Sunday, June 13, 2010

Tai Chi Linked to Improvements in Psychological Well-Being

From MedscapeCME Clinical Briefs

May 27, 2010 — Tai Chi appears to be associated with improvements in psychological well-being, although well-controlled, longer randomized trials are needed, according to the results of a systematic review and meta-analysis reported in the May 21 issue of BMC Complementary and Alternative Medicine.

"Tai Chi, the Chinese low impact mind-body exercise, has been practiced for centuries for health and fitness in the East and is currently gaining popularity in the West," said lead author Chenchen Wang, from Tufts Medical Center, Tufts University School of Medicine in Boston, Massachusetts, in a news release. "It is believed to improve mood and enhance overall psychological well being, but convincing evidence has so far been lacking."

The reviewers searched 8 English-language and 3 Chinese-language databases through March 2009 for randomized controlled trials, nonrandomized controlled studies, and observational studies reporting at least 1 psychological health outcome. Two reviewers extracted and verified data, and a random-effects model allowed meta-analysis of randomized trials in each subcategory of health outcomes.

Methodologic quality of each study was also evaluated.

The reviewers identified 40 studies enrolling a total of 3817 participants and reporting on a total of 29 psychological measurements. Of 33 randomized and nonrandomized trials, 21 reported significant improvements in psychological well-being with 1 hour to 1 year of regular Tai Chi. Specific effects in community-dwelling healthy participants and in patients with chronic conditions were decreased stress (effect size [ES], 0.66; 95% confidence interval [CI], 0.23 - 1.09), anxiety (ES, 0.66; 95% CI, 0.29 - 1.03), and depression (ES, 0.56; 95% CI, 0.31 - 0.80), and improved mood (ES, 0.45; 95% CI, 0.20 - 0.69).

"More detailed knowledge about the physiological and psychological effects of Tai Chi exercise may lead to new approaches to promote health, treat chronic medical conditions, better inform clinical decisions and further explicate the mechanisms of successful mind-body medicine," Dr. Wang said.

The beneficial association between Tai Chi practice and psychological health was supported by 7 observational studies with relatively large sample sizes.

"Tai Chi appears to be associated with improvements in psychological well-being including reduced stress, anxiety, depression and mood disturbance, and increased self-esteem. Definitive conclusions were limited due to variation in designs, comparisons, heterogeneous outcomes and inadequate controls. High-quality, well-controlled, longer randomized trials are needed to better inform clinical decisions."

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