Background Osteoporosis and osteopenia are common skeletal diseases in middle-aged and elderly individuals, characterized by reduced bone mineral density (BMD), microstructural deterioration, and increased fragility, significantly raising the risk of pathological fractures and mortality. Tai Chi, a traditional Chinese exercise, has gained increasing attention for its potential benefits in managing osteoporosis and osteopenia due to its gentle movements, moderate intensity, and adaptability to various populations. Studies have demonstrated that Tai Chi may significantly improve BMD in critical areas such as the lumbar spine and hip. However, existing research on the effects of Tai Chi on osteoporosis and osteopenia in middle-aged and elderly people remains inconclusive. Objective We aim to evaluate the effects of Tai Chi exercise on BMD in middle-aged and elderly individuals with osteoporosis or osteopenia through a systematic review and meta-analysis. Methods A comprehensive literature search was conducted across 7 databases (PubMed, Web of Science, EMBASE, Cochrane, Wanfang Database, VIP Database, and CNKI) up to February 16, 2025. Results A total of 19 randomized controlled trials (RCTs) met the inclusion criteria. Overall, Tai Chi significantly improved BMD in key skeletal regions, including: lumbar spine (L2–L4) (WMD = 0.05 g/cm2, 95% CI 0.02 to 0.08, p = 0.0003), femoral neck (WMD = 0.05 g/cm2, 95% CI 0.02 to 0.08, p = 0.001), greater trochanter (WMD = 0.05 g/cm2, 95% CI 0.02 to 0.08, p = 0.002), and Ward’s triangle (WMD = 0.04, 95% CI 0.02 to 0.06, p < 0.0001). Subgroup analysis indicated that Tai Chi practice for more than 24 weeks significantly improved BMD in the lumbar spine (L2–L4) (WMD = 0.05, 95% CI 0.02 to 0.07, p < 0.0001), femoral neck (WMD = 0.03, 95% CI 0.02 to 0.04, p < 0.0001), greater trochanter (WMD = 0.04, 95% CI 0.02 to 0.06, p = 0.0003), and Ward’s triangle (WMD = 0.04, 95% CI 0.02 to 0.07, p < 0.0001). Furthermore, less than 200 min per week of Tai Chi had a positive effect on BMD in these key areas: lumbar spine(L2–L4) (WMD = 0.04, 95% CI 0.01 to 0.07, p = 0.006), femoral neck (WMD = 0.03, 95% CI 0.01 to 0.05, p = 0.007), greater trochanter (WMD = 0.06, 95% CI 0.03 to 0.09, p < 0.0001), and Ward’s triangle (WMD = 0.05, 95% CI 0.02 to 0.07, p < 0.0001). Conclusion Long-term Tai Chi exercise significantly improves BMD in individuals with osteoporosis and osteopenia. A regimen of more than 24 weeks with a total weekly exercise time of 120–200 min is recommended for optimal effect. Graphical abstract

The impact of Tai Chi on osteoporosis and osteopenia in middle-aged and elderly adults: a systematic review and meta-analysis of randomized controlled trial

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发表日期：

2026年2月24日

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Xiude Guo,
Jieping Wang,
Yi Wang,
Qin Sun

摘要

Background

Osteoporosis and osteopenia are common skeletal diseases in middle-aged and elderly individuals, characterized by reduced bone mineral density (BMD), microstructural deterioration, and increased fragility, significantly raising the risk of pathological fractures and mortality. Tai Chi, a traditional Chinese exercise, has gained increasing attention for its potential benefits in managing osteoporosis and osteopenia due to its gentle movements, moderate intensity, and adaptability to various populations. Studies have demonstrated that Tai Chi may significantly improve BMD in critical areas such as the lumbar spine and hip. However, existing research on the effects of Tai Chi on osteoporosis and osteopenia in middle-aged and elderly people remains inconclusive.

Objective

We aim to evaluate the effects of Tai Chi exercise on BMD in middle-aged and elderly individuals with osteoporosis or osteopenia through a systematic review and meta-analysis.

Methods

A comprehensive literature search was conducted across 7 databases (PubMed, Web of Science, EMBASE, Cochrane, Wanfang Database, VIP Database, and CNKI) up to February 16, 2025.

Results

A total of 19 randomized controlled trials (RCTs) met the inclusion criteria. Overall, Tai Chi significantly improved BMD in key skeletal regions, including: lumbar spine (L₂–L₄) (WMD = 0.05 g/cm², 95% CI 0.02 to 0.08, p = 0.0003), femoral neck (WMD = 0.05 g/cm², 95% CI 0.02 to 0.08, p = 0.001), greater trochanter (WMD = 0.05 g/cm², 95% CI 0.02 to 0.08, p = 0.002), and Ward’s triangle (WMD = 0.04, 95% CI 0.02 to 0.06, p < 0.0001). Subgroup analysis indicated that Tai Chi practice for more than 24 weeks significantly improved BMD in the lumbar spine (L₂–L₄) (WMD = 0.05, 95% CI 0.02 to 0.07, p < 0.0001), femoral neck (WMD = 0.03, 95% CI 0.02 to 0.04, p < 0.0001), greater trochanter (WMD = 0.04, 95% CI 0.02 to 0.06, p = 0.0003), and Ward’s triangle (WMD = 0.04, 95% CI 0.02 to 0.07, p < 0.0001). Furthermore, less than 200 min per week of Tai Chi had a positive effect on BMD in these key areas: lumbar spine(L₂–L₄) (WMD = 0.04, 95% CI 0.01 to 0.07, p = 0.006), femoral neck (WMD = 0.03, 95% CI 0.01 to 0.05, p = 0.007), greater trochanter (WMD = 0.06, 95% CI 0.03 to 0.09, p < 0.0001), and Ward’s triangle (WMD = 0.05, 95% CI 0.02 to 0.07, p < 0.0001).

Conclusion

Long-term Tai Chi exercise significantly improves BMD in individuals with osteoporosis and osteopenia. A regimen of more than 24 weeks with a total weekly exercise time of 120–200 min is recommended for optimal effect.

Graphical abstract