Is Tai Chi safe to learn and practice?
Date of publication of the systematic review: December 2014
Design
Systematic review of 50 randomized control trials (RCTs).
Participants
5678 individuals (mean age: 65 years, male % range: not reported) practicing Tai Chi, including those with balance impairments, musculoskeletal weakness, or reduced physical function; with metabolic, cardiovascular, or immune disorders; with chronic pain; with cognitive deficits or mood disorders; and healthy individuals.
Intervention
Among included RCTs, Tai Chi was used as an intervention. There were no exclusions on the type of Tai Chi intervention or controls intervention.
Comparator
Comparison: Tai Chi versus intervention without Tai Chi.
Major Outcomes
Outcome 1: Number of RCTs reporting adverse events (AEs);
Outcome 2: Type of AEs occurrences in RCTs.
Settings
The reviewers did not state where the trials were conducted and whether the trials were conducted in inpatient or outpatient settings.
Comparison    Tai Chi versus intervention without Tai Chi
Main Results
Among the 153 eligible RCTs evaluating Tai Chi, only 50 RCTs (33%) included reporting of AEs. 103 RCTs were excluded for further quantitative analyses as 100 of them did not mention either AE monitoring protocols or AE reports and the remaining 3 RCTs only mentioned AE protocol but no AE report. Of the 50 RCTs that included an explicit AE report, only 18 trials (12% overall) included an explicit monitoring protocol. AEs in the included 50 studies were reported in various types. No Tai Chi-related serious AEs were reported and 32 studies reported no occurrence of any Tai Chi-related AEs. Fifteen of the 50 studies specifically reported occurrences of minor musculoskeletal aches and pain, with complaints of lower-extremity pain being the most common. Six studies mentioned a report of back-/spine-related pain. In 1 of these back pain reports, pain was severe, leading to withdrawal from the study. Four of the 50 studies reported falls.
Comparison    Tai Chi versus intervention without Tai Chi
Main Results
Among the 153 eligible RCTs evaluating Tai Chi, only 50 RCTs (33%) included reporting of AEs. 103 RCTs were excluded for further quantitative analyses as 100 of them did not mention either AE monitoring protocols or AE reports and the remaining 3 RCTs only mentioned AE protocol but no AE report. Of the 50 RCTs that included an explicit AE report, only 18 trials (12% overall) included an explicit monitoring protocol. AEs in the included 50 studies were reported in various types. No Tai Chi-related serious AEs were reported and 32 studies reported no occurrence of any Tai Chi-related AEs. Fifteen of the 50 studies specifically reported occurrences of minor musculoskeletal aches and pain, with complaints of lower-extremity pain being the most common. Six studies mentioned a report of back-/spine-related pain. In 1 of these back pain reports, pain was severe, leading to withdrawal from the study. Four of the 50 studies reported falls.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/24878398
The synopsis is based on the following article:
Wayne PM, Berkowitz DL, Litrownik DE, Buring JE, Yeh GY. What do we really know about the safety of tai chi?: A systematic review of adverse event reports in randomized trials. Archives of Physical Medicine and Rehabilitation. 2014 Dec 31;95(12):2470-83.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.