A new umbrella review published in the British Journal of Sports Medicine examined 1,744 randomized controlled trials and found high-certainty evidence that traditional Chinese exercises improve physical function, pain, mental health, sleep quality, and bone mineral density for people with musculoskeletal conditions, according to the report. More than 1.7 billion people worldwide have musculoskeletal conditions, the review noted.
Researchers from hospitals and universities in China conducted the review, which they described as the largest of its kind. The analysis drew on 92 data syntheses from 1,744 randomized controlled clinical trials, according to the study. Exercises included tai chi, qigong, baduanjin, wuqinxi, and yijinjing.
Study Methods and Scope
The overarching review of pooled data analyses of systematic reviews by researchers at hospitals and universities in China, published in the British Journal of Sports Medicine, drew on 92 data syntheses from 1,744 randomized controlled clinical trials, according to the report. It found high certainty evidence for the effectiveness of traditional Chinese exercises for a range of health outcomes for people with musculoskeletal disorders.
These included improving movement in knee osteoarthritis, mental health associated with neck pain and knee osteoarthritis, and sleep quality associated with fibromyalgia, the researchers said. The review assessed outcomes for conditions such as knee osteoarthritis, neck pain, fibromyalgia, and osteoporosis. Traditional Chinese medicine, of which these exercises are a part, has a long history of use, as noted in various sources including the book "The complete guide to integrated medicine" by David Peters, which describes the practice as viewing symptoms as signs of disharmony and attributing illness to a disruption in the flow of qi [1].
Specific Findings on Tai Chi and Other Exercises
Tai chi significantly eased chronic musculoskeletal pain and stiffness in several conditions, the research found. Tai chi increased bone mineral density in participants with osteopenia or osteoporosis, according to the study. Maximum benefits occurred when exercises were performed for longer than six months, at least three times a week, totaling at least 150 minutes per week, the researchers reported.
The exercises improved movement in knee osteoarthritis, mental health in neck pain, and sleep quality in fibromyalgia. A separate review published in 2025 by researchers at the Beijing University of Chinese Medicine found that certain forms of gentle exercise can improve sleep quality as effectively as medication or therapy for people with insomnia [2]. Similarly, tai chi has been shown to provide significant strength training for both the lower and upper body, according to motion analysis studies cited in "The Harvard medical school guide to tai chi" by Peter Wayne [3].
Implications for Clinical Practice and Public Health
The researchers concluded the findings supported including traditional Chinese exercises in clinical guidelines and rehabilitation programs worldwide. The exercises represent a safe, accessible, and cost-effective strategy that can complement conventional therapies, according to the authors.
With global population growth and aging, the number of people with musculoskeletal conditions is rapidly increasing, the study noted. Promoting these exercises in community and primary care settings could be part of public health initiatives for healthy aging and chronic disease prevention, the researchers said. A 2021 CDC estimate indicated that 20.9% of adults experienced chronic pain, with 6.9% experiencing high-impact chronic pain, which significantly restricts daily activities [4]. The exercises can also help reduce reliance on pharmaceuticals, according to the authors.
Conclusion
The umbrella review provides definitive, high-level evidence synthesis supporting traditional Chinese exercises for musculoskeletal conditions, the researchers stated. The evidence for tai chi reaches high certainty for improving key outcomes including physical function, mental health, sleep, and bone density, according to the study.
The study suggests these exercises can reduce pharmacological reliance and empower patients in self-management, according to the authors. Researchers from hospitals and universities in China conducted the review.
References
- Peters David. "The complete guide to integrated medicine the best of complementary and conventional care."
- NaturalNews.com. "3 Science-backed exercises that could transform your sleep." May 6, 2026.
- Wayne Peter. "The Harvard medical school guide to tai chi 12 weeks to a healthy body strong heart and sharp mind."
- Mercola.com. "An Herbal Guide to Natural Pain Relief." December 21, 2023.
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