Effects of Tai Chi on functional performance and fall-related psychological outcomes in Parkinson’s disease: a systematic review and meta-analysis

Abstract

Objective To systematically evaluate the effects of Tai Chi on objective motor performance and subjective fall-related psychological outcomes in patients with Parkinson’s disease (PD), and to examine whether intervention characteristics influence the magnitude of therapeutic effects. Methods Randomized controlled trials (RCTs) investigating Tai Chi interventions in patients with PD were identified through searches of electronic databases from inception to April 2026. The methodological quality and risk of bias were assessed using the Cochrane Risk of Bias 2 (RoB 2) tool and the PEDro scale. Meta-analyses were performed to evaluate the effects of Tai Chi on balance function, motor function, mobility, balance confidence, and fear of falling. Subgroup analyses were conducted according to intervention duration, weekly frequency, and session length to explore potential sources of heterogeneity. Results Seventeen RCTs involving 914 participants were included. Meta-analysis demonstrated that Tai Chi significantly improved balance function measured by the Berg Balance Scale (BBS) (MD = 3.35, 95% CI [1.40, 5.30], p < 0.001), motor function assessed by the Unified Parkinson’s Disease Rating Scale Part III (UPDRS-III) (MD = −4.10, 95% CI [−6.34, −1.85], p < 0.001), and mobility measured by the Timed Up and Go Test (TUGT) (MD = −1.97, 95% CI [−3.30, −0.64], p < 0.001). Limited evidence suggested possible improvements in fall-related psychological outcomes, including balance confidence and fear of falling; however, these findings should be interpreted cautiously due to the small number of studies, heterogeneity, and limited precision. Conclusion Tai Chi may improve balance, motor function, and mobility in patients with Parkinson’s disease. Evidence regarding fall-related psychological outcomes remains limited and requires further investigation. However, the optimal intervention dosage remains unclear, and the findings should be interpreted cautiously due to heterogeneity among studies and limited evidence for subjective outcomes. Future large-scale, well-designed RCTs with standardized intervention protocols and longer follow-up periods are warranted. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261371910, identifier CRD420261371910.