Table 2

Characteristics of 40 articles published in 1980-2009 on Tai Chi and psychological status

Referencea

Mean age, yr

Population, n

Duration

Intervention Frequency, style

Psychological Status Measured

Methodological Quality

Tai Chi

Control(s)

Randomizationb

Outcome Assessors Blindedc

(% dropout)d


17 Randomized Controlled Trials

Wang et al, 2009, USA

50

Individuals with FM, 60

12 wks

1 hr, 2×/wk (classical Yang style)

Attention control

Depression (CES-D)

Y

Y

10.6%


Dechamps et al, 2009, France

44

Sedentary obese women, 21

10 wks

2 hr, 1×/wk (Yang style)

Exercise Program

Depression (BDI)

Y

Y

0%


Wang, 2008, USA

50

Functional class I or II RA, 20

12 wks

1 hr, 2×/wk (classical Yang style)

Attention control

Depression (CES-D)

Y

Y

0%


Wang et al, 2008, USA

65

Elderly with symptomatic KOA, 40

12 wks

1 hr, 2×/wk (classical Yang style)

Attention control

Depression (CES-D)

Y

Y

0%


McCain et al, 2008, USA

42

Individuals with HIV infection, 252

10 wks

90 min, 1×/wk (focused short form of Tai Chi with 8 movements)

1.Cognitive -behavioral relaxation training

2.Spriritual growth

3.Wait Liste

Stress (IES, Salivary Cortisol Level)f , Mood and Emotion (FAHI)

Y

Y

47%


Fransen et al, 2007, Australia

70

Elderly with symptomatic hip or KOA,152

12 wks

1 hr, 2×/wk (modified 24 forms Sun style)

1.Hydrotherapy

2.Waiting Liste

Stress, Anxiety, Depression (DASS 21)

Y

Y

12.5%


Irwin et al, 2007, USA

70

Healthy elderly adults, 112

16 wks

40 min, 3×/wk (unspecified style)

Health education

Depression (BDI)

Y

ND

8.9%


Sattin et al, 2005, USA

Wolf et al, 2003, USA

81

Elderly transitioning to frailty, 311

48 wks

60-90 min progression, 2×/wk (6 of the 24 simplified TC forms)

Wellness education

Depression (CES-D)

ND

Y

29.9%


Galantino et al, 2005, USA

(20-60)

Advanced HIV/AIDS, 38

8 wks

1 hr, 2×/wk (unspecified style)

1.Aerobic exercise

2.Usual activity

Anxiety (POMS)

Y

ND

25.5%


Chou et al, 2004, China

73

Elderly with depression,14

12 wks

45 min, 3×/wk (18 form of Yang style)

Waiting list

Depression (CES-D-Chinese Version)

ND

Y

ND


Mustian et al, 2004, USA

52

Breast cancer survivors, 21

12 wks

1 hr, 3×/wk (15 short form Yang style)

Psychosocial support therapy

Self-Esteem (RSE)

ND

ND

32.3%


Tsai et al, 2003, China

52

Healthy elderly, 76

12 wks

50 min, 3×/wk (108 postures Yang style)

Sedentary life control

Anxiety (STAI)

IA

Y

13.6%


Li et al, 2001, USA

73

Healthy elderly, 72

24 wks

1 hr, 2×/wk (classical Yang style)

Waiting list

Stress (SEES) Depression (CES-D) Mood and Emotion (PANAS)

ND

ND

26.5%


Kutner et al, 1997, USA

76

Healthy elderly 130

15 wks

1 hr, 2×/wk (10 modified forms Yang style)

1. education control

2. balance training

Self-Esteem (RSE)

ND

ND

35%


Sun et al, 1996, USA

(60-79)

Healthy elderly Hmong immigrants, 20

12 wks

2 hrs, 1×/wk for 10 sessions (unspecified style)

Routine physical activity

Stress (SPS, Body Temperaturef)

ND

ND

0%


Brown et al, 1995, USA

53

Healthy adults, 135

16 wks

45 min, 3×/wk (unspecified style--"mindful exercise")

1.moderate intensity walk

2.low intensity walk

3.low intensity walk & relaxation

4.usual lifestyle behaviors

Anxiety, Depression, Mood and Emotion (STAI, POMS, Tukey multiple comparison test, LSES, PANAS) Self-Esteem (RSE, SPES and BCS)

ND

ND

25%


Jin, 1992, Australia

36

Healthy adults, 96

1 hr

Single 1 hr session (long form, Yang style or Wu variation of Yang style)

1.TC meditation

2.brisk walking

3.neutral reading

Stress (Salivary Cortisol Levelf) Anxiety (STAI Y-1) Mood and Emotion (POMS)

ND

Y

ND


16 Non-Randomized Comparison Studies


Lee et al, 2007, Hong Kong, China

83

Healthy elderly, 139

26 wks

1 hr, 3×/wk (unspecified style)

Usual activity

Self-Esteem (SSES-Chinese Version)

N

ND

ND


Esch et al, 2007, Germany

28

Healthy young adults, 9

14 wks

90 min, 1×/wk for 12 sessions (Yang style)

Self-comparison

Stress (Perceived Mental Stress (VAS), Salivary Cortisol level) f

N

ND

57.1%


Robins et al, 2006, USA

42

HIV disease, 59

10 wks

1 hr, 1×/wk (8 movements short form, unspecified style)

Self-comparison

Stress (FAHI, IES)

N

ND

ND


Taylor-Piliae et al, 2006, USA

66

Elderly Chinese with CVD risk factors, 38

12 wks

1 hr, 3×/wk (24-posture short form, Yang style)

Self-comparison

Stress (PSS) Anxiety, Depression, Mood and Emotion (POMS)

N

ND

2.6%


Chen et al, 2005, China

54

Healthy elderly, 30

24 wks

1 hr, 4×/wk (simplified 24 forms Yang style & 42 forms TC sword)

Self-comparison

Stress, Anxiety (STAI, POMS) Depression, Mood and Emotion (POMS)

N

ND

ND


Wall, 2005, USA

(11-13)

Healthy children, 11

5 wks

1 hr, 1×/wk (traditional segments of Yang style & MBSR)

Self-comparison

Anxiety (Written subjective statements)

N

ND

ND


Li, 2004, China

20

Healthy college students, 66

24 wks

1 hr, 3×/wk (unspecified style)

Self-comparison

Anxiety, Depression (SCL-90)

N

ND

ND


Taggart et al, 2003, USA

56

Individuals with FM, 21

6 wks

1 hr, 2×/wk (Yang style short form)

Self-comparison

Anxiety, Depression (FIQ)

N

ND

43.2%


Hernandez-Reif et al, 2001, USA

15

Adolescents with ADHD, 13

5 wks

30 min, 2×/wk (unspecified style)

Self-comparison

Anxiety, Mood and Emotion (CTRS-R)

N

ND

ND


Mills et al, 2000, UK

48

Adults with MS, 8

8 wks

6 individual sessions (unspecified style or duration)

Self-comparison

Anxiety, Depression (POMS)

N

ND

33.3%


Ross et al, 1999, USA

(68-92)

Healthy elderly, 13

8 wks

1 hr, 3×/wk (unspecified style)

Self-comparison

Mood and Emotion (MAACL-R-composite score)

N

ND

23.5%


Chen & Sun, 1997, USA

(50-74)

Healthy adults, 28

16 wks

4th mo to 9th mo follow-up

1 hr, 2×/wk, (simplified 24 forms) 1×/mo during follow-up

Routine activity

Anxiety (TMAS and SAI)

N

ND

22.2%


Gibb et al, 1997, Australia

80

Elderly with dementia (56%) or AD patients (44%), 9

7 wks

13 sessions 2×/wk (unspecified style)

Self-comparison

Mood and Emotion (Biographical Self Reflection Program)

N

ND

10%


Fu et al, 1996, Australia

34

Healthy students & teachers, 90

1 yr

30 min, 6×/wk (simplified 24 forms)

Self-comparison

Mood and Emotion (Records from self- report program)

N

ND

ND


Jin, 1989, Australia

(16-75)

Healthy adults with TC experience, 66

1 hr

Single 1 hr session (Long Form Yang style or Wu variation of Yang style)

Self-comparison

Stress (Salivary Cortisol Levelf) Depression (POMS) Anxiety (STAI) Mood and Emotion (POMS)

N

ND

ND


Mack, 1980, Australia

ND

Afro-American males, ND

24 wks

ND

Self-comparison

Mood and Emotion (no test reported)

N

ND

ND


7 Observational Studies


Chen et al, 2006, China

(20-35)

Healthy students & teachers, 480

0.5-8 yrs

Over 2 hrs/day (24, 28, 58, 88 forms of Chen, Wu, Yang style & TC sword)

Self-comparison

Mood and Emotion Self-design (10 items)

N

Y

ND


Wang & Wang, 2004, China

62

Healthy elderly, 76

>5 yrs

>30 min, >3×/wk (regular TC & TC sword)

1. some activity, <30 min, <3×/wk

2. other activity, >30 min, >3×/wk

Stress (Chinese Psychological Stress Scores)

N

ND

ND


Yang et al, 2004, China

62

Healthy elderly, and middle-aged, 373

>1 yr

Regular TC (unspecified style)

Routine activity

Anxiety (Zung SAS) Depression (Zung SDS)

N

ND

ND


Bond et al, 2002, USA

37

Healthy adults, 249

>6 mos

Regular TC at least 20 min, 3×/wk (unspecified style)

1.sedentary

2.moderate aerobic activity

Anxiety (STAI)

N

ND

0.8%


Chen et al, 2001, Taiwan, China

74

Healthy elderly, 80

≥1 yr

Regular TC at least 2×/wk & 30 min/session (unspecified style)

No exercise control group

Anxiety, Depression, Mood and Emotion (POMS-SF)

N

ND

ND


Liu & Zhang, 2000, China

(18-20)

Healthy individuals, 150

<1 yr

>1 yr

>2 yrs

Regular TC (unspecified frequency & style)

General population

Anxiety, Depression (Self-Rating Scale-90)

N

ND

ND


Long et al, 2000, China

62

Healthy adults, 239

1-14 yrs

Regular TC (Yang style)

Routine activity

Anxiety, Depression, Mood and Emotion (POMS)

N

ND

ND


Abbreviations: yr = year; n = only evaluated participants included; FM = Fibromyalgia; wk(s) = week(s); hr = hour; CES-D = Center for Epidemiology Studies Depression index; RA = Rheumatoid Arthritis; KOA = Knee Osteoarthritis; DASS 21 = Depression, Anxiety, Stress Scales 21 item questionnaire; min(s) = minute(s); BDI = Beck Depression Inventory; TC = Tai Chi; HIV = Human Immunodeficiency Virus; AIDS = Autoimmune Deficiency Syndrome; POMS = Profile of Mood States; ND = no data; RSE = Rosenberg Self-Esteem scale; STAI = State-Trait Anxiety Inventory; SEES = Subjective Exercise Experience Scale; PANAS = Positive and Negative Affect Schedule; SPS = Self-Perceived Stress score; LSES = Life Satisfaction in the Elderly Scale; SPES = Sonstroem Physical Examination Scale; BCS = Body Cathexis Score; SSES = State Self-Esteem Scale; VAS = Visual Analogue Scale; FAHI = Functional Assessment of HIV Infection; IES = Impact of Events Scale; CVD = Cardiovascular Disease; PSS = Perceived Stress Scale; MBSR = Mindfulness-Based Stress Reduction; SCL-90 = Symptom Checklist-90; FIQ = Fibromyalgia Impact Questionnaire; ADHD = Attention Deficit Hyperactive Disorder; CTRS-R = Conners' Teacher Rating Scale-Revised; MS = Multiple Sclerosis; MAACL-R = Multiple Affect Adjective Checklist-Revised; mo(s) = month(s); TMAS = Taylor Manifest Anxiety Scale; SAI = State Anxiety Inventory; AD = Advanced Dementia; SAS = Self-Rating Anxiety Scale; SDS = Self-Rating Depression Scale.

aStudies in bold are meta-analyzed

bRandomization: Was the study described as randomized (this includes the use of words such as randomly, random, and randomization)? Y = The method to generate the sequence of randomization was described and it was appropriate (table of random numbers, computer generated, etc.); ND = randomization not described; IA = The method to generate the sequence of randomization was described and it was inappropriate (patients were allocated alternately, or according to date of birth, hospital number, etc.); N = non-randomized trial.

cBlinding: Was the study described as blind? (Double-blinding is impractical in Tai Chi studies, our modification gave 1 point for proper single blinding of the outcome assessor.) Y = The method of double blinding was described and it was appropriate (identical placebo, active placebo, dummy, etc.); ND = blinding not described.

dDropouts and Withdrawals: Was there a description of withdrawals/dropouts? ND = withdrawals/dropouts not described.

eTreatment group compared to Tai Chi in meta-analysis.

f Objective measure.

Wang et al. BMC Complementary and Alternative Medicine 2010 10:23   doi:10.1186/1472-6882-10-23

Open Data