Effectiveness of tai chi for Parkinson's disease: a critical review

The objective of this review is to assess the effectiveness of tai chi as a treatment option for Parkinson's disease (PD). We have searched the literature using 21 databases from their inceptions to January 2008, without language restrictions. We included all types of clinical studies regardless of their design. Their methodological quality was assessed using the modified Jadad score. Of the seven studies included, one randomised clinical trial (RCT) found tai chi to be superior to conventional exercise in terms of the Unified PD Rating Scale (UPDRS) and prevention of falls. Another RCT found no effects of tai chi on locomotor ability compared with qigong. The third RCT failed to show effects of tai chi on the UPDRS and the PD Questionnaires compared with wait list control. The remaining studies were either non-randomised (n=1) or uncontrolled clinical trials (n=3). Collectively these data show that RCTs of the tai chi for PD are feasible but scarce. Most investigations suffer from methodological flaws such as inadequate study design, poor reporting of results, small sample size, and publication without appropriate peer review process. In conclusion, the evidence is insufficient to suggest tai chi is an effective intervention for PD. Further research is required to investigate whether there are specific benefits of tai chi for people with PD, such as its potential effect on balance and on the frequency of falls.