Benefits of Tai Chi Exercise among Adults with Chronic Heart Failure: A Systematic Review and Meta-Analysis

Ruth Taylor-Piliae, Brooke A. Finley

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Background Exercise-based cardiac rehabilitation is safe and effective for adults with chronic heart failure (CHF), yet services are greatly underutilized. However, tai chi is a popular and safe form of exercise among older adults with chronic health conditions. Objective A systematic review and meta-analysis was conducted to examine the benefits of tai chi exercise among persons with CHF. Methods An electronic literature search of 10 databases (Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted from January 1, 2004, to August 1, 2019. Clinical trials that examined tai chi exercise, were published in English or German languages, and conducted among participants with CHF were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc) was used to calculate effect sizes (ie, Hedges g) and 95% confidence intervals using random effects models. Results A total of 6 studies met the inclusion criteria, enrolling 229 participants (mean age, 68 years; 28% women; mean ejection fraction = 37%). At least 3 studies reported outcomes for exercise capacity (n = 5 studies), quality of life (n = 5 studies), depression (n = 4 studies), and b-type natriuretic peptide (n = 4 studies), allowing for meta-analysis. Compared with controls, tai chi participants had significantly better exercise capacity (g = 0.353; P =.026, I2 = 32.72%), improved quality of life (g = 0.617; P =.000, I2 = 0%), with less depression (g = 0.627; P =.000, I2 = 0%), and decreased b-type natriuretic peptide expression (g = 0.333; P =.016, I2 = 0%). Conclusion Tai chi can be easily integrated into existing cardiac rehabilitation programs. Further research is needed with rigorous study designs and larger samples before widespread recommendations can be made.

Original languageEnglish (US)
Pages (from-to)423-434
Number of pages12
JournalJournal of Cardiovascular Nursing
Issue number5
StatePublished - Sep 1 2020


  • depression
  • exercise tolerance
  • heart failure
  • meta-analysis
  • quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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