Tai Chi for Balance and Fall Prevention: Trial Evidence
What Cochrane and other reviews and trials found for tai chi and falls in older adults, how strong the evidence is, and who should check with a clinician first.
Content last updated . This page has not been medically reviewed.
What the reviews found
| Question | What the source found | Strength |
|---|---|---|
| How many falls happen (rate of falls)? | A 2019 Cochrane review found tai chi may cut the rate of falls by 19% (7 studies, 2,655 people). [2] | Low certainty: promising but limited |
| How many people fall at least once? | The same review found 20% fewer people had falls (8 studies, 2,677 people). [2] | High certainty |
| A newer pooled analysis | 24 randomized trials were pooled; the risk of falls was lower with tai chi (RR 0.76, 95% CI 0.71 to 0.82). [3] | Not graded in the abstract we read |
| Compared with other exercise | The Cochrane review found balance and functional exercises reduce the rate of falls by 24%. [2] | High certainty for those exercises, so tai chi is one good option, not the only one |
Cochrane noted that most of the trials it included had unclear or high risk of bias for one or more items. [2] That is a reason to read the numbers as a rough guide, not a promise.
One larger trial, in detail
In an Oregon trial, 670 people aged 70 or older who had fallen in the past year or had trouble moving about were assigned to one of three groups. [4] The tai chi group (a therapeutic version called Tai Ji Quan: Moving for Better Balance, using modified forms) took two 60-minute classes a week for 24 weeks. [4] The comparison groups did a multimodal exercise program or stretching. [4]At 6 months the rate of falls was lower in the tai chi group than in the stretching group (incidence rate ratio 0.42, 95% CI 0.31 to 0.56). [4] The trial was described as single-blind, but people cannot be blinded to whether they are doing tai chi or stretching, so expectation may play a part. [4] Because the comparison was stretching, the result tells us tai chi beat stretching; it does not tell us it beats every other exercise.
How it fits with national advice
The US Preventive Services Task Force recommends exercise interventions to prevent falls in community-dwelling adults 65 and older at increased risk for falls (grade B). [5] The line we read speaks of exercise in general and does not single out tai chi. A Canadian evidence review found the most certain benefit came from supervised, long-duration balance and resistance programs and from group tai chi. [6] It also found people tended to prefer balance and resistance training over tai chi. [6]Related pages
Read the overview at Tai Chi, compare yoga for balance and fall prevention and Pilates for older adults, or see the side-by-side tai chi, yoga and Pilates for older adults.Frequently asked questions
Does tai chi prevent falls?
It may reduce them. Cochrane found low-certainty evidence for a 19% lower rate of falls and high-certainty evidence for 20% fewer people falling. [2]
Is tai chi better than other exercise for balance?
Not shown. Cochrane found balance and functional exercises reduce the rate of falls by 24%, so several kinds of exercise work. [2]
Is tai chi safe for older adults?
NCCIH says it appears safe; side effects in studies were minor, such as aches. [1] Check first if you take medicines that cause dizziness. [7]
Does tai chi help after a stroke or with heart failure?
NCCIH says it is unknown whether it reduces falls in people who have had a stroke or have osteoarthritis or heart failure. [1]
When should I see a doctor instead of starting a class?
If you have fallen or worry about your balance, the NHS advises seeing a doctor. [8]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read the evidence labels
Labels used on this page: established, promising but limited, mixed, insufficient evidence.
Safety and who should check first
- NCCIH says tai chi appears to be safe, and reported side effects in studies were minor, such as muscle aches and pain. [1]
- Harvard Health advises checking with your medical care team first if you have a limiting musculoskeletal problem or take medicines that can make you dizzy or lightheaded. [7]
- If you are worried about your balance, or you have already had a fall, the NHS advises seeing a doctor. A falls service may check muscle weakness, weak bones and eyesight, and review your medicines. [8]
- After a fall, the NHS lists a possible injury to the head, back, neck or hip, or being unable to get up, as reasons for emergency help. [8] In the US, call 911.
Tai chi is not a replacement for a medical check of why you are falling. More on balance in general: falls and balance and older adults and natural remedy safety.
References
- National Center for Complementary and Integrative Health (NCCIH). Tai Chi: What You Need To Know. Read 2026-10-22.
- Sherrington C et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2019. Read 2026-10-22.
- Tai Chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trials. Frontiers in Public Health, 2023. Read 2026-10-22.
- Li F et al. Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling. JAMA Internal Medicine, 2018. Read 2026-10-22.
- US Preventive Services Task Force. Falls Prevention in Community-Dwelling Older Adults: Interventions. Read 2026-10-22.
- Falls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferences. Systematic Reviews, 2024. Read 2026-10-22.
- Harvard Health Publishing. The Health Benefits of Tai Chi. Read 2026-10-22.
- NHS (UK). Falls. Read 2026-10-22.