Efficacy and evidence certainty of traditional Chinese exercises for musculoskeletal disorders: an umbrella review of meta-analyses
In brief
Tai Chi improves knee osteoarthritis function and mental health, evidence high certainty
An umbrella review of 92 meta-analyses (1744 RCTs) found high-certainty evidence that Tai Chi significantly enhances physical function and mental health in knee osteoarthritis, and also eases chronic pain, stiffness and boosts bone density in osteoporosis. Longer, more frequent sessions yielded greater gains, but most other musculoskeletal benefits rest on moderate-certainty data, underscoring the need for further rigorous trials.
- Journal
- British journal of sports medicine (Q1)
- Published
- 17 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Wen-Xiao Chen, Yi-Zi Li, Long-Dan Kang, Xiao-Feng Jiang, Yu-Han Chen, Dan Yang, et al.
- PMID
- 42608034
- DOI
- 10.1136/bjsports-2026-111792
Why clinicians should know about it
- Picked for Rheumatology (top studies of the week, 23 August 2026): Umbrella review shows high‑certainty evidence for TCEs in knee osteoarthritis
Abstract
OBJECTIVES: To comprehensively evaluate the efficacy and exercise prescription parameters of traditional Chinese exercises (TCEs) on health outcomes in patients with musculoskeletal disorders (MSDs) and rigorously assess the certainty of the evidence. DESIGN: Umbrella review. DATA SOURCES: PubMed, Embase, Cochrane Library, Scopus, Web of Science, PEDro, Ovid Medline, CINAHL and SPORTDiscus databases were searched from inception to 6 March 2026. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Systematic reviews with meta-analyses of randomised controlled trials (RCTs) that investigated TCE interventions for individuals with MSDs. RESULTS: 92 meta-analyses, comprising data from 1744 primary RCTs, were included, yielding 547 unique outcome associations. TCE modalities included mixed/unspecified TCEs (37.3%), Tai Chi (41.5%), Baduanjin (11.0%), Yijinjing (4.2%), Qigong (3.8%), Wuqinxi (1.8%) and Daoyin (0.4%). Targeted MSDs spanned 10 categories, most commonly arthritis (38.8%). Methodological quality was high for 65 (70.7%) meta-analyses (A Measurement Tool to Assess Systematic Reviews). Applying the Grading of Recommendations, Assessment, Development and Evaluations framework, 23 associations (4.2%) were supported by high-certainty evidence and 179 (32.7%) by moderate-certainty evidence. High-certainty evidence demonstrated that TCEs significantly improved physical function in knee osteoarthritis, enhanced mental health in patients with knee osteoarthritis and neck pain and improved sleep quality in fibromyalgia. Tai Chi significantly alleviated chronic MSD-related pain and stiffness while increasing bone mineral density (BMD) in participants with osteopenia/osteoporosis. Subgroup analyses indicated that interventions with longer duration, higher frequency and moderate-to-high weekly volume were associated with greater clinical gains for knee osteoarthritis and osteoporosis. CONCLUSIONS: This umbrella review consolidates high-quality evidence demonstrating that TCEs, especially Tai Chi, provide multidimensional benefits for MSDs, improving function, pain, mental health, sleep and BMD with sustained practice. PROSPERO REGISTRATION NUMBER: CRD420251080573.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.