Tai chi began as a martial art, and its best-proven use is preventing falls

Key takeaways

• In a 2018 Oregon trial of 670 adults aged 70 and older at high risk of falling, a tai chi program led to 58% fewer falls than stretching and 31% fewer than a standard exercise class¹.
• In a 2016 Boston trial of 204 adults with knee osteoarthritis, 12 weeks of tai chi eased symptoms about as much as physical therapy and lifted mood more⁴⁵.
• Newer trials suggest tai chi may lower blood pressure a little and ease insomnia over the long run, but each claim rests on one or a few studies³⁶⁷.
• Tai chi teachers need no license, and there’s no national certification standard, so ask what training a teacher has³.
• The falls, knee and sleep trials met twice a week for 12 to 24 weeks, so plan on months, not days¹⁴⁷.

In February 2015, researchers in Oregon launched a trial for people aged 70 and older who had fallen in the past year or had trouble getting around. They enrolled 670 of them. The average age was nearly 78¹.

Chance decided which class each person joined: tai chi, a mix of aerobic, strength, balance and flexibility exercise, or stretching¹². Every group met for an hour, twice a week, for 24 weeks¹.

Over the study, the stretching group reported 363 falls. The exercise-mix group reported 218. The tai chi group reported 152¹.

That tai chi wasn’t the long, flowing routine you might see in a park at dawn. It was an eight-movement program built for balance, drawn from a simplified 24-movement routine¹¹. Still, it shows why a practice born as a Chinese martial art now appears on lists of evidence-based fall programs¹¹.

This guide covers where tai chi came from, what the strongest trials found, which claims are still early and how to pick a good class. Our balance article explains how balance works and how to test yours. A separate article walks through a tai chi trial for fibromyalgia, so we won’t repeat it here.

Tai chi grew from a 17th-century village martial art

Tai chi’s full name is taijiquan. UNESCO, the United Nations cultural agency, places its birth in the mid-1600s in Wenxian County, in China’s Henan Province⁹. China’s nomination file says the Chen school arose in Chenjiagou, a village in that county, in the same period¹⁰.

Three streams of Chinese thought feed it: Daoism, Confucianism and traditional medicine⁹. Its core ideas include yin and yang, paired opposites that keep turning into each other, and a oneness of heaven and humankind⁹. In practice, that looks like loose, rounded movement paced by the breath, with a calm and upright mind⁹.

Its building blocks are five steps and eight techniques⁹. Students learn set routines, called forms. Many also learn push hands, a hand-pushing drill done with a partner⁹.

As the art spread, families and individual masters gave their names to distinct styles⁹. China’s nomination lists the Chen, Yang, Wu, Li, Wang Qihe and He schools, with more than 80 routines among them¹⁰. Traditionally, the art passes within a family or from master to apprentice, a bond sealed in a ceremony called baishi⁹. In 2020, UNESCO added taijiquan to its list of the world’s intangible cultural heritage⁹.

The National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health, describes modern tai chi as slow movement, a meditative state of mind and controlled breathing. Its focus has shifted toward health and rehabilitation³.

Two points help when you shop for a class. Most health programs teach short, simplified routines, not a family’s full form. And styles differ: the best-tested falls program comes from the Simplified 24-Form, while a popular arthritis program uses Sun style¹¹¹².

The falls trial that put tai chi against standard exercise

Many studies have compared tai chi with gentle stretching or with nothing at all. The Oregon trial asked a harder question: could tai chi beat a well-rounded exercise class? Fuzhong Li, who developed the program at the Oregon Research Institute, led the study, published in JAMA Internal Medicine in 2018¹¹³.

The program is called Tai Ji Quan: Moving for Better Balance. It drills shifting your weight, turning the trunk and pelvis, swaying from the ankles, and coordinating the eyes, head and hands².

Compared with stretching, it cut the rate of falls by 58%. The exercise-mix class cut it by 40%¹. Head to head, tai chi had 31% fewer falls than the exercise class¹.

Several features make the result believable. The staff who measured outcomes didn’t know who was in which group, and every volunteer was counted in their assigned group¹. PEDro, a database that rates physical therapy trials, scored the study 7 out of 10. It took points off because volunteers and instructors knew their groups and assignments weren’t concealed¹.

It has limits, too. Falls were self-reported, 92% of volunteers were white, and all lived in one state¹².

There’s also a money question. According to MDedge, a medical news service that covered the study, Li reported that he founded and owns a consulting company, Exercise Alternatives, which receives the program’s licensing fees². The National Institute on Aging helped pay for the trial².

A financial stake doesn’t make a result wrong. It’s the same kind of tie you’d want disclosed for a drug study.

The wider research points the same way. NCCIH summarizes a 2019 review in which tai chi cut the number of older adults who fell by 20%, a finding rated high certainty³. Our balance article covers that review in detail.

For stiff knees, tai chi kept pace with physical therapy

Knee osteoarthritis, the common wear-related joint disease, is where tai chi has its next-best record. Researchers at Boston’s Tufts Medical Center randomly assigned 204 adults with painful knee osteoarthritis to tai chi or physical therapy⁴⁵. Their average age was 60, and 70% were women⁴.

The tai chi group took two one-hour group classes a week for 12 weeks. The physical therapy group had two 30-minute one-on-one sessions a week for six weeks, then six weeks of monitored home exercise⁵.

Both groups improved a lot, and by similar amounts⁴. On a standard scale of knee pain, stiffness and function, tai chi’s average gain was a bit larger, but the gap was small enough to be chance⁴. Gains held through the full year of follow-up⁴⁵.

Tai chi did better on depression and on the physical side of quality of life⁴. No serious side effects occurred⁴. NCCIH helped fund the study⁵. Its main limit is one every tai chi trial shares: volunteers know which treatment they’re getting⁴.

That trial isn’t alone. NCCIH cites a 2021 review of 16 studies in which tai chi improved knee pain, stiffness and function, though the reviewers rated the evidence low to moderate in strength³. Guidelines have taken note: in 2019, the American College of Rheumatology and the Arthritis Foundation strongly recommended tai chi for knee and hip osteoarthritis³. Our upcoming arthritis guide covers joint treatment in depth.

Blood pressure, sleep and memory: early but encouraging

Tai chi gets credit for many benefits. Here are three with newer trials behind them, and the catch for each.

Blood pressure. In a 2024 trial at two hospitals in China, 342 adults aged 18 to 65 with blood pressure just above normal did tai chi or aerobic exercise⁶. Both groups trained four times a week, an hour each time, for a full year. That’s a big commitment.

The top number, systolic pressure, fell about 7 points with tai chi and about 4.6 points with aerobic exercise⁶. The 2.4-point difference was small but unlikely to be chance⁶. An earlier review of 28 studies also favored tai chi, but its authors judged the studies poor quality, NCCIH notes³.

Sleep. In a 2025 trial in The BMJ, researchers in Hong Kong assigned 200 adults aged 50 and older with long-term insomnia to tai chi or to cognitive behavioral therapy for insomnia (CBT-I), the preferred talk-based treatment⁷⁸. Each group met twice a week for three months.

Right after the program, CBT-I worked clearly better⁷. A year later, the two were close enough that tai chi counted as no worse⁷. The authors note that some of tai chi’s later benefit may come from people who kept practicing⁸. Our upcoming sleep articles cover insomnia care.

Memory and thinking. NCCIH describes a 2023 trial of 318 older adults with mild memory and thinking problems, comparing stretching, standard tai chi and a version with added mental challenges³. After 24 weeks of twice-weekly classes, the mentally challenging version improved thinking scores, and the gains lasted six months³.

Each of these rests on one trial or a small set of studies, often from one country or one site. That’s why we rate them as promising but early.

What the evidence shows, claim by claim

Claim	Evidence level	What the research shows
Tai chi reduces falls in older adults	Strong evidence	20% fewer people fell in a 2019 review, rated high certainty; 58% fewer falls than stretching in a 670-person trial13
Tai chi beats standard exercise for falls	Promising but early	One large trial; the program’s developer has a financial stake12
Tai chi eases knee osteoarthritis pain, stiffness and function	Strong evidence	Consistent gains across 16 studies, though rated low to moderate in strength; strongly recommended by 2019 guidelines3
Tai chi works as well as physical therapy for knee osteoarthritis	Promising but early	One 204-person trial4
Tai chi lowers blood pressure	Promising but early	One year-long trial with a small edge; earlier studies were poor quality36
Tai chi eases long-term insomnia	Promising but early	Trailed CBT-I at 3 months, matched it at 15 months, in one trial7
Tai chi helps thinking skills in mild cognitive impairment	Promising but early	One trial of a version with added mental tasks3
Tai chi eases rheumatoid arthritis	Not enough evidence	Effects on pain, disease activity and function are uncertain; evidence very low quality3
Tai chi is safe for most adults	Strong evidence	Across 24 studies, side effects were about as common as with other exercise or none, mostly minor aches3

A quality checklist for choosing a class

No license is required to teach tai chi. Neither states nor the federal government regulate it, and there’s no national certification standard³. That puts the checking on you.

The National Council on Aging (NCOA) lists tai chi programs among its evidence-based programs. Three examples: Tai Ji Quan: Moving for Better Balance runs one-hour classes twice a week for 24 weeks, in person or online¹¹. YMCA Moving For Better Balance is based on it and doesn’t require a YMCA membership¹³. Tai Chi for Arthritis and Fall Prevention meets twice a week for 8 weeks or once a week for 16¹².

Use these questions on any class, named program or not:

Ask this	Good sign	Think twice if
Is this a named, tested program?	It’s one of the NCOA-listed programs, or the teacher can say what it’s based on111213	Nobody can tell you what you’ll learn
How was the teacher trained?	Training through a program’s authorized trainers; current CPR card1112	“I’ve practiced for years” is the only answer
Does the teacher ask about your health?	Questions about falls, joints and surgeries before you start	No questions at all
How low do I have to bend?	Knees stay over your toes, and you choose your depth14	Pushing you into a deeper stance14
How long does it run?	A set series of 8 to 24 weeks1112	Drop-in only, with no plan to build skill
Is home practice part of it?	Short daily practice, such as 30 minutes on 4 days a week12	Only class time counts
What will it do for me?	Balance, strength and calm, stated plainly	Promises to cure a disease or replace medicine3

Your first month of tai chi

This plan is our own. It pairs a class with short home practice, in the spirit of the tested programs¹¹¹². If no class meets near you, an online version of a named program is a reasonable start, unless you’ve fallen recently¹¹.

How hard should it feel? Easy to moderate. You should be able to chat between movements without gasping. Your legs may feel worked from the bent-knee stance, but your joints shouldn’t hurt.

Week	Class	Home practice	Focus
1	1 to 2 classes	5 minutes a day: stand with feet hip-width apart, hands near a counter, and shift your weight slowly side to side, then front to back	Soft knees over toes; slow, even breathing
2	2 classes	10 minutes on 4 or more days: warm up with weight shifts, then repeat the first one or two moves from class	Move without holding your breath
3	2 classes	15 minutes on 4 or more days, or two 7-minute sessions	Link moves together; add slow turns of the trunk
4	2 classes	15 to 20 minutes on 4 or more days, building toward 3012	Run the moves you know without watching anyone

A few rules carry through all four weeks:

• Keep a counter or sturdy chair within reach at home.
• Stand taller whenever a knee complains. Depth comes with time¹⁴.
• Write one line a week about daily life, such as how steady you feel stepping off a curb.
• Don’t stop at week four. The trials above ran from 12 weeks to a year¹⁴⁶.

A practice of self-cultivation that also passed fair tests

Many natural-health readers value practices that are low cost, gentle, rooted in tradition and in their own hands. Tai chi fits all four. It needs no equipment, and teachers have handed it down for centuries⁹.

It also shows that tradition and testing need not be rivals. In fair trials, tai chi held its own against physical therapy and against a well-designed exercise class¹⁴. Those results came from researchers who took the practice seriously enough to test it.

Respecting a tradition also means being honest about what hasn’t been shown. NCCIH advises against using tai chi to put off seeing a provider about a medical problem³. Keep your other care, and add tai chi to it.

Questions readers ask

The bottom line

Tai chi began as a martial art in a Chinese village nearly four centuries ago. Today its best-proven use is helping older adults stay on their feet, and it eases knee arthritis about as well as a standard course of physical therapy. Benefits for blood pressure, sleep and thinking skills look promising, but they rest on few studies.

If you want to try it, pick a structured class with a trained teacher, practice a little at home and give it at least three months. Check with a clinician first if you’ve fallen, feel unsteady or live with a chronic condition, and keep tai chi alongside your other care, not in place of it.

Related reading

• Balance fades after 50, and a 10-second test shows where you stand
• Tai chi beat aerobics in the headlines, and the full study tells a fuller story
• Tai chi, prayer and journaling: what research can measure and what it can’t
• Most adults skip strength training, though under an hour a week goes a long way
• The Eight Brocades are qigong’s most-studied moves, and the evidence for them is modest

Sources

1. Li F, Harmer P, Fitzgerald K, Eckstrom E, Akers L, Chou LS, Pidgeon D, Voit J, Winters-Stone K. “Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial.” JAMA Internal Medicine, 2018;178(10):1301-1310 (abstract and quality rating, PEDro database). search.pedro.org.au
2. MDedge. “Tai chi tempers risk of falls in older adults.” Summary of Li F, et al., JAMA Internal Medicine, September 2018. mdedge.com
3. National Center for Complementary and Integrative Health. “Tai Chi: What You Need To Know.” NIH, last updated December 2023. nccih.nih.gov
4. Wang C, Schmid CH, Iversen MD, et al. “Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial.” Annals of Internal Medicine, 2016;165(2):77-86 (abstract and quality rating, PEDro database). search.pedro.org.au
5. National Center for Complementary and Integrative Health. “Study Shows Tai Chi and Physical Therapy Were Equally Helpful for Knee Osteoarthritis.” NIH research spotlight, May 17, 2016. nccih.nih.gov
6. Li X, Chang P, Wu M, et al. “Effect of Tai Chi vs Aerobic Exercise on Blood Pressure in Patients With Prehypertension: A Randomized Clinical Trial.” JAMA Network Open, 2024;7(2):e2354937 (abstract and quality rating, PEDro database). search.pedro.org.au
7. Siu PM, Yu DJ, Yu AP, et al. “Tai Chi or Cognitive Behavioural Therapy for Treating Insomnia in Middle Aged and Older Adults: Randomised Non-Inferiority Trial.” The BMJ, 2025;391 (University of Hong Kong repository record). doi.org
8. BMJ Group. “Tai chi as good as talking therapy for managing chronic insomnia.” Press release, November 26, 2025. bmjgroup.com
9. UNESCO Intangible Cultural Heritage. “Taijiquan” (inscribed 2020, Decision 15.COM 8.B.21). ich.unesco.org
10. People’s Republic of China. “Nomination File No. 00424 for Inscription on the Representative List of the Intangible Cultural Heritage: Taijiquan.” UNESCO, 2019. ich.unesco.org
11. National Council on Aging. “Evidence-Based Program: Tai Ji Quan: Moving for Better Balance.” November 27, 2023. ncoa.org
12. National Council on Aging. “Evidence-Based Program: Tai Chi for Arthritis and Fall Prevention.” November 1, 2023. ncoa.org
13. National Council on Aging. “Evidence-Based Program: YMCA Moving For Better Balance.” November 27, 2023. ncoa.org
14. Tai Chi for Health Institute. “Safety First” (teaching guidance from the program developer). Accessed October 2026. taichiforhealthinstitute.org
15. National Institute on Aging. “Exercising With Chronic Conditions.” NIH, accessed October 2026. nia.nih.gov