Tai chi, prayer and journaling: what research can measure and what it can’t

Key takeaways

• In a 2024 trial of 702 Christians, 28 days of Centering Prayer raised well-being no more than a secular version did, though it boosted reported spiritual experiences compared with simple daily reflection.
• A 2019 Cochrane review summarized by the NIH found that tai chi cuts the number of older adults who fall by about 20%.
• Across 146 randomized studies, writing about a hard experience helped a little on average, and it often feels worse before it feels better.
• A 2006 trial of prayer by strangers for 1,802 heart-bypass patients found no benefit, but it never tested your own prayer or prayer by people you know.
• In 2014, adults 65 and older landed in the emergency room after yoga at nearly five times the rate of adults 18 to 44, so start gently.

In a 2024 study of 702 Christians, researchers asked people to spend about 20 minutes a day in silence for 28 days¹. One group practiced Centering Prayer, a Christian method made popular by the Trappist priest Thomas Keating in the 1970s. Each person chose a sacred word and came back to it gently whenever the mind wandered.

A second group used the same steps with the religious words taken out. The researchers called it Centering Practice. A third group simply reflected on their day and filled out surveys.

On the main measure, a scale of flourishing, all three groups improved by about the same amount¹. The prayer did not beat its secular twin.

One thing did set the prayer group apart. Its members reported more daily spiritual experiences than the reflection group, and that gap was still there a month later¹. On that score, though, it did not clearly beat the secular version.

That one study holds the main lesson of this article. Research can measure some of what contemplative practices do for body and mind. But what a practice is for, in the eyes of the person keeping it, often shows up where a health survey doesn’t look.

A contemplative practice is done for its own sake

Contemplative practices are slow, attentive habits of body and mind. Centering Prayer and lectio divina, the slow, prayerful reading of scripture, come from Christian contemplative traditions. Tai chi began as a Chinese martial art². Qigong, which joins breath, movement and focused attention, was developed in China thousands of years ago³.

Walking meditation, yoga nidra (a lying-down practice of guided rest), journaling and a weekly Sabbath belong on the list too. The share of U.S. adults who did yoga rose from 5.0% in 2002 to 15.8% in 2022, according to the National Center for Complementary and Integrative Health (NCCIH)⁴.

Research asks a narrow question: does this practice change a symptom, a score or a risk? That question is useful, but people kept these practices for centuries for other reasons, like prayer, discipline and rest. The evidence ratings below apply to health claims, not to the spiritual worth of a practice.

Tai chi has the strongest evidence: fewer falls

More than one in four adults 65 and older falls each year, and fewer than half tell a doctor, according to the Centers for Disease Control and Prevention (CDC)⁵. Falling once doubles the chance of falling again. Older adults make about 4.5 million emergency visits a year for falls.

A 2019 Cochrane review, summarized by NCCIH, found high-certainty evidence that tai chi cuts the number of older people who fall by 20%². It found lower-certainty evidence that it cuts the overall rate of falls by 19%.

One trial shows what that looks like in real life. In Portland, Oregon, researchers assigned 256 inactive adults aged 70 to 92, by chance, to tai chi three times a week or to stretching, for six months⁶. The tai chi group had 38 falls, compared with 73 in the stretching group. Only 7% had a fall that caused an injury, compared with 18%.

After the researchers adjusted for differences at the start, the tai chi group’s risk of falling more than once was 55% lower⁶. The CDC includes that program, “Tai Chi: Moving for Better Balance,” in its compendium of fall-prevention programs for older adults living at home⁷.

Tai chi may help joints, too. A 2019 guideline from the American College of Rheumatology and the Arthritis Foundation strongly recommends it for knee and hip osteoarthritis². The evidence behind that advice is thinner than for falls: a 2021 review of 16 knee studies rated it low to moderate.

When tai chi is practiced for health, it is considered a form of qigong³. NCCIH cites a 2019 survey of reviews that found enough evidence to support qigong for balance training and fall prevention.

In a 2019 review of 24 studies, side effects with tai chi were about as common as in comparison groups, and mostly minor aches². One caution: tai chi and qigong teachers don’t need a license, and there is no national standard for certifying them²³.

Yoga eases some pain, and the injury risk climbs with age

Low-back pain has the deepest research base. In a 2022 Cochrane review covering 21 studies and 2,223 people, yoga beat no exercise, but by a margin some patients might not notice⁴. A 2020 report from the federal Agency for Healthcare Research and Quality found that yoga’s gains in pain and function matched those of exercise or massage.

The picture for mood is mixed. A 2019 review of 38 studies found yoga eased anxiety symptoms⁴.

For diagnosed anxiety disorders, though, a 2021 review saw promise but too few rigorous studies to draw conclusions. And in a 2021 trial of 226 people with generalized anxiety disorder, Kundalini yoga helped, but less than cognitive behavioral therapy, a structured form of talk therapy.

Yoga is generally safe with a qualified teacher, and serious injuries are rare⁴. Still, the risk rises with age.

Using federal emergency-room data, two researchers estimated 29,590 yoga injuries treated there from 2001 to 2014⁸. Over that span, the injury rate rose from 9.55 to 17.01 per 100,000 people who practiced.

In 2014, adults 65 and older had a rate of 57.9 per 100,000, compared with 11.9 for adults aged 18 to 44⁸. About 45% of the injuries were strains and sprains, and the trunk was the most common place to get hurt.

NCCIH says learning yoga on your own, without a teacher, has been linked to more injuries⁴. If you’re new, hold off on extreme moves such as standing on your head or shoulders, sitting in full lotus, and forceful breathing exercises. Hot yoga brings a risk of overheating and dehydration, and pregnant women should avoid it. People with glaucoma, very high blood pressure, shaky balance or a lower-spine condition may need modified poses, so tell the teacher first.

Writing about hard things helps a little, and stings first

In 1986, psychologist James Pennebaker and a colleague asked college students to write for 15 minutes on four days in a row⁹. Some poured out their most private feelings about something painful. Others wrote about neutral topics. Four months later, the emotional writers had made fewer visits to the student health center.

The usual method that grew from it asks people to write for 15 to 20 minutes, over three to five sessions, without worrying about spelling or grammar⁹.

The best-known summary came in 2006, in the journal Psychological Bulletin. It pooled 146 randomized studies, where people are assigned to groups by chance, with nearly 11,000 people in all¹⁰. The average effect was positive and small. Results leaned positive in 102 of the 146 studies.

Among emotional outcomes, the biggest gain was in distress, with a smaller gain for depression¹⁰. Health habits did not change in a measurable way.

The first effect is often the opposite of what people expect. Right after a writing session, distress and low mood usually go up for a while⁹.

For a few people, this kind of writing has backfired. A 2005 review pointed to one study in which adults who had been abused as children did worse than a comparison group, and to a small study of Vietnam veterans with PTSD with a similar result⁹. The reviewers advise using expressive writing alongside treatment, not in place of it, and stopping if it becomes too much.

A large prayer trial found no benefit from strangers’ prayers

The Study of the Therapeutic Effects of Intercessory Prayer, known as STEP, was a large, carefully designed test. Led by Herbert Benson of the Mind/Body Medical Institute, it enrolled 1,802 heart-bypass patients at six U.S. hospitals from 1998 to 2001¹¹. The John Templeton Foundation and Baptist Memorial Health Care Corporation paid its $2.4 million cost.

Patients were split into three groups of about 600¹². Two groups were told they might or might not be prayed for. Only one of those two was. The third group was prayed for and told so.

Three Christian groups did the praying, one Protestant and two Catholic¹¹. For 14 days, beginning the night before surgery, they prayed for each patient by first name and last initial, asking “for successful surgery with a quick, healthy recovery and no complications.”

Within 30 days, complications struck 52% of patients who were prayed for but unsure of it, and 51% of those not prayed for¹². That gap was too small to mean anything. Patients who knew they were being prayed for had more complications, 58.6%. Deaths were about the same in all three groups.

The researchers said they had no clear explanation for the higher rate¹¹. Jeffrey Dusek, one of the researchers, and his colleagues stressed that the results did not challenge the existence of God.

A 2009 Cochrane review, which searched studies through mid-2007, included 10 trials of intercessory prayer, meaning prayer offered for someone else, with 7,646 patients¹³. It found no clear effect on deaths. The authors called the results “equivocal” and doubted that more trials were worth doing.

Notice what STEP tested: prayer by strangers, with set words, for a set time. It did not test prayer by family or friends¹², or your own prayer, or prayer as a relationship rather than a remedy. Those are different questions, and a companion article on spiritual well-being covers them.

Attention and rest are newer questions with early answers

Can contemplative practice sharpen attention? In a 2010 study, researchers assigned 60 people by chance to about five hours a day of focused-attention meditation for three months, or to a waiting list¹⁴. The meditators got better at telling fine visual details apart and at staying alert during a task that demanded steady attention.

That dose looks more like a monastery than a lunch break, so the study can’t tell you what 10 minutes a day does.

Sabbath rest has drawn only a little research. Researchers with Duke University’s Clergy Health Initiative followed 167 United Methodist clergy in North Carolina after workshops on keeping a Sabbath¹⁵. Each pastor defined Sabbath for themselves. Pastors whose Sabbath-keeping dropped off reported worse anxiety three months later, but that link was gone at nine months.

The authors were candid about limits. There was no comparison group, and they noted that a stricter statistical test would erase all but one of their findings¹⁵.

The Centering Prayer trial has a similar wrinkle. Flourishing rose in all three groups, and none of them sat idle. Even the reflection group got daily reminders and was asked to think back over each day¹, which may have worked as a light practice of its own.

The evidence at a glance

Claim	Evidence level	What the research shows
Tai chi lowers the number of older adults who fall	Strong evidence	About 20% fewer fallers in a Cochrane review; 55% lower risk of repeat falls in one trial26
Tai chi eases knee and hip osteoarthritis	Promising but early	Strongly recommended in a 2019 guideline, but a 2021 knee review rated the evidence low to moderate2
Tai chi’s side effects are mostly minor	Strong evidence	In a review of 24 studies, side effects were about as common as in comparison groups2
Yoga brings slight relief from low-back pain	Strong evidence	Large research base; a small benefit, similar to exercise or massage4
Yoga treats diagnosed anxiety disorders	Promising but early	Some promising results but too few rigorous studies; one trial found it less helpful than talk therapy4
Expressive writing gives a small lift to emotional health	Strong evidence	Small average effect across 146 randomized studies10
Intensive meditation sharpens attention	Promising but early	One three-month trial at about five hours a day14
Centering Prayer deepens spiritual experience	Promising but early	One 28-day online trial1
A weekly Sabbath protects mental health	Not enough evidence	One study, no comparison group15
Prayer by strangers improves surgery recovery	Evidence says no	No benefit in STEP or in a Cochrane review1213

Choose a practice by what you want it to be for

Start with why you’re drawn to a practice, then pick a form you can keep up. Treat this table as a starting point.

If you are looking for	Practices to consider	What to know first
Steadier balance and fewer falls	Tai chi, qigong	Look for a class built for older adults; the Portland trial met three times a week6
Stillness and prayer within your faith	Centering Prayer, lectio divina, Sabbath	Ask your clergy or a spiritual director; health surveys may miss what matters most to you
Making sense of a hard experience	Expressive writing	15 to 20 minutes, three to five sessions, in private; expect a short dip in mood9
Gentle stretching and back comfort	Yoga	Start with a teacher; skip inversions until you’re steady4
Calm attention during the day	Walking meditation, breath focus	Costs nothing and needs no gear

Then try a simple four-week routine:

1. Pick one practice and a modest dose, such as 20 minutes a day, as in the Centering Prayer trial¹, or a class two or three times a week.
2. Keep the same time and place each day, so the habit has a home.
3. After each session, write one line about what you noticed. Skip the scorekeeping.
4. Tell your clinician if you’re pregnant, have balance problems, glaucoma or high blood pressure, or are working through trauma.
5. At four weeks, decide whether to keep going, adjust the dose or try something else.

These practices fit what many natural-health readers already value. They cost little, need no product, and lean on the body’s own ability to settle and steady itself. They come from living traditions, not a lab. Research can tell you which health claims hold up, but it doesn’t get the final word on whether a practice is worth keeping.

Questions readers ask

The bottom line

Contemplative practices do measurable good in some areas. Tai chi helps prevent falls, yoga offers modest relief for back pain, and expressive writing helps a little, on average, after a rough start. Prayer offered by strangers did not improve surgery outcomes in a large trial.

Those findings matter for health choices, and they still leave most of the story untold. Pick a practice for what you want it to be in your life, keep the safety steps in mind, and let the research guide your health expectations without deciding the practice’s worth.

Related reading

• What meditation groups can do, and what they can stir up
• Walking clubs work, and you need fewer steps than you were told
• What rehabilitation covers, and why so many people skip it
• Gratitude helps a little, and saying thanks to someone helps more

Sources

1. Rohde JS, Goldy S, Graziosi M, et al. “Centering and flourishing: an online intervention study assessing the effects of a Christian contemplative practice on stress-reduction and human flourishing.” BMC Psychology, 2024. bmcpsychology.biomedcentral.com
2. National Center for Complementary and Integrative Health. “Tai Chi: What You Need To Know (In Depth).” NIH, updated December 2023. nccih.nih.gov
3. National Center for Complementary and Integrative Health. “Qigong: What You Need To Know.” NIH, updated February 2022. nccih.nih.gov
4. National Center for Complementary and Integrative Health. “Yoga: Effectiveness and Safety.” NIH, updated August 2023. nccih.nih.gov
5. Centers for Disease Control and Prevention. “Older Adult Fall Facts.” CDC, updated September 2026. cdc.gov
6. Li F, Harmer P, Fisher KJ, et al. “Tai Chi and Fall Reductions in Older Adults: A Randomized Controlled Trial.” The Journals of Gerontology: Series A, 2005. pubmed.ncbi.nlm.nih.gov
7. Centers for Disease Control and Prevention. “Falls Compendium.” CDC, updated July 2025. cdc.gov
8. Swain TA, McGwin G. “Yoga-Related Injuries in the United States From 2001 to 2014.” Orthopaedic Journal of Sports Medicine, 2016. pubmed.ncbi.nlm.nih.gov
9. Baikie KA, Wilhelm K. “Emotional and physical health benefits of expressive writing.” Advances in Psychiatric Treatment, 2005. sparq.stanford.edu
10. Frattaroli J. “Experimental Disclosure and Its Moderators: A Meta-Analysis.” Psychological Bulletin, 2006. doi.org
11. Cromie WJ. “Prayers don’t help heart surgery patients.” Harvard Gazette, April 6, 2006. news.harvard.edu
12. American College of Cardiology. “Study of the Therapeutic Effects of Intercessory Prayer – STEP” (trial summary of Benson H, et al., American Heart Journal, 2006). ACC. acc.org
13. Roberts L, Ahmed I, Davison A. “Intercessory prayer for the alleviation of ill health.” Cochrane Database of Systematic Reviews, 2009, CD000368.pub3 (studies searched through June 2007). cochranelibrary.com
14. MacLean KA, Ferrer E, Aichele SR, et al. “Intensive Meditation Training Improves Perceptual Discrimination and Sustained Attention.” Psychological Science, 2010. psychologicalscience.org
15. Proeschold-Bell RJ, Stringfield B, Yao J, et al. “Changes in Sabbath-Keeping and Mental Health Over Time: Evaluation Findings From the Sabbath Living Study.” Journal of Psychology and Theology, 2022. doi.org