The Science of Tai Chi and Qigong as Whole Person Health,April 30-May 1,2026,Harvard Medical School,Boston,MA

¹The Chinese University of Hong Kong, Hong Kong, Hong Kong, China

²University of Arizona, College of Nursing, Tucson, AZ

Abstract

Background: Tai Chi is a safe and popular form of physical activity among older adults, yet direct comparisons with Tai Chi and brisk walking in reducing cardiovascular disease risk factors and improving psychosocial well-being are lacking.

Method(s): A total of 246 adults with hypertension and two to three modifiable cardiovascular disease risk factors were randomly assigned equally to Tai Chi, brisk walking, or control groups. The Tai Chi and brisk walking groups engaged in moderate-intensity physical activity 150 min/week for 3 months; daily home-based practice was encouraged for another 6 months. The primary outcome was blood pressure. Secondary outcomes were fasting blood sugar, glycated haemoglobin, total cholesterol, triglycerides, high- and low-density lipoprotein, body mass index, waist circumference, aerobic endurance, perceived stress, quality of life and exercise self-efficacy. Data were collected at baseline, postintervention at 3 months and follow-up assessments at 6 and 9 months. Generalised estimating equations were used to compare outcomes changes over time between groups.

Results: At baseline, no significant difference was noted between groups. Tai Chi significantly lowered blood pressure, fasting blood sugar, glycated haemoglobin and perceived stress and improved perceived mental health and exercise self-efficacy at 9 months, compared to the control group. In the Tai Chi group, significantly greater reductions in blood pressure, fasting blood sugar, glycated haemoglobin, lower perceived stress, and improved perceived mental health and exercise self-efficacy were observed, compared to the brisk walking group. No significant changes in the other cardiovascular disease risk indicators were observed over time between groups.

Conclusions: Nurses play a key role in promoting exercise to reduce cardiovascular disease risk and foster a healthy lifestyle among adults. Tai Chi is better than brisk walking in reducing several cardiovascular disease risk factors and improving psychosocial well-being, and can be recommended as a viable exercise for building a healthy life free of cardiovascular disease.

¹NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia

²Department of Traditional Chinese Medicine, Changying Community Health Service Center, Beijing, China

³Department of Traditional Chinese Medicine, Dougezhuang Community Health Service Center, Beijing, China

⁴Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China; Hospital of Traditional Chinese Medicine Affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610036, Beijing, China

⁵School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia

⁶NICM Health Research Institute, Western Sydney University, Sydney, Australian Capital Territory, Australia

⁷Beijing University of Chinese Medicine, Beijing, China

⁸Cardiac Health Institute, Sydney, New South Wales, Australia

Abstract

Background: Coronary heart disease (CHD) remains the leading cause of death worldwide, with hypertension as a major risk factor. Psychological factors such as stress, anxiety, and depression are increasingly recognised as modifiable cardiovascular risk factors, yet they are frequently underdiagnosed and undertreated. This study aimed to evaluate the effects and safety of a Tai Chi intervention on psychological distress and cardiovascular function in individuals with CHD and/or hypertension.

Method(s): 120 adults aged ≥40 years with CHD and/or hypertension were randomly assigned (1:1 ratio) to either a Tai Chi or a waitlist control group. The Tai Chi group participated in a 24-week program, consisting of two-hour sessions twice weekly for the first 12 weeks, followed by once-weekly sessions for the remaining 12 weeks. The primary outcome was perceived stress, measured by the Perceived Stress Scale-10 (PSS-10). Secondary outcomes included anxiety (Zung Self-Rating Anxiety Scale), depression (Beck Depression Inventory-II), cardiovascular function (blood pressure, heart rate, heart rate variability, lipid and glucose profiles, and C-reactive protein), quality of life (SF-36) and physical fitness (6-Minute Walk test). Assessments were conducted at baseline, week 12, and week 24.

Results: Tai Chi group showed a statistically greater reduction in PSS-10 mean scores (95% CI) at week 12 than the waitlist control (10.38 [8.81 to 11.97] and 12.46 [10.85 to 14.07] respectively; p=0.006). Statistically and clinically significant improvement of physical fitness in the Tai Chi group compared with the waitlist group were found at 12 weeks (558.41 [533.48 to 583.34] and 513.59 [488.59 to 538.58]; p<0.001) and 24 weeks (552.81 [528.17 to 544.84] respectively; p=0.002). The attendance rate was 82.5%. No severe Tai Chi-related adverse events were reported.

Conclusions: A 24-week Tai Chi program appears to be safe and feasible intervention that may improve perceived stress, cardiovascular and psychological outcomes in individuals with CHD and/or hypertension.

¹Mass General Brigham, Boston, MA

²University of Illinois Urbana-Champaign, Urbana, IL

³University of Illinois Urbana-Champaign, Gurnee, IL

⁴Northeastern University, Boston, MA

Abstract

Background: Interoception is the sensing and interpreting of internal bodily sensations and may contribute to yoga’s pain-modulating benefits. Herein we describe the preliminary findings of a 6-week yoga intervention designed to train interoceptive skills in individuals with chronic pain.

Method(s): Participants with self-reported chronic pain (N=24, mean age = 42.5 years, 75% female) attended twice weekly interoception-based yoga classes for 6 weeks. Yoga instruction emphasized attending to and using bodily sensations to adapt the practice to individual needs. Two dimensions of interoception (interoceptive sensibility and interoceptive accuracy) were assessed with the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2) and a heartbeat counting task (HCT), respectively. Pain outcomes included the PROMIS Pain Interference and Intensity forms. We used paired sample t-tests to examine changes pre- to post-intervention and Pearson’s partial correlations, controlled for age, to examine associations between pain and interoception. Significance was set to p<.05.

Results: N=19 completed the intervention. There was a significant improvement in overall interoceptive sensibility (p=0.007), pain interference (p=0.045) and pain intensity (p=0.044) and an increase in HCT accuracy (p=0.019). Subscale analyses revealed significant improvement on four of the MAIA-2 subscales: Noticing (p=0.004), Attention Regulation (p=0.036), Self-Regulation (p<0.001), and Body Listening (p=0.001). At baseline, more pain interference was associated with lower Noticing (r=-0.485, p=0.018) and Not Worrying scores (r=-0.423, p=0.05). Similarly, higher pain intensity was associated with lower Not Worrying (r=-0.510, p=.015) and Self-Regulation scores (r=-0.45, p=0.036). There was no association between HCT accuracy and interoceptive sensibility (p>.05). Increased HCT accuracy after intervention demonstrated a trend relationship with greater pain intensity (r=.472, p=.065).

Conclusions: Interoception-based yoga may improve pain and multidimensional interoception outcomes in persons with chronic pain. However, training sensitivity to internal sensations could contribute to increased pain, at least in the short-term, and warrants further study.

¹Duke University, Durham, NC

²Hong Kong Education University, Kwai Tsing, Hong Kong

Abstract

Background: Cognitive Behavioral Therapy (CBT) is a gold-standard intervention for late-life depression and anxiety, yet access barriers—including clinician shortages and stigma—limit its reach among older adults. Tai Chi and Qigong (TCQ), mind-body practices rooted in traditional Chinese medicine, have shown promise in improving mood, sleep, and cognitive function. Leveraging telehealth and wearable technologies, TCQ may offer a culturally adaptable, scalable alternative to CBT for elderly mental health management.

Method(s): We conducted a comparative pilot study assessing an 8-week remotely delivered TCQ program versus virtual CBT in older adults (aged 65+) diagnosed with mild-to-moderate depression or anxiety (n=80). Both interventions used HIPAA-compliant telehealth platforms for weekly group sessions. The TCQ group also wore biosensor-enabled wristbands to monitor heart rate variability and physical activity. Primary outcomes included changes in Geriatric Depression Scale (GDS), Generalized Anxiety Disorder scale (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes assessed participant satisfaction and engagement.

Results: Both interventions significantly reduced depression and anxiety symptoms, with no statistical difference between groups (GDS ↓4.8 vs. ↓5.1; GAD-7 ↓3.9 vs. ↓4.1; p>0.05). TCQ participants showed greater improvement in sleep quality (PSQI ↓3.2 vs. ↓1.7; p=0.04) and physical activity (steps/day ↑1,200, p<0.01). Adherence was higher in the TCQ group (88% vs. 74%), and wearable data revealed real-time stress reduction patterns correlated with TCQ sessions.

Conclusions: Technology-assisted TCQ is comparable to CBT in reducing depression and anxiety in older adults and offers added benefits for sleep and physical activity. Its accessibility, cultural flexibility, and integration with wearable biosensing suggest TCQ may serve as a viable, tech-enabled adjunct or alternative to CBT in aging populations. Larger trials are warranted to validate long-term outcomes and implementation scalability.

¹The Hong Kong Polytechnic University, Kowloon City, Hong Kong

²Centre for Health and Clinical Research, University of the West of England, United Kingdom, Bristol, United Kingdom

Abstract

Background: Hyperarousal states have been well documented as the pathophysiological mechanism underlying sleep disturbance. Research has shown that Tai Chi (TC) as well as repetitive transcranial magnetic stimulation (rTMS) regulate arousal components in a bottom–up and top–down pathway, respectively. This work was a pioneering attempt to investigate the efficacy of TC combined with rTMS in improving sleep disturbance in the elderly. Trial registration at ClinicalTrials.Gov: NCT06411509.

Method(s): A total of 152 participants were randomly assigned to: (1) TC combined with active rTMS group (n = 38), (2) TC combined with sham rTMS group (n = 38), (3) TC-alone group (n = 38), and (4) physical exercise (PE) group (n = 38). Each group underwent a four-week intervention. Outcomes included insomnia severity, objective sleep patterns assessed using ActiGraph, and subjective sleep patterns measured through sleep diary.

Results: Significant improvements in objective sleep onset latency were observed in TC combined with active rTMS group compared to the sham comparator after intervention, and this advantage lasted three months. In addition, TC combined with active rTMS yielded a superior benefit in objective sleep efficiency and wake time after sleep onset for participants without depressive symptoms after intervention, compared to PE group and its sham comparator. Meanwhile, all three TC groups, either alone or combined with rTMS, showed a significant improvement in subjective sleep onset latency for participants with depressive symptoms at both post-intervention and three-month follow-up assessments.

Conclusions: Findings from our study suggested that integrating TC with rTMS had synergistic and long-lasting effects on sleep disturbance in older adults. Specific sample characteristics, such as depressive symptoms, should be considered in clinical application. Further studies are warrants to optimize the protocol to maximize therapeutic effectiveness and to unravel the underlying mechanisms.

¹The Hong Kong Polytechnic University, Kowloon City, Hong Kong

²The Hong Kong Polytechnic University, Hung Hom, Kowloon City, Hong Kong

Abstract

Background: Baduanjin is a traditional qigong practice that combines mental focus with physical movement. Although both mindfulness-based therapies and physical activity have demonstrated effectiveness in treating depression, it is uncertain whether Baduanjin offers similar benefits. This study aimed to compare the impact of Baduanjin on depressive symptoms with that of mindfulness training, physical exercise, and a waitlist control. Given its potential to influence neural plasticity and stress regulation, the study also examined changes in biomarkers—BDNF, adiponectin, and cortisol—across the four groups.

Method(s): A four-arm, parallel, single-blind randomized controlled trial was conducted with 142 older adults (≥60 years) experiencing mild depressive symptoms. Participants were randomly allocated to one of four groups: Baduanjin (n = 35), mindfulness-based intervention (n = 38), physical exercise (n = 35), or waitlist control (n = 34). The intervention groups underwent 12 weeks of training, while the waitlist group participated in Baduanjin sessions after completing all assessments. Depression levels were measured before and after the intervention as the primary outcome. Secondary outcomes included biomarkers (BDNF, adiponectin, cortisol) measured via blood and saliva samples. Repeated measures ANOVA was used to analyze group differences.

Results: Preliminary analyses revealed a significant Time effect (F = 14.54, p< .001, ηp2 = .095). Reductions in depressive symptoms were shown in the first three groups, but not the waitlist group. A significant increase in BDNF (Mean Difference = 3.65, p = .004) and a decreasing trend in cortisol (Mean Difference = -.77, p = .109) were observed only in the Baduanjin group.

Conclusions: In addition to mindfulness and physical exercise, Baduanjin appears to be a promising approach for reducing depressive symptoms. Its ability to elevate BDNF suggests a role in supporting neuroplasticity. These results highlight the potential of Baduanjin as a community-based mental health intervention for older adults.

¹National Center for PTSD at VA Boston Healthcare System, Boston University School of Medicine, Boston, MA

²VA Boston Healthcare System, Boston, MA

³National Center for PTSD, Behavioral Science Division, Jamaica Plain, MA

⁴National Center for PTSD, Behavioral Science Division, Boston, MA

⁵Tufts Medicine, Boston, MA

⁶National Center for PTSD, Behavioral Science Division, VA Boston, Boston, MA

⁷Boston University Chobanian & Avedisian School of Medicine, Boston, MA

Abstract

Background: Mind-body interventions and wellness education have received increasing attention in recent decades to prevent and treat chronic disorders. The Veterans Health Administration (VHA) has been at the forefront of promoting a person-centered holistic approach to healthcare with the VHA Whole Health program. Empirical support for mind-body treatments for Veterans is growing with numerous studies showing high patient satisfaction and promising outcomes. However, scalability challenges stymie wide dissemination to address chronic conditions.

Method(s): Participants were 114 Veterans who served in the 1990-1991 Gulf War and reported musculoskeletal pain, fatigue, and mood-cognition difficulties, thus meeting criteria for Gulf War Illness. Veterans were randomized to one of two 12-week, twice weekly group interventions: Tai Chi (n = 58) or Wellness (n = 56). Assessments of self-reported mental health problems were conducted at baseline, posttreatment, and 3- and 9-month follow-up. The trial was adapted to be fully remote during the pandemic, which allowed us to examine treatment modality differences between the 53 Veterans who participated in-person and the 61 who participated remotely.

Results: No differences in outcomes were detected between the Tai Chi and Wellness interventions (all p’s> .05). However, both interventions were associated with improvements in pain interference, depression, anxiety, mindfulness, mental and physical health-related quality of life, and PTSD symptoms (all p’s<.05). The positive changes in pain interference, mindfulness, quality of life, and PTSD symptoms were sustained at 9-month follow-up. Outcomes did not differ between modalities (all p’s<.05).

Conclusions: Two holistic integrative group interventions were associated with improvements in mental health outcomes among veterans with Gulf War Illness. Encouragingly, we found that treatment benefits persisted at the 9-month follow-up, suggesting enduring positive effects for an illness that has been shown to worsen over time. Telehealth delivery of these interventions may aid dissemination efforts, as comparable therapeutic benefits were found for both modalities.

¹Center for Taiji and Qigong Studies, New York, NY

²Independent Researcher, White Salmon, WA

³University of Chicago, Chicago, IL

⁴Weill Cornell Medicine, New York, NY

⁵Mayo Clinic, Rochester, MN

⁶Weill Cornell Medical College, New York, NY

⁷Weill Cornell Medicine / New York-Presbyterian Hospital, New York, NY

⁸National Cancer Institute, Bethesda, MD

⁹Independent Researcher, Urbana, IL

¹⁰Appalachian State University, Boone, NC

¹¹New York Medical College, New York, NY

¹²Umm Al-Qura University, Mecca, Makkah, Saudi Arabia

¹³University of Minnesota Medical School, Minneapolis, MN

¹⁴Mayo Clinic College of Medicine, Rochester, MN

¹⁵City University of New York, New York, NY

¹⁶University of Calgary, Calgary, AB

Abstract

Background: Chronic low back pain (cLBP) is the leading cause of disability worldwide. Nonpharmacologic approaches such as Tai Chi and Qigong are promising, but evidence on virtual delivery is limited.

Method(s): A pragmatic randomized controlled trial enrolled 350 adults with nonspecific LBP ≥6 weeks. Participants were randomized to a 12-week virtually delivered program integrating Tai Chi, Qigong, and meditation plus usual care (n=175) or to usual care alone (n=175). The intervention included twice-weekly 60-min live online sessions plus 24/7 access to class recordings. Primary outcome was pain-related disability (Oswestry Disability Index, ODI). Secondary outcomes included pain intensity (VAS), sleep quality (PSQI), and quality of life (SF-36). Assessments occurred at baseline, 8, 12, and 16 weeks.

Results: Mean age was 58.8 years; 79% were female. Compared with usual care alone, the intervention group had significantly greater improvements in ODI (−4.7, −6.4, and −8.1 points at 8, 12, and 16 weeks; all p<.01). Pain intensity improved by −0.7, −0.9, and −1.2 points (all p<.01). Sleep quality improved by −0.6 to −1.0 points (p≤.02). Quality of life improved by +8.6, +11.7, and +14.9 points (all p<.01). No serious adverse events were reported.

Conclusions: A virtually delivered program integrating Tai Chi, Qigong, and meditation, when added to usual care, produced statistically and clinically meaningful improvements in disability, pain, sleep, and quality of life among adults with LBP. Benefits persisted one month post-intervention, supporting this model as a safe, scalable, and accessible nonpharmacologic treatment.

¹Dalian University of Technology, Dalian, Liaoning, China

Abstract

Background: Tai chi is a type of exercise recommended for knee osteoarthritis, but access to in-person tai chi can be limited. OBJECTIVE To evaluate the effects of an unsupervised multimodal online tai chi intervention on knee pain and function for people with knee osteoarthritis. DESIGN, SETTING, AND PARTICIPANTS The RETREAT study was a 2-group superiority randomized clinical trial enrolling participants who met clinical criteria for knee osteoarthritis in Australian communities from August 2023 and November 2024. INTERVENTIONS Participants in the control group received access to a purpose-built website containing information about osteoarthritis and exercise benefits. Participants in the intervention group received the My Joint Tai Chi intervention comprising access to the same website plus tai chi information, a 12-week unsupervised video-based Yang-style tai chi program, and encouragement to use an app to facilitate program adherence.

Method(s): Changes in knee pain during walking (Numeric Rating Scale; range 0-10 with higher scores indicating greater pain) and difficulty with physical function (Western Ontario and McMaster Universities Osteoarthritis Index; range 0-68 with higher scores indicating greater dysfunction) during 12 weeks. Secondary outcomes included another knee pain measure, sport and recreation function, quality of life, physical and mental well-being, fear of movement, self-efficacy, balance confidence, positive activated affect, sleep quality, global improvement, and oral medication use.

Results: Of 2106 patients screened, 178 met inclusion criteria and were randomized, 89 (mean [SD] age, 61.0 [8.7] years; 66 female [74%] and 23 [26%] male participants) to the control group and 89 (mean [SD] age, 62.1 [7.3] years; 59 [66%] female and 30 male [34%] participants) to the tai chi intervention. Of the total, 170 (96%) completed both of the primary outcomes at 12 weeks. The tai chi group reported greater improvements in knee pain (control, −1.3; tai chi, −2.7; mean difference, −1.4 [95%CI, −2.1 to −0.7] units; P < .001) and function (control, −6.9; tai chi, −12.0; mean difference, −5.6 [95%CI, −9.0 to −2.3] units; P < .001) compared to the control group. More participants in the tai chi than in the control group achieved a minimal clinically important difference in pain (73%vs 47%; risk difference, 0.3; 95%CI, 0.1 to 0.4; P < .001) and function (72%vs 52%; risk difference, 0.2; 95%CI, 0.1 to 0.3; P = .007). Between-group differences for most secondary outcomes favored tai chi, including another knee pain measure, sport and recreation function, quality of life, physical and mental well-being, global improvement, pain self-efficacy, and balance confidence. No associated serious adverse events were reported. Participants also reported high satisfaction towards this program and would highly recommend it to others.

Conclusion: This randomized clinical trial found that this unsupervised multimodal online tai chi intervention improved knee pain and function compared with the control at 12 weeks. This free-to-access web-based intervention offers an effective, safe, accessible, and scalable option for guideline-recommended osteoarthritis exercise.

Centre for Health Exercise and Sports Medicine, Australia

Abstract

Background: The Exercise and Self-Esteem Model (EXSEM) supports the mechanisms by which physical activity enhances overall well-being through improvements in self-esteem, encompassing subdomains such as physical condition, body attractiveness, strength, and physical self-worth. This study aimed to compare the effects of a Tai Chi intervention, based on EXSEM, with brisk walking and usual activities on self-esteem and clinical outcomes among breast cancer survivors (BCSs) through a 3-arm randomized controlled trial. Our preliminary findings suggest that this theory-driven Tai Chi intervention effectively enhances self-esteem, physical condition, and exercise self-efficacy in BCSs over the short term. Therefore, this abstract reports preliminary clinical outcome results.

Method(s): This study was conducted with 150 community-dwelling BCSs in Hong Kong (target sample size: 225), completing a 3-month follow-up. The Tai Chi group (n=50) received group-based Tai Chi over 9 weeks (60 minutes/session, 3 times/week). The brisk walking group (n=50) performed 9 weeks of brisk walking (5 days/week, 35-40min/day). The control group (n=50) continued usual activities. Clinical outcomes included muscle strength (Chair Stand and Arm Curl Tests), cardiorespiratory fitness (2-Minute Step Test), body weight, blood pressure, and lipid profiles. Generalized estimating equations were used to examine intervention effects.

Results: No significant difference was noted between groups at baseline. At 3 months, the Tai Chi group demonstrated significant improvements in lower body strength (Chair stand test: β=1.620, 95% CI 0.435 to 2.805, p=0.007), body weight (β=0.538, 95% CI 0.086 to 0.990, p=0.020), and triglyceride (β=0.276, 95% CI 0.063 to 0.489, p=0.011) compared to the control group. No significant differences were observed in other clinical outcomes.

Conclusions: Preliminary findings suggest Tai Chi, guided by EXSEM, effectively enhances lower body strength, body weight, and lipid profiles in BCSs in the short term. These results support incorporating Tai Chi into discharge planning and ongoing care for BCSs, with important implications for nursing practice.

The Hong Kong Polytechnic University, Kowloon City, Hong Kong

Abstract

Background: Pain of a moderate or severe intensity affects over half of patients with advanced cancer and remains undertreated in at least one-third of these patients. Uncontrolled pain severely compromises quality of life in this population. This secondary analysis of a randomized controlled trial compared the effectiveness of two widely-recognized physical activity modalities, namely Tai Chi (TC) and aerobic exercise (AE) for managing cancer-related pain in patients with advanced lung cancer.

Method(s): Patients with advanced lung cancer (n=226) were randomized to TC, AE, or control groups for 16 weeks. The TC group received two supervised 60-minute sessions per week. The AE group received two supervised 60-minute sessions per month plus home-based exercise. The control group received exercise guidelines. Pain outcomes (overall pain, lung cancer-specific pain) were assessed at baseline (T0), post-intervention (16 weeks, T1), and 1-year follow-up (T2).

Results: At T1, neither TC (between-group difference, -5.49; P=0.11) nor AE (between-group difference, -3.75; P=0.45) showed statistically significant improvement in overall pain. At T2, TC demonstrated a significant reduction in overall pain compared to control (between-group difference, -12.22; P<0.001) and to AE (between-group difference, -10.24; P<0.001). AE did not significantly differ from control at T2 (between-group difference, -1.98; P=1.00). TC significantly reduced lung cancer-specific arm/shoulder pain versus control at T1 (between-group difference, -1.29; P=0.04), but not pain in other body parts.

Conclusions: Tai Chi, but not aerobic exercise, provided significant long-term reduction in overall cancer-related pain for advanced lung cancer patients compared to control, with additional benefit over AE. TC also demonstrated early efficacy for reducing arm/shoulder-specific pain. These findings position Tai Chi as a beneficial, well-tolerated mind-body intervention for pain management in this population.

¹Nanyang Technological University, Singapore, Singapore

²Memorial Sloan Kettering Cancer Center, New York, NY

³Memorial Sloan Kettering Cancer Center, Weston, MA

⁴Harvard Medical School / Osher Center for Integrative Health, Boston, MA

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) negatively impacts balance in people living with cancer. Tai Chi has proven effects on balance improvement in the general population, but not in individuals with CIPN. We designed a feasibility trial of Tai Chi among individuals with CIPN, based on existing evidence in the non-cancer populations.

Method(s): We conducted a scoping review with a literature search from inception until December 19, 2023. Two authors reviewed key information from each study. We designed a randomized waitlist-controlled feasibility trial on Tai Chi for managing CIPN in cancer survivors.

Results: This review included 508 participants diagnosed with clinical peripheral neuropathy (PN), but none with cancer. Tai Chi interventions varied in frequency, ranging from one to four sessions per week (60-minute sessions) for durations spanning eight weeks to 18 months. Notably, pre- and post-exercise assessments revealed that Tai Chi significantly enhanced single-leg stance (SLS), 6-minute walk (6MW), timed up-and-go (TUG), and gait speed among participants with clinical PN. However, Tai Chi was not superior to sham exercises (calisthenics and stretching) in improving SLS or 6MW. Additionally, Tai Chi was associated with increased plantar vibration and tactile sensitivity. The impact of Tai Chi on postural control depended on the status of plantar sensory loss, while results concerning muscle strength were inconclusive. Thus, we propose to assess the feasibility of Tai Chi for cancer survivors experiencing CIPN-related balance difficulties (n = 21) in a pilot study involving randomized participants (2:1) assigned to either virtual biweekly Tai Chi training or a waitlist control for 12 weeks. We will evaluate feasibility outcomes and changes in CIPN symptom severity, sensory function, and objective gait health from baseline to week 12.

Conclusions: Tai Chi may enhance balance through sensory restoration in individuals with PN, prompting the design of a feasibility-testing trial in cancer survivors with CIPN.

¹N&HS, HKMU, Hong Kong, China

²Hong Kong Metropolitan University, Hong Kong, Guangdong, China

³FHS Rehabilitation Centre, Fu Hong Society, Hong Kong, Guangdong, China

Abstract

Background: This study aimed to explore the effects of three months of seated Tai Chi (TC) practice on eye-hand coordination and sitting balance in individuals with Parkinson’s disease.

Method(s): We conducted a prospective non-randomized study with 29 participants engaged in TC and 27 control subjects, chosen based on their preferences. The seated TC group participated in 24 sessions over three months (one hour per session, twice a week). We measured outcomes through a dynamic finger pointing task (assessing reaction time, movement time, and accuracy) and a sequential weight shifting balance test (measuring completion time) while seated.

Results: The TC group demonstrated significantly faster movement times in the dynamic finger pointing task (p = 0.003) and quicker completion times in the sequential weight shifting balance test (p = 0.021). No significant differences were found in the control group.

Conclusions: The findings indicate that three months of seated TC training can enhance movement time in finger pointing tasks and improve sitting balance in individuals with Parkinson’s disease. A future randomized controlled trial is recommended.

Mashhad Medical University, Mashhad, Khorasan, Iran

Abstract

Background: While tai chi is a guideline-recommended treatment for knee osteoarthritis, it has not been widely adopted by primary care providers (PCPs) or large healthcare systems. Thus, there is a need to identify perceived barriers and facilitators of tai chi adoption in healthcare systems.

Method(s): This qualitative study recruited key informants from four healthcare systems in California, Florida, Massachusetts, and Ohio to participate in a single, 30- to 60-minute, in-depth interview. We used a semi-structured guide and transcribed recordings verbatim. Participants were asked about factors that may influence use of—or referral to— in-person or remotely delivered tai chi for knee osteoarthritis. Major themes were identified using thematic content analysis and an a priori codebook informed by the Consolidated Framework for Implementation Research.

Results: From September 2023 to June 2024, 59 participants (median age=58 [range=36-85]; 54% women; 42% White) completed interviews including 13 patients with knee osteoarthritis, 16 PCPs, 12 instructors, and 18 health system leaders. Participants reported that logistical barriers to in-person practice (e.g., transportation time, costs) would be reduced by remote delivery. By contrast, instructor form correction and social interaction of in-person group tai chi were perceived as facilitators that may be diminished by remote delivery. While participants generally perceived a relative advantage of meditative movement over high intensity exercise for knee osteoarthritis, PCPs expressed limited knowledge and low self-efficacy when recommending tai chi compared to other familiar treatments (e.g., medications, physical therapy). Furthermore, PCPs/leaders identified inability to refer or communicate with instructors via their electronic health record as barriers.

Conclusions: In-depth key informant interviews across four healthcare systems revealed practical barriers such as low PCP knowledge about tai chi and the inability to make referrals to tai chi. In our upcoming pragmatic trial of remote tai chi for knee osteoarthritis, we will develop several implementation strategies to address these known barriers.

¹RMIT University, Bundoora, Victoria, Australia

²Swinburne University of Technology, Hawthorn, Victoria, Australia

³Charles Sturt University, Bathurst, New South Wales, Australia

Abstract

Background: Qigong, a traditional mind–body practice, offers physical and psychosocial benefits to older adults, yet little is known about how engagement unfolds when delivered digitally. This study explored engagement with the Online Qigong Plus (QGP) program and its impact on behaviour and wellbeing, guided by the COM-B behaviour change framework.

Method(s): Twenty-two older adults (≥60 years) participated in a 12-week program of weekly live Qigong sessions, supported by orientation, reminders, and self-practice resources. Quantitative outcomes included session attendance, Physical Activity Scale for the Elderly (PASE), EQ- visual analogue scale (EQ-VAS), and Body Awareness Questionnaire. Qualitative interviews and focus groups were thematically analysed using COM-B.

Results: Engagement extended beyond attendance. While 45% completed ≥75% of sessions, others engaged flexibly through recordings and self-practice. Despite varied patterns, participants reported high acceptability and demonstrated significant improvements in physical activity (PASE: 122 ± 48 to 174 ± 78; p<0.01) and quality of life (EQ-VAS: 64 ± 22 to 76 ± 17; p<0.05). Engagement was shaped by Capability (orientation, safety guidance, resources), Opportunity (social connection, home environment, recordings), and Motivation (reminders, personal relevance, perceived benefits, integration into daily routine). Barriers were largely opportunity-based including health conditions, poor internet connection, limited digital literacy and competing commitments.

Conclusions: Older adults engage with online Qigong in diverse ways that cannot be captured by adherence metrics alone. Even with modest attendance, participants experienced ripple effects in physical activity and wellbeing, suggesting that holistic measures of engagement better reflect older adults’ interaction with digital health programs. Enhancing Opportunity factors through internet and digital literacy support, flexible scheduling, and tailored contents may further strengthen sustained engagement. Online Qigong shows promise as a scalable, low-cost approach to support healthy ageing by promoting physical activity and fostering social connection.

¹T’ai Chi Chih Research Group, Tampa, FL

²T’ai Chi Chih Research Group, Santa Fe, NM

³Sculpt Your Life® & T’ai Chi Chih for Veterans, Claymont, DE

⁴Tai Chi Chih, Banbury, Oxfordshire, United Kingdom

Abstract

Background: This observational study examines mindfulness using MAAS self-report among older adult T’ai Chi Chih students and teachers across America and Europe, investigating relationships between practice intensity and mindfulness scores. There is sufficient evidence that improved psychological well-being is correlated with mindfulness. This study seeks to understand the association between TCQ practice and mindfulness. The relevance of this study may be that it is easily replicated by the novice researcher (or teacher) interested in exploring mind-body integration in TCQ practitioners.

Method(s): A self-report survey was made available to T'ai Chi Chih teachers and students across Americas, UK and Europe between May and August 2025 collecting demographics and Mindful Attention Awareness Scale (MAAS) scores. A novel Intensity of Practice Score was developed incorporating duration, frequency, and years of practice. SPSS tests done include Pearson correlations between intensity and MAAS scores, and multi-regression analyses for combined and regional datasets. (n = 387)

Results: Sample demographics: 79% Female, 90% White, mean age 72. 19% from UK/Europe. Data analysis was done with SPSS and MAPlab. Among four predictor variables, three -- Years of Practice, Frequency of Practice, and Age -- are significantly correlated with MAAS. Correlation of YOP with MAAS is r = +.21, p < .001; Correlation of FOP with MAAS is r = +.16, p < .01; Correlation of Age with MAAS is r = +.19, p < .001.

Conclusions: Results show statistical significance between mindfulness, practice frequency, years of practice, and age among older adults. Prior research suggests the meditative component of TCQ may have direct benefits on enhancing attention and executive functions (Wayne et al 2014.) This current pilot study notes the complexity of capturing mindfulness through self-report scales such as MAAS. We recommend qualitative exploration of the meditative component of T’ai Chi Chih to further understand associations with psychological well-being and integrative health.

¹National Taiwan University, Taipei, Taiwan

²National Taiwan University, Taipei, Taiwan

³Global Chinese Association of Zen-Jin Tai Chi for Wellness Enhancement, Taipei, Taiwan

Abstract

Background: Tai Chi is a traditional martial art that stresses body coordination, internal force, and mind–body unity. Two key phases are Song Chen (relaxing and sinking to store energy) and Fa Jin (releasing energy explosively). Despite their importance, these skills lack measurable biomechanical indicators and rely on subjective teaching. This study aims to establish a method to quantify biomechanics of Song Chen and Fa Jin to create a scientific basis for training.

Method(s): Participants included four Tai Chi masters and age-matched older adults, all screened for their ability to perform the movements and for absence of injuries. A custom setup combined the external calf expansion pressure measurement (intracalf pressure), surface EMG, and video recording to capture muscle activity and internal pressure. Standing with one foot forward and one foot back, participants performed guided Song Chen and Fa Jin sequences, repeating the cycle five times while electrical signals were recorded. Key indicators such as calf pressure and muscle activation were then statistically compared between Song Chen and Fa Jin.

Results: The measurements revealed that calf pressure clearly indicated continuous expansion of the rear-leg soleus muscles during the Song Chen phase, whereas the sEMG recordings showed no meaningful signals. This phenomenon was consistently observed in three well-trained participants. However, the temporal profiles of calf pressure increase varied across individuals, suggesting progressive expansion of the soleus or related deep muscles. During the Fa Jin phase, both the rear and front legs showed a rapid decrease in calf pressure, and brief sEMG activity occasionally appeared during the short interval of explosive release.

Conclusions: The external calf expansion pressure could be an indicator of Song Chen and Fa Jin, while sEMG showed little useful information. The results suggest that this method can objectively measure Tai Chi biomechanics and support training beyond traditional subjective teaching.

¹University of Denver, Colorado School of Traditional Chinese Medicine, Denver, CO

²University of Denver Osher Institute for Lifelong learning, Denver, CO

Abstract

Background: Tai Chi and Qigong (TCQ) are evidence-based mind-body practices with demonstrated benefits for balance, autonomic regulation, cognitive function, and quality of life. While their physiological effects are well documented, less is known about how TCQ can be embedded within real-world community contexts to sustain engagement and promote whole-person health. The Year of the Dragon Initiative (YODI) integrated TCQ into a multimodal lifelong learning program that also included yoga, cultural education, and healthy living workshops. Grounded in implementation science, this project evaluated how TCQ programming could be scaled and sustained in diverse community settings.

Method(s): YODI delivered TCQ via in-person workshops, online classes, and outdoor sessions. Evaluation followed the RE-AIM framework to assess reach, adoption, implementation, and maintenance. Data sources included attendance logs, participant satisfaction surveys, and partner engagement metrics. Physiological and health outcomes were interpreted through the established evidence base on TCQ’s role in autonomic regulation, stress reduction, and physical function, consistent with NCCIH-supported findings.

Results: Across 55 events, YODI engaged 19,065 participants from over 40 U.S. cities and international locations. Tai Chi, Qigong, meditation, acupuncture, and diet sessions drew 626 registrants, with 97% reporting high satisfaction and intent to recommend. Adoption was robust, with 283 community businesses and organizations contributing resources and partnerships. Tai Chi and Qigong were identified as highly feasible, low-cost, and sustainable practices, continuing through weekly park sessions and online delivery beyond initial funding.

Conclusions: Embedding TCQ within lifelong learning programs offers a scalable strategy to support physiological integration of mind and body, foster healthy lifestyle behaviors, and advance whole-person health. This implementation model highlights TCQ’s potential to bridge evidence-based physiological outcomes with community-based practice, aligning with NCCIH priorities for pragmatic research and culturally grounded health promotion.

¹School of Medicine, University of Western Sydney, Sydney, New South Wales, Australia

²NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia

³Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, Sydney, New South Wales, Australia

⁴NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Sydney, New South Wales, Australia

⁵Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, NSW 2145, Sydney, New South Wales, Australia

⁶NICM Health Research Institute, Western Sydney University; Faculty of Medicine, Human and Health Sciences, Macquarie University; ANU College of Health and Medicine, Australian National University; Cardiac Health Institute, Sydney, New South Wales, Australia

Abstract

Background: Cardiac rehabilitation (CR) improves recovery and long-term outcomes after acute coronary events, yet participant remains low, particularly among culturally and linguistically diverse populations. Tai Chi, with its emphasis on mind-body integration, may offer a sustainable and culturally meaningful exercise modality when delivered through telehealth for Chinese migrants. This study explored the perceptions and satisfaction with a telehealth-integrated, Tai Chi-based program co-designed for Chinese migrants in Australia.

Method(s): This is a qualitative sub-study embedded in a 24-week pilot randomised controlled trial evaluating a community-based CR program among participants who were of Chinese migrant background and had undergone a recent stent placement or coronary bypass graft surgery. This program was conducted in Chinese language composed of a virtual shared medical appointment, virtual Tai Chi classes, and semi-personalised health education messages delivered via text messages. Semi-structured interviews with 11 participants (mean age 69, 82% male), transcribed, translated, and thematically analyzed.

Results: Tai Chi was central to participants’ positive experiences, with reported benefits in physical function, body awareness, mood, and reduced depressive symptoms. Social connectedness emerged as a strong theme, with participants valuing shared experiences and mutual encouragement as key facilitators to participation and completion of the CR program. Remote delivery was well accepted, emphasizing convenience and cultural relevance, while text message education received mixed feedback due to generic content. High overall satisfaction was linked to supportive team interactions, perceived health improvements, and the sustainability of Tai Chi as long-term practice. Suggested areas for improvement included expansion of services and more frequent engagement with healthcare professionals to support their recovery.

Conclusions: A telehealth-delivered, culturally tailored CR program incorporating Tai Chi was well received by Chinese migrants, enhancing physical, psychological, and social well-being. Findings underscore the promise of integrating Tai Chi into CR, particularly via digital platforms, to improve engagement and equity in cardiovascular care.

RMIT University, Melbourne, Victoria, Australia

Abstract

Background: Long COVID affects millions worldwide. Current rehabilitation programs have been shown to be effective; however, their safety remains inconclusive, highlighting the need for safer movement alternatives. Qigong, a low-intensity, adaptable, holistic practice, is feasible for online delivery and shows potential for recovery from COVID-19; however, its suitability and safety for online delivery in Long COVID are unclear. This study aimed to co-design a safe, user-centred online Qigong program, informed by a systematic review and refined through user and expert focus groups and interviews.

Method(s): A human-centred co-design approach guided by the Medical Research Council complex intervention framework was used. Experts reviewed the initial draft to ensure safety and feasibility. Following a 10-minute demonstration of the modified program, Long COVID participants provided feedback to improve relevance. Further refinements based on expert comments were made before finalisation. Thematic analysis followed Braun and Clarke’s six-phase framework in NVivo 15.

Results: The expert panel (n= 10) included Qigong instructors, rehabilitation specialists, physiotherapists, an exercise physiologist, and a yoga instructor with experience in COVID-19 or Long COVID. Long COVID participants (n= 10; mean age= 45.8; 8 female) all reported fatigue, cognitive difficulties, and post-exertional malaise. One physiotherapist interviewed reflected, “I’ve had to completely rethink the effect and harm that exercise causes people who have (…) Long COVID”. Experts deemed Qigong safe and appropriate movements for people with Long COVID, emphasising program safety, adaptability, supervision, user engagement, and potential barriers (e.g., digital literacy and technological access). Long COVID participants found the draft Qigong program safe, achievable, and easy to integrate into daily routines, but highlighted the need for flexibility, pacing guidance, education, and high-quality practice videos.

Conclusions: Co-design with experts and people with Long COVID facilitated the development of a safe, individually adaptable online Qigong program. Next, a feasibility study will evaluate safety, feasibility, and preliminary outcomes.

¹QUEEN’S UNIVERSITY AT KINGSTON, Kingston, ON

²Ji Hong Wushu & Tai Chi College, Edmonton, AB

Abstract

Background: Taijiquan is often taught through traditional oral and visual methods. While these approaches are culturally meaningful, they can lead to miscommunication, gaps in knowledge transfer, and risks of injury or disengagement. Incorporating modern, quantitative assessment tools could greatly improve the safety, effectiveness, and accessibility of Taijiquan training. The sensors deployment is motivated by body posture requirement during Taijiquan practice. By voluntary musculature activation and skeletal alignment, the body is stretched into one integrated and tensile scaffold. The whole-body eccentric contraction extends from the crown to the feet soles, and manifests itself physically in ground reaction force variations.

Method(s): This study investigates biomechanical signals among Taijiquan practitioners of varying expertise during a standardized, standing posture, with straight torso and legs. Ten participants took part in the study. The test setup consisted of a commercial pressure mat, EMG sensors, and an open-source motion capture software controlled by a generic laptop. Time-stamped sensor data were synchronized for each participant to characterize the leg activity to determine whether the subject was engaged in concentric, eccentric muscle activation, or simply remained in a state of rest.

Results: The results revealed significantly different signatures while the participants were engaged in the same posture that is indistinguishable based on the body anatomy landmarks produced by the motion capture software. Quantitative metrics were defined to produce meaningful comparison between practitioners of different skill levels. The metrics appeared similar across different skill levels when the subjects were instructed to remain in a state of rest, and contrasted significantly when instructed to engage in concentric and eccentric muscular deployment while maintaining the same posture.

Conclusions: This study introduces a scalable framework for skill assessment through the use of quantitative metrics and non-invasive sensors. The findings demonstrate the potential of integrating wearable technology to improve training efficacy, supporting the evidence-based modernization of traditional practices.

¹Loughborough University, Loughborough, Leicestershire, United Kingdom

Abstract

Background: Although the health benefits of Tai Chi are widely recognised, many older adults do not practise Tai Chi to maximise health. Understanding factors affecting Tai Chi participation is needed to maximise effectiveness of Tai Chi interventions for older adults. The purposes of this review were to: (1) explore the facilitators and barriers to Tai Chi participation in community-dwelling older adults; and (2) identify potential gaps in the literature and future directions for research in this area.

Method(s): A scoping review of the literature was conducted, following the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-ScR). Six databases were searched up to May 2025, including PubMed, Web of Science Core Collection, APA PsycINFO, APA PsycArticles, SPORTDiscus, and Scopus. The Capabilities, Opportunities, Motivations, Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) were employed to frame facilitators and barriers.

Results: A total of 37 studies (qualitative, quantitative, and mixed methods) were synthesised in the current scoping review, identifying 52 facilitators and 35 barriers mapped to several behaviour change domains. Tai Chi participation in older adults was found to be shaped by multiple facilitators (e.g., improved fitness, enjoyment, quality instruction) and barriers (e.g., health issues, time constraints, location challenges). The COM-B model and Theoretical Domains Framework provided a structured lens to understand behavioural influences on Tai Chi participation. Findings highlight the need for tailored interventions and further research to address barriers and leverage facilitators when recommending Tai Chi to older adults.

Conclusions: This review has identified the complex interplay between facilitators and barriers to Tai Chi participation in community-dwelling older adults. Exercise and behaviour change scientists as well as healthcare professionals should consider the identified factors when recommending Tai Chi interventions for this population. Researchers and developers could consider how the facilitators/barriers can best be addressed.

¹University of Arizona, Tucson, AZ

²University of Arizona, College of Public Health, Tucson, AZ

Abstract

Background: Falls are a major cause of injury and mortality among older adults, with Hispanic communities disproportionately affected due to barriers in access and language. Tai Chi and Qigong have demonstrated benefits for fall prevention. This study assessed the feasibility and effectiveness of telehealth versus in-person delivery of a Tai Chi program among older Hispanics in Southern Arizona.

Method(s): A hybrid implementation-effectiveness design was used with 20 Hispanic adults aged ≥60 from two senior centers. One site received in-person sessions, and the other telehealth. The 8-week program included three one-hour sessions weekly, led by trained instructors with interpreter support. Assessments at baseline, midpoint, and post-intervention included the Functional Reach Test (FRT), Timed Up and Go (TUG), Frailty Index (FI), Falls Efficacy Scale-International (FES-I), Quality of Life (QoL), and CDC 4-Stage Balance Test. Analyses used mixed models and ANCOVA. Focus groups with coordinators and participants provided qualitative insights.

Results: Participants’ mean age was 77.8 (±6.8) years and 15 were female. Attrition occurred in both groups (n=7). Remaining participants demonstrated trends of improvements in both groups. TUG improved from 15.38 (± 7.8) to 9.10 (± 2.74) seconds for in-person group and 14.28 (± 4.1) to 9.95 (±1.9) seconds in telehealth group. Frailty Index scores decreased slightly for in-person group (0.59 ± 0.07 to 0.57 ± 0.06) and substantially in the online group (0.61 ± 0.07 to 0.52 ± 0.08). FES scores declined, noticeably for telehealth group (from 27.58 ± 6.7 to 23.40 ± 4.2). FRT scores improved, QoL and balance outcomes trended upward in both groups. While statistical significance was limited by small sample, qualitative data emphasized perceived strength, confidence, and program feasibility.

Conclusions: Both in-person and telehealth Tai Chi showed promising trends in mobility, balance, and confidence among participants. Findings support feasibility and acceptability of telehealth delivery, warranting larger trials to confirm effectiveness and scalability.

¹University of California-Los Angeles Center for East-West Medicine, Los Angeles, CA

²University of California-Los Angeles Health, Los Angeles, CA

³Tufts Medicine, Boston, MA

Abstract

Background: Intervention fidelity is essential to the rigor and validity of clinical trials, particularly for complex health interventions implemented across heterogeneous settings. Pragmatic trials must balance fidelity to core components and flexibility for real-world adaptations. Few studies have described systematic approaches for monitoring fidelity in remotely delivered mind-body interventions such as Tai Chi.

Method(s): The TaiChiKnee pragmatic trial evaluates feasibility and effectiveness of remote Tai Chi for patients with knee osteoarthritis across diverse health systems. A fidelity monitoring plan was developed with three key components: (1) intervention manuals for instructors and patients; (2) structured instructor training, including manual review, didactics, supervised practice, and pilot sessions); and (3) iterative refinement through ongoing supervision and retraining. Fidelity data were collected during the first three cohorts, each consisting of 24 sessions over 12 weeks. Data sources included structured observation checklists from two randomly observed sessions per cohort, interventionist process notes, and supervision feedback. Quantitative checklist data were summarized descriptively, while qualitative data from notes and meetings with 11 Tai Chi instructors were analyzed thematically.

Results: The first three of six total cohorts will be completed in February, 2026. Preliminary findings suggest consistent adherence to session structure, Tai Chi sequence, and pacing across instructors. Process notes identified recurrent challenges, including technology barriers, participant mobility limitations, and variations in pacing. Regular supervision meetings enabled timely feedback and retraining, reinforcing adherence to core components while guiding context-appropriate adaptations. Iterative revisions to manuals and training procedures improved clarity and usability, and alignment with pragmatic trial principles.

Conclusions: Fidelity monitoring for remote Tai Chi delivery is feasible and enhances both rigor and adaptability in pragmatic trials. Integrating structured observation, interventionist self-reported process notes, and iterative feedback provides a robust framework for balancing fidelity with flexibility. These strategies may be generalizable to other technology-enabled behavioral and mind-body interventions.

¹QuanZhou normal university, QuanZhou, Fujian, China

Abstract

Background: Tai Chi has been proven to significantly improve the balance ability of middle-aged and elderly people. However, at present, the research on the influence of Tai Chi on the balance ability of young people is relatively limited.This study aims to analyze the impact of 12 weeks Tai Chi (24-form simplified Tai Chi) intervention on multiple balance indicators of young people.

Method(s): 77 participants aged 18-21 years were recruited and participated in a 60-min Tai Chi exercise session 4 times weekly for 12 weeks. Balance was assessed before and after the intervention using the Super Balance test system, which measured the following indicators: the total length of the shaking trajectory (STL), average swing speed in the X-axis direction(X-Speed), average swing speed in the Y-axis direction (Y-Speed), and average swing speed (Ave-Speed).

Results: After 12 weeks of Tai Chi intervention, we observed significant improvements in most balance indicators. In the single-legged eye-open state, the STL significantly decreased from 576.27±221.64 mm to 483.32±248.47 mm (p=0.004); The X-Speed decreased from 17.98±7.88 mm/s to 15.25±9.76 mm/s (p=0.025); The Y-Speed decreased from 18.75±7.28 mm/s to 15.27±6.96 mm/s (p<0.001); The Ave-Speed decreased from 26.25±10.02 mm/s to 21.95±11.29 mm/s (p=0.004). In the state of closed eyes on one foot, the STL decreased from 391.61±226.87 mm to 300.67±173.95 mm (p=0.002); The X-Speed decreased from 24.28±18.68 mm/s to 17.59±12.20 mm/s (p=0.003); The Y-Speed decreased from 25.48±11.33 mm/s to 20.46±10.80 mm/s (p=0.001); The Ave-Speed decreased from 35.85±20.74 mm/s to 27.35±15.67 mm/s.

Conclusions: 12 weeks of Tai Chi intervention can significantly improve the static balance ability of young people. In practice, teachers and coaches can use Tai Chi as a training method to enhance young people' balance abilities, thereby promoting physical fitness development.

¹VA, Sacramento, CA

²University of California Davis, Department of Internal Medicine, Sacramento, CA

Abstract

Background: A substantial proportion of individuals who have been infected with the SARS-CoV-2 virus causing COVID-19 disease have persistent symptoms beyond 12 weeks. These individuals have so-called “long COVID.” Few treatments for these symptoms have been identified. It has been suggested that these patients may benefit from complementary and integrative health (CIH) approaches. Qigong may be one such approach. Qigong is a Traditional Chinese Medicine practice based on the idea that qi (“vital energy”) circulates through the body to facilitate gong (“function”). We conducted a pilot feasibility trial of group-based, combination external-internal qigong for long COVID symptoms.

Method(s): Thirty-nine individuals with long COVID symptoms were randomized 1:1 to participate in qigong immediately or in a waitlist control group. Study participants received six weekly group-based, combination external-internal qigong sessions delivered in a group-based format (2-9 individuals). Participants completed PROMIS-29 v2.1 and PROMIS cognitive function questionnaires at baseline, 8, and 16 weeks. Intent-to-treat paired samples t-tests were performed to examine differences in symptoms before and after the qigong intervention for all participants, regardless of group assignment. Longitudinal analyses were used to examine differences between the immediate and waitlist control groups.

Results: Thirty-one individuals completed questionnaires at all timepoints; 26 participated in at least 4 of 6 qigong sessions. The average age of participants was 54 years (range 25-79), and 72% identified as female with 77% identifying as white. Paired samples t-tests demonstrated significant improvements in ability to participate in social roles (p=0.003), anxiety (0.02), depression (0.005), fatigue (0.001), and pain interference (p=0.045) following participation in the qigong intervention. Longitudinal analyses demonstrated a significant improvement in fatigue (p=0.048) between groups at 8 weeks with a trend toward improvement in ability to participate in social roles (p=0.07) and pain interference (p=0.12).

Conclusions: Group-based, combination external-internal qigong is a low-risk CIH approach that may improve long COVID symptoms.

¹University of Calgary, Calgary, AB

²FOP-UNICAMP, Piracicaba, Sao Paulo, Brazil

³Brazilian Society of Tai Chi Chuan and Oriental Culture, Piracicaba, Sao Paulo, Brazil

⁴McGill University, Montreal, QC

Abstract

Background: People with chronic conditions like diabetes and hypertension frequently experience anxiety and stress, highlighting the urgent need for accessible, non-pharmacological interventions such as Tai Chi and Qigong to improve mental health within primary care settings. This study investigated the effects of Tai Chi/Qigong practice over 13 weeks on anxiety and perceived stress levels in middle-aged or older Brazilian hypertensive and diabetic individuals assisted in a primary healthcare setting.

Method(s): Ninety-one patients with diabetes mellitus and/or hypertension diagnosed and followed up at a primary care center were randomized to the Tai Chi/Qigong intervention (n=45) or waitlist (n=46) group for 13 weeks. Outcome measures were collected at baseline and at 6 and 13 weeks for anxiety (State-Trait Anxiety Inventory) and stress (Perceived Stress Scale - PSS14). The primary endpoint of the study was 13 weeks. We used a linear mixed-effects model to analyze the primary and secondary outcomes, considering the treatment group and time as covariates and treating the subject as a random effect.

Results: Of the included 91 participants, 53 completed the 6-week assessment, and 42 completed the 13-week assessment. After 13 weeks, the Tai Chi/Qigong Group had lower scores for anxiety (STAI Estimate = -6.421; SD = 2.679; 95% confidence interval (95%CI) = [-11.615,-1.224]; p=0.018) and stress (PSS14 Estimate = -9.290; SD= 2.262; 95%CI= [-13.678,-4.906]; p<0.001).

Conclusions: A 13-week Tai Chi/Qigong intervention was efficacious in lowering anxiety and perceived stress scores in middle-aged and older patients with diabetes mellitus and hypertension. It can potentially be used in primary care centers as an adjunct therapy.

¹Nanyang Technological University, Singapore

²First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China

³NTU SBS, Singapore

⁴Memorial Sloan Kettering Cancer Center, New York, NY

Abstract

Background: Metabolic disorders can elevate cancer risk and complicate treatments, affecting disease progression and survival. This systematic review assesses the impact of non-pharmacological traditional Chinese medicine (TCM) treatments on metabolic health in cancer patients.

Method(s): We systematically searched PubMed, Embase, and Cochrane CENTRAL from inception to June 13, 2025. Eligible studies were randomized controlled trials (RCTs) assessing non-pharmacological TCM interventions (i.e., acupuncture, Tuina, Tai Chi and Qigong (TCQ)) targeting any clinical metabolic outcomes (i.e., fasting glucose, obesity, body mass index (BMI)) or biological metabolic signatures (i.e., insulin, metabolites). All study procedures were conducted in accordance with the PRISMA guidelines.

Results: Nine studies with 592 cancer survivors and patients with cancer (264 breast, 166 prostate, 85 lung, 14 thyroid) were included, with an overall moderate-to-high risk of bias due to inadequate blinding. Among breast cancer survivors, TCQ vs. psychosocial therapy control significantly improved BMI and insulin levels but not weight or fat mass. TCQ also significantly lowered IGF-1, IL-2, and IFN-γ, while increasing IGFBP-1, IGFBP-3, and IL-6, from pre- to post-treatment. TCQ vs. support therapy control significantly increased the bone remodelling index (p=.04), with correlations to IGFBP-1, IL-8, and IL-6. In contrast, real vs. sham acupuncture did not lead to significant changes in BMI or metabolism-related hormones among patients with cachexia or anorexia. There were statistically significant reductions in serum ghrelin, gastric inhibitory polypeptide, leptin, and insulin (all p<.05) in acupuncture vs. standard care. For safety outcomes, all studies reported no significant differences in adverse events between the intervention and control groups.

Conclusions: Among cancer patients and survivors, TCQ is promising in maintaining BMI and bone metabolism through regulating metabolism-related hormones and reducing pro-inflammatory cytokines, whereas evidence of acupuncture is limited. The observed effects remain limited by a small sample size and heterogeneity in outcome assessment, warranting rigorous randomized trials with standardized metabolic endpoints.

¹University of Arizona College of Nursing, Tucson, AZ

²University of Arizona, Tucson, AZ

Abstract

Background: Following the coronavirus disease 2019 pandemic, there is increasing interest and aptitude among adults of all ages to participate in remotely-delivered interventions. Given this shift in online engagement, it is important to evaluate the viability of remotely-delivered Tai Chi. A systematic review and meta-analysis was conducted to assess the feasibility and acceptability of remotely-delivered Tai Chi interventions.

Method(s): An electronic literature search of five databases (AMED, CINAHL, PubMed, Scopus, Web of Science) was conducted for published studies (inception to September 2025). Clinical trials that remotely-delivered a Tai Chi intervention (tai chi or tai chi chuan or tai ji) synchronously or asynchronously (internet-based interventions or web-based or electronic health intervention), published in English among adults (≥18 years) with/without a chronic illness were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc.) was used to calculate effect sizes (i.e., point estimate) and 95% confidence intervals (CI) using random effects models.

Results: A total of 13 studies (RCTs, n=7, Quasi-Exp, n=6) met the inclusion criteria, enrolling 429 adults (mean age=64 years old, 72% women). The remotely-delivered Tai Chi interventions (synchronous=8, asynchronous=5) used video conferencing or recorded videos (e.g., private YouTube channel). Post-intervention, participants reported high feasibility (point estimate=-0.91 [95% CI=-0.70, -0.98]; p<0.001, I2=82.66%) and acceptability (point estimate=-0.86 [95% CI=-0.77, -0.91]; p<0.001, I2=66.95%) of the remotely-delivered interventions. A sub-group analysis of participants’ acceptability was similar for the synchronous (point estimate=-0.89 [95% CI=-0.76, -0.95]; p<0.001, I2=79.20%) and asynchronous (point estimate=-0.81 [95% CI=-0.70, -0.88]; p<0.001, I2=4.72%) interventions. Good intervention adherence (point estimate=-0.74 [95% CI=-0.66, -0.81]; p<0.001, I2=49.95%) and fidelity (point estimate=-0.94 [95% CI=-0.74, -0.99]; p<0.001, I2=77.77%) were reported.

Conclusions: Remotely-delivered Tai Chi interventions are feasible and acceptable as alternatives to in-person classes, especially for adults who prefer participating online, are home-bound, are full-time caregivers, working, have transportation issues, or are experiencing inclement weather.

¹University of Arizona, Tucson, AZ

²University of Arizona, College of Nursing, Tucson, AZ

Abstract

Background: The COVID-19 pandemic hastened the need for online health promotion and mind–body practices, including Tai Chi. While Tai Chi is traditionally taught in person, classes have been adapted for remote delivery. Understanding the benefits and challenges of online classes can support the optimization of remotely-delivered Tai Chi interventions.

Method(s): An online 60-minute Tai Chi intervention was remotely-delivered twice/week for 12 weeks to older adults using an experimental design. Classes were conducted synchronously via Zoom videoconferencing platform. The classes were recorded for participants who wished to review the class or make up for missed synchronous sessions. Other strategies included personalized greetings at the beginning of class, frequent and structured check-ins during class, and question-and-answer time after class. Benefits and challenges were based on instructor experience, participant feedback (e.g., satisfaction survey), and engagement patterns (e.g., class attendance).

Results: A total of 41 older adults (mean age=70.8±5.6, 78% females) enrolled. Benefits of these remotely-delivered classes included increased accessibility by eliminating transportation barriers, allowing participants to attend from their homes, or while traveling (e.g., at hotels, airports, or friends’ homes). Practicing at their chosen space supported continued engagement, while the online classes connected individuals, fostering a greater sense of community. Study satisfaction was very high (94%) with high accessibility (85%) and good class attendance (85% attended ≥18/24 sessions) reported. Challenges of these remotely-delivered classes included technological issues, faulty internet connection, and limitations in providing individualized feedback.

Conclusions: Remotely-delivered Tai Chi offers opportunities to enhance reach and accessibility, to benefit older adults facing obstacles to in-person participation. However, challenges related to technology and engagement must be addressed to optimize success. These findings emphasize the importance of quality internet connection, and meaningful engagement strategies when offering remotely-delivered Tai Chi. Future studies are warranted to determine the optimal strategies for best practices and implementation.

¹Western Sydney University NICM Health Research Institute, Merrylands, New South Wales, Australia

²Western Sydney University, Sydney, New South Wales, Australia

³NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia

⁴University New South Wales Sydney, Sydney, New South Wales, Australia

⁵UNIVERSITY OF AUCKLAND, Auckland, New Zealand

⁶Massachusetts General Hospital, Boston, MA

⁷University of Sydney Medical School/ Royal North Shore Hospital, St Loenards, New South Wales, Australia

Abstract

Background: University students experience rising levels of stress, anxiety, and depression, often facing barriers to conventional psychological care. Tai Chi is a promising mind-body approach for stress reduction, yet young adults’ motivations for engagement remains unclear. Exploring these perspectives can inform the design and implementation of more accessible and engaging interventions.

Method(s): This qualitative study was embedded within a pilot randomised controlled trial (RCT) evaluating an 8-week Tai Chi-based stress reduction program for tertiary students with elevated levels of stress, anxiety, or depression symptoms, or diagnosed depressive or anxiety disorders. One-on-one semi-structured interviews were conducted via Zoom to explore participants’ motivations, expectations, and barriers. Interviews were transcribed and analysed thematically using NVivo 15 software.

Results: Twenty students completed virtual interviews prior to starting the program, including 12 from the in-person Tai Chi group and 8 from the online group. Three key themes were identified: (1) motivations for enrolling, (2) perceived benefits and expectations, and (3) anticipated barriers to participation. Students described joining the program in the hope of improving emotional wellbeing, reducing stress, and building sustainable routines. Intrinsic motivations included seeking balance, calm, and self-regulation, while extrinsic motivators included university promotion, peer influence, and cost-free access. One student shared, “It felt like something peaceful I could try without pressure.” Barriers included time constraints, fatigue, and uncertainty about relevance to their symptoms. Online delivery was valued for flexibility, though some felt it might reduce social engagement.

Conclusions: Tai Chi was perceived as a meaningful tool for managing mental health and life demands. Participants valued its accessible, non-clinical nature and holistic benefits. Tailoring programs to students’ motivations may improve engagement and retention in mind–body interventions.

¹Western Sydney University, Sydney, New South Wales, Australia

²NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia

³NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Sydney, New South Wales, Australia

Abstract

Background: University students often encounter substantial barriers to accessing necessary care for managing mental health challenges. This qualitative study aims to explore university students’ perspectives on Tai Chi as a potential intervention for stress reduction and overall wellbeing enhancement.

Method(s): Five focus groups with eighteen university students who reported stress, anxiety, and/or depression were held online between July and December 2023, covering topics related to mental health, perceptions of Tai Chi, and feedback on a proposed Tai Chi-based stress reduction program. An inductive thematic analysis was conducted using NVivo 14.

Results: Three key themes were generated that included: (1) student wellbeing challenges, (2) the perceptions of Tai Chi as a potential resource for coping with demands of being a university student, and (3) enhancing relevance and engagement of students in Tai Chi. Participants highlighted Tai Chi as a promising intervention to address gaps in students’ mental health care, emphasising its potential to enhance and integrate physical and psychological health and foster social connection. However, barriers such as age-related stereotypes and the need for flexible, accessible delivery were noted as crucial to maximising student engagement and participation. The findings will inform the development of a Tai Chi-based stress reduction program.

Conclusions: This study provides valuable insights into how Tai Chi is perceived by university students, which can guide future research in developing tailored mind-body interventions to enhance university students’ mental health and support overall wellbeing.

¹My Metro Medicine, Burke, VA

²BOD Pain Management & Wellness, Falls Church, VA

Abstract

Background: While research supports Qigong’s therapeutic role in chronic disease management, its effects on healthy adults are less well understood. This preliminary cohort study explored potential physiological and psychosocial benefits of Qigong in adults without chronic illness, psychological symptoms, or physical limitations.

Method(s): Participants engaged in a 10-week program, attending one 90-minute group session weekly with a master-level instructor and practicing individually 1–2 times per week for 15–30 minutes. None had prior Qigong experience. Health outcomes were measured using the 36-Item Short Form Health Survey (SF-36) and the Mental Health Quality of Life questionnaire (MHQoL). Physiological markers (blood pressure, oxygen saturation, heart rate) were recorded before and after the intervention.

Results: Physiological Outcomes: Systolic blood pressure decreased significantly from 127.63 mmHg (SD = 14.35) to 119.93 mmHg (SD = 11.68, p = 0.017). No significant changes were found in diastolic pressure (p = 0.254) or oxygen saturation (p = 0.061). Heart rate increased modestly from 76.63 bpm (SD = 12.67) to 80.73 bpm (SD = 12.43, p = 0.038). MHQoL Outcomes: Significant improvements were observed in self-image (p < 0.001), independence (p = 0.006), mood (p = 0.003), physical health (p = 0.010), future outlook (p = 0.001), and psychological well-being (p = 0.041). Total MHQoL scores increased from 17.10 (SD = 3.25) to 19.20 (SD = 1.77, p < 0.001). SF-36 Outcomes: Participants reported improvements in energy/fatigue (p = 0.009), emotional well-being (p = 0.038), social functioning (p = 0.028), bodily pain (p = 0.021), and general health (p = 0.050). No significant changes were noted in physical functioning, role limitations, or health change (p > 0.05).

Conclusions: Qigong may enhance physiological and psychosocial well-being in healthy adults. As a simple, low-cost practice, it holds promise as a preventive health strategy supporting resilience, balance, and overall wellness.

¹Rutgers Cancer Institute, PISCATAWAY, NJ

²Cousins Center for Psychoneuroimmunology, Semel Institute for Neurosciences, University of California-Los Angeles, Los Angeles, California, Los Angeles, CA

³Department of Internal Medicine, University of New Mexico, Albuquerque, NM

⁴School of Nursing, Indiana State University, Terra Haute, IN

⁵Rutgers Cancer Institute, New Brunswick, NJ

⁶Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ

Abstract

Background: Sleep disturbance is a common yet undertreated condition in cancer survivorship, and available evidence for it in older men is limited. We compared Tai Chi Qigong (TCQ), an embodied mindfulness program, with an exercise intensity–matched program (EIM) and usual care (UC) on sleep quality in older male cancer survivors.

Method(s): Men ≥55 years, ≥3 months post–primary treatment, were randomized (2:2:1) to TCQ, EIM, or UC. TCQ and EIM involved 12 weeks of twice-weekly 60-minute classes (TCQ: breathing/movement/meditation; EIM: stretching/static/eccentric); UC received standard care. Sleep quality with the Pittsburgh Sleep Quality Index (PSQI) was assessed at 6 weeks mid-point, 1 week post-intervention, 3 months post-intervention, and 12 months post-intervention. Mixed-effects models with linear contrasts estimated within-arm changes, and clinical remission was defined as PSQI ≤ 5.

Results: Among 113 participants (mean age 69.1±7.0 years), 87% had prostate cancer, 77% were White, and 57% had a bachelor’s degree or higher. Attendance was high and similar between intervention groups (TCQ 78.4%, EIM 76.8%). At 3 months post-intervention, there were within-arm improvements in sleep quality in both the TCQ (mean change=-0.59; p=0.082) and EIM arm (mean change=-1.04; p=0.048). No clinically meaningful between-group differences in sleep quality were observed at any time point. PSQI subscales suggested domain-specific effects: EIM improved sleep efficiency at 3 months post-intervention (mean change=-0.46; p=0.04), whereas TCQ improved sleep duration at 1-week post-intervention (mean change=-0.22, p=0.044). At 12 months, a higher proportion of TCQ participants achieved clinical remission of sleep disturbance (62%) versus EIM (47%) and UC (43%).

Conclusions: TCQ and EIM improved sleep quality in male cancer survivors, with more TCQ participants having clinical remission at 12 months. These findings support integrating low-intensity programs such as TCQ into survivorship care of older male survivors of cancer and warrant larger, more diverse clinical trials.

¹Simmons University, Boston, MA

Abstract

Background: 50% of children experience at least one adverse childhood experience and (ACE) and 14.8% of children experienced 4 or more ACEs. The rise in school shootings creates further trauma exposure for children. Exposure to traumatic events can have negative mental health, social, academic and educational consequences for school aged children. Trauma-informed Yoga and Body-Based (TIYBB) interventions offer promising treatment options for children who experience trauma.

Method(s): This qualitative research study explores themes that emerged from an online TIYBB training for Master’s in Social Work/Counseling (MSW/C) students across the US who are completing an internship in a school setting. The training is provided by the Institute for Trauma Treatment in Schools (ITTS), a SAMHSA funded project focused on enhancing trauma-informed care in schools. To better understand the impact of the TIYBB training, we asked the following exploratory research question: What are students' perceptions of trauma-informed yoga following a brief introductory on-line training? We reviewed written responses submitted by 29 pre-service MSW/C students who completed the TIYBB training between 12/23 -6/24. As part of the training participants were asked to answer knowledge and discussion questions. Thematic analysis was applied to interpret the findings.

Results: Initial themes include: using invitational language; promoting dialogue/communication; adapting to the individual; checking in; allowing choice; grounding; awareness, sensing; and action.

Conclusions: Based on our preliminary findings, students identified important aspects of trauma-informed body-based practice including using invitational language and allowing choice and autonomy for the children and adolescents who may engage in such practices. Additionally, students understood “bottom up” interventions to mean grounding in one’s body, engaging in increasing awareness, sensing the body, awareness and sensing leading to action. These findings suggest that online TIYBB training may be beneficial for supporting MSW/C students in applying TIYBB interventions with children who have experienced trauma.

¹NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia

²Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, Sydney, New South Wales, Australia

³Cardiac Health Institute, Sydney, New South Wales, Australia

Abstract

Background: Traditional cardiac rehabilitation (CR) programs face low participation and high dropout rates, especially among culturally and linguistically diverse communities, such as Chinese migrants. This study assessed the feasibility and effectiveness of a co-designed, community-based CR program tailored to the needs of Chinese migrants in Australia.

Method(s): This pilot randomised controlled trial included 19 Chinese migrants (31.6% female) who had undergone stent or bypass surgery. Participants were randomly assigned to a CR group or a waitlist control. The CR program comprised: (1) Virtual shared medical appointment: a one-time 90-minute group consultation and 30-min individual consultations; (2) Virtual Tai Chi: twice-weekly, 60-minute sessions for 24 weeks; and (3) Health education: four semi-personalised weekly messages for 24 weeks. Primary outcomes included recruitment rate, retention rate, and safety. Secondary outcomes included cardiometabolic markers, physical capacity, self-efficacy, social support, quality of life, psychological wellbeing, physical activity and satisfaction. Assessments were conducted at baseline, week 12 and 24. Statistically analysis were conducted using SPSS (version 26.0).

Results: No program-related adverse events were reported, and the retention rate was 86%. Compared with the waitlist control, the CR group showed significant improvements over 24 weeks in physical capacity (6-minute walk test, p=0.041), physical activity (7-day walking distance, p=0.01), and psychological wellbeing, including depression p=0.017, anxiety p=0.006, and overall distress (total DASS-21 score, p=0.017).

Conclusions: A community-based CR program is feasible and effective in improving physical fitness, physical activity, and psychological wellbeing among Chinese migrants over 24 weeks. Future fully powered randomized clinical trial should confirm its effectiveness.

¹Akdeniz University, Antalya, Antalya, Turkey

²Hangzhou Normal University, Hangzhou, Zhejiang, China

³NICM Health Research Institute, Sydney, Western Australia, Australia

⁴NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia

Abstract

Background: Tai Chi movements may be effective in children with various diagnoses, as they improve physical and psychological health. This systematic review aimed to map the physical and psychological outcomes assessed in randomized controlled trials of Tai Chi in children and adolescents. We also aimed to evaluate the effects and safety of Tai Chi on these outcomes in these populations and to explore the underlying mechanisms and rationale.

Method(s): We included parallel randomised controlled trials and the first phase of cross-over randomised controlled trials. Children and adolescents under the age of 18 years at the time of the trial were eligible. Electronic literature search was conducted from major English and Chinese databases including PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Sino-Med, and Wanfang Database. Two authors independently conducted study selection and data extraction. Risk of bias was assessed.

Results: A total of 15 randomised-controlled trial (RCT) met the inclusion criteria and were included in this review. 1004 children and adolescents (children with 8-12 years adolescent with 13-18 years) who were healthy or had various diseases were in these studies. Based on the Cochrane RoB Tool overall RoB of three sudies (20 %) had low risk 6 studies (40 %) had some

Conclusions: Tai Chi appears to has beneficial effects on physical parameters such as balance, flexibility, motor skills, physical fitness in children and adolescents, and on psychological factors such as stress, anxiety, self-regulation and self-concept, and behavior. In order to prove the effects of Tai Ch and understand its mechanism by conducting meta-analysis studies, more high-quality RCTs are needed.

¹The National University of Natural Medicine, Portland, OR

²Oregon Health & Science University, Portland, OR

³National University of Natural Medicine, Portland, OR

⁴NUNM, Portland, OR

⁵Canadian College of Naturopathic Medicine, Toronto, ON

⁶Department of Neurology, Oregon Health and Sciences University, Portland, OR

⁷Harvard Medical School, Boston, MA

Abstract

Background: Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative condition affecting physical, cognitive, and psychological domains. Exercise is a recommended non-pharmacological approach to addressing MS symptoms. Mind-body movement interventions (MBMIs) combine movement, mindfulness, and breathwork, offering multi-component exercise options. While research on MBMIs for MS is growing, results are often conflicting. This study used an umbrella review to assess current best evidence on the efficacy of MBMIs for MS symptoms.

Method(s): We followed Cochrane guidance on conducting and reporting umbrella reviews. We searched 12 electronic databases and grey literature for systematic reviews and meta-analyses of MBMIs including ai chi (aquatic tai chi), dance, Pilates, qigong, tai chi, and yoga. Selection, extraction, methodological quality and evidence certainty assessments were conducted independently and in duplicate. Outcomes included fatigue, depression, pain, cognition, physical function, and quality of life.

Results: We identified 104 reviews with 38 meeting inclusion criteria. After eliminating redundant reviews, we extracted 28 and reported meta-analytic outcomes from seven. Significant improvements from ai chi/tai chi/qigong, Pilates, and yoga were found in balance and fatigue, equal or superior to active controls (AC) or usual care (UC). Tai chi/qigong significantly improved depression, while yoga was equivalent to AC/UC. Analyzed with other mind-body therapies, yoga reduced pain compared to AC/US. MBMIs were not more effective at improving physical or cognitive function and quality of life compared to AC. The certainty of evidence was low to very low for most MBMIs, except yoga, which showed moderate certainty for cognitive, physical, and psychological function. Most reviews were “critically low” quality, with only two rated “high” and six “low.”

Conclusions: MBMIs are commonly included in exercise reviews for MS, and may significantly improve balance, fatigue, and depression. However, there is still a need for larger trials with active comparators, and full reporting of results, including heterogeneity, to improve quality and certainty.

¹National Center for PTSD, Behavioral Science Division, Jamaica Plain, MA

²National Center for PTSD, Behavioral Science Division, Boston, MA

³Boston University Chobanian & Avedisian School of Medicine, Boston, MA

⁴Tufts Medicine, Boston, MA

⁵National Center for PTSD at VA Boston Healthcare System, Boston University School of Medicine, Boston, MA

Abstract

Background: Posttraumatic stress disorder (PTSD) has been found to increase in prevalence with each service era, currently afflicting nearly a quarter of military Veterans utilizing VA care. Impacting both body and mind, PTSD is considered a systemic disorder associated with many health concerns, including chronic, musculoskeletal pain. Although mind-body treatments are already widely used, their efficacy in ameliorating symptoms of PTSD is not well supported. The present 3-year study funded by the National Center for Complementary and Integrative Health (NCCIH) aimed to evaluate the feasibility and acceptability of virtually delivered mind-body PTSD interventions.

Method(s): The trial was delivered remotely to Veterans throughout the US in two phases. After a non-randomized Phase 1, the study team refined and standardized treatments prior to randomizing participants in Phase 2. All participants were assigned to one of two mind-body interventions that met twice weekly for 12 weeks: Tai Chi or Wellness. To quantify feasibility and acceptability, the study team tracked rates of screening eligibility, enrollment, adherence, retention, and compliance with weekly home practice.

Results: Of the 91 Veterans originally phone-screened for Phase 2, 42 were validated for randomization. Consistent with preliminary findings from Phase 1, Phase 2 participants exhibited high adherence to treatment, with 69.0% attending at least 70% of class sessions, 78.6% completing the posttreatment assessment, and 71.4% following through to complete 3-month follow-up. Robust compliance was further evidenced by 76.2% of Veterans completing at least 70% of home practice calls and 81.0% completing at least 70% weekly surveys.

Conclusions: This study demonstrated that virtual Tai Chi and Wellness interventions to target chronic pain and PTSD are feasible. Further, by taking advantage of the national subject recruitment enabled by remote delivery, a larger trial may be developed to evaluate the efficacy of Tai Chi and Wellness as treatment for chronic pain and PTSD.

Beijing University of Traditional Chinese Medicine, Beijing, China

Abstract

Background: More and more evidence suggests that Traditional Chinese Exercise (TCE) has potential benefits in improving chronic heart failure. To evaluate the clinical efficacy of TCE in the treatment of CHF, we conducted a systematic review of existing randomized controlled trials (RCTs) for CHF and summarized the biological mechanisms of TCE in CHF treatment.

Method(s): From the establishment of the database until July 2025, systematic searches were conducted in six electronic databases: PubMed, Embase, Cochrane Library, CINAHL, CNKI, and Wanfang Database. The quality of all included RCTs was evaluated using the Physical Therapy Evidence Database Scale (PEDro). The main results include sports ability, including 6-minute walking test and peak oxygen uptake

Results: A total of 15 RCTs were included. According to PEDro, the quality of all 15 RCTs included ranges from medium to high. The results indicate that TCE can significantly improve the exercise ability of CHF patients. TCE also has significant effects on secondary outcomes such as quality of life, exercise self-efficacy, and sleep stability.

Conclusions: Our system review indicates that TCE is effective in improving the exercise capacity of CHF patients. The biological mechanism of TCE treatment for CHF may be related to meditation, breathing and posture control, strength and flexibility training, and regulation of body stability.

¹Tufts Medicine, Boston, MA

²University of California-Los Angeles Health, Los Angeles, CA

³Boston Medical Center, Boston, MA

⁴Cleveland Clinic, Cleveland, OH

⁵University of New Mexico, Albuquerque, NM

Abstract

Background: Knee osteoarthritis (OA) is a leading cause of disability and healthcare costs. Tai Chi is strongly recommended by clinical guidelines as an effective mind–body intervention for knee OA, yet little is known about the real-world effectiveness and feasibility of remote delivery. This study evaluates recruitment challenges and implementation feasibility of a multi-site, remotely delivered Tai Chi program embedded within diverse healthcare systems.

Method(s): We conducted a pragmatic, individually randomized group-treatment trial comparing a 12-week, twice-weekly remote Tai Chi intervention to routine care. The trial is embedded within five healthcare systems: Tufts Medicine, Boston Medical Center, UCLA Health, Cleveland Clinic, and the University of New Mexico. A total of 480 patients with clinically diagnosed knee OA will be enrolled. Tai Chi sessions (60 minutes) are delivered remotely twice-weekly for 3 months (24 sessions). The primary outcome is change in WOMAC pain at 3 months; secondary outcomes include physical function, pain interference, quality of life, and healthcare utilization. Recruitment strategies included physician referrals, electronic health record (EHR) screening, and patient self-referral.

Results: In Year 1 (9/2024–9/2025), >8,000 patients were screened, 273 consented, and 167 randomized. Physician referrals yielded the lowest enrollment, while EHR outreach and MyChart produced the highest, with nearly half of screened patients randomized. All 80 participants in Cohort 1 completed the intervention and 3-month follow-up, with high adherence and retention.

Conclusions: Multi-site coordination across time zones and systems was complex, but centralized workflows and communication improved efficiency. Recruitment favored EHR outreach over physician referrals. Remote delivery supported strong engagement, with high adherence and retention. Flexibility in scheduling, standardized manuals, and structured instructor training-maintained fidelity and feasibility across systems. This study demonstrates the feasibility of remotely delivered Tai Chi for knee OA across diverse health systems. EHR-based recruitment outperformed physician referrals. These findings support scalable, pragmatic models for mind–body interventions in clinical practice.

¹Florida International University, Miami, FL

²Florida International University, Miami Springs, FL

Abstract

Background: Almost half of the people living with HIV in the U.S. are over the age of 50 and often report pain as common comorbidity. However, very few non-pharmacological interventions exist for both psychological and physical symptoms in this population. Tai Chi/Qigong (TCQ), a mind-body intervention, improves both physical and psychological health. It comprises of a series of slow, low-impact, meditative movements that integrate breathwork, meditation, and stances.

Method(s): This exploratory clinical trial evaluated the acceptability and feasibility of a 12-week small group TCQ intervention (n=16), a sham qigong control condition (n=16) and standard care control condition (n=16) for older PWH. It explored the associations between TCQ intervention and pain using the Graded Chronic Pain Scale. Participants were recruited from either HIV clinics in Florida, or an on-line recruiting service. Participants were randomized to one of the 3 study conditions. Participants were interviewed at baseline and at 2-weeks post intervention. Descriptive statistics on socio-demographic, pain, and technology preference data were collected.

Results: Participants were mostly Black (55%), male (55%), unemployed or on disability (70%), with a mean age of 61.0. The TCQ group pain scores improved from baseline to 2 weeks post intervention with a median score of 28 to 2; the sham qigong group also improved from 14 to 2; and the control from 29 to 25. Participants who reported very frequent vs. infrequent TCQ home practice also reported lower pain scores (2 vs. 6). 53% reported they preferred the classes over zoom than in person with another 23% reporting no preference.

Conclusions: The small sample size prohibits any significance testing. However, TCQ reported larger improvement than either control groups. A larger randomized clinical trial is needed to determine the efficacy of TCQ for pain.

¹Osher Center for Integrative Health, Boston, MA

²University of Florida, Gainesville, FL

³Harvard Medical School / Osher Center for Integrative Health, Boston, MA

Abstract

Background: Chronic neck pain (CNP) is a significant public health concern. While individual complementary and integrative health (CIH) therapies show promise in reducing CNP-related disability and pain, little is known about participant perspectives of safety and effectiveness of combining manual and mind-body CIH therapies.

Method(s): Forty-eight individuals with CNP were enrolled in a pilot three-arm randomized, mixed-methods trial evaluating validated community-based multimodal chiropractic care (10 sessions over 16 weeks), chiropractic care combined with 16 weeks of virtual Tai Chi instruction, and enhanced usual care. Each participant participated in qualitative interviews at baseline and 16 weeks. This qualitative sub-study aims to provide insights into the perspectives of participants who were exposed to combined multimodal manual and mind-body CIH therapies during a larger study titled A Pilot Randomized Trial of Combined Chiropractic Care and Tai Chi for Chronic Non-Specific Neck Pain.

Results: Patients viewed both Tai Chi and chiropractic care as effective in reducing stress and CNP-related disability and pain. Participants described their chiropractors as perceptive regarding their pain, responsive to their individual needs, and capable of providing clear explanations. They learned about the complexity of their neck pain and its relationship to musculoskeletal issues. Generally, participants were surprised by the extension of chiropractic work beyond just spinal manipulation. Tai Chi was viewed effective for reducing stress throughout the body and increasing somatic awareness. While participants noted that chiropractic care and Tai Chi were qualitatively different interventions, they described a potential synergistic effect between chiropractic care and Tai Chi.

Conclusions: Tai Chi and Chiropractic care both show promise to help patients with CNP-related disability and pain. Participants viewed both chiropractic care and Tai Chi as helpful in changing how they thought about and felt their pain, and further study of tai chi and chiropractic care for CNP-related disability and pain is warranted.

¹Beijing University of Chinese Medicine, Beijing, Beijing, China

²Western Sydney University NICM Health Research Institute, Merrylands, New South Wales, Australia

³NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia; School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Sydney, New South Wales, Australia

⁴Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China; Xiyuan Hospital of China Academy of Chinese Medical Science, Beijing 100091, Beijing, China

⁵NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia

⁶UNIVERSITY OF AUCKLAND, Auckland, Auckland, New Zealand

⁷Massachusetts General Hospital, Boston, MA

Abstract

Background: Higher education students experience high levels of depression, anxiety, and stress, which can negatively impact their mental well-being and academic performance. Tai Chi has shown potential benefits in improving mental health, but its effects on university students remain inconclusive. This systematic review and meta-analysis aimed to assess the effects of Tai Chi on ameliorating mental health of higher education students.

Method(s): We searched multiple databases and trial registries to identify randomized controlled trials which evaluated Tai Chi interventions in higher education students with elevated symptoms of depression, anxiety, or stress. Review Manager software was used for meta-analyses and subgroup analyses. The risk of bias was evaluated using Cochrane Risk of Bias 2.0, and the quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results: Ten trials with 598 participants were included in this review. Meta-analysis showed that Tai Chi significantly reduced depression symptoms compared to no intervention or usual care (SMD = -1.39, 95% CI [-1.85, -0.93], P < 0.00001, 8 studies, I² = 81%). For anxiety, a significant reduction was also observed (SMD = -1.12, 95% CI [-1.84, -0.40], P = 0.002, 2 studies, I² = 76%). However, the GRADE assessment demonstrated the evidence quality of both depression and anxiety was very low due to high risk of bias and significant heterogeneity.

Conclusions: Tai Chi seems to be a beneficial intervention for reducing depression and anxiety symptoms in higher education students. However, more high-quality studies are needed to establish its effectiveness.

¹Royal London Hospital for Intergrated Health, Brighton, East Sussex, United Kingdom

²NHS, London, United Kingdom

³UCLH, London, United Kingdom

Abstract

Background: Chronic musculoskeletal pain significantly impacts quality of life. Tai Chi, a mind-body practice integrating movement and mindfulness, shows promise in supporting physical and emotional wellbeing, but its effects in a diverse chronic pain population remain underexplored.

Method(s): This qualitative descriptive study explored the experiences of patients with chronic musculoskeletal pain who completed a Tai Chi course at a hospital in the United Kingdom. Semi-structured telephone interviews were conducted with 13 participants and analysed using the Framework Method.

Results: Five themes were identified: 1) Living with pain: context and expectations for Tai Chi, 2)Learning Tai Chi: what helped and what got in the way, 3) Adapting the practice: access, modifications and fit, 4) Community dynamics: connection, challenge and support and 5) Reframing pain: physical relief, emotional change and reconnection with the body. Most participants reported improved mobility, reduced pain and enhanced wellbeing, including increased body awareness and emotional regulation. Instructor style, group support, and personal adaptability were key to positive engagement. However, some participants reported minimal benefit, highlighting the need for individualised approaches.

Conclusions: Tai Chi was experienced by many as a valuable, adaptable intervention for managing chronic pain. Findings support its integration into care pathways, particularly when delivered flexibly and with attention to individual needs and support structures.

¹Dalian University of Technology, Dalian, Liaoning, China

Abstract

Background: Against the backdrop of China’s strategic response to population aging, the development of intelligent elderly care systems presents new opportunities for enhancing the health and quality of life of older adults. Tai Chi, as a traditional Chinese wellness practice, has gained wide popularity among elderly populations. However, its integration within the framework of smart elderly care remains insufficiently understood. This study aims to investigate the multidimensional exercise needs of elderly Tai Chi practitioners and to construct a comprehensive behavioral path model aligned with the evolving paradigm of intelligent elderly care.

Method(s): Based on a systematic literature review and expert consultations, five core dimensions of Tai Chi exercise demand were identified: health promotion, social interaction, emotional well-being, technological support, and environmental adaptation. A structured questionnaire was designed accordingly and administered to a stratified sample of 1,080 Tai Chi practitioners aged 60 and above from Liaoning, Jilin, and Heilongjiang provinces. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted to validate the measurement constructs. Structural Equation Modeling (SEM) was subsequently applied to test the hypothesized relationships and construct the “Smart Environment–Functional Support–Multi-Dimensional Needs–Behavioral Engagement” path model.

Results: The model results indicate that the availability of smart service infrastructures significantly enhances motivation and adherence to Tai Chi practice, primarily mediated by digital health management and access to personalized knowledge systems. Furthermore, social support and psychological fulfillment were found to be key moderating variables influencing behavioral engagement. The proposed tripartite coordination mechanism—“Platform–Community–Family”—was shown to be effective in supporting sustained participation and satisfaction among elderly users.

Conclusions: This research advances theoretical understanding of health behavior among aging populations by embedding traditional physical practices into smart service ecosystems. The findings provide empirical insights for policy-makers community health planners and digital service designers suggesting that the incorporation of Tai Chi-oriented modules into intelligent elderly care platforms can facilitate

¹Mercer University School of Medicine, MACON, GA

Abstract

Background: Older adults are a rapidly growing segment of society, particularly in rural areas. Medical care is also lacking in many rural areas, which makes prevention a priority. The current study seeks to target chronic pain, stress, and risk of death and injury from falls. Tai chi has been identified as being effective for addressing these concerns. A range of studies have demonstrated benefits for these areas, with the range of instruction typically ranging from 2 to 3 instructor led sessions for an hour each week. The current study seeks to determine if a 30-minute instructor led session once a week, supported by independent practice using guided online videos, would benefit targeted concerns.

Method(s): A 16-week instructor-led tai chi intervention was implemented at a senior center in a rural Georgia county which met for 30-minutes once a week, combined with an easy to follow 10-minute video for independent practice. Twenty-five participants volunteered for the study. Measurements were taken using the 4-Stage Balance Test, the Numeric Rating Scale-11 (NRS-11) to measure and assess pain, and the perceived stress scale (PSS), before starting the program, and at the 10-week and 16-week follow-up.

Results: Thirteen participants were able to complete the 10-week follow-up due to severe storms and flooding the week of the tests. The 16-week post-test will be completed in October 2025. Results for those who were able to complete the 10-week measurements (n=13) showed no significant difference in scores, except for balance scores which increased significantly in the five participants who reported the most practice for the combined balance scores (p=.049) and for the 1-leg balance test (p=.036). Aside from affecting participation in the 10-week measures, storms and flooding may have negatively impacted measurements, particularly for stress measurements. The 16-week post-test results will be presented in the conference poster.

¹Thomas Jefferson University, Philadelphia, PA

²Harvard Medical School, Boston, MA

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and distressing long-term toxicity among gastrointestinal (GI) cancer survivors. Symptoms such as numbness and tingling often persist long after treatment, impairing function and quality of life. Despite its burden, few effective and scalable treatment strategies exist. Integrative therapies including Tai Chi, α-lipoic acid (ALA), and acupuncture show promise but have not been tested within adaptive trial designs. This pilot Sequential Multiple Assignment Randomized Trial (SMART) evaluates the feasibility, acceptability, and preliminary efficacy of a stepped-care integrative approach for CIPN. The SMART design enables treatment adaptation based on individual response, offering a flexible, patient-centered strategy to optimize symptom management.

Method(s): We aim to enroll 60 GI cancer survivors with moderate CIPN at least three months post-chemotherapy. Participants are randomized to one of two 8-week initial treatments: (1) virtual Tai Chi (twice-weekly instructor-led sessions, simplified Yang 24 forms), or (2) daily oral ALA (600 mg with food). Responders (≥2-point symptom reduction) continue their initial therapy. Non-responders are re-randomized to either add the alternate integrative therapy or acupuncture (auricular and Ba Feng points) for another 8 weeks.

Results: The primary objective is to assess feasibility through consent rate, racial diversity, treatment adherence (≥80%), retention (≥85%), and progression to Stage II (≥90% among non-responders). Secondary objectives include evaluating acceptability via standardized satisfaction surveys and qualitative exit interviews. Exploratory analyses will examine CIPN symptom changes across six treatment sequences at 16 weeks using self-reported neuropathy scores and quantitative sensory testing.

Conclusions: Recruitment and intervention delivery are ongoing. Preliminary data on enrollment, intervention uptake, participant feedback, and early impact will be presented. This trial-in-progress highlights the design and implementation of a novel SMART pilot combining scalable (Tai Chi, ALA) and intensive (acupuncture) interventions to individualize CIPN care. Findings will inform a future fully powered SMART trial with usual care and sham controls.

¹Kutztown University / Health, Prosperity & Leadership Institute, Douglassville, PA

²CNS Occupational Medicine, Reading, PA

³Health Action Synergies, Santa Barbara, CA

⁴University of Kansas Medical Center, Overland Park, KS

⁵University of Guelph, Guelph, ON

⁶Zakim Center, DFCI, Boston, MA

Abstract

Background: Aging is associated with a progressive decline in balance and an increased fall risk, a leading cause of injury and lost independence in older adults. Whereas Tai Chi is proven to mitigate these risks, access is often hindered by a scarcity of structured programs. Home-based interventions could address this issue, yet their efficacy is limited by the lack of objective movement assessment and hence the ability to generate feedback. To address this problem, we developed a video-based platform to evaluate Tai Chi proficiency and provide automated feedback for practitioners at home.

Method(s): Video recordings of 42 older adults performing Tai Chi were collected in home and laboratory settings. A parametric 3D Human Body Model (SMPL) was used for markerless pose estimation to reconstruct full-body kinematics. Execution errors were annotated by a Tai Chi expert (e.g., excessive wrist elevation). A separate Random Forest model was trained for detecting each type of execution error. A second Random Forest model estimated overall proficiency (i.e., low, medium, and high) based on expert scores. Performance was evaluated using macro-averaged F1-score.

Results: The proposed approach enabled the extraction of kinematic features from SMPL-based motion reconstruction and supported automated detection of execution errors and proficiency levels. Preliminary results indicate good accuracy of execution error detection and proficiency classification.

Conclusions: This work suggests the feasibility of objective Tai Chi assessment using SMPL based motion reconstruction and machine learning, supporting scalable remote monitoring of home-based Tai Chi interventions

¹Kutztown University / Health, Prosperity & Leadership Institute, Douglassville, PA

²CNS Occupational Medicine, Reading, PA

³Health Action Synergies, Santa Barbara, CA

⁴University of Kansas Medical Center, Overland Park, KS

⁵University of Guelph, Guelph, ON

⁶Zakim Center, Dana-Farber Cancer Institute, Boston, MA

Abstract

Background: There is evidence that Tai Chi and Qigong (TC&Q) are beneficial for health challenges of adults. However, evidence for children is sparse. The purpose of this research is to find and evaluate any available evidence. We ask about the prevalence of studies, the type of outcomes, the level of quality, and if we can draw conclusions from what we find.

Method(s): This systematic review follows PRISMA 2020 guidelines (https://www.crd.york.ac.uk/PROSPERO/view/CRD420251114754). From 785 articles, 45 articles met the original criteria. Descriptive data on the 45 articles is reported. A revision of the criteria netted 10 studies on TC&Q for children with neurodiversity. More detailed analysis and quality assessment was performed on them.

Results: From the 45 initial studies from16 countries, China produced 29% of the studies. Portugal and the USA had 13%. Most (64%) were RCTs, ranging from 3 to 231 subjects and a large variety of durations, lengths, and frequencies with 122 different outcomes measurements. For the systematic review of 10 studies, generally the quality of the studies was high. The areas of concern for two of the studies was reporting incomplete data. Four of the studies did not blind the assessors, and only one of the studies blinded the participants. Most of the outcomes (69.4% of them) were significant at the .05 alpha level showing an effective TC&Q intervention. The average effect size when compared to controls is 1.01 (±.34) (CL of 95%). When looking at the effect size for the pre-tests with the post-tests, the effect size is 1.71 (±.62) (CL of 95%).

Conclusions: The conclusion is there are more studies on TC&Q and children than we had realized. TC&Q studies of children with neurodiversity are relatively high quality. Furthermore, TC&Q interventions have a large impact on children with neurodiversity. These impacts are equal, or superior, to other types of interventions.

¹Dalian University of Technology, Dalian, Liaoning, China

Abstract

Background: Falls are the leading cause of unintentional injury-related mortality among older adults globally, and women have a substantially higher incidence than men. Tai Chi may improve balance through controlled weight shifting and trunk control. We investigated the effect of a Tai Chi intervention on gait stability in older women.

Method(s): We enrolled 35 Tai Chi–naïve older women, all right-leg dominant, and randomly assigned them to a Tai Chi group or a control group that maintained usual activities. The intervention lasted 12 weeks, with three 60-minute sessions per week. We used a Vicon three-dimensional motion-capture system and AMTI force platforms to collect walking data. From center-of-mass (COM) trajectories and center of pressure (COP), we derived margins of stability (MoS) in the anterior–posterior (AP) and mediolateral (ML) directions. Pre–post changes were evaluated using repeated-measures ANOVA.

Results: After the intervention, MoS decreased in controls but increased in the Tai Chi group. Relative to controls, the between-group change (Tai Chi − control) for the non-dominant (left) limb was ΔMoS=0.042 m (AP, p=0.023) and ΔMoS=0.030 m (ML, p=0.009). For the dominant (right) limb, the corresponding differences were 0.030 m (AP, p=0.150) and 0.035 m (ML, p=0.110), indicating a favorable but non-significant trend.

Conclusions: Twelve weeks of Tai Chi significantly enhanced dynamic stability of the non-dominant limb during gait in older women, with a favorable, non-significant effect on the dominant side. As a safe and feasible exercise, Tai Chi shows potential for preventing gait-related falls in older women.

Open Tai Chi Foundation, Los Gatos, CA

Abstract

Background: Tai Chi and Qigong students often practice at home between live classes yet lack immediate guidance on sequencing, alignment, and terminology. Video tutorials are static and cannot respond to individual questions, while wearable-sensor solutions remain expensive and limited. To fill this gap we created Asksifu.org, a free, web-based AI advisor designed to provide safe, lineage-respectful guidance and 24/7 answers to routine learner questions.

Method(s): The platform integrates a conversational front end with a fine-tuned large-language-model (LLM) trained on curated classical texts, teaching manuals, bilingual terminology, and instructor-approved FAQ responses. A lightweight knowledge-graph links form names, postural checkpoints, and common errors, enabling the AI to reason over entire movement sequences rather than isolated poses. Safety guard-rails route potentially risky alignment or health-related questions to human-teacher follow-up. The interface supports natural-language dialogue, step-by-step form reminders, audio pronunciation of Chinese terms, and links to trusted demonstration videos.

Results: We will present results from a small (n < 20) participant test group of different skill levels. So far users have found the tool useful for clarifying choreography, remembering form names, and receiving basic corrections. Common feature requests included optional camera-based posture feedback, multilingual expansion, and integration with class schedules for reminders.

Conclusions: Asksifu.org illustrates how carefully-designed AI can complement—not replace—human teachers by extending access to quality information, reinforcing terminology, and promoting safer independent practice. We discuss lessons learned about content curation, trust-building, and ethical boundaries, and outline future directions: hybrid human-AI review for nuanced corrections, low-cost sensor or camera feedback, and culturally-sensitive multilingual outreach. Our experience highlights opportunities and pitfalls in bringing AI to mind-body instruction while preserving the relational essence of Tai Chi pedagogy.

¹University of Arizona, Tucson, AZ

²University of Arizona, College of Public Health, Tucson, AZ

³University of Arizona, College of Public Health, Health Promotion Sciences Department, Tucson, AZ

⁴Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ

Abstract

Background: Sleep disturbance is a common concern in older adults. While in-person Tai Chi intervention has shown positive impact on sleep efficiency, quality and onset latency, the effect of virtual Tai Chi intervention on sleep is less known. The study objective is to examine changes in sleep quality among older adults after completing a 6-week virtual Tai Chi/Qigong (TCQT) intervention.

Method(s): This study was conducted in 2020-2021 among university employees aged 50 or older. An incomplete randomized intervention design was used. Participants (n= 72) were randomized into the intervention group and the waitlist group. Seven participants in the intervention group requested to switch to the waitlist group, leaving 29 participants in the intervention arm and 43 in the waitlist group. The intervention included three 50-mins TCQT sessions on Zoom weekly for 6 weeks. During weeks 7-12, the TCQT classes were offered to the waitlist group and the intervention group participants were encouraged to continually practice TCQT. The Pittsburg Sleep Quality Index (PSQI) was used to assess sleep quality at baseline, 6-week and 12-week.

Results: The intention to treat analysis showed statistically significant improvements in subjective sleep quality, sleep latency, sleep disturbances and global PSQI score (p<0.05) by the end of the first 6 weeks. Among 13 participants from the intervention group who completed the 12-weeks survey, the improvements in the first 6 weeks were attenuated, but remained positive by the end of 12 weeks. Twenty-nine participants from the waitlist also showed a trend of improvements in Global PSQI and daytime dysfunction between weeks 6 and 12.

Conclusions: A 6-week virtual TCQT intervention improved sleep quality among a sample of older adults. While positive changes became smaller, they still stayed positive 6 weeks after the intervention. Future studies should examine the longer-term benefits of TCQT on sleep, including TCGT delivered virtually.

¹Massachusetts Institute of Technology, Cambridge, MA

²The Fire Mountain School, NEW YORK, NY

Abstract

Background: The ancient practice of Tai Chi distinguishes between two fundamental movement approaches: Yi (intention/inspiration-driven) and Li (muscular force-driven). Despite widespread recognition of these distinct approaches in traditional practices, the mechanisms underlying the intention-driven Yi movements are not well understood. We hypothesize that Yi-movements show greater embodiment in the differential motions among bones and soft tissues.

Method(s): We simultaneously captured the motions of the body segments (kinematics) and the motions of tissues within each body segment as a Tai Chi master performed movements with and without Yi. To achieve this, we employed synchronized motion capture with ultrasound imaging simultaneously in the lower leg and the forearm. We then quantified relative tissue motions using point-tracking methods that employ a combination of deep learning and optical flow based algorithms.

Results: Yi-movements demonstrated greater embodiment in the differential motions among bones and soft tissues. Principal components of joint motions showed high correlation with these differential tissue movements. In contrast, while Li-movements approximated the external kinematic appearance of the motion sequences, they failed to capture the nuanced differential movements within body segments.

Conclusions: We identify differential tissue motions as a mechanistic target for intention-driven (Yi) coordinated movements used in Tai Chi. These findings suggest that the differential tissue dynamics associated with Yi-movements represent a more integrated and coordinated movement strategy that potentially aligns with traditional concepts of qi flow through fascial networks and meridian systems. This research bridges traditional movement wisdom with modern biomechanical analysis, offering insights into the physiological mechanisms underlying whole-person health practices.

¹Shanghai University of Sport, Shanghai, China

Abstract

Background: Qigong dance, an emerging exercise modality that integrates elements of health qigong and dance, was promoted nationwide in 2023 by the Health Qigong Administrative Center of the General Administration of Sport of China. Qigong dance is primarily based on the movements of qigong techniques, incorporating the rhythm, posture, and expressiveness of dance. Through coordinated integration of movement, breathing, and mental focus, it aims to strengthen the body, regulate the mind, and enhance artistic cultivation. Due to its low intensity, ease of practice, and graceful movements, it has gained wide popularity among the public. However, current research on the intervention effects of qigong dance as a novel exercise form remains limited, and this study aims to fill this gap in the field.

Method(s): This study used literature review, statistical analysis, and experimental approaches. A total of 42 community-dwelling older adults aged 50–70 years, without severe exercise contraindications, were recruited from Yangpu and Hongkou districts in Shanghai. Participants engaged in qigong dance training five times per week, 60 minutes per session, for seven weeks. One-way repeated measures analysis of variance (ANOVA) was used to determine the effects of the seven-week intervention on height, weight, body fat percentage, sit-and-reach flexibility, grip strength, vital capacity, choice reaction time, 30-second sit-to-stand, and two-minute high-knee exercise performance. The Wilcoxon signed-rank test was used to evaluate changes in one-leg standing with eyes closed and the Timed Up-and-Go (TUG) test.

Results: Compared with baseline, participants showed statistically significant improvements after seven weeks of qigong dance intervention in body weight (P < 0.001), grip strength (P = 0.027), 30-second sit-to-stand performance (P = 0.010), and choice reaction time (P = 0.003). No significant differences were found in height, vital capacity, two-minute high-knee exercise, or sit-and-reach flexibility (P > 0.05). The Timed Up and Go (TUG) test showed a statistically significant improvement (P = 0.019), whereas one-leg standing with eyes closed did not differ significantly (P > 0.05).

Conclusions: A seven-week qigong dance intervention can improve physical constitution in middle-aged and elderly people - by reducing body weight and enhancing lower-limb muscle strength - and reduce risk of falling, offering a feasible exercise intervention strategy for healthy aging.

¹Department of Natural Science, Eastern Mennonite University

²Biomedicine Program, Eastern Mennonite University

³Department of Psychology, Eastern Mennonite University

Abstract

Background: Qigong is a traditional mind–body practice integrating coordinated movement, breath regulation, and focused attention, with growing evidence for effects on stress physiology and psychological well-being. Eight Pieces of Brocade (EPB) is a classical Qigong form practiced for over a millennium and has been associated with the modulation of stress-related biomarkers, including cortisol.

Method(s): Participants from Eastern Mennonite University were randomized to virtual or in-person EPB groups during Spring 2025, with additional recruitment in Spring 2026 to increase sample size. Both groups completed four Saturday sessions over three weeks, practicing EPB for one hour per session. Saliva samples and self-report surveys were collected at baseline and post-intervention. Participants also completed self-practice journals documenting practice duration and subjective experiences. Saliva was collected using Salimetrics swabs, stored at −20 °C, and analyzed for cortisol and secretory immunoglobulin A (s-IgA) using ELISA. Paired t-tests assessed pre–post changes and group differences, and regression analysis examined predictors of stress reduction.

Results: No significant differences were observed between the virtual and in-person groups for salivary cortisol or secretory IgA (s-IgA), nor were significant pre- and post-changes detected in these biomarkers. In contrast, self-reported anxiety significantly decreased across all participants following EPB practice (p = 0.0067). Marginal improvements were observed in depressive symptoms (p = 0.078), attitudes toward Qigong (p = 0.0827), and life satisfaction (p = 0.0802). Notably, total practice time emerged as a significant predictor of stress reduction (p = 0.0264). Data collected during Spring 2026 are currently being analyzed and will be incorporated into the final results.

Conclusions: A short-term EPB intervention reduced anxiety among participants regardless of delivery modality. While no significant physiological biomarker changes were detected over the intervention period, virtual Qigong demonstrated psychological benefits comparable to in-person practice. These findings support the feasibility of virtual Qigong as an accessible modality for mind–body health, while highlighting the importance of practice dosage in stress regulation.

¹VA Research and Development Service, VA Boston Healthcare System, Boston, MA

²Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA

³Osher Center for Integrative Health, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA

⁴Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA

⁵VA Connecticut Healthcare System, West Haven, CT

⁶Department of Family Medicine, University of Michigan, Ann Arbor, MI

⁷Massachusetts Veterans Epidemiology Research and Information Collaborative (MAVERIC), Boston, MA

⁸Department of Biostatistics, Boston University School of Public Health, Boston, MA

⁹Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA

¹⁰Harvard Medical School, Boston, MA

Abstract

Background: Promoting physical activity (PA) in people with chronic obstructive pulmonary disease (COPD) is guideline-driven care. Along with shortness of breath, chronic musculoskeletal pain (CMP) limits PA in people with COPD. A mind-body exercise, Tai Chi (TC) reduces fear of movement, aids pain management, targets coordination of breathing, and provides cardiopulmonary benefits that address dyspnea and CMP. We developed a remotely delivered intervention that integrates a website and Fitbit pedometer [Every Step Counts (ESC)] with virtual TC classes to promote PA in people with co-occurring COPD and CMP.

Method(s): We designed a randomized controlled trial to examine the efficacy of ESC-TC. U.S. Veterans >40 years with COPD and CMP are being recruited nationally. Inclusion criteria include technological capability to engage with the intervention and self-reported ability to ambulate. Exclusion criteria include COPD exacerbation in the previous month, unstable cardiovascular disease, supplemental oxygen use, high fall risk, participation in a separate exercise program or study, and average daily step count >10,000. At least 136 participants will be randomized 1:1 to the ESC-TC intervention or usual care for 6 months. The ESC component provides tailored step-count goals, iterative feedback, motivational and educational content, and an online community. The TC component progresses from asynchronous videos for 2 months to once-a-week synchronous group classes taught by TC instructors for 2 months and concludes with twice-a-week classes for 2 months. Usual care receives written instructions to increase walking. Follow-up study visits, conducted virtually, occur every 2 months. Daily step counts are measured for two weeks at each follow-up visit. Secondary outcomes assessed by questionnaires include pain intensity and interference, dyspnea, health-related quality of life, mobility, depression, exercise self-efficacy, kinesiophobia, pain catastrophizing, and sleep quality.

Results: If efficacious, the integrated ESC-TC intervention would provide a non-pharmacologic treatment to improve PA in people with COPD and CMP.

¹School of Nursing, Indiana State University, Terra Haute, IN

²Rutgers Cancer Institute, Piscataway, NJ

³Rutgers Cancer Institute, New Brunswick, NJ

⁴Department of Internal Medicine, University of New Mexico, Albuquerque, NM

⁵Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ

⁶Cousins Center for Psychoneuroimmunology, Semel Institute for Neurosciences, University of California-Los Angeles, Los Angeles, CA

Abstract

Background: Current literature provides compelling evidence that inflammatory cytokines and the signaling pathways associated with inflammatory activation play a key role in cancer-related fatigue during and after cancer treatment. However, information on the effects of Tai Chi Qigong (TCQ) on these mechanisms among older fatigued male cancer survivors is limited. We hypothesized that TCQ would reduce systemic and cellular markers of inflammation as compared with exercise intensity-matched (EIM) and usual care (UC).

Method(s): In this three-arm, single-blinded, randomized trial, 113 older (55+ years) male cancer survivors with fatigue were randomly assigned to 12 weeks of TCQ (twice weekly, n=45), EIM (twice weekly, n=43), or UC (n=25). Blood samples were collected at baseline, and at 1-week, 3-month, and 12-month post-intervention. The systemic inflammation biomarker (C-reactive protein) and cellular biomarkers (toll-like receptor-4 activated monocyte production of inflammatory cytokines, including IL-6, IL-8, IL-10, IFN-γ, and TNF-α) were measured. Intervention effects on the inflammatory biomarkers were tested on an intention-to-treat basis using a mixed model approach, covarying for baseline levels, with the exact time of post-intervention sample collection (in weeks) included as a time-varying variable.

Results: Compared with EIM, TCQ showed a greater reduction in CRP at 3-month post-intervention (between-arm mean differences = -2.95, p=0.027) and in IFN-γ at 12 months post-intervention (MD= -6.19, p=0.042). The levels of other inflammatory cytokines were heterogeneous and did not change significantly.

Conclusions: Among older male cancer survivors with fatigue, 12 weeks of TCQ reduced systemic inflammation, whereas cellular innate reactivity (TLR4-stimulated cytokines) showed no consistent between-arm differences. The results provide preliminary mechanistic support for TCQ’s role in survivorship care among older men, though further testing is warranted in larger trials.