Chi/Qi Gong: Kavitha Reddy or Alison Whitehead.  Kavitha.Reddy@va.gov; Alison.Whitehead@va.gov

Other Websites

• • American Tai Chi and Qigong Association: http://www.americantaichi.org/
  • Supreme Chi Living: http://www.americantaichi.net/
    • An online journal and community run by American Tai Chi and Qi Gong Association
  • Tai Chi Health: https://taichihealth.com/
    • Introduction videos under Tai Chi Fundamentals tab
  • Tai Chi: A Gentle Way to Fight Stress: http://www.mayoclinic.org/tai-chi/ART-20045184
    • Mayo Clinic’s introduction to tai chi
  • Tai Chi for Beginners 01: Tai Chi Fundamentals: https://www.youtube.com/watch?v=oCnCSOWgIUU
    • YouTube video
  • Tai Chi Fundamentals Adapted Program Seated Basic Moves Part 1: https://www.youtube.com/watch?v=UCTjyqX_vZ0
    • YouTube video
  • Tai Chi Fundamentals^® Basic Moves Part One: https://www.youtube.com/watch?v=dSsqgdRsf5U
    • YouTube video led by Tricia Yu

Books

• Harvard Medical School Guide to Tai Chi, Peter Wayne (2013)
• Qi Gong for Beginners, Stanley Wilson (2007)
• The Tai Chi Workbook, Paul Crompton (1987)
• The Way of Qigong: The Art and Science of Chinese Energy Healing, Ken Cohen (1999)

Apps and Monitoring Software

• 7 Minute Chi. Demonstrates various tai chi exercises.

“Tai Chi and Qi Gong” was written by J. Adam Rindfleisch, Mphil, MD and updated by Sagar Shah, MD (2020, updated 2022).

This Whole Health tool was made possible through a collaborative effort between the University of Wisconsin Integrative Health Program, VA Office of Patient Centered Care and Cultural Transformation, and Pacific Institute for Research and Evaluation.