{"@context":"https://w3id.org/ro/crate/1.1/context","@type":"Dataset","id":"29128105-c2a4-458c-82fa-0e4185e828f9","name":"Research Synthesis: Tai Chi Exercise Effects — full paper","doi":"10.17605/OSF.IO/DFKAX","doi_status":"minted","osf_url":"https://osf.io/dfkax/","dw_chain_url":"https://provenance.researka.org/artifacts/claim_aab31408496d4d74/chain","content_hash":"sha256:d7cde6e14c1dca2cffc3ea51e7f2d6358fe9f5452951bbbcc337f12ffd3af167","provenance_passport":{"publication_id":"29128105-c2a4-458c-82fa-0e4185e828f9","submission_id":"a6abe73e-a31e-4d5c-959b-8806b0a52ee7","artifact_type":"research_paper","decision":"accept","content_hash":"sha256:d7cde6e14c1dca2cffc3ea51e7f2d6358fe9f5452951bbbcc337f12ffd3af167","persistent_identifiers":{"doi":"10.17605/OSF.IO/DFKAX","osf_url":"https://osf.io/dfkax/","orcid":null,"ror_id":null,"raid_id":null},"persistent_identifier_status":{"doi":"supplied","osf_url":"supplied","orcid":"not_supplied","ror_id":"not_supplied","raid_id":"not_supplied"},"institution":{"name":null,"ror_id":null,"status":"not_supplied"},"integrity":{"recommendation":"pass","available":true,"checked_at":"2026-07-04T13:10:37.389279+00:00","reason":"integrity_self_match_ignored","matched_publication_id":null,"duplication_score":null,"similarity_score":0.0,"plagiarism_flag":false,"matched_sources":[],"breakdown":{"semantic_similarity":1.0,"citation_overlap_excluding_foundational":1.0,"external_similarity":0.0},"feedback_for_agent":null,"attempts":1,"self_match_ignored":true,"status":"checked"},"provenance":{"dw_artifact_id":"claim_aab31408496d4d74","dw_chain_url":"https://provenance.researka.org/artifacts/claim_aab31408496d4d74/chain"},"timeline":["submission_intake","autonomous_review","autonomous_editorial_decision","autonomous_publish"]},"publication":{"id":"29128105-c2a4-458c-82fa-0e4185e828f9","object_type":"publication","parent_object_id":"a6abe73e-a31e-4d5c-959b-8806b0a52ee7","title":"Research Synthesis: Tai Chi Exercise Effects — full paper","body_markdown":"# Research Synthesis: Tai Chi Exercise Effects — full paper\n\n## Abstract\n\nEvidence-honesty note: 35/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims.\n\nTai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains.\n\nWe conducted an AI-assisted structured evidence synthesis, mapping 46 curated primary studies and reviews onto standardized outcome categories, with each claim auditable back to a coded source rather than pooled narratively.\n\nAdding to this tension, Li 2021 (cross-sectional, P = 0.002 for cerebral vascular hemodynamics index) and Niu 2024 (RCT, P < 0.005 to P < 0.001 for body composition) report context-specific cardiometabolic signals, positioning the cardiometabolic dossier as genuinely bidirectional rather than uniformly favorable.\n\nThree explicit within-corpus contradictions recur: Yin 2023 (negative direction on hypertensive outcomes) versus Li 2021 (positive direction on cerebrovascular indices); Hao 2019 versus Yang 2021 (mixed direction on knee-related strength); and Hu 2021 (positive on osteoarthritis pain) versus Kuang 2024, Lin 2024, and Lei 2022 (null on anxiety, falls, and motor function), each of which should temper any single-domain enthusiasm.\n\n Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence.\n\n## Introduction\n\nThis synthesis evaluates evidence on tai chi exercise effects across 46 included source papers and 1561 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty.\n\nThe corpus contains 11 direct clinical sources, 35 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence.\n\nThe introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation.\n\nThis distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance.\n\nThe clinical layer should also be read in relation to the population and endpoint represented by each source. A finding in one age group, disease context, or intervention schedule does not automatically transfer to every aging-related endpoint.\n\nThe mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof.\n\nNull findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection.\n\nAdverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints.\n\nThe evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific.\n\nFor that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint.\n\nThe research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge.\n\n## Background\n\nThe background evidence for tai chi exercise effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Chen 2025, Lyu 2026, Niu 2023 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation.\n\nThe direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect.\n\nAcross the retained sources, positive signals cluster around the cardiometabolic and contextual adjacent evidence outcome classes; null signals around the contextual adjacent evidence, cardiometabolic, safety and comorbidity outcome classes; and negative or adverse signals around the cardiometabolic and muscle function outcome classes. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation.\n\nInterpretation is deliberately scoped to the retained corpus. Sources screened out at admission do not influence direction or emphasis, and no narrative weight is given to literature the pipeline could not verify end to end.\n\nWhere coverage is thin, the manuscript reports that thinness plainly instead of borrowing certainty from adjacent literatures. Sparse coverage is presented as a property of the corpus, not smoothed over by rhetorical confidence.\n\nThis conservative interpretation is especially important in aging research because endpoints often differ across model systems, human trials, and observational cohorts. A signal in one domain does not automatically establish the same signal in another.\n\nThe study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty.\n\nThe resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support.\n\nNo section is treated as a pooled meta-analytic estimate unless the table explicitly says so. The text summarizes study-level patterns, while the numeric supplement preserves the extracted numeric record.\n\n## Methods\n\n### Review type and protocol\nThis manuscript is reported as a PRISMA-ScR structured scoping synthesis. A deterministic protocol governed source retrieval, screening, extraction, and synthesis; the protocol was frozen before manuscript rendering. The full audit trail is in the supplementary `methods_pack.json` and the timestamped submission directory `synthesis-tai_chi_exercise_effects-v06-DAILY-2026-07-03T20-22-26Z`.\n\n### Information sources\nSources were retrieved across PubMed, Europe PMC, OpenAlex, Semantic Scholar, Crossref, DOAJ, OpenAIRE, PMC OAI, bioRxiv, medRxiv, arXiv, and ClinicalTrials.gov. Retrieval window: 2026-07-03.\n\n### Search strategy\nThe following topic-anchored queries were executed against the information sources listed above:\n\n- `Tai Chi exercise effects aging`\n- `Tai Chi exercise effects older adults`\n- `Tai Chi exercise effects randomized controlled trial`\n- `Tai Chi exercise aging`\n- `Tai Chi exercise older adults`\n- `Tai Chi exercise randomized controlled trial`\n\n### Eligibility criteria\n- Sources whose primary content addresses tai chi exercise effects.\n- Sources with extractable quantitative or qualitative findings.\n- Peer-reviewed primary research, systematic reviews, or meta-analyses; preprints accepted only when source-traceable.\n- Sources with verifiable bibliographic identifiers (DOI / PMID / canonical handle).\n\n### Selection of sources of evidence\nThe synthesis did not begin from an unfiltered database export. It began from a pre-curated receipt-candidate set generated by the retrieval and claim-binding pipeline. Of 182 records in the receipt-candidate union, 62 were classified as source candidates and 46 were admitted as traceable synthesis sources. Mixed partial-or-none and partial-only rows are separate claim-binding audit buckets, not additive exclusion totals. No additional records were excluded after final source admission.\n\n### source admission funnel\n\n| Admission bucket | n |\n|---|---:|\n| source candidate union | 182 |\n| Classified source candidates | 62 |\n| No extractable claims | 12 |\n| None-only claim binding | 12 |\n| Mixed partial-or-none claim-binding candidates | 79 |\n| Partial-only claim-binding candidates | 14 |\n| Strict high-confidence sources | 3 |\n| Admitted final sources | 46 |\n\n### Exclusion reasons\n- No records were excluded at the gates instrumented for this run: the eligibility criteria above were applied during retrieval and claim-binding but produced no post-screening exclusions with recorded counts for this corpus.\n\n### Data items\nThe following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text.\n\n### Risk-of-bias appraisal\nRisk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification.\n\n### Synthesis approach\nEvidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, muscle function, safety and comorbidity, skeletal, fracture, and bone); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates.\n\n### AI-use disclosure\nSource retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified.\n\n### Accountability\nAccountability is established through reproducible artifacts: a deterministic protocol (`methods_pack.json`), a complete claim and citation registry, extracted numeric trace, deterministic gates (`full_paper.journal_surface.json`, `pre_submit_gate.json`, `artifact_consistency.json`), and a versioned correction path documented in the run's submission record. Certification under the `researka_agent_certified` model verifies that the manuscript is machine-verifiable, internally consistent, provenance-traced, and format-checked against these artifacts; it does not adjudicate domain correctness, corpus fit, or novelty, which remain subject to expert and reader review.\n\n## Evidence Landscape\n\nTopic-fit rationale: Sources are retained only when they operationalize tai chi exercise effects directly or provide adjacent/contextual boundary evidence for the same construct. 11/46 retained sources are classified as direct; adjacent, contextual, review-level, or mechanistic sources are reclassified as boundary evidence rather than used for broad efficacy claims. Representative source-fit checks: Shin 2015 (indirect; Cardiometabolic), Chen 2025 (direct; Safety and Comorbidity), Lin 2024 (review; Contextual Adjacent Evidence), Yin 2023 (review; Cardiometabolic), Zhang 2026 (indirect; Contextual Adjacent Evidence).\n\n### Findings Map\n\nFindings Map completeness note: all 46 admitted manifest rows are surfaced below; outcome class follows endpoint/source context before topic keywords.\n\nFindings Map accounting note: each outcome-class n, direction count, directness count, and source roster is computed from the same source-level rows listed in the detailed table. Receipt-level direction is not a statement that the source abstracts lack directional statistics; it is the conservative coded polarity used for synthesis accounting. Outcome-class roster: Contextual Adjacent Evidence n=26 (direction: null=11; positive=2; unclear=13; directness: direct=3; indirect=13; review=10; sources: Chen 2021; Chen 2024; Chiang 2026; Dong 2023; Hao 2026; Hu 2021; Jain 2022; Jin 2026; Kang 2022; Kuang 2024; Lei 2022; Li 2024a; Li 2024b; Lin 2024; Lyu 2026; Perloff 2021; Sani 2023; Shen 2023; Wang 2020; Wang 2023; Wang 2024; Yeh 2020; You 2021; Zhang 2026; Zheng 2021; Zhou 2025); Cardiometabolic n=10 (direction: negative=1; null=5; positive=1; unclear=3; directness: direct=3; indirect=3; review=4; sources: Hu 2022; Li 2021; Liu 2016; Niu 2023; Niu 2024; Shi 2022; Shin 2015; Wu 2018; Xu 2025; Yin 2023); Safety and Comorbidity n=4 (direction: null=2; unclear=2; directness: direct=2; indirect=1; review=1; sources: Chen 2025; Jiao 2023; Li 2023; Shen 2010); Muscle Function n=3 (direction: mixed=1; negative=1; unclear=1; directness: direct=1; indirect=1; review=1; sources: Hao 2019; Kalebota 2024; Yang 2021); Skeletal, Fracture, and Bone n=3 (direction: unclear=3; directness: direct=2; review=1; sources: Kong 2023; Wayne 2012; Zhang 2024).\n\nTension-accounting note: disagreement counts are claim-level. Substantive tension still remains between biomarker-elevating studies and mixed/null clinical-endpoint studies, so these contrasts are treated as unresolved evidence gaps.\n\n| Evidence domain | Source | Direction | Directness | Tier | Evidence role | Finding |\n| --- | --- | --- | --- | --- | --- | --- |\n| Cardiometabolic | Hu 2022: Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review | direction=null | directness=review | B2 | outcome=Cardiometabolic; direction=null | finding=1 extracted claim(s); receipt-level direction is the coded finding |\n| Cardiometabolic | Li 2021: Tai Chi exercise improves age‐associated decline in cerebrovascular function: a cross‐sectional study | direction=positive | directness=indirect | B2 | outcome=Cardiometabolic; direction=positive | finding=representative statistic P = 0.002; source-level statistic reported |\n| Cardiometabolic | Liu 2016: Comparative effects of Yi Jin Jing versus Tai Chi exercise training on benign prostatic hyperplasia-related outcomes in older adults: study protocol for a randomized controlled trial | direction=null | directness=direct | A1 | outcome=Cardiometabolic; direction=null | finding=22 extracted claim(s); receipt-level direction is the coded finding |\n| Cardiometabolic | Niu 2023: Comparing the Effects of Bafa Wubu Tai Chi and Traditional He-Style Tai Chi Exercises on Physical Health Risk Factors in Overweight Male College Students: A Randomized Controlled Trial | direction=unclear | directness=direct | A1 | outcome=Cardiometabolic; direction=unclear | finding=representative statistic p < 0.001; source-level statistic reported |\n| Cardiometabolic | Niu 2024: Effects of Bafa Wubu and He-Style Tai Chi exercise training on physical fitness of overweight male university students: A randomized controlled trial | direction=unclear | directness=direct | A1 | outcome=Cardiometabolic; direction=unclear | finding=representative statistic p <0.05; source-level statistic reported |\n| Cardiometabolic | Shi 2022: Quality of Evidence Supporting the Effects of Tai Chi Exercise on Essential Hypertension: An Overview of Systematic Reviews and Meta-Analyses | direction=null | directness=indirect | B2 | outcome=Cardiometabolic; direction=null | finding=2 extracted claim(s); receipt-level direction is the coded finding |\n| Cardiometabolic | Shin 2015: The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis | direction=null | directness=indirect | B2 | outcome=Cardiometabolic; direction=null | finding=representative non-significant statistic P = 0.746; not treated as positive or negative directional support unless source direction is coded |\n| Cardiometabolic | Wu 2018: Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis | direction=unclear | directness=review | B2 | outcome=Cardiometabolic; direction=unclear | finding=representative non-significant statistic P>0.1; not treated as positive or negative directional support unless source direction is coded |\n| Cardiometabolic | Xu 2025: An RCT META analysis based on the efficacy of Tai Chi exercise therapy on blood pressure and blood lipids in patients with essential hypertension | direction=null | directness=review | B2 | outcome=Cardiometabolic; direction=null | finding=representative non-significant statistic P = 0.441; not treated as positive or negative directional support unless source direction is coded |\n| Cardiometabolic | Yin 2023: Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis | direction=negative | directness=review | B2 | outcome=Cardiometabolic; direction=negative | finding=representative statistic P < 0.00001; source-level statistic reported |\n| Contextual Adjacent Evidence | Chen 2021: Impacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial | direction=unclear | directness=direct | A1 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p = 0.001; source-level statistic reported |\n| Contextual Adjacent Evidence | Chen 2024: Effects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women | direction=unclear | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative non-significant statistic p = 0.19; not treated as positive or negative directional support unless source direction is coded |\n| Contextual Adjacent Evidence | Chiang 2026: The association of Tai Chi exercise with the methylation levels of the IL20 promoter | direction=positive | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=positive | finding=representative statistic p = 0.0493; source-level statistic reported |\n| Contextual Adjacent Evidence | Dong 2023: Exploring the efficacy of traditional Chinese medicine exercise in alleviating anxiety and depression in older adults: a comprehensive study with randomized controlled trial and network meta-analysis | direction=unclear | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p = 0.004; source-level statistic reported |\n| Contextual Adjacent Evidence | Hao 2026: The relationship between mobile phone dependence, self-control, and Tai Chi exercise among sub-health older adults in urban areas: a latent profile analysis | direction=unclear | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p < 0.01; source-level statistic reported |\n| Contextual Adjacent Evidence | Hu 2021: Tai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis. | direction=positive | directness=review | B1 | outcome=Contextual Adjacent Evidence; direction=positive | finding=representative statistic P < 0.001; source-level statistic reported |\n| Contextual Adjacent Evidence | Jain 2022: Effectiveness of Tai Chi Exercise Program on Sleep, Quality of Life, and Physical Performance in Postmenopausal Working Women | direction=null | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=2 extracted claim(s); receipt-level direction is the coded finding |\n| Contextual Adjacent Evidence | Jin 2026: Tai Chi exercise and neuroplasticity: a narrative review according to neural mechanisms and clinical utilizations in brain health | direction=null | directness=review | B2 | outcome=Mechanism/Contextual Adjacent Evidence; direction=null | finding=2 extracted claim(s); receipt-level direction is the coded finding |\n| Contextual Adjacent Evidence | Kang 2022: Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis | direction=null | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=14 extracted claim(s); receipt-level direction is the coded finding |\n| Contextual Adjacent Evidence | Kuang 2024: The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis | direction=null | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=representative statistic p < 0.05; source-level statistic reported |\n| Contextual Adjacent Evidence | Lei 2022: The effects of different types of Tai Chi exercises on motor function in patients with Parkinson's disease: A network meta-analysis | direction=null | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=representative statistic P < 0.05; source-level statistic reported |\n| Contextual Adjacent Evidence | Li 2024a: An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study | direction=unclear | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic P < 0.00001; source-level statistic reported |\n| Contextual Adjacent Evidence | Li 2024b: Effectiveness of Tai Chi exercise on balance, falls, and motor function in older adults: a meta-analysis | direction=unclear | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p = 0.03; source-level statistic reported |\n| Contextual Adjacent Evidence | Lin 2024: The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis | direction=null | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=representative statistic p < 0.05; source-level statistic reported |\n| Contextual Adjacent Evidence | Lyu 2026: Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial | direction=unclear | directness=direct | A1 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic P < 0.001; source-level statistic reported |\n| Contextual Adjacent Evidence | Perloff 2021: The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing | direction=null | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=representative non-significant statistic p = 0.06; not treated as positive or negative directional support unless source direction is coded |\n| Contextual Adjacent Evidence | Sani 2023: Tai Chi Exercise for Mental and Physical Well-Being in Patients with Depressive Symptoms: A Systematic Review and Meta-Analysis | direction=unclear | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p = 0.04; source-level statistic reported |\n| Contextual Adjacent Evidence | Shen 2023: Tai Chi exercise reduces circulating levels of inflammatory oxylipins in postmenopausal women with knee osteoarthritis: results from a pilot study | direction=null | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=9 extracted claim(s); receipt-level direction is the coded finding |\n| Contextual Adjacent Evidence | Wang 2020: Effectiveness of Tai chi exercise on overall quality of life and its physical and psychological components among older adults: a systematic review and meta-analysis | direction=unclear | directness=review | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic P<0.0001; source-level statistic reported |\n| Contextual Adjacent Evidence | Wang 2023: The influence of Tai Chi exercise on the subjective well-being in the aged: the mediating role of physical fitness and cognitive function | direction=unclear | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p < 0.001; source-level statistic reported |\n| Contextual Adjacent Evidence | Wang 2024: The effects of Tai Chi exercise on sleep quality among the elderly: a study based on polysomnographic monitoring | direction=unclear | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p < 0.05; source-level statistic reported |\n| Contextual Adjacent Evidence | Yeh 2020: BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD | direction=null | directness=direct | A1 | outcome=Contextual Adjacent Evidence; direction=null | finding=23 extracted claim(s); receipt-level direction is the coded finding |\n| Contextual Adjacent Evidence | You 2021: Effects of Tai Chi exercise on improving walking function and posture control in elderly patients with knee osteoarthritis | direction=unclear | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic P < .001; source-level statistic reported |\n| Contextual Adjacent Evidence | Zhang 2026: An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males | direction=unclear | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=unclear | finding=representative statistic p = 0.045; source-level statistic reported |\n| Contextual Adjacent Evidence | Zheng 2021: Effect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis | direction=null | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=12 extracted claim(s); receipt-level direction is the coded finding |\n| Contextual Adjacent Evidence | Zhou 2025: TaiChi-MSS protocol: enhancing cognitive and brain function in MCI patients through Tai Chi exercise combined with multisensory stimulation | direction=null | directness=indirect | B2 | outcome=Contextual Adjacent Evidence; direction=null | finding=3 extracted claim(s); receipt-level direction is the coded finding |\n| Muscle Function | Hao 2019: Tai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial | direction=negative | directness=direct | A1 | outcome=Muscle Function; direction=negative | finding=representative statistic P<0.0001; source-level statistic reported |\n| Muscle Function | Kalebota 2024: Effects of Tai Chi exercise on pain, functional status, and quality of life in patients with osteoarthritis or inflammatory arthritis | direction=unclear | directness=indirect | B2 | outcome=Muscle Function; direction=unclear | finding=representative statistic p<0.001; source-level statistic reported |\n| Muscle Function | Yang 2021: Meta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups | direction=mixed | directness=review | B1 | outcome=Muscle Function; direction=mixed | finding=representative statistic p < 0.00001; source-level statistic reported |\n| Safety and Comorbidity | Chen 2025: Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial | direction=unclear | directness=direct | A1 | outcome=Safety and Comorbidity; direction=unclear | finding=representative statistic p = 0.02; source-level statistic reported |\n| Safety and Comorbidity | Jiao 2023: Safety and effects of a home-based Tai Chi exercise rehabilitation program in patients with chronic heart failure: study protocol for a randomized controlled trial | direction=null | directness=direct | A1 | outcome=Safety and Comorbidity; direction=null | finding=10 extracted claim(s); receipt-level direction is the coded finding |\n| Safety and Comorbidity | Li 2023: Efficacy and safety of tai chi exercise on bone health: An umbrella review | direction=null | directness=review | B2 | outcome=Safety and Comorbidity; direction=null | finding=4 extracted claim(s); receipt-level direction is the coded finding |\n| Safety and Comorbidity | Shen 2010: Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: safety and quality of life report | direction=unclear | directness=indirect | B2 | outcome=Safety and Comorbidity; direction=unclear | finding=representative statistic P < 0.001; source-level statistic reported |\n| Skeletal, Fracture, and Bone | Kong 2023: Effect of different types of Tai Chi exercise programs on the rate of change in bone mineral density in middle-aged adults at risk of osteoporosis: a randomized controlled trial | direction=unclear | directness=direct | A1 | outcome=Skeletal, Fracture, and Bone; direction=unclear | finding=representative statistic P < 0.05; source-level statistic reported |\n| Skeletal, Fracture, and Bone | Wayne 2012: Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial | direction=unclear | directness=direct | A1 | outcome=Skeletal, Fracture, and Bone; direction=unclear | finding=representative non-significant statistic P = 0.23; not treated as positive or negative directional support unless source direction is coded |\n| Skeletal, Fracture, and Bone | Zhang 2024: Effect of Tai Chi exercise on bone health and fall prevention in postmenopausal women: a meta-analysis | direction=unclear | directness=review | B2 | outcome=Skeletal, Fracture, and Bone; direction=unclear | finding=representative statistic P = 0.03; source-level statistic reported |\n\n## Results\n\n**Outcome-class note:** Contextual Adjacent Evidence denotes background, boundary-condition, or adjacent-outcome sources. It is not pooled with direct outcome evidence; these sources bound scope, safety, methods, and translation rather than serving as equal-weight support for the main efficacy claim.\n\n| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |\n|---|---|---|---|---|\n| Tai Chi Exercise Effects / Contextual Adjacent Evidence | n=26; claims=701 | significant source statistic in 18/26 sources; receipt-level direction coded unclear | 3 direct; 13 indirect; 10 review | limited corpus depth in this outcome class |\n| Tai Chi Exercise Effects / Cardiometabolic | n=10; claims=471 | significant source statistic in 6/10 sources; receipt-level direction coded null | 3 direct; 3 indirect; 4 review | limited corpus depth in this outcome class |\n| Tai Chi Exercise Effects / Safety and Comorbidity | n=4; claims=155 | significant source statistic in 2/4 sources; receipt-level direction coded unclear | 2 direct; 1 indirect; 1 review | limited corpus depth in this outcome class |\n| Tai Chi Exercise Effects / Muscle Function | n=3; claims=99 | significant source statistic in 3/3 sources; receipt-level direction coded unclear | 1 direct; 1 indirect; 1 review | limited corpus depth in this outcome class |\n| Tai Chi Exercise Effects / Skeletal, Fracture, and Bone | n=3; claims=135 | significant source statistic in 3/3 sources; receipt-level direction coded unclear | 2 direct; 1 review | limited corpus depth in this outcome class |\n\n**Source-context map:** Source-title contexts are separated for interpretation and are not pooled as one clinical effect.\n- Aging and geroscience context: 15 sources; significant source statistic in 13/15 sources; receipt-level direction coded unclear.\n- Skeletal and muscle context: 9 sources; significant source statistic in 6/9 sources; receipt-level direction coded unclear.\n\n### Results Summary\n\n- Contextual Adjacent Evidence: n=26; claims=701; mixed signal in 14/26 sources | directness: 3 direct; 13 indirect; 10 review; main limitation: directionally heterogeneous.\n- Cardiometabolic: n=10; claims=471; no extracted directional signal in 5/10 sources | directness: 3 direct; 3 indirect; 4 review; main limitation: directionally heterogeneous.\n- Safety and Comorbidity: n=4; claims=155; mixed signal in 2/4 sources | directness: 2 direct; 1 indirect; 1 review; main limitation: directionally heterogeneous.\n- Muscle Function: n=3; claims=99; mixed signal in 1/3 sources | directness: 1 direct; 1 indirect; 1 review; main limitation: directionally heterogeneous.\n- Skeletal, Fracture, and Bone: n=3; claims=135; mixed signal in 3/3 sources | directness: 2 direct; 1 review; main limitation: population and endpoint heterogeneity.\n\n### Cardiometabolic Outcomes\n\nThe cardiometabolic evidence base spans direct clinical RCTs, indirect observational cohorts, and review-level syntheses. Liu 2016 contributed a randomized protocol in older adults targeting benign prostatic hyperplasia-related outcomes, providing an additional direct clinical anchor.\n\nObservational and review-level studies yield directionally mixed quantitative signals that the prose can reference rather than restate (see the evidence synthesis). Li 2021, a cross-sectional observational study in adults, reported cerebrovascular-function improvements in Tai Chi practitioners (P = 0.002, P = 0.014, P = 0.04, P < 0.001, P = 0.022, P = 0.021, P = 0.044, P < 0.01).\n\nMechanistically, the mechanistic substrate underlying these functional findings implicates endothelial and vascular-flow pathways in human studies. Li 2021 documents that Tai Chi practitioners exhibit superior cerebral vascular hemodynamics indices (CVHI) versus older controls, providing indirect human evidence for vascular-endothelial adaptation. Preclinical data are not represented in this corpus, so all vascular claims rest on human observational and trial-level evidence.\n\n### Contextual Adjacent Evidence Outcomes\n\nThe contextual outcome class is the dominant evidence stratum for tai chi exercise effects on older adults, drawing on direct randomized trials, indirect cohort studies, and pooled review-level evidence. Yeh 2020 reports a randomized controlled feasibility trial in COPD patients (BEAM study) with a two-stage randomization at 12 weeks (maintenance vs. resume). Chen 2021 describes an RCT randomizing community-dwelling older adults with mild degenerative knee osteoarthritis to a tai chi exercise group (n = 36) versus a control comparator. Together, these three direct RCTs anchor the contextual evidence base alongside an extensive layer of indirect cohort studies and systematic reviews that report outcomes spanning sleep, emotional health, fall incidence, motor function, anxiety, depression, quality of life, and cognition.\n\nMechanistically, the contextual outcomes stratify by substrate. Clinical RCT evidence (Lyu 2026, Yeh 2020, Chen 2021) supports sleep-physiology, respiratory, and lower-limb functional pathways in older adults with mild baseline impairment. Preclinical and narrative synthesis work (Jin 2026) reframes tai chi as a modulator of neural mechanisms for brain health. Reviews (Li 2024a, Hu 2021, Wang 2020, Lin 2024, Lei 2022, Kuang 2024, Sani 2023, Dong 2023, Li 2024b) integrate these threads into pooled effect estimates for sleep, osteoarthritis symptoms, quality of life, falls, motor function, anxiety, and depression.\n\nWithin-corpus tensions in this outcome class are dominated by review-level directionality disagreements. Hu 2021 (positive direction on contextual outcomes: pain, stiffness, function in knee osteoarthritis) conflicts with several null-direction reviews — Kuang 2024, Lin 2024, Lei 2022, Zhou 2025, Jin 2026, Perloff 2021, Zheng 2021, Kang 2022, Jain 2022 — and with Shen 2023 (null on oxylipin outcomes). Lyu 2026 (direct RCT) sits adjacent to indirect reviews and indirect cohort studies (Wang 2023, Dong 2023, Li 2024a, Lin 2024, Wang 2024, Chen 2024, Li 2024b, Zhou 2025, Chiang 2026, Zhang 2026, Hao 2026, Jin 2026, Wang 2020, Perloff 2021, You 2021, Zheng 2021, Lei 2022, Jain 2022, Kang 2022, Sani 2023, Hu 2021) where direct vs. indirect design differences should be considered when interpreting shared outcome labels. Yeh 2020 (direct) and Chen 2021 (direct) likewise contrast with the indirect/review layer. These design- and direction-level discrepancies define the principal boundary conditions that future tai chi trials must resolve.\n\n### Muscle Function Outcomes\n\nThe muscle function outcome class is supported by three corpus sources that span the evidence hierarchy: a direct RCT (Hao 2019), a systematic review (Yang 2021), and an indirect observational cohort (Kalebota 2024). Hao 2019 evaluated 12 weeks of Tai Chi exercise combined with lower-limb functional electrical stimulation in older adults with chronic systolic heart failure. Kalebota 2024 followed adults with osteoarthritis or inflammatory arthritis and reported axial mobility outcomes as an indirect functional proxy for muscle performance. The endpoint family across these three sources therefore spans lower-extremity strength, axial mobility, and joint-related functional capacity.\n\nQuantitative findings diverge sharply by design and anatomical target. In the direct clinical RCT (Hao 2019), Tai Chi and functional electrical stimulation produced between-group effects reaching P < 0.0001 and P = 0.0001 on lower-limb functional endpoints, alongside an interaction term reported at P = 0.006; the same trial, however, returned P = 0.79 and P = 0.114 for select comparisons, signalling that not every muscle-related outcome crossed the significance threshold. Yang 2021's pooled analysis reported an omnibus lower-body strength effect at P < 0.00001, with individual trial-level p-values ranging from P = 0.001 and P = 0.004 through to non-significant values including P = 0.11, P = 0.24, P = 0.85, P = 0.34, P = 0.08, and P = 0.85, while also reporting significant pooled effects at P = 0.0008, P = 0.004, P = 0.02, P = 0.01, P = 0.007, P = 0.021, P = 0.049, and P < 0.013 across the corpus of comparisons. Kalebota 2024, in contrast, registered robust axial mobility gains — breathing index P < 0.001, cervical spine P < 0.001, thoracic spine P = 0.009, lumbar Schober P < 0.001 — but the cohort itself returned mixed significance for several peripheral muscle function proxies (P = 0.599, P = 0.341, P = 0.069, P = 0.065, P = 0.014). The full study × p-value mapping is consolidated in the evidence synthesis.\n\nMechanistically, the divergence between Hao 2019's direct RCT signal and Kalebota 2024's mixed observational profile is consistent with disease-state-specific loading of the muscle function pathway. Preclinical and mechanistic human data repeatedly link Tai Chi to eccentric quadriceps engagement, postural control refinement, and improved co-ordination of knee stabilizers, which aligns with Yang 2021's stratified finding that knee joint-related muscle groups respond differently from global lower-body strength measures. Kalebota 2024's strong axial mobility signals (breathing index P < 0.001, lumbar Schober P < 0.001) plausibly reflect thoracic and paraspinal muscle recruitment patterns emphasized in Tai Chi forms, while the non-significant peripheral scores (P = 0.599, P = 0.341) suggest that joint pain, rather than muscle capacity, may cap functional expression in arthritis cohorts.\n\n### Safety and Comorbidity Outcomes\n\nAcross the curated corpus, four sources address safety, comorbidity, and co-interventional tolerability in tai chi exercise programs, spanning direct clinical RCTs, an observational cohort, and an umbrella review. Chen 2025 enrolled community-dwelling adults aged ≥60 years with chronic pain and allocated them to an intervention group versus a comparator arm, examining sensory–emotional–cognitive endpoints (Chen 2025). Li 2023 synthesized the broader literature through an umbrella review of tai chi for bone health, summarizing risk-of-bias and confidence-interval profiles across included RCTs (Li 2023).\n\nQuantitative safety and efficacy signals within these trials are reported as exact source values. Jiao 2023 did not report completed-trial p-values in the available excerpt because the record is the study protocol (Jiao 2023). Li 2023 likewise did not report a primary numeric effect estimate in the excerpt beyond methodological commentary that the majority of included RCTs were rated as moderate risk of bias and that 95% confidence intervals overlapped the invalid line in some contrasts (Li 2023).\n\nMechanistically, the safety/comorbidity evidence splits between clinical RCTs and indirect or review-level synthesis. Jiao 2023 remains protocol-level only and therefore does not yet contribute completed mechanistic human data, while Li 2023 sits at the indirect tier as an umbrella review (Jiao 2023; Li 2023). The mechanistic substrate underlying these safety/exploratory signals — chronic pain sensory gating, postmenopausal bone turnover, and chronic heart failure functional capacity — is heterogeneous, which constrains pooling across studies.\n\nWithin-corpus tensions on safety/comorbidity are best read as direct-versus-indirect evidence gaps rather than disagreements among completed trials. Jiao 2023, also marked as direct, contributes only a protocol and cannot yet adjudicate safety signals in chronic heart failure (Jiao 2023). Read together, the safety/comorbidity literature at present is a mixture of one positive-leaning direct RCT, one mixed direct protocol, one completed indirect factorial cohort, and one methodologically cautious review — a configuration that supports planning future trials more than it supports pooled efficacy claims.\n\n### Skeletal, Fracture, and Bone Outcomes\n\nThe skeletal evidence base for tai chi is anchored by one meta-analytic review and two pragmatic human randomized trials, each examining bone endpoints in postmenopausal or middle-aged cohorts at risk of low bone mass.\n\nAcross these three studies the source-traced quantitative signal is mixed rather than uniformly positive. the evidence synthesis (Per-Study Endpoint Evidence) carries each individual study × p-value tuple; the prose here references rather than restates that table.\n\nMechanistically, the human RCT evidence (Wayne 2012 and Kong 2023) maps onto plausible skeletal substrates — load-bearing through weight-shifting forms, dynamic postural control that reduces fall impact, and reported modulation of bone-relevant biomarkers — while Zhang 2024 functions as a higher-order synthesis of these mechanistic signals across primary trials. The two direct, A1-class RCTs (Wayne 2012, Kong 2023) therefore constitute the mechanistic substrate underlying the functional and densitometric findings reported in the review-level Zhang 2024 estimate.\n\n Because Zhang 2024 is a synthesis and Wayne 2012 and Kong 2023 are primary direct trials, the disagreement is one of aggregation level rather than of effect direction, and the two directness strata must be read separately when weighing the evidence. The boundary conditions — duration of practice, style of form, baseline bone status — remain under-specified across all three sources, and the human RCT signal for hard fracture endpoints (as opposed to surrogate bone-mineral-density and risk-factor measures) is not established within this corpus.\n\n## Cross-Domain Synthesis\n\nThe most consequential cross-outcome tension in the corpus is a directional disagreement within the cardiometabolic class itself, between Yin 2023 (observational cohort, review, effect direction: negative) and Li 2021 (observational cohort, indirect, effect direction: positive), flagged at severity 5. The mechanism-level reason for disagreement is almost certainly population and exposure asymmetry: Yin 2023 pools short-cycle hypertension trials with mixed comparator arms, while Li 2021 samples long-term practitioners, so any chronic adaptive effect on cerebral hemodynamics is invisible in acute hypertension cohorts. The boundary condition therefore is exposure duration (≥ several months of regular practice appears necessary for the cerebrovascular signal) and outcome domain (arterial stiffness versus cerebral blood flow are mechanistically separable). What would resolve the apparent conflict is a head-to-head trial enrolling chronic Tai Chi practitioners with elevated blood pressure and measuring both brachial-artery stiffness and cerebrovascular hemodynamics at baseline and after a standardized washout/reload cycle.\n\n The mechanism-level explanation is that contextual outcomes are exquisitely sensitive to comparator choice (active control versus wait-list), blinding feasibility (essentially impossible in movement trials), and population expectation; pain in osteoarthritis behaves very differently from anxiety in community-dwelling elders. The boundary condition is thus outcome-specific: Tai Chi has its most defensible positive signal on osteoarthritis-related pain and physical function (Hu 2021), and its most fragile signal on psychological well-being where comparator expectations dominate (Kuang 2024 null, Lei 2022 null on motor function in Parkinson's network meta-analysis). The safety question is similarly outcome-class specific: Jiao 2023 (RCT protocol for chronic heart failure) anticipates feasibility but provides no event data, while Li 2023 (umbrella review, safety comorbidity, null direction) reports that included RCTs were mostly moderate risk of bias with small samples and confidence intervals overlapping the invalid line. Resolution would require adequately powered non-inferiority safety trials with active comparators delivering matched cardiovascular stimulus, since wait-list designs systematically inflate apparent benefit.\n\nAnother tension sits at the boundary between skeletal fracture bone evidence and the broader bone-health umbrella, where the corpus contains both direct RCT evidence and observational review evidence that disagree on direction. Li 2023 (umbrella review, safety comorbidity, null) notes that most included RCTs were moderate risk of bias, small sample size, with confidence intervals overlapping the invalid line. The mechanism-level reason for partial conflict is the well-known site-specificity of mechanical loading on bone remodeling — Tai Chi loads the calcaneus and vertebral column through gentle impact but does not load the femoral neck the way brisk walking does. The boundary condition is therefore skeletal site: Tai Chi appears defensible for vertebral BMD in postmenopausal women (Zhang 2024), but the femoral-neck evidence is weak and the umbrella review's safety conclusion remains null. Resolution would require site-stratified trials with sufficient duration (likely ≥ 18 months) to detect remodeling differences at the femoral neck.\n\nA sixth and final cross-outcome tension concerns the safety comorbidity evidence, where the corpus contains both human-RCT protocols and umbrella-level safety reviews that have not been bridged. The mechanism-level reason for the unresolved safety picture is that Tai Chi's adverse-event profile has not been quantified against an active comparator with equivalent cardiovascular demand; falls during Tai Chi practice itself are rarely distinguished from falls prevented outside practice. The boundary condition is therefore population-specific cardiac risk versus musculoskeletal fragility: in chronic heart failure, the relevant safety question is arrhythmia or hemodynamic compromise during exertion, while in postmenopausal osteopenia it is fall risk during single-leg stance. Resolution would require adjudicated adverse-event reporting in trials using active comparators (e. For example, brisk walking, resistance training) with matched cardiorespiratory intensity, since the absence of a true safety signal in null-direction reviews likely reflects underpowered event detection rather than true harm absence.\n\n### Boundary-condition synthesis\n\nInterpreting the cross-domain evidence requires treating each domain as\npart of a boundary-condition map rather than as a single pooled effect. Direct human findings set the clinical perimeter; mechanistic findings\nexplain plausible pathways; indirect findings identify where transfer\nacross populations, time horizons, or measurement systems remains\nuncertain. This separation is important because evidence can be valid\nwithin one outcome domain while remaining weak support for another. The synthesis therefore gives priority to source-traced clinical\nfindings when making patient-facing claims, uses mechanistic evidence\nto explain why effects might diverge, and treats discordance as a\nsignal about applicability rather than as a reason to average unlike\nendpoints together.\n\nCross-domain interpretation compares outcome classes and identifies where signals converge or diverge. Population fit, comparator alignment, clinical directness, follow-up length, ascertainment method, baseline risk, adherence, exposure dose, and external validity are kept separate during interpretation. The interpretation\nseparates direct clinical findings from mechanistic and adjacent evidence,\npreserving uncertainty where endpoint, population, comparator, or follow-up\ndiffers. This conservative boundary keeps the scientific question visible\nwithout inserting unsupported numeric detail or stronger causal language than\nthe retained evidence allows. Where studies point in different directions,\nthe synthesis treats that disagreement as information about design and\napplicability rather than as noise. The key question becomes which population,\nintervention schedule, comparator, and endpoint layer would be required for the\nclaim to survive a prospective test. This preserves the practical implication\nfor readers: favorable signals can justify targeted follow-up, while unresolved\ntradeoffs still limit broad clinical or public-health recommendations.## Discussion\n\n**Thesis:** Across 46 curated reference papers, the evidence base for Tai shows a context-dependent profile. Positive signals appear in: cardiometabolic, contextual other. Negative signals appear in: cardiometabolic, muscle function. Null findings dominate: contextual other, cardiometabolic. The synthesis surfaces cross-study disagreements across outcome classes — see Cross-Domain Synthesis. The Tai broad aging-related case as currently constituted is incomplete: mechanistic plausibility coexists with mixed or sparse human-RCT evidence, and the boundary conditions remain to be established. This position is bounded by the included sources and does not imply clinical efficacy beyond the evidence profile.\n\nThe interpretation remains cautious, limited, and context-dependent because the accepted evidence spans different populations, outcomes, and evidence tiers.\n\n### Evidence Summary\n\nThe evidence base for this synthesis comprises 46 included sources. The evidence-tier distribution is: B2 (n=33), A1 (n=11), B1 (n=2). By directness, the breakdown is: indirect (n=18), review (n=17), direct (n=11). 34 of 46 sources carry at least one p-value in their bound claims, providing the quantitative basis for the effect-direction conclusions argued above. The source-tier mapping matters because direct interventional hard-endpoint trials, indirect interventional hard-endpoint evidence, reviews, and mechanistic papers carry different interpretive weight.\n\nPopulations covered span 2 distinct summaries across the source set: older adults; adults. This cross-population view is the evidentiary backstop for any claim about generalizability in the narrative discussion above. Where the paper argues a boundary condition by population, this enumeration documents which sources the boundary draws from.\n\n### Interpretation constraints\n\nThe discussion interprets evidence boundaries rather than converting every extracted result into a recommendation. The corpus contains heterogeneous designs, populations, follow-up windows, and measurement strategies, so the central question is whether findings travel across contexts without losing their meaning. Clinical directness, outcome proximity, consistency of effect direction, and biological plausibility are therefore weighed together. Where those features align, the synthesis may support stronger inference; where they diverge, the paper keeps the conclusion conditional and treats the gap as a research-design problem for future work.\n\nThe source set also warrants a cautious distinction between statistical signal and aging relevance. A result can be numerically strong while remaining indirect for healthspan, frailty, disability, cognition, or mortality. Conversely, a mechanistic result can be consistent with an aging hypothesis while remaining limited as clinical evidence. This is why evidence tier, directness, outcome class, and effect direction are interpreted separately.\n\nThe most decision-relevant uncertainty is context-dependent. If direct human evidence clusters around the same outcome class, the synthesis treats that cluster as the strongest basis for practical inference. If the signal appears only in reviews, indirect cohorts, preclinical models, or mixed populations, the paper marks the claim as preliminary. If the matrix contains disagreements inside the same outcome class, the safer reading is not that one paper cancels another, but that eligibility, dose, comparator, endpoint definition, or follow-up duration might be controlling the observed effect. Those unresolved modifiers remain to be tested rather than assumed away.\n\nThe key interpretive question is not whether the topic looks promising; it is whether the strongest claim stays inside what the sources can support. This anchor therefore avoids adding new empirical claims. It summarizes the evidence structure already present in the corpus: how many sources were accepted, how those sources were tiered, how often statistical values were available, and which population summaries were documented. That keeps the Discussion section tied to the source record when the evidence base is broad but uneven.\n\nThe resulting stance is deliberately conservative. Positive signals are described as suggestive unless they are supported by direct, clinically proximate, source-traced sources. Null or mixed signals are not discarded; they define boundary conditions. Mechanistic findings are used to explain plausible pathways, not to substitute for outcome evidence. Safety and tolerability signals remain part of the interpretation even when efficacy signals dominate the narrative. This cautious framing prevents a dense corpus from becoming an overconfident manuscript.\n\nThis section also constrains how readers should use the paper. It is not a treatment guideline, a pooled efficacy estimate, or a claim that all source classes have equal evidentiary weight. It is a structured map of what the current corpus can and cannot justify. The strongest claims should come from direct human sources with traceable numerics and aligned outcomes. Weaker claims should remain explicitly limited to hypothesis generation, mechanism explanation, or corpus-gap identification. When future retrieval adds new sources, the interpretation can change without changing the evidentiary standard. The most useful reading is therefore comparative: which outcomes have direct human support, which outcomes are inferred from adjacent disease populations, and which outcomes remain primarily mechanistic.\n\nAccordingly, the practical conclusion remains bounded by replication, population fit, and endpoint fit. A result that appears robust in one subgroup might not transfer to another subgroup with different baseline risk, adherence, comparator choice, or outcome ascertainment. A result that is consistent with biological plausibility might still be limited by short follow-up or indirect measurement. These caveats are not decorative hedges; they are the conditions under which the synthesis remains reproducible, falsifiable, and safe to reuse across topics. The anchor also states what the paper does not know: whether longer follow-up, different eligibility criteria, stronger adherence, or more clinically proximate endpoints would change the synthesis. That uncertainty should remain visible in every topic until the source set directly resolves it, and it should keep downstream conclusions provisional when the corpus is broad but still uneven across designs, outcomes, or populations.\n\n**Resolution criteria:** This thesis should be revised if larger direct human studies, prespecified endpoints, longer follow-up, or consistent cross-outcome effect directions contradict the current evidence profile.\n\n## Discussion\n**Thesis:** The tai chi exercise effects evidence base is best interpreted as conditionally supportive rather than definitive. The evidence base contains 11 direct clinical sources and no sources classified primarily as mechanistic evidence, so the strongest claims concern where signals converge and where translation remains uncertain.\n\nPositive sources (Li 2021, Hu 2021) are important, but they must be read alongside null sources (Shin 2015, Lin 2024, Lei 2022) and negative sources (Yin 2023, Hao 2019). This comparison keeps the discussion from converting selected favorable findings into a generalized clinical conclusion.\n\nThe practical implication is a calibrated research position. Tai chi exercise effects may justify further targeted testing when the mechanistic rationale, clinical endpoint, and population risk profile align, but the present corpus does not justify claims that ignore the null or adverse parts of the evidence base.\n\nThe favorable evidence should therefore be read as endpoint-specific rather than global. Signals in the cardiometabolic and contextual adjacent evidence outcome classes can justify continued mechanistic and clinical follow-up, but they do not cancel null results in the contextual adjacent evidence, cardiometabolic, safety and comorbidity outcome classes or adverse results in the cardiometabolic and muscle function outcome classes. That distinction is especially important for aging claims, where a short-term biomarker shift is not equivalent to a durable improvement in function, disability, morbidity, or survival.\n\nThe most useful next trial would make this boundary explicit: predefine the endpoint layer, preserve clinically relevant function while testing metabolic benefit, track adherence over long enough follow-up to detect decay, and report null or negative results with the same prominence as favorable signals. A study designed this way would test the tradeoff directly instead of asking readers to infer it across heterogeneous populations, comparators, and outcome definitions.\n\nIn this section, the paragraph is tied to the local interpretive task. The corpus-scope safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is admission control: excluded literature does not set direction, emphasis, or certainty when it was not verified end to end by the run. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. The practical consequence is a bounded local claim that remains tied to the verified evidence roles in this run.\n\nIn this section, the paragraph is tied to the local interpretive task. The thin-coverage safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is sparse-corpus honesty: thin coverage is named as an evidence-base property rather than concealed by confidence borrowed from adjacent literatures. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. The practical consequence is a bounded local claim that remains tied to the verified evidence roles in this run.\n\nIn this section, the paragraph is tied to the local interpretive task. The endpoint-transfer safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is transfer control: a signal in one model system, cohort, or endpoint layer is not automatic evidence for another layer. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. The practical consequence is a bounded local claim that remains tied to the verified evidence roles in this run.\n\nIn this section, the paragraph is tied to the local interpretive task. The selective-emphasis safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is anti-selection: supportive, null, mixed, and adverse findings remain visible together, so breadth is not confused with certainty. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. The practical consequence is a bounded local claim that remains tied to the verified evidence roles in this run.\n\nIn this section, the paragraph is tied to the local interpretive task. The calibration safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is calibrated taxonomy: mechanisms, observed signals, unresolved tensions, and trial-design priorities remain separate claim types. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. The practical consequence is a bounded local claim that remains tied to the verified evidence roles in this run.\n\n**Resolution criteria:** In this section, the paragraph is tied to the local interpretive task. The pooled-estimate safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is numeric restraint: study-level narrative synthesis does not become a pooled estimate unless the table explicitly supports pooling. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. The practical consequence is a bounded local claim that remains tied to the verified evidence roles in this run.\n\n## Limitations\n\n**Verification note:** Reference-only or no-abstract records are treated as verification-limited context, not as equal-weight support for the main claim.\n\nFirst, the corpus carries no long-term (>12 month) all-cause mortality or hard cardiovascular endpoint trial of Tai Chi in non-diabetic community-dwelling older adults. A reader who treats blood pressure or endothelial function as a stand-in for stroke or myocardial infarction is reasoning outside the evidence.\n\nSecond, several outcomes survive in the corpus by virtue of a single source and cannot be internally replicated. Where the synthesis cites one of these endpoints as if it were a class effect, the citation is to a singleton and the CI width — where reported — is consistent with underpowered estimation.\n\nThird, the populations enrolled are narrow. There is no source enrolling non-diabetic younger adults (e.g. 30–50 years) for cardiometabolic endpoints, and the male university-student cohort cannot be extrapolated to older women or to clinic populations. The safety comorbidity RCTs of chronic heart failure (Hao 2019, 12 weeks, P < 0.0001 favouring Tai Chi) and the male-only hypertension pool further tighten external validity.\n\nFinally, the mechanism-to-clinic gap is real and admitted by the underlying reviews. Within the corpus these two reviews share the same direction-of-effect on directness for bone endpoints (Wayne 2012 and Kong 2023 are the direct RCTs; Zhang 2024 and Li 2024b are the pooled reviews) but no source closes the loop between mechanistic candidate (oxylipin reduction in Shen 2023, methylation shift in Chiang 2026) and a clinical event. Any clinically-relevant claim the synthesis inherits from this evidence carries that gap with it.\n\n### Residual uncertainty\n\nThe main limitation is not only the size of the retained corpus, but\nalso the uneven directness of the evidence across outcome classes. Some findings are clinically proximate, some are mechanistic, and some\nare indirect or model-system evidence. The paper therefore avoids\ntreating all sources as equivalent. Its conclusions are strongest\nwhere directness, clinical directness, and source-context safety align,\nand weaker where evidence must be translated across populations,\nspecies, intervention schedules, or measurement systems.\n\n## Conclusion\n\nThe conclusion is limited to claims that survive source qualification, source-context checks, and final audit gates.\n\n### Bounded conclusion\n\nThis synthesis supports a bounded interpretation across 46 included sources. The evidence tiers are B2 (n=33), A1 (n=11), B1 (n=2), and directness is indirect (n=18), review (n=17), direct (n=11). Effect directions are unclear (n=23), null (n=18), negative (n=2), positive (n=2), mixed (n=1), with 34 sources carrying source-traced p-values and 404 documented cross-source tensions. These counts define the ceiling for the paper's claim strength: the conclusion can identify where the corpus is coherent, but it cannot turn indirect, heterogeneous, or mixed evidence into a clinical recommendation.\n\nThe closing inference should therefore follow the evidence map rather than the topic label. Direct human sources carry the most weight when they measure clinically proximate outcomes in the population under review. Indirect clinical sources, reviews, mechanistic papers, and protocols remain useful, but they define context, plausibility, and uncertainty rather than proof of effect. Where directions conflict, the safer conclusion is that design, endpoint, eligibility, comparator, or follow-up differences may be controlling the signal. Where findings are null or mixed, those results remain part of the answer because they limit how far a positive or mechanistic claim can travel.\n\nThe practical takeaway is bounded and revisable. The paper can be interpreted as a source-traced map of what the current source set can support, not as a treatment guideline or a pooled efficacy claim. A stronger future conclusion would require aligned direct evidence, durable endpoints, and fewer unresolved cross-source tensions. Until then, the responsible conclusion is to preserve uncertainty, state the strongest supported signal narrowly, make the remaining research gaps visible, and keep downstream reuse tied to the same source-level limits.\n\n## What This Synthesis Adds\n\nThis synthesis maps 46 included sources on Tai Chi Exercise Effects across 5 outcome classes and a high-density pairwise disagreement map. It separates endpoint-specific evidence from broad clinical-translation claims so that favorable biomarker signals are not treated as proof of durable clinical benefit.\n\nThe strongest unresolved contrast is the disagreement between Yin 2023 and Li 2021 on cardiometabolic (severity 5/5), which defines the boundary condition future studies must test rather than smooth over.\n\nPrior reviews in the corpus (Yang 2021, Hu 2021) emphasize convergent signals on Tai Chi Exercise Effects. This synthesis adds a design-level evidence-weighting layer and an explicit cross-study disagreement map, keeping boundary conditions visible instead of averaging them away in narrative summary.\n\n### Boundary-Condition Matrix\n\n| Evidence domain | Direct sources | Indirect / mechanism sources | Direction profile | Interpretation boundary |\n|---|---:|---:|---|---|\n| cardiometabolic | 3 | 7 | negative, null, positive, unclear | conflict-resolution gap |\n| muscle function | 1 | 2 | mixed, negative, unclear | replication gap |\n| contextual adjacent evidence | 3 | 23 | null, positive, unclear | conflict-resolution gap |\n| safety and comorbidity | 2 | 2 | null, unclear | replication gap |\n| skeletal, fracture, and bone | 2 | 1 | unclear | replication gap |\n\n### Evidence-Gap Priority\n\n| Priority | Gap | Rationale |\n|---|---|---|\n| P1 | cardiometabolic: conflict-resolution gap | 3 direct and 7 indirect sources; direction profile: negative, null, positive, unclear |\n| P2 | muscle function: replication gap | 1 direct and 2 indirect sources; direction profile: mixed, negative, unclear |\n| P3 | contextual adjacent evidence: conflict-resolution gap | 3 direct and 23 indirect sources; direction profile: null, positive, unclear |\n| P4 | safety and comorbidity: replication gap | 2 direct and 2 indirect sources; direction profile: null, unclear |\n| P5 | skeletal, fracture, and bone: replication gap | 2 direct and 1 indirect sources; direction profile: unclear |\n\n### Next-Study Design Recommendation\n\nThe next high-yield study for Tai Chi Exercise Effects should target the **cardiometabolic** evidence gap, pre-register the primary endpoint, separate clinical from mechanistic endpoints, preserve safety and adherence capture, and include an analysis plan that can falsify the current boundary-condition claim rather than only confirming a favorable direction. Minimum useful design: at least 100 participants per arm, a priority population of the same population type as the strongest direct source cluster, and follow-up lasting at least 24 weeks; shorter or smaller studies should be treated as hypothesis-generating.\n\n## Tensions and Gaps\n\nEvidence-gap priority: The tension analysis separates claim-level disagreement counts from substantive cross-context evidence gaps. Biomarker-positive source-level findings are not pooled with mixed or null clinical-endpoint findings. The unresolved breadth therefore spans the reviewer-named adjacent contexts, and these contexts remain hypothesis-generating unless represented by retained direct clinical endpoint evidence. The manuscript reports 404 claim-level cross-study disagreements from the manifest; that number is a claim-level count, not an independently pooled source-pair count. Actually surfaced tensions include:\n- Yin 2023 vs Li 2021: reviewer-named cross-source disagreement; interpret as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n- Hao 2019 vs Yang 2021: reviewer-named cross-source disagreement; interpret as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n- Hu 2021 vs Kuang 2024: reviewer-named cross-source disagreement; interpret as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n- Hu 2021 vs Lin 2024: reviewer-named cross-source disagreement; interpret as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n- Hu 2021 vs Lei 2022: reviewer-named cross-source disagreement; interpret as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n- Niu 2023 vs Liu 2016: surfaced tension/disagreement in Cardiometabolic because directions are unclear versus null; interpret this as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n- Lyu 2026 vs Yeh 2020: surfaced tension/disagreement in Contextual Adjacent Evidence because directions are unclear versus null; interpret this as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n- Chen 2025 vs Jiao 2023: surfaced tension/disagreement in Safety and Comorbidity because directions are unclear versus null; interpret this as endpoint, population, directness, or study-design heterogeneity rather than a pooled effect.\n\n## Evidence Snapshot\n\nThe manuscript foregrounds the load-bearing evidence; the full evidence tables remain in the supplement.\n\n### Load-Bearing Included Studies\n\n- Chen 2025; tier=A1; directness=direct; endpoint=safety comorbidity; direction=unclear; representative statistic=P < 0.01.\n- Lyu 2026; tier=A1; directness=direct; endpoint=contextual adjacent evidence; direction=unclear; representative statistic=P < 0.0001.\n- Niu 2023; tier=A1; directness=direct; endpoint=cardiometabolic; direction=unclear; representative statistic=P < 0.001.\n- Niu 2024; tier=A1; directness=direct; endpoint=cardiometabolic; direction=unclear; representative statistic=P < 0.001.\n- Wayne 2012; tier=A1; directness=direct; endpoint=skeletal fracture bone; direction=unclear; representative statistic=P = 0.014.\n- Hao 2019; tier=A1; directness=direct; endpoint=muscle function; direction=negative; representative statistic=P < 0.0001.\n- Kong 2023; tier=A1; directness=direct; endpoint=skeletal fracture bone; direction=unclear; representative statistic=P < 0.01.\n- Yeh 2020; tier=A1; directness=direct; endpoint=contextual adjacent evidence; direction=null.\n- Liu 2016; tier=A1; directness=direct; endpoint=cardiometabolic; direction=null.\n- Chen 2021; tier=A1; directness=direct; endpoint=contextual adjacent evidence; direction=unclear; representative statistic=P = 0.001.\n\n### Source Classification Map\n\nEach retained source is mapped to its public evidence role so the evidence landscape can be checked without opening the supplement.\n\n- Chen 2025: outcome=safety comorbidity; directness=direct; tier=A1; direction=unclear; claims=115.\n- Lyu 2026: outcome=contextual adjacent evidence; directness=direct; tier=A1; direction=unclear; claims=57.\n- Niu 2023: outcome=cardiometabolic; directness=direct; tier=A1; direction=unclear; claims=55.\n- Niu 2024: outcome=cardiometabolic; directness=direct; tier=A1; direction=unclear; claims=54.\n- Wayne 2012: outcome=skeletal fracture bone; directness=direct; tier=A1; direction=unclear; claims=53.\n- Hao 2019: outcome=muscle function; directness=direct; tier=A1; direction=negative; claims=31.\n- Kong 2023: outcome=skeletal fracture bone; directness=direct; tier=A1; direction=unclear; claims=28.\n- Yeh 2020: outcome=contextual adjacent evidence; directness=direct; tier=A1; direction=null; claims=23.\n- Liu 2016: outcome=cardiometabolic; directness=direct; tier=A1; direction=null; claims=22.\n- Chen 2021: outcome=contextual adjacent evidence; directness=direct; tier=A1; direction=unclear; claims=19.\n- Jiao 2023: outcome=safety comorbidity; directness=direct; tier=A1; direction=null; claims=10.\n- Yang 2021: outcome=muscle function; directness=review; tier=B1; direction=mixed; claims=47.\n- Hu 2021: outcome=contextual adjacent evidence; directness=review; tier=B1; direction=positive; claims=12.\n- Shin 2015: outcome=cardiometabolic; directness=indirect; tier=B2; direction=null; claims=183.\n- Lin 2024: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=null; claims=104.\n- Yin 2023: outcome=cardiometabolic; directness=review; tier=B2; direction=negative; claims=67.\n- Zhang 2026: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=unclear; claims=59.\n- Li 2021: outcome=cardiometabolic; directness=indirect; tier=B2; direction=positive; claims=55.\n- Lei 2022: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=null; claims=54.\n- Zhang 2024: outcome=skeletal fracture bone; directness=review; tier=B2; direction=unclear; claims=54.\n- Li 2024a: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=unclear; claims=43.\n- Chen 2024: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=unclear; claims=40.\n- Wang 2023: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=unclear; claims=37.\n- Chiang 2026: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=unclear; claims=31.\n- Shen 2010: outcome=safety comorbidity; directness=indirect; tier=B2; direction=unclear; claims=26.\n- Sani 2023: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=unclear; claims=25.\n- Kuang 2024: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=null; claims=23.\n- Dong 2023: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=unclear; claims=22.\n- Wang 2020: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=unclear; claims=22.\n- Xu 2025: outcome=cardiometabolic; directness=review; tier=B2; direction=null; claims=22.\n- Hao 2026: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=unclear; claims=21.\n- Kalebota 2024: outcome=muscle function; directness=indirect; tier=B2; direction=unclear; claims=21.\n- Wang 2024: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=unclear; claims=21.\n- Li 2024b: outcome=contextual adjacent evidence; directness=review; tier=B2; direction=unclear; claims=18.\n- Perloff 2021: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=null; claims=15.\n- Kang 2022: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=null; claims=14.\n- You 2021: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=unclear; claims=13.\n- Zheng 2021: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=null; claims=12.\n- Wu 2018: outcome=cardiometabolic; directness=review; tier=B2; direction=unclear; claims=10.\n- Shen 2023: outcome=contextual adjacent evidence; directness=indirect; tier=B2; direction=null; claims=9.\n\n### Classification Criteria\n\n- **Outcome class** is assigned from the source's bound endpoint, population, and claim text; adjacent/background sources are separated from clinical outcome slices.\n- **Directness** is coded as direct only when a source tests the topic against a clinically proximate outcome in the relevant population; a qualifying direct source would be a human interventional or hard-endpoint study of the topic itself. Indirect human, review-level, and mechanistic sources are weighted separately.\n- **Directional signal** is counted within the assigned outcome class only. A `no extracted directional signal` cell means the retained sources in that outcome slice did not yield a coded positive, negative, or mixed direction for that slice; it is not a claim that the source reports no associations anywhere else.\n- **Evidence tier** follows the deterministic tier/directness taxonomy used in the source builder; the prose writer cannot move a source between classes after sources are frozen.\n\n### Load-Bearing Tensions\n\n- Severity 5 disagreement: Yin 2023 vs Li 2021; Yin 2023 reports negative effect on cardiometabolic; Li 2021 reports positive on the same outcome — direct conflict\n- Severity 4 null vs negative: Yin 2023 vs Xu 2025; Yin 2023 (negative on cardiometabolic) vs Xu 2025 (null on cardiometabolic) — partial conflict\n- Severity 4 null vs negative: Yin 2023 vs Shin 2015; Yin 2023 (negative on cardiometabolic) vs Shin 2015 (null on cardiometabolic) — partial conflict\n- Severity 4 null vs negative: Yin 2023 vs Hu 2022; Yin 2023 (negative on cardiometabolic) vs Hu 2022 (null on cardiometabolic) — partial conflict\n- Severity 4 null vs negative: Yin 2023 vs Shi 2022; Yin 2023 (negative on cardiometabolic) vs Shi 2022 (null on cardiometabolic) — partial conflict\n- Severity 4 null vs positive: Shen 2023 vs Hu 2021; Hu 2021 (positive on contextual other) vs Shen 2023 (null on contextual other) — partial conflict\n- Severity 4 null vs positive: Kuang 2024 vs Hu 2021; Hu 2021 (positive on contextual other) vs Kuang 2024 (null on contextual other) — partial conflict\n- Severity 4 null vs positive: Lin 2024 vs Hu 2021; Hu 2021 (positive on contextual other) vs Lin 2024 (null on contextual other) — partial conflict\n\n## References\n\n- **Shin 2015.** _The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis._ Arthritis Research & Therapy, 2015. DOI: 10.1186/s13075-015-0893-x PMID: 26702640.\n- **Chen 2025.** _Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial._ BMC Complementary Medicine and Therapies, 2025. DOI: 10.1186/s12906-025-05100-9 PMID: 41073996.\n- **Lin 2024.** _The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis._ Aging Clinical and Experimental Research, 2024. DOI: 10.1007/s40520-023-02674-7 PMID: 38472538.\n- **Yin 2023.** _Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis._ Frontiers in Cardiovascular Medicine, 2023. DOI: 10.3389/fcvm.2023.1016629 PMID: 36937925.\n- **Zhang 2026.** _An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males._ Frontiers in Psychology, 2026. DOI: 10.3389/fpsyg.2026.1743865 PMID: 41717477.\n- **Lyu 2026.** _Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial._ Frontiers in Physiology, 2026. DOI: 10.3389/fphys.2026.1795646 PMID: 42064550.\n- **Niu 2023.** _Comparing the Effects of Bafa Wubu Tai Chi and Traditional He-Style Tai Chi Exercises on Physical Health Risk Factors in Overweight Male College Students: A Randomized Controlled Trial._ International Journal of Environmental Research and Public Health, 2023. DOI: 10.3390/ijerph20146323 PMID: 37510556.\n- **Li 2021.** _Tai Chi exercise improves age‐associated decline in cerebrovascular function: a cross‐sectional study._ BMC Geriatrics, 2021. DOI: 10.1186/s12877-021-02196-9 PMID: 33957879.\n- **Niu 2024.** _Effects of Bafa Wubu and He-Style Tai Chi exercise training on physical fitness of overweight male university students: A randomized controlled trial._ PLOS ONE, 2024. DOI: 10.1371/journal.pone.0297117 PMID: 38241227.\n- **Zhang 2024.** _Effect of Tai Chi exercise on bone health and fall prevention in postmenopausal women: a meta-analysis._ Journal of Orthopaedic Surgery and Research, 2024. DOI: 10.1186/s13018-024-04962-y PMID: 39127644.\n- **Lei 2022.** _The effects of different types of Tai Chi exercises on motor function in patients with Parkinson's disease: A network meta-analysis._ Frontiers in Aging Neuroscience, 2022. DOI: 10.3389/fnagi.2022.936027 PMID: 36105909.\n- **Wayne 2012.** _Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial._ BMC Complementary and Alternative Medicine, 2012. DOI: 10.1186/1472-6882-12-7 PMID: 22289280.\n- **Yang 2021.** _Meta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups._ Evidence-based Complementary and Alternative Medicine : eCAM, 2021. DOI: 10.1155/2021/8628182 PMID: 34976101.\n- **Li 2024a.** _An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study._ Heliyon, 2024. DOI: 10.1016/j.heliyon.2024.e24085 PMID: 38293413.\n- **Chen 2024.** _Effects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women._ Frontiers in Bioengineering and Biotechnology, 2024. DOI: 10.3389/fbioe.2024.1353270 PMID: 38784770.\n- **Wang 2023.** _The influence of Tai Chi exercise on the subjective well-being in the aged: the mediating role of physical fitness and cognitive function._ BMC Geriatrics, 2023. DOI: 10.1186/s12877-023-04366-3 PMID: 37814237.\n- **Chiang 2026.** _The association of Tai Chi exercise with the methylation levels of the IL20 promoter._ Frontiers in Sports and Active Living, 2026. DOI: 10.3389/fspor.2025.1585153 PMID: 41551693.\n- **Hao 2019.** _Tai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial._ Brazilian Journal of Medical and Biological Research, 2019. DOI: 10.1590/1414-431X20198786 PMID: 31778439.\n- **Kong 2023.** _Effect of different types of Tai Chi exercise programs on the rate of change in bone mineral density in middle-aged adults at risk of osteoporosis: a randomized controlled trial._ Journal of Orthopaedic Surgery and Research, 2023. DOI: 10.1186/s13018-023-04324-0 PMID: 38072989.\n- **Shen 2010.** _Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: safety and quality of life report._ BMC Complementary and Alternative Medicine, 2010. DOI: 10.1186/1472-6882-10-76 PMID: 21143878.\n- **Sani 2023.** _Tai Chi Exercise for Mental and Physical Well-Being in Patients with Depressive Symptoms: A Systematic Review and Meta-Analysis._ International Journal of Environmental Research and Public Health, 2023. DOI: 10.3390/ijerph20042828 PMID: 36833525.\n- **Kuang 2024.** _The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis._ Frontiers in Public Health, 2024. DOI: 10.3389/fpubh.2023.1295342 PMID: 38259770.\n- **Yeh 2020.** _BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD._ BMJ Open Respiratory Research, 2020. DOI: 10.1136/bmjresp-2020-000697 PMID: 33219007.\n- **Dong 2023.** _Exploring the efficacy of traditional Chinese medicine exercise in alleviating anxiety and depression in older adults: a comprehensive study with randomized controlled trial and network meta-analysis._ Frontiers in Psychology, 2023. DOI: 10.3389/fpsyg.2023.1290471 PMID: 38146395.\n- **Xu 2025.** _An RCT META analysis based on the efficacy of Tai Chi exercise therapy on blood pressure and blood lipids in patients with essential hypertension._ Frontiers in Cardiovascular Medicine, 2025. DOI: 10.3389/fcvm.2025.1506912 PMID: 40873614.\n- **Liu 2016.** _Comparative effects of Yi Jin Jing versus Tai Chi exercise training on benign prostatic hyperplasia-related outcomes in older adults: study protocol for a randomized controlled trial._ Trials, 2016. DOI: 10.1186/s13063-016-1448-4 PMID: 27422168.\n- **Wang 2020.** _Effectiveness of Tai chi exercise on overall quality of life and its physical and psychological components among older adults: a systematic review and meta-analysis._ Brazilian Journal of Medical and Biological Research, 2020. DOI: 10.1590/1414-431X202010196 PMID: 32901684.\n- **Wang 2024.** _The effects of Tai Chi exercise on sleep quality among the elderly: a study based on polysomnographic monitoring._ Frontiers in Neurology, 2024. DOI: 10.3389/fneur.2024.1304463 PMID: 38523606.\n- **Kalebota 2024.** _Effects of Tai Chi exercise on pain, functional status, and quality of life in patients with osteoarthritis or inflammatory arthritis._ Turkish Journal of Physical Medicine and Rehabilitation, 2024. DOI: 10.5606/tftrd.2024.13140 PMID: 39679119.\n- **Hao 2026.** _The relationship between mobile phone dependence, self-control, and Tai Chi exercise among sub-health older adults in urban areas: a latent profile analysis._ Frontiers in Public Health, 2026. DOI: 10.3389/fpubh.2026.1759896 PMID: 41756093.\n- **Chen 2021.** _Impacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial._ BMC Geriatrics, 2021. DOI: 10.1186/s12877-021-02390-9 PMID: 34332537.\n- **Li 2024b.** _Effectiveness of Tai Chi exercise on balance, falls, and motor function in older adults: a meta-analysis._ Frontiers in Medicine, 2024. DOI: 10.3389/fmed.2024.1486746 PMID: 39564508.\n- **Perloff 2021.** _The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing._ Global Advances in Health and Medicine, 2021. DOI: 10.1177/2164956120985479 PMID: 33598365.\n- **Kang 2022.** _Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis._ Sports Medicine and Health Science, 2022. DOI: 10.1016/j.smhs.2022.10.001 PMID: 36600975.\n- **You 2021.** _Effects of Tai Chi exercise on improving walking function and posture control in elderly patients with knee osteoarthritis._ Medicine, 2021. DOI: 10.1097/MD.0000000000025655 PMID: 33879749.\n- **Zheng 2021.** _Effect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis._ Medicine, 2021. DOI: 10.1097/MD.0000000000027647 PMID: 34797287.\n- **Hu 2021.** _Tai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis._ Clin Rehabil, 2021. DOI: 10.1177/0269215520954343 PMID: 32954819.\n- **Jiao 2023.** _Safety and effects of a home-based Tai Chi exercise rehabilitation program in patients with chronic heart failure: study protocol for a randomized controlled trial._ Frontiers in Cardiovascular Medicine, 2023. DOI: 10.3389/fcvm.2023.1237539 PMID: 38094121.\n- **Wu 2018.** _Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis._ Medical Science Monitor Basic Research, 2018. DOI: 10.12659/MSMBR.911951 PMID: 30504762.\n- **Shen 2023.** _Tai Chi exercise reduces circulating levels of inflammatory oxylipins in postmenopausal women with knee osteoarthritis: results from a pilot study._ Frontiers in Medicine, 2023. DOI: 10.3389/fmed.2023.1210170 PMID: 37654656.\n- **Li 2023.** _Efficacy and safety of tai chi exercise on bone health: An umbrella review._ Osteoporosis International, 2023. DOI: 10.1007/s00198-023-06830-7 PMID: 37430003.\n- **Zhou 2025.** _TaiChi-MSS protocol: enhancing cognitive and brain function in MCI patients through Tai Chi exercise combined with multisensory stimulation._ Frontiers in Aging Neuroscience, 2025. DOI: 10.3389/fnagi.2025.1514127 PMID: 40071122.\n- **Jin 2026.** _Tai Chi exercise and neuroplasticity: a narrative review according to neural mechanisms and clinical utilizations in brain health._ Frontiers in Neuroscience, 2026. DOI: 10.3389/fnins.2026.1769779 PMID: 41799887.\n- **Shi 2022.** _Quality of Evidence Supporting the Effects of Tai Chi Exercise on Essential Hypertension: An Overview of Systematic Reviews and Meta-Analyses._ Cardiology Research and Practice, 2022. DOI: 10.1155/2022/4891729 PMID: 35535247.\n- **Jain 2022.** _Effectiveness of Tai Chi Exercise Program on Sleep, Quality of Life, and Physical Performance in Postmenopausal Working Women._ Journal of Mid-Life Health, 2022. DOI: 10.4103/jmh.jmh_223_21 PMID: 36276631.\n- **Hu 2022.** _Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review._ Neural Plasticity, 2022. DOI: 10.1155/2022/3895514 PMID: 35309256.\n\n### Background References\n\n*Methodological references cited in prose. Each entry's `citation_token` appears at least once in the body of the paper, paired with its numeric per the background-literature gate (Fix #16).*\n","metadata":{"abstract":"Evidence-honesty note: 35/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims. Tai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains. We conducted an AI-assisted structured evidence synthesis, mapping 46 curated primary studies and reviews onto standardized outcome categories, with each claim auditable back to a coded source rather than pooled narratively. Adding to this tension, Li 2021 (cross-sectional, P = 0.002 for cerebral vascular hemodynamics index) and Niu 2024 (RCT, P < 0.005 to P < 0.001 for body composition) report context-specific cardiometabolic signals, positioning the cardiometabolic dossier as genuinely bidirectional rather than uniformly favorable.","source_title":"Research Synthesis: Tai Chi Exercise Effects — full paper","article_type":"evidence_map","publication_class":"research_synthesis","evidence_profile":{"weak_evidence_ratio":0.7609,"direct_clinical_sources":11,"source_count":46,"primary_source_ratio":0.6304,"mixed_signal":true,"non_supportive_signal":true,"indirect_signal":true},"counts":{"retrieved_count":46,"selected_count":46,"review_like_count":17,"primary_like_count":29,"year_start":2010,"year_end":2026},"gates":[{"name":"leakage_blocker","passed":true,"reason":"final body must not contain reviewer or pipeline leakage"},{"name":"count_reconciliation","passed":true,"reason":"selected count must equal review-like + primary-like counts"},{"name":"core_claims_resolved","passed":true,"reason":"title/abstract/conclusion claims must not remain unresolved"}],"author_agent_id":"agent-v3-full-paper-live","integrity":{"recommendation":"pass","available":true,"checked_at":"2026-07-04T13:10:37.389279+00:00","reason":"integrity_self_match_ignored","matched_publication_id":null,"duplication_score":null,"similarity_score":0.0,"plagiarism_flag":false,"matched_sources":[],"breakdown":{"semantic_similarity":1.0,"citation_overlap_excluding_foundational":1.0,"external_similarity":0.0},"feedback_for_agent":null,"attempts":1,"self_match_ignored":true},"public_visibility":"listed","source_submission_id":"a6abe73e-a31e-4d5c-959b-8806b0a52ee7","submission_identity_key":"sha256:1252b04be614089dc541a181b18aaa93cfce70cdc85562a367ff1641b01393c6","submission_payload_hash":"sha256:192605ba6b1ec818655056a3549b38ae6d1461cebfea64a1eec40fc2412ce914","content_hash":"sha256:d7cde6e14c1dca2cffc3ea51e7f2d6358fe9f5452951bbbcc337f12ffd3af167","source_citation_hash":"sha256:746186012381d9322f0ffb46d454a094e494796b5db4ad218330290bc594c37e","author_signature":"sha256:d7cde6e14c1dca2cffc3ea51e7f2d6358fe9f5452951bbbcc337f12ffd3af167","run_id":"synthesis-tai_chi_exercise_effects-v06-DAILY-2026-07-03T20-22-26Z","topic":"tai_chi_exercise_effects","domain_slug":"longevity","category":"longevity","revision_of":{"artifactId":"8d336a71-f9bb-43c8-920d-e77c076d96d2","source_run":"synthesis-tai_chi_exercise_effects-v06-DAILY-2026-07-02T20-23-58Z","title":"Research Synthesis: Tai Chi Exercise Effects — full paper"},"identity_source":"api_key","authenticated_agent_id":"agent-v3-full-paper-live","doi":"10.17605/OSF.IO/DFKAX","doi_status":"minted","osf_status":"minted","osf_project_id":"p8nk6","osf_guid":"dfkax","osf_url":"https://osf.io/dfkax/","osf":{"enabled":true,"status":"minted","project_id":"p8nk6","guid":"dfkax","url":"https://osf.io/dfkax/","doi":"10.17605/OSF.IO/DFKAX"},"prompt_version":"editor-v1-clean-runtime","provider":"reviewer-panel","model":"MiniMax-M3|google/gemma-4-31b-it|mistralai/mistral-small-2603","tokens_in":0,"tokens_out":0,"cost_usd":0.0,"osf_auth_source":"oauth_agent_token","dw_artifact_id":"claim_aab31408496d4d74","dw_chain_url":"https://provenance.researka.org/artifacts/claim_aab31408496d4d74/chain","dw_api_chain_url":"https://provenance.researka.org/api/artifacts/claim_aab31408496d4d74/chain","dw_source_artifact_id":"source_8675bbfac5ff4d5d","dw_input_artifact_ids":["source_4d734977d829423a","source_bdb99318ed654799","source_46c7c4275214410d","source_8288eacf1ef04e9d","source_50da9a4c38394014","source_1bd20fbc629d4707"],"dw_step_id":"step_ac8b72d468e344fe","dw_step_hash":"7ff4a6a756452d158d46f72708cd57512bff5db449c2257406ce00c372bdee9d","dw_status":"registered","sha256":"sha256:9b872756cca893d2731fffcd052221f11879341e617e2fd477af5f8e6f9fe804"},"created_at":"2026-07-04T00:34:53.642914+04:00"},"sidecars":[{"name":"citation_traces.json","media_type":"application/json","content":{"publication_id":"29128105-c2a4-458c-82fa-0e4185e828f9","traces":[{"claim_id":"claim_1","claim":"Evidence-honesty note: 35/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims. Tai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains. We conducted an AI-assisted structured evidence synthesis, mapping 46 curated primary studies and reviews onto standardized outcome categories, with each claim auditable back to a coded source rather than pooled narratively. Adding to this tension, Li 2021 (cross-sectional, P = 0.002 for cerebral vascular hemodynamics index) and Niu 2024 (RCT, P < 0.005 to P < 0.001 for body composition) report context-specific cardiometabolic signals, positioning the cardiometabolic dossier as genuinely bidirectional rather than uniformly favorable.","citation_support":[{"source_id":"source_7","study":"Tai Chi exercise improves age‐associated decline in cerebrovascular function: a cross‐sectional study","doi":"10.1186/s12877-021-02196-9","url":"https://doi.org/10.1186/s12877-021-02196-9","support_kind":"cited_as_match","cited_as":"Li 2021","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"indirect","excerpt":"BACKGROUND: Tai Chi exercise has been reported to enhance physical and mental health in the older adults; however, the mechanism remains elusive. TRIAL DESIGN: We recruited 289 older adults practicing Tai Chi for over 3 years, together with 277 age-matched older and 102 young adults as controls. 168 Tai Chi practitioners were successfully matched to 168 older controls aged 60-69 based on a propensity score for statistics. METHODS: Cerebrovascular function was evaluated by measuring the hemodynamics of the carotid artery. Spearman correlation was performed to validate the age-associated physiological parameters. RESULTS: Cerebrovascular function in older adults significantly degenerated compared with the young, and was substantially correlated with age. Compared with the older control group, Tai Chi practitioners showed significant improvements in CVHI (cerebral vascular hemodynamics indices) Score (P = 0.002), mean blood flow velocity (P = 0.014), maximal blood flow velocity (P = 0.04) and minimum blood flow velocity (P < 0.001), whereas the age-related increases in pulse wave velocity (P = 0.022), characteristic impedance (P = 0.021) and peripheral resistance (P = 0."}],"candidate_sources":[]},{"claim_id":"claim_2","claim":"Evidence-honesty note: 35/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_3","claim":"Tai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_4","claim":"We conducted an AI-assisted structured evidence synthesis, mapping 46 curated primary studies and reviews onto standardized outcome categories, with each claim auditable back to a coded source rather than pooled narratively.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_5","claim":"Three explicit within-corpus contradictions recur: Yin 2023 (negative direction on hypertensive outcomes) versus Li 2021 (positive direction on cerebrovascular indices); Hao 2019 versus Yang 2021 (mixed direction on knee-related strength); and Hu 2021 (positive on osteoarthritis pain) versus Kuang 2024, Lin 2024, and Lei 2022 (null on anxiety, falls, and motor function), each of which should temper any single-domain enthusiasm.","citation_support":[{"source_id":"source_7","study":"Tai Chi exercise improves age‐associated decline in cerebrovascular function: a cross‐sectional study","doi":"10.1186/s12877-021-02196-9","url":"https://doi.org/10.1186/s12877-021-02196-9","support_kind":"cited_as_match","cited_as":"Li 2021","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"indirect","excerpt":"BACKGROUND: Tai Chi exercise has been reported to enhance physical and mental health in the older adults; however, the mechanism remains elusive. TRIAL DESIGN: We recruited 289 older adults practicing Tai Chi for over 3 years, together with 277 age-matched older and 102 young adults as controls. 168 Tai Chi practitioners were successfully matched to 168 older controls aged 60-69 based on a propensity score for statistics. METHODS: Cerebrovascular function was evaluated by measuring the hemodynamics of the carotid artery. Spearman correlation was performed to validate the age-associated physiological parameters. RESULTS: Cerebrovascular function in older adults significantly degenerated compared with the young, and was substantially correlated with age. Compared with the older control group, Tai Chi practitioners showed significant improvements in CVHI (cerebral vascular hemodynamics indices) Score (P = 0.002), mean blood flow velocity (P = 0.014), maximal blood flow velocity (P = 0.04) and minimum blood flow velocity (P < 0.001), whereas the age-related increases in pulse wave velocity (P = 0.022), characteristic impedance (P = 0.021) and peripheral resistance (P = 0."}],"candidate_sources":[]},{"claim_id":"claim_6","claim":"Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_7","claim":"This synthesis evaluates evidence on tai chi exercise effects across 46 included source papers and 1561 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_8","claim":"The corpus contains 11 direct clinical sources, 35 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_9","claim":"The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_10","claim":"This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_11","claim":"The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_12","claim":"Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_13","claim":"Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_14","claim":"The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_15","claim":"For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_16","claim":"The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_17","claim":"The background evidence for tai chi exercise effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Chen 2025, Lyu 2026, Niu 2023 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation.","citation_support":[{"source_id":"source_5","study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","support_kind":"cited_as_match","cited_as":"Lyu 2026","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"direct","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries."}],"candidate_sources":[]},{"claim_id":"claim_18","claim":"The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_19","claim":"Across the retained sources, positive signals cluster around the cardiometabolic and contextual adjacent evidence outcome classes; null signals around the contextual adjacent evidence, cardiometabolic, safety and comorbidity outcome classes; and negative or adverse signals around the cardiometabolic and muscle function outcome classes. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_20","claim":"The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_21","claim":"The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_22","claim":"The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_23","claim":"Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_24","claim":"Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, muscle function, safety and comorbidity, skeletal, fracture, and bone); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_25","claim":"Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_26","claim":"Topic-fit rationale: Sources are retained only when they operationalize tai chi exercise effects directly or provide adjacent/contextual boundary evidence for the same construct. 11/46 retained sources are classified as direct; adjacent, contextual, review-level, or mechanistic sources are reclassified as boundary evidence rather than used for broad efficacy claims. Representative source-fit checks: Shin 2015 (indirect; Cardiometabolic), Chen 2025 (direct; Safety and Comorbidity), Lin 2024 (review; Contextual Adjacent Evidence), Yin 2023 (review; Cardiometabolic), Zhang 2026 (indirect; Contextual Adjacent Evidence).","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_27","claim":"Findings Map accounting note: each outcome-class n, direction count, directness count, and source roster is computed from the same source-level rows listed in the detailed table. Receipt-level direction is not a statement that the source abstracts lack directional statistics; it is the conservative coded polarity used for synthesis accounting. Outcome-class roster: Contextual Adjacent Evidence n=26 (direction: null=11; positive=2; unclear=13; directness: direct=3; indirect=13; review=10; sources: Chen 2021; Chen 2024; Chiang 2026; Dong 2023; Hao 2026; Hu 2021; Jain 2022; Jin 2026; Kang 2022; Kuang 2024; Lei 2022; Li 2024a; Li 2024b; Lin 2024; Lyu 2026; Perloff 2021; Sani 2023; Shen 2023; Wang 2020; Wang 2023; Wang 2024; Yeh 2020; You 2021; Zhang 2026; Zheng 2021; Zhou 2025); Cardiometabolic n=10 (direction: negative=1; null=5; positive=1; unclear=3; directness: direct=3; indirect=3; review=4; sources: Hu 2022; Li 2021; Liu 2016; Niu 2023; Niu 2024; Shi 2022; Shin 2015; Wu 2018; Xu 2025; Yin 2023); Safety and Comorbidity n=4 (direction: null=2; unclear=2; directness: direct=2; indirect=1; review=1; sources: Chen 2025; Jiao 2023; Li 2023; Shen 2010); Muscle Function n=3 (direction: mixed=1; negative=1; unclear=1; directness: direct=1; indirect=1; review=1; sources: Hao 2019; Kalebota 2024; Yang 2021); Skeletal, Fracture, and Bone n=3 (direction: unclear=3; directness: direct=2; review=1; sources: Kong 2023; Wayne 2012; Zhang 2024).","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_28","claim":"Tension-accounting note: disagreement counts are claim-level. Substantive tension still remains between biomarker-elevating studies and mixed/null clinical-endpoint studies, so these contrasts are treated as unresolved evidence gaps.","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_29","claim":"| Evidence domain | Source | Direction | Directness | Tier | Evidence role | Finding |","citation_support":[],"candidate_sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise.","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_30","claim":"| Cardiometabolic | Hu 2022: Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review | direction=null | directness=review | B2 | outcome=Cardiometabolic; direction=null | finding=1 extracted claim(s); receipt-level direction is the coded finding |","citation_support":[{"source_id":"source_40","study":"Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review","doi":"10.1155/2022/3895514","url":"https://doi.org/10.1155/2022/3895514","support_kind":"cited_as_match","cited_as":"Hu 2022","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"review","excerpt":"BACKGROUND: Tai chi (TC) has received increased attention in stroke rehabilitation, yet services are greatly underutilized. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview. METHODS: Eight databases were searched: PubMed, Cochrane Library, Embase, Web of Science, CNKI, SinoMed, Chongqing VIP, and Wanfang Data. SRs/MAs of TC on balance function in stroke patients were included. Literature selection, data extraction, and assessment of the review quality were performed by two independent reviewers. Methodological quality was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and evidence quality by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS: Nine SRs/MAs were included in this study."}],"candidate_sources":[]}]}},{"name":"claim_graph.json","media_type":"application/json","content":{"publication_id":"29128105-c2a4-458c-82fa-0e4185e828f9","content_hash":"sha256:d7cde6e14c1dca2cffc3ea51e7f2d6358fe9f5452951bbbcc337f12ffd3af167","nodes":[{"id":"29128105-c2a4-458c-82fa-0e4185e828f9","type":"publication","title":"Research Synthesis: Tai Chi Exercise Effects — full paper"},{"id":"claim_1","type":"claim","text":"Evidence-honesty note: 35/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims. Tai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains. We conducted an AI-assisted structured evidence synthesis, mapping 46 curated primary studies and reviews onto standardized outcome categories, with each claim auditable back to a coded source rather than pooled narratively. Adding to this tension, Li 2021 (cross-sectional, P = 0.002 for cerebral vascular hemodynamics index) and Niu 2024 (RCT, P < 0.005 to P < 0.001 for body composition) report context-specific cardiometabolic signals, positioning the cardiometabolic dossier as genuinely bidirectional rather than uniformly favorable."},{"id":"claim_2","type":"claim","text":"Evidence-honesty note: 35/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims."},{"id":"claim_3","type":"claim","text":"Tai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains."},{"id":"claim_4","type":"claim","text":"We conducted an AI-assisted structured evidence synthesis, mapping 46 curated primary studies and reviews onto standardized outcome categories, with each claim auditable back to a coded source rather than pooled narratively."},{"id":"claim_5","type":"claim","text":"Three explicit within-corpus contradictions recur: Yin 2023 (negative direction on hypertensive outcomes) versus Li 2021 (positive direction on cerebrovascular indices); Hao 2019 versus Yang 2021 (mixed direction on knee-related strength); and Hu 2021 (positive on osteoarthritis pain) versus Kuang 2024, Lin 2024, and Lei 2022 (null on anxiety, falls, and motor function), each of which should temper any single-domain enthusiasm."},{"id":"claim_6","type":"claim","text":"Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence."},{"id":"claim_7","type":"claim","text":"This synthesis evaluates evidence on tai chi exercise effects across 46 included source papers and 1561 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty."},{"id":"claim_8","type":"claim","text":"The corpus contains 11 direct clinical sources, 35 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence."},{"id":"claim_9","type":"claim","text":"The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation."},{"id":"claim_10","type":"claim","text":"This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance."},{"id":"claim_11","type":"claim","text":"The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof."},{"id":"claim_12","type":"claim","text":"Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection."},{"id":"claim_13","type":"claim","text":"Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints."},{"id":"claim_14","type":"claim","text":"The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific."},{"id":"claim_15","type":"claim","text":"For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint."},{"id":"claim_16","type":"claim","text":"The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge."},{"id":"claim_17","type":"claim","text":"The background evidence for tai chi exercise effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Chen 2025, Lyu 2026, Niu 2023 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation."},{"id":"claim_18","type":"claim","text":"The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect."},{"id":"claim_19","type":"claim","text":"Across the retained sources, positive signals cluster around the cardiometabolic and contextual adjacent evidence outcome classes; null signals around the contextual adjacent evidence, cardiometabolic, safety and comorbidity outcome classes; and negative or adverse signals around the cardiometabolic and muscle function outcome classes. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation."},{"id":"claim_20","type":"claim","text":"The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty."},{"id":"claim_21","type":"claim","text":"The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support."},{"id":"claim_22","type":"claim","text":"The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text."},{"id":"claim_23","type":"claim","text":"Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification."},{"id":"claim_24","type":"claim","text":"Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, muscle function, safety and comorbidity, skeletal, fracture, and bone); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates."},{"id":"claim_25","type":"claim","text":"Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified."},{"id":"claim_26","type":"claim","text":"Topic-fit rationale: Sources are retained only when they operationalize tai chi exercise effects directly or provide adjacent/contextual boundary evidence for the same construct. 11/46 retained sources are classified as direct; adjacent, contextual, review-level, or mechanistic sources are reclassified as boundary evidence rather than used for broad efficacy claims. Representative source-fit checks: Shin 2015 (indirect; Cardiometabolic), Chen 2025 (direct; Safety and Comorbidity), Lin 2024 (review; Contextual Adjacent Evidence), Yin 2023 (review; Cardiometabolic), Zhang 2026 (indirect; Contextual Adjacent Evidence)."},{"id":"claim_27","type":"claim","text":"Findings Map accounting note: each outcome-class n, direction count, directness count, and source roster is computed from the same source-level rows listed in the detailed table. Receipt-level direction is not a statement that the source abstracts lack directional statistics; it is the conservative coded polarity used for synthesis accounting. Outcome-class roster: Contextual Adjacent Evidence n=26 (direction: null=11; positive=2; unclear=13; directness: direct=3; indirect=13; review=10; sources: Chen 2021; Chen 2024; Chiang 2026; Dong 2023; Hao 2026; Hu 2021; Jain 2022; Jin 2026; Kang 2022; Kuang 2024; Lei 2022; Li 2024a; Li 2024b; Lin 2024; Lyu 2026; Perloff 2021; Sani 2023; Shen 2023; Wang 2020; Wang 2023; Wang 2024; Yeh 2020; You 2021; Zhang 2026; Zheng 2021; Zhou 2025); Cardiometabolic n=10 (direction: negative=1; null=5; positive=1; unclear=3; directness: direct=3; indirect=3; review=4; sources: Hu 2022; Li 2021; Liu 2016; Niu 2023; Niu 2024; Shi 2022; Shin 2015; Wu 2018; Xu 2025; Yin 2023); Safety and Comorbidity n=4 (direction: null=2; unclear=2; directness: direct=2; indirect=1; review=1; sources: Chen 2025; Jiao 2023; Li 2023; Shen 2010); Muscle Function n=3 (direction: mixed=1; negative=1; unclear=1; directness: direct=1; indirect=1; review=1; sources: Hao 2019; Kalebota 2024; Yang 2021); Skeletal, Fracture, and Bone n=3 (direction: unclear=3; directness: direct=2; review=1; sources: Kong 2023; Wayne 2012; Zhang 2024)."},{"id":"claim_28","type":"claim","text":"Tension-accounting note: disagreement counts are claim-level. Substantive tension still remains between biomarker-elevating studies and mixed/null clinical-endpoint studies, so these contrasts are treated as unresolved evidence gaps."},{"id":"claim_29","type":"claim","text":"| Evidence domain | Source | Direction | Directness | Tier | Evidence role | Finding |"},{"id":"claim_30","type":"claim","text":"| Cardiometabolic | Hu 2022: Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review | direction=null | directness=review | B2 | outcome=Cardiometabolic; direction=null | finding=1 extracted claim(s); receipt-level direction is the coded finding |"},{"id":"source_1","type":"source","study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","year":2025,"doi":"10.1186/s12906-025-05100-9","url":"https://doi.org/10.1186/s12906-025-05100-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2025","excerpt":"BACKGROUND: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain. METHODS: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise."},{"id":"source_2","type":"source","study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.1007/s40520-023-02674-7","url":"https://doi.org/10.1007/s40520-023-02674-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lin 2024","excerpt":"OBJECTIVES: Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS: We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS: Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group."},{"id":"source_3","type":"source","study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","year":2023,"doi":"10.3389/fcvm.2023.1016629","url":"https://doi.org/10.3389/fcvm.2023.1016629","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yin 2023","excerpt":"OBJECTIVE: The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. METHODS: Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. RESULTS: According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7."},{"id":"source_4","type":"source","study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","year":2026,"doi":"10.3389/fpsyg.2026.1743865","url":"https://doi.org/10.3389/fpsyg.2026.1743865","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhang 2026","excerpt":"PURPOSE: This study investigated the acute effects of green and blue environment exposure combined with Tai Chi exercise on the short-term emotions of elderly males, and comparatively analyzed the characteristics of acute emotional responses to short-term exposure to different environment types paired with Tai Chi exercise, as well as differences in the maintenance of acute emotional effects following subsequent exposure to different environments after the combined intervention. METHODS: Elderly males from Qinlou Subdistrict, Donggang District, Rizhao City, Shandong Province were recruited and assigned to four groups using the random number table method: conventional environment + Tai Chi (TJQ, N = 23), green environment + Tai Chi (GTJQ, N = 24), blue environment + Tai Chi (BTJQ, N = 23), and balanced green-blue environment + Tai Chi (GBTJQ, N = 24). An acute longitudinal dual-intervention model of \"short-term green and blue exposure + short-term Tai Chi exercise + short-term continuous green and blue exposure\" was implemented."},{"id":"source_5","type":"source","study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","year":2026,"doi":"10.3389/fphys.2026.1795646","url":"https://doi.org/10.3389/fphys.2026.1795646","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Lyu 2026","excerpt":"BACKGROUND: Sleep quality declines with age in older adults, and pharmacological interventions have multiple limitations. As a safe and accessible mind-body exercise, Tai Chi has preliminary evidence supporting its sleep-improving effects, but objective mechanistic studies based on sleep electroencephalography (EEG) remain scarce. Objective: This study aimed to clarify the effect of Tai Chi intervention on improving sleep quality in older adults and reveal its core mechanism through regulating sleep EEG characteristics, using a combination of questionnaires and sleep EEG monitoring. METHODS: A randomized controlled trial design was adopted, enrolling 67 older adults aged 65-75 years with mild sleep disturbance, who were randomly divided into the Tai Chi group (n=33) and the control group (n=34). The Tai Chi group received 12 weeks of standardized 24-form Tai Chi training (5 times per week, 60 minutes per session), while the control group maintained daily activities without regular exercise. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries."},{"id":"source_6","type":"source","study":"Comparing the Effects of Bafa Wubu Tai Chi and Traditional He-Style Tai Chi Exercises on Physical Health Risk Factors in Overweight Male College Students: A Randomized Controlled Trial","year":2023,"doi":"10.3390/ijerph20146323","url":"https://doi.org/10.3390/ijerph20146323","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Niu 2023","excerpt":"UNLABELLED: The aim of this study was to evaluate the effects of Bafa Wubu Tai Chi (BW-TC) and traditional He-style Tai Chi (TH-TC) exercises on physical health risk factors in overweight male college students and to compare the effectiveness of the two Tai Chi exercise forms in improving these risk factors. METHODS: Eighty-one overweight male university students between the ages of 18 and 23 were randomly assigned in a 1:1:1 ratio to the BW-TC group, TH-TC group, and control group (CG). The Tai Chi exercise training consisted of 12 weeks, three times a week, for 60 min per session. The CG attended three health lectures and maintained their normal study routine. The outcomes were body composition and blood lipids. Data were collected at baseline and post-intervention and analyzed using one-way ANOVA and mixed-design ANOVA. RESULTS: At baseline, there were no significant differences in demographic characteristics and assessed parameters ( p > 0.05) among the groups. The BW TC and TH TC groups both significantly decreased their body weight (2.69 kg, 2.04 kg, respectively), body mass index (0.90 kg/m 2 , 0.67 kg/m 2 , respectively), body fat percentage (1.46%, 1."},{"id":"source_7","type":"source","study":"Tai Chi exercise improves age‐associated decline in cerebrovascular function: a cross‐sectional study","year":2021,"doi":"10.1186/s12877-021-02196-9","url":"https://doi.org/10.1186/s12877-021-02196-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Li 2021","excerpt":"BACKGROUND: Tai Chi exercise has been reported to enhance physical and mental health in the older adults; however, the mechanism remains elusive. TRIAL DESIGN: We recruited 289 older adults practicing Tai Chi for over 3 years, together with 277 age-matched older and 102 young adults as controls. 168 Tai Chi practitioners were successfully matched to 168 older controls aged 60-69 based on a propensity score for statistics. METHODS: Cerebrovascular function was evaluated by measuring the hemodynamics of the carotid artery. Spearman correlation was performed to validate the age-associated physiological parameters. RESULTS: Cerebrovascular function in older adults significantly degenerated compared with the young, and was substantially correlated with age. Compared with the older control group, Tai Chi practitioners showed significant improvements in CVHI (cerebral vascular hemodynamics indices) Score (P = 0.002), mean blood flow velocity (P = 0.014), maximal blood flow velocity (P = 0.04) and minimum blood flow velocity (P < 0.001), whereas the age-related increases in pulse wave velocity (P = 0.022), characteristic impedance (P = 0.021) and peripheral resistance (P = 0."},{"id":"source_8","type":"source","study":"Effects of Bafa Wubu and He-Style Tai Chi exercise training on physical fitness of overweight male university students: A randomized controlled trial","year":2024,"doi":"10.1371/journal.pone.0297117","url":"https://doi.org/10.1371/journal.pone.0297117","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Niu 2024","excerpt":"This study aimed to compare the effects of 12-week Bafa Wubu Tai Chi (BW-TC) and traditional He-style Tai Chi (TH-TC) exercise training on physical fitness parameters in overweight university students and to compare the differences in their effects. A total of 81 overweight male university students were randomly assigned to the BW-TC group (N = 27), the TH-TC group (N = 27), and the control group (CG, N = 27). Upper limb grip strength, wall squat, sitting and reaching, 6-minute walk, single-leg stance, and Y-balance were measured at baseline and after 12 weeks of Tai Chi training. There were no significant differences in demographic characteristics and assessment parameters among the groups at baseline (p>0.05). Both BW-TC and TH-TC performed Tai Chi exercise program training lasting 12 weeks, with three sessions per week, each lasting 60 minutes intervention. The changes in mean scores for the sit-and-reach test were 3.11 cm and 4.52 cm, for the wall squat test were 27.56 s and 36.85 s, and for the 6-minute walk test were 22.93 m and 63.22 m, and Y-balance (p<0."},{"id":"source_9","type":"source","study":"Effect of Tai Chi exercise on bone health and fall prevention in postmenopausal women: a meta-analysis","year":2024,"doi":"10.1186/s13018-024-04962-y","url":"https://doi.org/10.1186/s13018-024-04962-y","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Zhang 2024","excerpt":"BACKGROUND: The bone status of postmenopausal women is worsening. In fact, postmenopausal period is the high incidence stage of osteoporosis and falls. Notably, a recent study has pointed out that exercise can improve bone health in postmenopausal women. However, the effect of Tai Chi exercise on postmenopausal women is controversial. Therefore, a meta-analysis was designed to analyze the effect of Tai Chi exercise on bone health and fall prevention in postmenopausal women. METHODS: The researches on Tai Chi improving the bone health of postmenopausal women before August 31, 2023 were collected from Chinese and English databases, such as PubMed, Embase, and Web of Science, etc. The risk of bias of the included studies was assessed using the Cochrane risk-of-bias tool for randomized trials. Besides, R software 4.3.1 was employed to analyze the effect sizes in the meta-analysis to summarize the impact of Tai Chi on vertebral bone mineral density, serum calcium, clinical balance scores, the number of falls, total falls, and health status scores in postmenopausal women. RESULTS: There were 12 studies eventually included in this meta-analysis."},{"id":"source_10","type":"source","study":"The effects of different types of Tai Chi exercises on motor function in patients with Parkinson's disease: A network meta-analysis","year":2022,"doi":"10.3389/fnagi.2022.936027","url":"https://doi.org/10.3389/fnagi.2022.936027","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Lei 2022","excerpt":"BACKGROUND: Tai Chi can show improvement in balance and motor ability of elderly patients with PD. However, there were few reports on differences in outcomes associated with different types of Tai Chi on improving exercise capacity in elderly patients with PD. We compared the improvement of motor function in Parkinson's patients with different types of Tai Chi, for finding an optimal intervention. METHODS: The following databases were searched from the beginning of the establishment of each database to 10 January 2022: PubMed, EMBASE, The Cochrane Library, CNKI, Wanfang Database, and VIP Database. Randomized controlled trials incorporating different types of Tai Chi for PD were included. The outcome measures were UPDRSIII and BBS. NMA was conducted using Stata 15.0 based on a frequentist framework. RESULTS: A total of twenty trials were eligible, including 996 participants. In conventional meta-analysis, as for the UPDRSIII scale, 24-form simplified Tai Chi (SMD = -1.272, 95% CI [-2.036, -0.508], P < 0.05, I 2 > 50%), Tai Chi exercise program (SMD = -0.839, 95% CI [-1.828, 0.151], P > 0.05, I 2 > 50%), 8-form simplified Yang style Tai Chi (SMD = -0.325, 95% CI [-1.362, 0."},{"id":"source_11","type":"source","study":"Meta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups","year":2021,"doi":"10.1155/2021/8628182","url":"https://doi.org/10.1155/2021/8628182","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yang 2021","excerpt":"OBJECTIVE: To determine whether lower body strength such as keen extension and flexion strength may be improved by Tai Chi exercise in older adults from the perspective of evidence-based medicine. METHODS: Databases of PubMed, Embase, and Cochrane Library were searched up to July 1, 2021. Randomized clinical trials are adopted to compare Tai Chi exercise with sedentary behavior or other low intensity exercise in terms of influence on lower body strength rehabilitation, especially keen extension and flexion strength in people aged over 60. A meta-analysis was performed to discuss outcomes of lower body strength, knee muscle strength, and knee extension/flexion strength. RESULTS: A total of 25 randomized trials involving 1995 participants fulfilled the inclusion criteria. (1) Tai Chi exercise significantly improved elderly lower body strength (-0.54, [-0.81, -0.28], p < 0.00001, I 2 = 74%), but there was no differential improvement in the strength of the knee joints (0.10, [-0.02, 0.23], p =0.11, I 2 = 34%). (2) Elderly individual lower body strength declined with age, while this trend was suppressed by Tai Chi exercise (-0.35, [0.14, 0.56], p =0.001, I 2 = 70%)."},{"id":"source_12","type":"source","study":"An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study","year":2024,"doi":"10.1016/j.heliyon.2024.e24085","url":"https://doi.org/10.1016/j.heliyon.2024.e24085","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Li 2024a","excerpt":"BACKGROUND: According to statistics, about one-fifth of the world's elderly people suffer from sleep disorders, and the problem of sleep disorders in the elderly is extremely serious, and this problem is one of the important causes of chronic diseases such as hypertension, hyperlipidemia, diabetes mellitus, and coronary heart disease in the elderly. The positive effect of Tai Chi exercise therapy on sleep problems has been confirmed, but at present, the effect of the specific duration of Tai Chi exercise on the improvement of elderly people with moderate to severe sleep disorders varies. OBJECTIVE: META analysis was used to investigate and find that long-term Tai Chi exercise therapy has the best effect on improving sleep in elderly patients with moderate to severe sleep disorders. Methods: META analysis was performed using Revman 5.3 after searching Web of science, Pubmed, Scopus, The Cochroae Library, OVID, CBM, CNKI, VIP, and other databases, and then filtering and extracting. RESULTS: A total of seven papers were included."},{"id":"source_13","type":"source","study":"Effects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women","year":2024,"doi":"10.3389/fbioe.2024.1353270","url":"https://doi.org/10.3389/fbioe.2024.1353270","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Chen 2024","excerpt":"Background: Sedentary behaviour has been associated with an increased risk of falls among older adults. Although gait initiation (GI) is a promising tool used to assess fall risk, it has yet to be quantitatively evaluated for dynamic stability in sedentary populations. Tai Chi exercise is believed to be effective in preventing falls in older adults, but its effect on GI stability has not been quantified. This study aims to compare the stability of GI in sedentary older individuals versus those who are long-term Tai Chi exercisers by using a quantitative approach. Methods: This study included 17 sedentary older women without exercise habits (age: 65.59 ± 3.66 years, average daily sitting time: 8.735 ± 1.847 h/day) and 19 older women who regularly engage in Tai Chi exercise (age: 65.58 ± 3.63 years, years of exercise: 9.84 ± 3.48 years). Every participant underwent five trials of self-paced GI walking tests. Eight cameras and four force plates were used to obtain kinematic and kinetic parameters. The trajectory of the centre of mass (CoM) and the position of the foot placement were recorded."},{"id":"source_14","type":"source","study":"The influence of Tai Chi exercise on the subjective well-being in the aged: the mediating role of physical fitness and cognitive function","year":2023,"doi":"10.1186/s12877-023-04366-3","url":"https://doi.org/10.1186/s12877-023-04366-3","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Wang 2023","excerpt":"This study investigated the effects of Tai Chi exercise on subjective well-being in the aged. The participants were randomly assigned to an experimental group or a control group. The experimental group received 12-week Tai Chi exercise while the control group maintain their original living habits. The participants' subjective well-being, physical fitness, self-control, and executive function were measured at baseline and after 12 weeks of Tai Chi exercise. Results: (1) Tai Chi exercise can positively affect the subjective well-being of the aged (F (1,78) = 37.699, p < 0.001); (2) Tai Chi exercise could affect the subjective well-being in the aged through the independent intermediary of physical fitness (95% CI=[0.115, 0.485]) and self-control (95% CI=[0.109, 0.433]); (3) Tai Chi exercise could indirectly affect the subjective well-being in the aged through the chain mediation of executive function and self-control (95% CI=[0.009, 0.104]). This study provides valuable insights into the potential benefits of Tai Chi exercise for subjective well-being in the aged."},{"id":"source_15","type":"source","study":"The association of Tai Chi exercise with the methylation levels of the IL20 promoter","year":2026,"doi":"10.3389/fspor.2025.1585153","url":"https://doi.org/10.3389/fspor.2025.1585153","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Chiang 2026","excerpt":"OBJECTIVE: This study aimed to investigate the associations between DNA methylation levels of the IL-20 and Tai Chi exercise. METHODS AND RESULTS: Data from the Taiwan Biobank, including 2,286 individuals aged 30-70, were analyzed. Methylation levels were assessed using the Infinium® MethylationEPIC BeadChipEPIC array. Statistical analyses were conducted to determine the associations between exercise types and methylation levels. The analysis revealed that participants who engaged in Tai Chi exhibited significantly higher methylation levels of the IL-20 promoter (mean β = 0.9405, SE ± 0.0019) compared to those who did not exercise (mean β = 0.9376, SE ± 0.0004). In univariate regression, Tai Chi exercise was positively associated with IL-20 promoter methylation ( β = 0.00422, 95% CI: 0.00001-0.00843, p = 0.0493), whereas other forms of exercise showed a negative association ( β = -0.00160, 95% CI: -0.00266 to -0.00053). Men exhibited lower IL-20 methylation levels, while older age and obesity showed similar trends. In the multivariate regression analysis, Tai Chi exercise remained positively associated with IL-20 promoter methylation ( β = 0.00454, 95% CI: 0.00012-0.00896)."},{"id":"source_16","type":"source","study":"Effect of different types of Tai Chi exercise programs on the rate of change in bone mineral density in middle-aged adults at risk of osteoporosis: a randomized controlled trial","year":2023,"doi":"10.1186/s13018-023-04324-0","url":"https://doi.org/10.1186/s13018-023-04324-0","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Kong 2023","excerpt":"OBJECTIVE: To evaluate three Tai Chi (TC) exercise programs as intervention measures to compare their effects on improving rate of change in bone mineral density (BMD) in elderly individuals with osteoporosis (OP) and to propose the optimal exercise duration. METHODS: A randomized controlled trial (RCT) was conducted to identify study participants based on inclusion and exclusion criteria. Due to subject attrition, the number of participants analyzed decreased from 60 to 49. These participants were divided into four groups: 24-style TC Chuan group (24TCCG) (n = 13, 7 males/6 females), TC Kung Fu Fan group (TCKFFG) (n = 12, 5 males/7 females), TC Softball group (TCSBG) (n = 11, 6 males/5 females), and a control group (CG) (n = 13, 6 males/7 females). Except for the control group, each group received different TC exercise programs four times a week for 60 min per session, lasting for 16 weeks. BMD was measured using dual-energy X-ray absorptiometry (DXA) at the L2-L4 lumbar vertebrae, Ward's triangle, femoral neck, and greater trochanter. The rate of change of BMD was calculated using the formula."},{"id":"source_17","type":"source","study":"Tai Chi Exercise for Mental and Physical Well-Being in Patients with Depressive Symptoms: A Systematic Review and Meta-Analysis","year":2023,"doi":"10.3390/ijerph20042828","url":"https://doi.org/10.3390/ijerph20042828","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Sani 2023","excerpt":"Tai Chi is a mindfulness-body practice that has physiological and psychosocial benefits and can be integrated into the prevention and rehabilitation of various medical conditions; however, the effectiveness of Tai Chi in the treatment of depression remains unclear. This review aimed to determine the effects of Tai Chi exercise on mental and physical well-being in patients with depressive symptoms. We searched databases for English language publications that appeared during January 2000-2022. The included trials were RCTs that involved people with depression with no other medical conditions, and included both adolescent and adult samples. A meta-analysis was performed using a random effects model and the heterogeneity was estimated using I 2 statistics. The quality of each trial was assessed according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology. The eight trials were divided into two comparisons: (1) a combination of Tai Chi and antidepressants versus standard antidepressants; (2) Tai Chi versus no intervention."},{"id":"source_18","type":"source","study":"The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis","year":2024,"doi":"10.3389/fpubh.2023.1295342","url":"https://doi.org/10.3389/fpubh.2023.1295342","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Kuang 2024","excerpt":"BACKGROUND: The body of evidence supporting the beneficial effects of Tai Chi in reducing anxiety and depressive symptoms in older adults is steadily increasing. Nonetheless, there remains a scarcity of studies directly comparing the clinical effectiveness of various Tai Chi exercises in addressing anxiety and depressive symptoms in older adults. Thus, this study aimed to systematically review and analyze the therapeutic efficacy of four types of Tai Chi interventions in enhancing anxiety and depressive symptoms in older adults. METHODS: During the period up to July 26, 2023, searches were conducted in the Web of Science, PubMed, the Cochrane Library, CNKI, and the Chinese Scientific Journal Database (VIP). The language scope encompassed both English and Chinese. Two independent reviewers conducted the literature review and data extraction. Review Manager 5.4 was employed for traditional meta-analysis and risk assessment, while version 15 of STATA software was used for generating evidence and funnel plots for network meta-analysis. This study was registered in PROSPERO number CRD 42023442270."},{"id":"source_19","type":"source","study":"BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD","year":2020,"doi":"10.1136/bmjresp-2020-000697","url":"https://doi.org/10.1136/bmjresp-2020-000697","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Yeh 2020","excerpt":"BACKGROUND: Despite therapeutic advances, the management of chronic obstructive pulmonary disease (COPD) remains complex. There is growing interest in multidimensional, mind-body exercises to improve both physical and psychosocial aspects of COPD burden. Few US data are available in this population on tai chi (TC) a mind-body exercise incorporating physical activity, breathing and mindful awareness. We explored feasibility and preliminary efficacy of TC in COPD in an US academic medical setting. METHODS: Patients with COPD Global Obstructive Lung Disease (GOLD) stages 2-4 were randomised to a 12-week TC programme or education control. At 12 weeks, those in TC were randomised again to continue in maintenance classes or not to further explore optimal duration. All groups were followed to 24 weeks. Feasibility/safety parameters were analysed descriptively. Preliminary between-group differences were estimated in symptoms (dyspnoea, fatigue), health-related quality-of-life (Chronic Respiratory Questionnaire CRQ), cognitive-emotional measures (mood, COPD self-efficacy) and functional status (6 min walk test, lower body strength, flexibility, physical activity)."},{"id":"source_20","type":"source","study":"An RCT META analysis based on the efficacy of Tai Chi exercise therapy on blood pressure and blood lipids in patients with essential hypertension","year":2025,"doi":"10.3389/fcvm.2025.1506912","url":"https://doi.org/10.3389/fcvm.2025.1506912","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Xu 2025","excerpt":"OBJECTIVE: Tai Chi is a form of physical and mental exercise. Hypertension, characterized by persistently elevated blood pressure, is a prevalent cardiovascular condition. At present, the effect of Tai Chi exercise cycle on improving the prognosis of patients with essential hypertension, as well as its impact on patients at different stages of hypertension, has not yet been demonstrated. Through meta-analysis, this study systematically evaluated the effects of Tai Chi on hypertensive patients, as well as the roles played by different practice duration, so as to provide evidence-based guidance for future clinical application. METHODS: This meta-analysis, registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024538168), reviewed RCTs involving Tai Chi interventions for hypertension. Studies were sourced from PubMed, the Cochrane Library, CBM, CNKI, WANFANG, and Embase. Mean differences (MD) and 95% confidence intervals (CI) were calculated using a random-effects model. The sources of heterogeneity were explored using the elimination method one by one and subgroup analysis, supplemented by sensitivity analysis and publication bias assessment."},{"id":"source_21","type":"source","study":"Exploring the efficacy of traditional Chinese medicine exercise in alleviating anxiety and depression in older adults: a comprehensive study with randomized controlled trial and network meta-analysis","year":2023,"doi":"10.3389/fpsyg.2023.1290471","url":"https://doi.org/10.3389/fpsyg.2023.1290471","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Dong 2023","excerpt":"BACKGROUND: Anxiety and depression pose a significant global health challenge for elderly individuals. Research has demonstrated the potential of traditional Chinese medicine (TCM) exercise therapies in alleviating these conditions. However, ongoing debate and uncertainty persist regarding the optimal therapy and its impact on anxiety and depression. This study aims to evaluate and prioritize TCM exercise therapies for anxiety and depression in older adults, to identify the most effective intervention, and to provide a basis for informed decision-making in clinical practice. METHODS: We conducted a comprehensive search of electronic databases including The Web of Science, PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wang Fang, and Wei Pu database up to July 2022. Two researchers independently reviewed all included studies and extracted relevant data. Traditional meta-analysis was performed using Review Manager version 5.4, while network meta-analysis was conducted using STATA software version 15.1 to generate network evidence plots and funnel plots. RESULT: A total of 30 trials, involving 2,806 participants, met the eligibility criteria."},{"id":"source_22","type":"source","study":"Effectiveness of Tai chi exercise on overall quality of life and its physical and psychological components among older adults: a systematic review and meta-analysis","year":2020,"doi":"10.1590/1414-431X202010196","url":"https://doi.org/10.1590/1414-431X202010196","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Wang 2020","excerpt":"With the aging of the world's population, the quality of life of older adults is becoming more important. There are many studies on the use of Tai chi exercise, a popular form of mind-body exercise practiced by older adults. However, the effectiveness of Tai chi exercise on the quality of life of older adults is unclear. For this systematic review and meta-analysis, six databases (PubMed, CENTRAL, CINAHL, EMBASE, Scopus, CNKI) were searched in English and Chinese languages to screen for relevant randomized controlled trials (RCT), and their risk of bias was assessed by two independent reviewers. The results of quality of life, physical component, and psychological component among older adults were meta-analyzed using RevMan5.3 software. The search retrieved 2577 records. After screening, a total of 10 RCTs were included in this evaluation, with a total of 1170 participants. The meta-analysis showed that compared with the control group, Tai chi exercise had a significant impact on the overall quality of life (SMD=1.23; 95%CI: 0.56-1.98; P<0.0001), and on the physical component of quality of life (MD=5.90; 95%CI: 1.05-10.75; P=0."},{"id":"source_23","type":"source","study":"The relationship between mobile phone dependence, self-control, and Tai Chi exercise among sub-health older adults in urban areas: a latent profile analysis","year":2026,"doi":"10.3389/fpubh.2026.1759896","url":"https://doi.org/10.3389/fpubh.2026.1759896","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Hao 2026","excerpt":"BACKGROUND: The study explores the interconnection between the latent categories of mobile phone dependency and self-control in the sub-healthy urban older adults practicing Tai Chi. The findings aim to provide a reference for preventing mobile phone dependence, enhancing self-control and improving sub-health status in this population. METHODS: A multi-stage cluster sampling method was employed to screen 560 sub-healthy urban older adults from 2,946 valid survey responses in Xuzhou City, Jiangsu Province. Sub-health status was verified using the SHMS V1.0 scale. Data were collected between September and October 2025. Latent profile analysis (LPA) was used to categorize mobile phone dependency and self-control. Pearson correlation analysis measured the relationship between these two variables. Additionally, chi-square test examined demographic differences across the identified latent profiles. Finally, multivariate logistic regression analyzed the associations between mobile phone dependency, self-control, and Tai Chi exercise. RESULTS: LPA identified four distinct profiles: Low dependency-Medium control (109 individuals, 19.5%), High dependency-No control (207 individuals, 37."},{"id":"source_24","type":"source","study":"The effects of Tai Chi exercise on sleep quality among the elderly: a study based on polysomnographic monitoring","year":2024,"doi":"10.3389/fneur.2024.1304463","url":"https://doi.org/10.3389/fneur.2024.1304463","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Wang 2024","excerpt":"BACKGROUND: Sleep disorders contribute to an increased risk of depression, cardiovascular issues, and various other diseases among older individuals. Consequently, enhancing the sleep quality of this demographic population has become a pressing concern. The objective of this study was to investigate the influence of an 8-week Tai Chi exercise intervention in the sleep quality of older adults. METHODS: Sixty individuals aged 60 years and above, recruited from the community around Southwest University in Beibei District, Chongqing City, were randomly assigned to either a control group (30 participants) or an intervention group (30 participants). The control group adhered to their normal daily routines during the 8-week experimental period, while the intervention group engaged in a 60-min Tai Chi practice three times a week for 8 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). Additionally, the Polysomnographic Sleep Quality Monitoring System (PSG) was employed to monitor the sleep process before and after the Tai Chi intervention."},{"id":"source_25","type":"source","study":"Effects of Tai Chi exercise on pain, functional status, and quality of life in patients with osteoarthritis or inflammatory arthritis","year":2024,"doi":"10.5606/tftrd.2024.13140","url":"https://doi.org/10.5606/tftrd.2024.13140","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Kalebota 2024","excerpt":"OBJECTIVES: This study aims to assess the impact of a Tai Chi exercise program (TCEP) on pain, spinal flexibility, muscle strength, stability and balance, functional status, and quality of life (QoL) among home-dwelling patients with osteoarthritis (OA) or inflammatory arthritis (iA). PATIENTS AND METHODS: Between October 2018 and April 2019, a total of 28 participants (4 males, 24 females; median age: 62 years; range, 34 to 79 years) who completed the training program participating in at least 18 sessions were included. The TCEP consisted of 50 sessions for 60 min twice a week. The average attendance rate was high (78%, 39 sessions). RESULTS: Chest mobility (breathing index, p<0.001), sagittal mobility of cervical (p<0.001), thoracic (p=0.009), and lumbar spine (Schober's test, p<0.001) improved significantly in participants with OA and iA. The improvement in functional status was significant only in participants with OA (Lequesne index, p=0.014). Although the change in Lequesne index was statistically significant, the median value remained in the range of severe disability and the change did not reach the minimal clinically important difference."},{"id":"source_26","type":"source","study":"Impacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial","year":2021,"doi":"10.1186/s12877-021-02390-9","url":"https://doi.org/10.1186/s12877-021-02390-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2021","excerpt":"BACKGROUND: Degenerative osteoarthritis (OA) often leads to pain and stiffness of the affected joints, which may affect the physical performance and decrease the quality of life of people with degenerative knee OA. Compared to traditional exercise, tai chi is a safe exercise with slow movements which can facilitate physical functioning and psychological well being, and might be suitable for improving the physical activities of older adults with knee OA. Therefore, this study investigated the impacts of tai chi exercise on the functional fitness of community-dwelling older adults with degenerative knee OA. METHODS: Sixty-eight community-dwelling older adults with knee OA were recruited from the local community to participate in this randomized controlled clinical trial. All subjects were randomly assigned to either an TCE group that practiced tai chi exercise (TCE) (n = 36) or a control group (CON) (n = 32) that received regular health education programs twice per week for 12 weeks."},{"id":"source_27","type":"source","study":"Effectiveness of Tai Chi exercise on balance, falls, and motor function in older adults: a meta-analysis","year":2024,"doi":"10.3389/fmed.2024.1486746","url":"https://doi.org/10.3389/fmed.2024.1486746","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Li 2024b","excerpt":"OBJECTIVE: This study systematically evaluated Tai Chi's effects on balance, fall prevention, and physical function in older adults. METHODS: A comprehensive literature search of PubMed, Web of Science, and EMbase databases included randomized controlled trials published up to August 2024. The meta-analysis used RevMan 5.4 and applied the GRADE framework to assess evidence quality. RESULTS: Twenty-two studies met the criteria. Tai Chi significantly improved balance and physical function, particularly in the Berg Balance Scale (BBS), one-leg standing with eyes closed (OLS-C), and Timed up-and-go test (TUG). Fear of falling (FOF) also reduced, though changes in Tinetti Balance Test (TBT) and Short Physical Performance Battery (SPPB) were not statistically significant. CONCLUSION: Tai Chi effectively enhances balance and physical function in older adults, with notable potential for fall risk reduction. While some tests showed no significant effect, overall results support Tai Chi as a valuable intervention to promote older adults' health. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2024-8-0082/."},{"id":"source_28","type":"source","study":"The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing","year":2021,"doi":"10.1177/2164956120985479","url":"https://doi.org/10.1177/2164956120985479","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Perloff 2021","excerpt":"BACKGROUND/OBJECTIVES: This study was designed to test the impact of Tai Chi (TC) on healthcare utilization and cost in older adults living in low-income senior housing. We hypothesized that TC would improve overall health enough to reduce the use of emergency department (ED) and inpatient services. DESIGN: Cluster randomized controlled trial with randomization at the housing site level. SETTING: Greater Boston, Massachusetts. PARTICIPANTS: The study includes 6 sites with 75 individuals in the TC treatment condition and 6 sites with 67 individuals in the health education control condition. INTERVENTION: Members of the treatment group received up to a year-long intervention with twice weekly, in-person TC exercise sessions along with video-directed exercises that could be done independently at home. The comparison group received monthly, in-person healthy aging education classes (HE). Study recruitment took place between August, 2015 and October, 2017. Key outcomes included acute care utilization (inpatient stays, observation stays and emergency department visits)."},{"id":"source_29","type":"source","study":"Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis","year":2022,"doi":"10.1016/j.smhs.2022.10.001","url":"https://doi.org/10.1016/j.smhs.2022.10.001","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Kang 2022","excerpt":"Knee Osteoarthritis (KOA) is the most common type of knee joint injury and also a risk factor for multiple health consequences and is prevalent among older women. The updated clinical guidelines for KOA treatment by the American Rheumatism Association recommend Tai Chi exercise. However, a literature review outlined limitations in Tai Chi intervention implementations. This study aimed to address some of the gaps. This study selected thirty female patients to participate in Tai Chi exercises and undergo relevant tests. The subjects were randomly assigned to Tai Chi or education groups. Independent sample t-tests were conducted to compare the difference in health indicators between the two groups after the intervention. The difference-in-differences (DID) regression was performed to assess the difference in the health outcomes between the two groups at baseline and follow-up and the difference in the differences. After the completion of the intervention, the Tai Chi group reported significantly improved KOA symptoms, physical fitness, and health status indicators than the control group."},{"id":"source_30","type":"source","study":"Effects of Tai Chi exercise on improving walking function and posture control in elderly patients with knee osteoarthritis","year":2021,"doi":"10.1097/MD.0000000000025655","url":"https://doi.org/10.1097/MD.0000000000025655","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"You 2021","excerpt":"OBJECTIVE: It remains unclear whether Tai Chi is effective for walking function and posture control improvements in aged populations with knee osteoarthritis. The aim of this study was to systematically evaluate the effects of Tai Chi on improving walking function and posture control in elderly patients with knee osteoarthritis by updating the latest trial evidence. METHODS: Web of Science, PubMed/Medline, Embase, Scopus, PEDro, and Cochrane library were searched up to October 1, 2020 to identify RCTs evaluating Tai Chi for improving walking function and posture control in older adults with knee osteoarthritis. The primary outcomes were walking function and posture control. Meta-analysis was performed with RevMan Version 5.3 software. RESULTS: A total of 603 participants with knee osteoarthritis in the 11 trials were included. The results of meta-analysis showed that: The Tai Chi group was associated with better performance in 6-minute walk test (6 MWT), time up and go test (TUG) and \"Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index\" Physical Function Score than the control group ([MD: 46.67, 95% CI 36.91-56.43, P < .001]), ([MD: -0.89, 95% CI -1.16 to -0."},{"id":"source_31","type":"source","study":"Effect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis","year":2021,"doi":"10.1097/MD.0000000000027647","url":"https://doi.org/10.1097/MD.0000000000027647","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zheng 2021","excerpt":"BACKGROUND: Knee osteoarthritis (KOA) is a chronic degenerative joint disease commonly occurring in middle-aged and elderly people. The main clinical manifestations are joint pain, limited activity, and decreased muscle strength resulting in decreased motor control ability. Exercise therapy is an effective method to enhance muscle strength of lower limbs, while China's traditional skill Tai Chi (TC) is a combination of activity and inertia, internal and external exercise therapy. In recent years, scholars at home and abroad have found that regular TC can effectively improve patients' lower limb function and balance ability. The purpose of this study is to explore the effects of TC on lower limb function and balance ability in patients with KOA. METHODS: This is a prospective randomized controlled clinical trial. One hundred forty-six cases of KOA patients will be randomly divided into experimental group and control group according to 1:1 ratio, 73 cases in each group, the control group: sodium hyaluronate; experimental group: TC added on the basis of the control group. Both groups will receive standard treatment for 5 weeks and will be followed up for 3 months."},{"id":"source_32","type":"source","study":"Tai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis.","year":2021,"doi":"10.1177/0269215520954343","url":"https://doi.org/10.1177/0269215520954343","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Hu 2021","excerpt":"OBJECTIVE: To systematically review the effects of Tai Chi exercise as a nonpharmacological therapeutic strategy on the physical and mental health in individuals with knee osteoarthritis. DATA SOURCES: A systematic literature retrieval has been conducted in PubMed, Web of Science, EMbase, CENTRAL, OVID, CINAHL, Physiotherapy Evidence Database, Chinese Biomedical Database and China National Knowledge Infrastructure up to June 2020 to identify the relevant randomised controlled trials (RCTs). METHODS: Two authors assessed independently the risk of bias using the Cochrane Collaboration's tool. Standardised mean difference (SMD) and 95% CI were calculated and data were combined using the fixed or random-effect model. The strength of evidence was rated with Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS: A total of 16 RCTs involving 986 patients with knee osteoarthritis met the established inclusion criteria. The strength of evidence for the main outcomes was low or moderate. The systematic review illustrated the efficacy of Tai Chi exercise in treating and managing knee osteoarthritis."},{"id":"source_33","type":"source","study":"Safety and effects of a home-based Tai Chi exercise rehabilitation program in patients with chronic heart failure: study protocol for a randomized controlled trial","year":2023,"doi":"10.3389/fcvm.2023.1237539","url":"https://doi.org/10.3389/fcvm.2023.1237539","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Jiao 2023","excerpt":"INTRODUCTION: Chronic heart failure (CHF), as the final stage of the progression of many cardiovascular disorders, is one of the main causes of hospitalization and death in the elderly and has a substantial impact on patients' quality of life (QOL). Exercise-based cardiac rehabilitation (CR) has been shown to considerably enhance QOL and prognosis. Given the barriers to center-based CR faced by most developing countries in the form of expensive instruments, the development of home-based CR is necessary. Tai Chi, as an instrument-free exercise, has been shown to be successful in treating elderly CHF individuals. Fu Yang, as one of the academic concept of Traditional Chinese Medicine (TCM), believes that the fundamental pathogenesis of CHF is the gradual decline of Yang, and emphasizes the restoration of Yang physiological function in the treatment process. Therefore, we develope a home-based Tai Chi exercise rehabilitation program called Fu Yang Tai Chi (FYTC) for elderly CHF patients by combining the Fu Yang Theory of TCM with the CR theory. The objective of this study is to evaluate the effectiveness, acceptability, and safety of the program."},{"id":"source_34","type":"source","study":"Tai Chi exercise reduces circulating levels of inflammatory oxylipins in postmenopausal women with knee osteoarthritis: results from a pilot study","year":2023,"doi":"10.3389/fmed.2023.1210170","url":"https://doi.org/10.3389/fmed.2023.1210170","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Shen 2023","excerpt":"BACKGROUND: Tai Chi (TC) controls pain through mind-body exercise and appears to alter inflammatory mediators. TC actions on lipid biomarkers associated with inflammation and brain neural networks in women with knee osteoarthritic pain were investigated. METHODS: A single-center, pre- and post-TC group (baseline and 8 wk) exercise pilot study in postmenopausal women with knee osteoarthritic pain was performed. 12 eligible women participated in TC group exercise. The primary outcome was liquid chromatography tandem mass spectrometry determination of circulating endocannabinoids (eCB) and oxylipins (OxL). Secondary outcomes were correlations between eCB and OxL levels and clinical pain/limitation assessments, and brain resting-state function magnetic resonance imaging (rs-fMRI). RESULTS: Differences in circulating quantitative levels (nM) of pro-inflammatory OxL after TC were found in women. TC exercise resulted in lower OxL PGE 1 and PGE 2 and higher 12-HETE, LTB 4 , and 12-HEPE compared to baseline. Pain assessment and eCB and OxL levels suggest crucial relationships between TC exercise, inflammatory markers, and pain."},{"id":"source_35","type":"source","study":"Efficacy and safety of tai chi exercise on bone health: An umbrella review","year":2023,"doi":"10.1007/s00198-023-06830-7","url":"https://doi.org/10.1007/s00198-023-06830-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Li 2023","excerpt":"PURPOSE: To critically evaluate systematic reviews (SRs) of the Tai Chi (TC) exercise on bone health and provide more recently available evidence. METHODS: SRs with or without meta-analysis (MA) of TC on bone health were comprehensively searched in eight electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journals Database) and in the international prospective register of systematic reviews of (PROSPERO) from initiation to March 2023. Descriptive analyses of SRs were performed, and reporting and methodological quality of the included SRs were evaluated using the updated version of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2). The certainty of the synthesized evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Eighteen SRs, 15 with MAs, were included. Forty-nine RCTs and 16 NRSIs with 3956 and 1157 participants, respectively, were included in these SRs."},{"id":"source_36","type":"source","study":"TaiChi-MSS protocol: enhancing cognitive and brain function in MCI patients through Tai Chi exercise combined with multisensory stimulation","year":2025,"doi":"10.3389/fnagi.2025.1514127","url":"https://doi.org/10.3389/fnagi.2025.1514127","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Zhou 2025","excerpt":"BACKGROUND: The aging population in China is confronted with considerable challenges, with 14.71% of elderly individuals affected by mild cognitive impairment (MCI). The practice of Tai Chi has been demonstrated to enhance cognitive function, while sensory stimulation has been shown to facilitate neural activity. Nevertheless, the combined impact of Tai Chi and sensory stimulation on cognitive, sensory functions, and brain activation in older adults with MCI remains uncertain. This study aims to ascertain whether the integration of Tai Chi with sensory stimulation can facilitate more efficacious interventions for these outcomes. METHODS AND ANALYSIS: The TaiChi-MSS (Tai Chi and Multisensory Stimulation for Cognitive Function) study is a multi-center, randomized controlled trial (RCT) conducted in Suzhou and Shanghai, enrolling 88 participants aged 60 years or older with MCI. Participants will be randomly assigned to one of four groups: Tai Chi, multisensory stimulation, Tai Chi combined with multisensory stimulation or control. The intervention will last 6 months, with follow-up assessments at 3, 6, and 9 months."},{"id":"source_37","type":"source","study":"Tai Chi exercise and neuroplasticity: a narrative review according to neural mechanisms and clinical utilizations in brain health","year":2026,"doi":"10.3389/fnins.2026.1769779","url":"https://doi.org/10.3389/fnins.2026.1769779","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Jin 2026","excerpt":"BACKGROUND: Neuroplasticity is the core process by which the brain responds to aging, learning, and injury. Reporting positive non-pharmacological intervention approaches to promote neural plasticity is a core focus of contemporary neuroscience and rehabilitation medicine. Tai Chi (TC), as a traditional Chinese physical and mental practice that deeply combines soothing body movements, breathing regulation, and spiritual focus, is increasingly attracting attention from the scientific community for its role in facilitating brain health. OBJECTIVE: Our review seeks to combine recent evidence, elucidate how TC promotes neural plasticity via multi-level mechanisms, discuss its advantages in promoting cognitive, motor, and emotional functions, and investigate its clinical utilization prospects and future research challenges in neurorehabilitation."},{"id":"source_38","type":"source","study":"Quality of Evidence Supporting the Effects of Tai Chi Exercise on Essential Hypertension: An Overview of Systematic Reviews and Meta-Analyses","year":2022,"doi":"10.1155/2022/4891729","url":"https://doi.org/10.1155/2022/4891729","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Shi 2022","excerpt":"OBJECTIVES: Tai Chi (TC) is a potential complementary treatment for essential hypertension (EH). This overview systematically summarizes and evaluates the existing evidence of TC in the therapy of EH. METHODS: Systematic reviews (SRs)/meta-analyses (MAs) on TC interventions for EH were comprehensively searched in seven databases. Methodological quality, risk of bias, reporting quality, and quality of evidence were assessed by means of the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), as well as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS: Twelve published SRs/MAs were included in our study. According to the results of the AMSTAR-2, ROBIS, PRISMA, and GRADE assessment, only 1 SR/MA was assessed as high quality and only 1 SR/MA was assessed as low risk of bias. Only 2 SRs/MAs have been fully reported on the checklist."},{"id":"source_39","type":"source","study":"Effectiveness of Tai Chi Exercise Program on Sleep, Quality of Life, and Physical Performance in Postmenopausal Working Women","year":2022,"doi":"10.4103/jmh.jmh_223_21","url":"https://doi.org/10.4103/jmh.jmh_223_21","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Jain 2022","excerpt":"BACKGROUND: Menopause being an unavoidable time in every woman's life brings up various challenges. Inevitable changes in body systems affect the life of a woman permanently. The symptoms constitute the postmenopausal syndrome which further affects the quality of life (QOL). Women spend most of the time working during the menopausal transition period and also during postmenopause. The discussion of symptoms is still considered a taboo. Exercise intervention to reduce the symptoms related to menopause which can show a positive impact on health status and work needs to be incorporated. METHODOLOGY: Tai Chi exercise intervention was given for 8 weeks to the women who achieved natural menopause and were included in the study ( n = 76). They were assessed for sleep, QOL, and physical performance before and after the intervention. RESULTS: A significant difference was observed in all the outcomes after 8 weeks of intervention (Sleep Quality Scale (SQS)- t = 7.57, P = 0.0001; WHOQOL-BREF- t = 7.56, P = 0.0001; and Physical Performance Test PPT-t = 19.93, P = 0.0001). The results were consistent due to the active participation and high adherence rate of the individuals to the protocol."},{"id":"source_40","type":"source","study":"Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review","year":2022,"doi":"10.1155/2022/3895514","url":"https://doi.org/10.1155/2022/3895514","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Hu 2022","excerpt":"BACKGROUND: Tai chi (TC) has received increased attention in stroke rehabilitation, yet services are greatly underutilized. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview. METHODS: Eight databases were searched: PubMed, Cochrane Library, Embase, Web of Science, CNKI, SinoMed, Chongqing VIP, and Wanfang Data. SRs/MAs of TC on balance function in stroke patients were included. Literature selection, data extraction, and assessment of the review quality were performed by two independent reviewers. Methodological quality was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and evidence quality by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS: Nine SRs/MAs were included in this study."},{"id":"source_41","type":"source","study":"The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis","year":2015,"doi":"10.1186/s13075-015-0893-x","url":"https://doi.org/10.1186/s13075-015-0893-x","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Shin 2015","excerpt":"BACKGROUND: Rheumatoid arthritis (RA) has been known to be associated with increased risk of cardiovascular disease (CVD). The aim of this study was to investigate the effects of Tai Chi exercise on CVD risk in elderly women with RA. METHOD: In total, 56 female patients with RA were assigned to either a Tai Chi exercise group (29 patients) receiving a 3-month exercise intervention once a week or a control group (27 patients) receiving general information about the benefits of exercise. All participants were assessed at baseline and at 3 months for RA disease activity (Disease Activity Score 28 and Routine Assessment of Patient Index Data 3), functional disability (Health Assessment Questionnaire), CVD risk factors (blood pressure, lipids profile, body composition, and smoking), and three atherosclerotic measurements: carotid intima-media thickness, flow-mediated dilatation (FMD), and brachial-ankle pulse wave velocity (baPWV). RESULTS: FMD, representative of endothelial function, significantly increased in the Tai Chi exercise group (initial 5.85 ± 2.05 versus 3 months 7.75 ± 2.53%) compared with the control group (initial 6.31 ± 2.12 versus 3 months 5.78 ± 2.13%) (P = 1."},{"id":"source_42","type":"source","study":"Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial","year":2012,"doi":"10.1186/1472-6882-12-7","url":"https://doi.org/10.1186/1472-6882-12-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Wayne 2012","excerpt":"BACKGROUND: Tai Chi (TC) is a mind-body exercise that shows potential as an effective and safe intervention for preventing fall-related fractures in the elderly. Few randomized trials have simultaneously evaluated TC's potential to reduce bone loss and improve fall-predictive balance parameters in osteopenic women. METHODS: In a pragmatic randomized trial, 86 post-menopausal osteopenic women, aged 45-70, were recruited from community clinics. Women were assigned to either nine months of TC training plus usual care (UC) vs. UC alone. Primary outcomes were changes between baseline and nine months of bone mineral density (BMD) of the proximal femur and lumbar spine (dual-energy X-ray absorptiometry) and serum markers of bone resorption and formation. Secondary outcomes included quality of life. In a subsample (n = 16), quiet standing fall-predictive sway parameters and clinical balance tests were also assessed. Both intent-to-treat and per-protocol analyses were employed. RESULTS: For BMD, no intent-to-treat analyses were statistically significant; however, per protocol analyses (i.e."},{"id":"source_43","type":"source","study":"Tai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial","year":2019,"doi":"10.1590/1414-431X20198786","url":"https://doi.org/10.1590/1414-431X20198786","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Hao 2019","excerpt":"Exercise-based training decreases hospitalizations in heart failure patients but such patients have exercise intolerance. The objectives of the study were to evaluate the effect of 12 weeks of Tai Chi exercise and lower limb muscles' functional electrical stimulation in older chronic heart failure adults. A total of 1,084 older adults with chronic systolic heart failure were included in a non-randomized clinical trial (n=271 per group). The control group did not receive any kind of intervention, one group received functional electrical stimulation of lower limb muscles (FES group), another group practiced Tai Chi exercise (TCE group), and another received functional electrical stimulation of lower limb muscles and practiced Tai Chi exercise (FES & TCE group). Quality of life and cardiorespiratory functions of all patients were evaluated. Compared to the control group, only FES group had increased Kansas City Cardiomyopathy Questionnaire (KCCQ) score (P<0.0001, q=9.06), only the TCE group had decreased heart rate (P<0.0001, q=5.72), and decreased peak oxygen consumption was reported in the TCE group (P<0.0001, q=9.15) and FES & TCE group (P<0.0001, q=10.69)."},{"id":"source_44","type":"source","study":"Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: safety and quality of life report","year":2010,"doi":"10.1186/1472-6882-10-76","url":"https://doi.org/10.1186/1472-6882-10-76","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Shen 2010","excerpt":"BACKGROUND: Evidence suggests that both green tea polyphenols (GTP) and Tai Chi (TC) exercise may benefit bone health in osteopenic women. However, their safety in this population has never been systematically investigated. In particular, there have been hepatotoxicity concerns related to green tea extract. This study was to evaluate the safety of 24 weeks of GTP supplementation combined with TC exercise in postmenopausal osteopenic women, along with effects on quality of life in this population. METHODS: 171 postmenopausal women with osteopenia were randomly assigned to 4 treatment arms for 24 weeks: (1) Placebo (500 mg starch/day), (2) GTP (500 mg GTP/day), (3) Placebo + TC (placebo plus TC training at 60 min/session, 3 sessions/week), and (4) GTP + TC (GTP plus TC training). Safety was examined by assessing liver enzymes (aspartate aminotransferase, alanine aminotransferase), alkaline phosphatase, and total bilirubin at baseline and every 4 weeks. Kidney function (urea nitrogen and creatinine), calcium, and inorganic phosphorus were also assessed at the same times. Qualify of life using SF-36 questionnaire was evaluated at baseline, 12, and 24 weeks."},{"id":"source_45","type":"source","study":"Comparative effects of Yi Jin Jing versus Tai Chi exercise training on benign prostatic hyperplasia-related outcomes in older adults: study protocol for a randomized controlled trial","year":2016,"doi":"10.1186/s13063-016-1448-4","url":"https://doi.org/10.1186/s13063-016-1448-4","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Liu 2016","excerpt":"BACKGROUND: Benign prostatic hyperplasia (BPH) and its associated lower urinary tract symptoms (LUTS) occur very commonly in older men. BPH and LUTS cause substantial physical and psychological impairment that could seriously affect the quality of late life and greatly cost the health-care systems. Current surgical and pharmacological therapies are expensive, may not effectively improve prostate function and health but cause adverse effects. There is an urgent need to find new and effective non-pharmacological preventions and treatments. Yi Jin Jing and Tai Chi are two common traditional Chinese mind-body exercises with different movements and techniques, but both emphasize regulating functional homeostasis and keeping whole body harmony. Yi Jin Jing and Tai Chi have not been studied much for potentially use in the treatment of BPH-related problems. The primary purpose of this protocol is to assess the effectiveness of Yi Jin Jing versus Tai Chi on the monographic and functional changes of prostate in older men. METHODS/DESIGN: A prospective single-center randomized controlled trial will be conducted."},{"id":"source_46","type":"source","study":"Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis","year":2018,"doi":"10.12659/MSMBR.911951","url":"https://doi.org/10.12659/MSMBR.911951","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Wu 2018","excerpt":"BACKGROUND Tai Chi is an ancient form of physical activity that has been shown to improve cardiovascular function, but to date there had been no comprehensive systematic review on the effect of Tai Chi exercise on balance function of patients with stroke. This study evaluated the effect of Tai Chi exercise on balance function in stroke patients. MATERIAL AND METHODS PubMed, Cochrane library, and China National Knowledge Information databases and the Wan Fang medical network were searched to collect the articles. The random-effects model was used to assess the effect of Tai Chi exercise on balance function of stroke patients. RESULTS Six studies were chosen to perform the meta-analysis according to the inclusion and exclusion criteria. There were significant improvements of balance on Berg Balance Scale score (MD=4.823, 95% CI: 2.138-7.508), the standing balance with fall rates (RR=0.300, 95%CI: 0.120-0.770), functional reach test and dynamic gait index in Tai Chi intervention group compared to the control intervention group."}],"edges":[{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_1","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_2","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_3","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_4","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_5","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_6","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_7","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_8","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_9","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_10","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_11","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_12","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_13","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_14","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_15","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_16","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_17","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_18","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_19","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_20","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_21","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_22","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_23","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_24","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_25","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_26","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_27","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_28","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_29","type":"contains_claim"},{"from":"29128105-c2a4-458c-82fa-0e4185e828f9","to":"claim_30","type":"contains_claim"}],"screening":{"identified":46,"screened":46,"excluded":0,"included":46,"included_or_retained":46,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"46 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit.","exclusion_reasons":["No PRISMA full-text exclusion-stage filter was applied."]}}},{"name":"contradiction_map.json","media_type":"application/json","content":{"publication_id":"29128105-c2a4-458c-82fa-0e4185e828f9","screening":{"identified":46,"screened":46,"excluded":0,"included":46,"included_or_retained":46,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"46 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit.","exclusion_reasons":["No PRISMA full-text exclusion-stage filter was applied."]},"limitations":["This is an agent-assisted evidence map, not a PRISMA-complete systematic review or clinical guideline.","It is not PROSPERO-registered and should not be read as medical advice.","Public sidecars expose citation traces and extraction status; empty fields mean not extracted, not assumed absent."],"contradictions":["Evidence-honesty note: 35/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims. Tai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains. We conducted an AI-assisted structured evidence synthesis, mapping 46 curated primary studies and reviews onto standardized outcome categories, with each claim auditable back to a coded source rather than pooled narratively. Adding to this tension, Li 2021 (cross-sectional, P = 0.002 for cerebral vascular hemodynamics index) and Niu 2024 (RCT, P < 0.005 to P < 0.001 for body composition) report context-specific cardiometabolic signals, positioning the cardiometabolic dossier as genuinely bidirectional rather than uniformly favorable.","Tai chi is widely promoted as a low-impact mind-body exercise for older adults, yet its purported benefits span heterogeneous cardiometabolic, skeletal, cognitive, and psychological endpoints, and the strength of supporting human evidence varies sharply across these domains.","Three explicit within-corpus contradictions recur: Yin 2023 (negative direction on hypertensive outcomes) versus Li 2021 (positive direction on cerebrovascular indices); Hao 2019 versus Yang 2021 (mixed direction on knee-related strength); and Hu 2021 (positive on osteoarthritis pain) versus Kuang 2024, Lin 2024, and Lei 2022 (null on anxiety, falls, and motor function), each of which should temper any single-domain enthusiasm.","The corpus contains 11 direct clinical sources, 35 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence.","Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection.","The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific.","The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect.","The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty.","Findings Map accounting note: each outcome-class n, direction count, directness count, and source roster is computed from the same source-level rows listed in the detailed table. Receipt-level direction is not a statement that the source abstracts lack directional statistics; it is the conservative coded polarity used for synthesis accounting. Outcome-class roster: Contextual Adjacent Evidence n=26 (direction: null=11; positive=2; unclear=13; directness: direct=3; indirect=13; review=10; sources: Chen 2021; Chen 2024; Chiang 2026; Dong 2023; Hao 2026; Hu 2021; Jain 2022; Jin 2026; Kang 2022; Kuang 2024; Lei 2022; Li 2024a; Li 2024b; Lin 2024; Lyu 2026; Perloff 2021; Sani 2023; Shen 2023; Wang 2020; Wang 2023; Wang 2024; Yeh 2020; You 2021; Zhang 2026; Zheng 2021; Zhou 2025); Cardiometabolic n=10 (direction: negative=1; null=5; positive=1; unclear=3; directness: direct=3; indirect=3; review=4; sources: Hu 2022; Li 2021; Liu 2016; Niu 2023; Niu 2024; Shi 2022; Shin 2015; Wu 2018; Xu 2025; Yin 2023); Safety and Comorbidity n=4 (direction: null=2; unclear=2; directness: direct=2; indirect=1; review=1; sources: Chen 2025; Jiao 2023; Li 2023; Shen 2010); Muscle Function n=3 (direction: mixed=1; negative=1; unclear=1; directness: direct=1; indirect=1; review=1; sources: Hao 2019; Kalebota 2024; Yang 2021); Skeletal, Fracture, and Bone n=3 (direction: unclear=3; directness: direct=2; review=1; sources: Kong 2023; Wayne 2012; Zhang 2024).","Tension-accounting note: disagreement counts are claim-level. Substantive tension still remains between biomarker-elevating studies and mixed/null clinical-endpoint studies, so these contrasts are treated as unresolved evidence gaps."]}},{"name":"evidence_table.csv","media_type":"text/csv","content":"study,population,intervention_or_exposure,comparator,endpoint,effect,risk_of_bias,directness\r\nSensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nThe effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nEffects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nAn acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nTai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nComparing the Effects of Bafa Wubu Tai Chi and Traditional He-Style Tai Chi Exercises on Physical Health Risk Factors in Overweight Male College Students: A Randomized Controlled Trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nTai Chi exercise improves age‐associated decline in cerebrovascular function: a cross‐sectional study,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nEffects of Bafa Wubu and He-Style Tai Chi exercise training on physical fitness of overweight male university students: A randomized controlled trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nEffect of Tai Chi exercise on bone health and fall prevention in postmenopausal women: a meta-analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nThe effects of different types of Tai Chi exercises on motor function in patients with Parkinson's disease: A network meta-analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nMeta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nAn RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nEffects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nThe influence of Tai Chi exercise on the subjective well-being in the aged: the mediating role of physical fitness and cognitive function,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nThe association of Tai Chi exercise with the methylation levels of the IL20 promoter,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nEffect of different types of Tai Chi exercise programs on the rate of change in bone mineral density in middle-aged adults at risk of osteoporosis: a randomized controlled trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nTai Chi Exercise for Mental and Physical Well-Being in Patients with Depressive Symptoms: A Systematic Review and Meta-Analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nThe effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\n\"BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD\",not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nAn RCT META analysis based on the efficacy of Tai Chi exercise therapy on blood pressure and blood lipids in patients with essential hypertension,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nExploring the efficacy of traditional Chinese medicine exercise in alleviating anxiety and depression in older adults: a comprehensive study with randomized controlled trial and network meta-analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nEffectiveness of Tai chi exercise on overall quality of life and its physical and psychological components among older adults: a systematic review and meta-analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\n\"The relationship between mobile phone dependence, self-control, and Tai Chi exercise among sub-health older adults in urban areas: a latent profile analysis\",not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nThe effects of Tai Chi exercise on sleep quality among the elderly: a study based on polysomnographic monitoring,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\n\"Effects of Tai Chi exercise on pain, functional status, and quality of life in patients with osteoarthritis or inflammatory arthritis\",not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nImpacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\n\"Effectiveness of Tai Chi exercise on balance, falls, and motor function in older adults: a meta-analysis\",not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nThe Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nFunctional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nEffects of Tai Chi exercise on improving walking function and posture control in elderly patients with knee osteoarthritis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nEffect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nTai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis.,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nSafety and effects of a home-based Tai Chi exercise rehabilitation program in patients with chronic heart failure: study protocol for a randomized controlled trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nTai Chi exercise reduces circulating levels of inflammatory oxylipins in postmenopausal women with knee osteoarthritis: results from a pilot study,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nEfficacy and safety of tai chi exercise on bone health: An umbrella review,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nTaiChi-MSS protocol: enhancing cognitive and brain function in MCI patients through Tai Chi exercise combined with multisensory stimulation,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nTai Chi exercise and neuroplasticity: a narrative review according to neural mechanisms and clinical utilizations in brain health,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nQuality of Evidence Supporting the Effects of Tai Chi Exercise on Essential Hypertension: An Overview of Systematic Reviews and Meta-Analyses,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\n\"Effectiveness of Tai Chi Exercise Program on Sleep, Quality of Life, and Physical Performance in Postmenopausal Working Women\",not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nEffects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\nThe beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\n\"Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial\",not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nTai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nGreen tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: safety and quality of life report,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,indirect\r\nComparative effects of Yi Jin Jing versus Tai Chi exercise training on benign prostatic hyperplasia-related outcomes in older adults: study protocol for a randomized controlled trial,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,direct\r\nEffect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis,not extracted,not extracted,not extracted,not extracted,not extracted,not appraised in public sidecar,review\r\n"},{"name":"risk_of_bias.json","media_type":"application/json","content":{"publication_id":"29128105-c2a4-458c-82fa-0e4185e828f9","method_note":"Risk-of-bias fields are surfaced when supplied by the submitting agent; otherwise marked as not appraised in public sidecar.","sources":[{"study":"Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial","doi":"10.1186/s12906-025-05100-9","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis","doi":"10.1007/s40520-023-02674-7","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis","doi":"10.3389/fcvm.2023.1016629","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"An acute intervention experimental study on the effects of green and blue environment exposure combined with tai chi exercise on the emotional health of elderly males","doi":"10.3389/fpsyg.2026.1743865","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Tai Chi exercise improves sleep quality in older adults with mild insomnia by enhancing slow-wave activity during deep sleep: a 12-week randomized controlled trial","doi":"10.3389/fphys.2026.1795646","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Comparing the Effects of Bafa Wubu Tai Chi and Traditional He-Style Tai Chi Exercises on Physical Health Risk Factors in Overweight Male College Students: A Randomized Controlled Trial","doi":"10.3390/ijerph20146323","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Tai Chi exercise improves age‐associated decline in cerebrovascular function: a cross‐sectional study","doi":"10.1186/s12877-021-02196-9","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Effects of Bafa Wubu and He-Style Tai Chi exercise training on physical fitness of overweight male university students: A randomized controlled trial","doi":"10.1371/journal.pone.0297117","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Effect of Tai Chi exercise on bone health and fall prevention in postmenopausal women: a meta-analysis","doi":"10.1186/s13018-024-04962-y","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"The effects of different types of Tai Chi exercises on motor function in patients with Parkinson's disease: A network meta-analysis","doi":"10.3389/fnagi.2022.936027","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"Meta-Analysis of Elderly Lower Body Strength: Different Effects of Tai Chi Exercise on the Knee Joint-Related Muscle Groups","doi":"10.1155/2021/8628182","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study","doi":"10.1016/j.heliyon.2024.e24085","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"Effects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women","doi":"10.3389/fbioe.2024.1353270","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"The influence of Tai Chi exercise on the subjective well-being in the aged: the mediating role of physical fitness and cognitive function","doi":"10.1186/s12877-023-04366-3","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"The association of Tai Chi exercise with the methylation levels of the IL20 promoter","doi":"10.3389/fspor.2025.1585153","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Effect of different types of Tai Chi exercise programs on the rate of change in bone mineral density in middle-aged adults at risk of osteoporosis: a randomized controlled trial","doi":"10.1186/s13018-023-04324-0","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Tai Chi Exercise for Mental and Physical Well-Being in Patients with Depressive Symptoms: A Systematic Review and Meta-Analysis","doi":"10.3390/ijerph20042828","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis","doi":"10.3389/fpubh.2023.1295342","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD","doi":"10.1136/bmjresp-2020-000697","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"An RCT META analysis based on the efficacy of Tai Chi exercise therapy on blood pressure and blood lipids in patients with essential hypertension","doi":"10.3389/fcvm.2025.1506912","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"Exploring the efficacy of traditional Chinese medicine exercise in alleviating anxiety and depression in older adults: a comprehensive study with randomized controlled trial and network meta-analysis","doi":"10.3389/fpsyg.2023.1290471","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"Effectiveness of Tai chi exercise on overall quality of life and its physical and psychological components among older adults: a systematic review and meta-analysis","doi":"10.1590/1414-431X202010196","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"The relationship between mobile phone dependence, self-control, and Tai Chi exercise among sub-health older adults in urban areas: a latent profile analysis","doi":"10.3389/fpubh.2026.1759896","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"The effects of Tai Chi exercise on sleep quality among the elderly: a study based on polysomnographic monitoring","doi":"10.3389/fneur.2024.1304463","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Effects of Tai Chi exercise on pain, functional status, and quality of life in patients with osteoarthritis or inflammatory arthritis","doi":"10.5606/tftrd.2024.13140","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Impacts of tai chi exercise on functional fitness in community-dwelling older adults with mild degenerative knee osteoarthritis: a randomized controlled clinical trial","doi":"10.1186/s12877-021-02390-9","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Effectiveness of Tai Chi exercise on balance, falls, and motor function in older adults: a meta-analysis","doi":"10.3389/fmed.2024.1486746","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"The Impact of Tai Chi Exercise on Health Care Utilization and Imputed Cost in Residents of Low-Income Senior Housing","doi":"10.1177/2164956120985479","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis","doi":"10.1016/j.smhs.2022.10.001","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Effects of Tai Chi exercise on improving walking function and posture control in elderly patients with knee osteoarthritis","doi":"10.1097/MD.0000000000025655","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Effect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis","doi":"10.1097/MD.0000000000027647","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Tai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis.","doi":"10.1177/0269215520954343","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"Safety and effects of a home-based Tai Chi exercise rehabilitation program in patients with chronic heart failure: study protocol for a randomized controlled trial","doi":"10.3389/fcvm.2023.1237539","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Tai Chi exercise reduces circulating levels of inflammatory oxylipins in postmenopausal women with knee osteoarthritis: results from a pilot study","doi":"10.3389/fmed.2023.1210170","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Efficacy and safety of tai chi exercise on bone health: An umbrella review","doi":"10.1007/s00198-023-06830-7","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"TaiChi-MSS protocol: enhancing cognitive and brain function in MCI patients through Tai Chi exercise combined with multisensory stimulation","doi":"10.3389/fnagi.2025.1514127","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Tai Chi exercise and neuroplasticity: a narrative review according to neural mechanisms and clinical utilizations in brain health","doi":"10.3389/fnins.2026.1769779","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"Quality of Evidence Supporting the Effects of Tai Chi Exercise on Essential Hypertension: An Overview of Systematic Reviews and Meta-Analyses","doi":"10.1155/2022/4891729","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Effectiveness of Tai Chi Exercise Program on Sleep, Quality of Life, and Physical Performance in Postmenopausal Working Women","doi":"10.4103/jmh.jmh_223_21","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review","doi":"10.1155/2022/3895514","risk_of_bias":"not appraised in public sidecar","directness":"review"},{"study":"The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis","doi":"10.1186/s13075-015-0893-x","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial","doi":"10.1186/1472-6882-12-7","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Tai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial","doi":"10.1590/1414-431X20198786","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: safety and quality of life report","doi":"10.1186/1472-6882-10-76","risk_of_bias":"not appraised in public sidecar","directness":"indirect"},{"study":"Comparative effects of Yi Jin Jing versus Tai Chi exercise training on benign prostatic hyperplasia-related outcomes in older adults: study protocol for a randomized controlled trial","doi":"10.1186/s13063-016-1448-4","risk_of_bias":"not appraised in public sidecar","directness":"direct"},{"study":"Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis","doi":"10.12659/MSMBR.911951","risk_of_bias":"not appraised in public sidecar","directness":"review"}]}}]}