title: What do we really know about the safety of tai chi?: A systematic review of adverse event reports in randomized trials.
abstract: OBJECTIVE
  To systematically review the frequency and quality of adverse event (AE) reports in randomized controlled trials (RCTs) of tai chi (TC).
  
  
  METHODS
  Electronic searches of PubMed/MEDLINE and additional databases from inception through March 2013 of English-language RCTs. Search terms included tai chi, taiji, and tai chi chuan. Data were independently extracted by 2 investigators.
  
  
  METHODS
  We included all available RCTs that were published in English and used TC as an intervention. Inclusion and exclusion criteria of studies were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
  
  
  METHODS
  Eligible RCTs were categorized with respect to AE reporting: no mention of protocol for monitoring AEs or reports of AEs, and reports of AEs either with or without explicit protocol for monitoring AEs.
  
  
  RESULTS
  There were 153 eligible RCTs identified; most targeted older adults. Only 50 eligible trials (33%) included reporting of AEs; of these, only 18 trials (12% overall) also reported an explicit AE monitoring protocol. Protocols varied with respect to the rigor of systematic monitoring in both the TC and comparison groups. Reported AEs were typically minor and expected and primarily musculoskeletal related (eg, knee and back pain); no intervention-related serious AEs were reported.
  
  
  CONCLUSIONS
  TC is unlikely to result in serious AEs, but it may be associated with minor musculoskeletal aches and pains. However, poor and inconsistent reporting of AEs greatly limits the conclusions that can be drawn regarding the safety of TC.
authors.affiliation: Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Harvard Medical School, Boston, MA; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA. Electronic address: pwayne@partners.org.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Wayne
authors.affiliation: Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Berkowitz
authors.affiliation: Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Litrownik
authors.affiliation: Harvard Medical School, Boston, MA; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.affiliation: Harvard Medical School, Boston, MA; Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Gloria Y
authors.initials: GY
authors.lastname: Yeh
mesh_terms: D006801:Humans; D061214:Patient Safety; D016032:Randomized Controlled Trials as Topic; D012046:Rehabilitation / Q000379:methods; D012107:Research Design / Q000592:standards*; D026302:Tai Ji / Q000009:adverse effects*
keywords: Exercise; Mind-body therapies; Rehabilitation; Safety