title: So much research, so little application: Barriers to dissemination and practical implementation of Tai Ji Quan.
abstract: Despite the large number of articles published in the medical literature advocating the use of Tai Ji Quan for a wide variety of health-related outcomes, there has been little systematic broad-scale implementation of these programs. It may be argued that the lack of funding from organizations capable of implementing and overseeing large-scale programs, such as governmental health agencies or national non-governmental organizations concerned with healthcare for older adults, is to blame. However, the evidence these organizations need to justify underwriting such programs is in short supply because of conflicting priorities and standards related to determining the efficacy and effectiveness of Tai Ji Quan. Establishing efficacy through acceptable designs such as randomized controlled trials involves strict protocols to ensure meaningful internal validity but different approaches are needed to demonstrate meaningful effectiveness (external validity) outside the study setting. By examining the quality, quantity, and relative proportions of the randomized controlled trials, systematic reviews, and dissemination studies reported in the medical literature, this paper highlights the disparity in emphasis between efficacy and effectiveness research that has impeded the development of a cohesive literature on Tai Ji Quan and concludes that until more researchers develop a systematic, long-range commitment to investigating its health-related benefits, the research related will remain fractured and sporadic, limiting the incentive of large funding agencies to support its wide-spread use.
authors.affiliation: Department of Exercise Science, Willamette University, Salem, OR 97301, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Harmer
keywords: Tai Ji Quan; dissemination; effectiveness; efficacy; practical trials; randomized controlled trial
references.citation: J Am Geriatr Soc. 1996 May;44(5):489-97
references.pmid: 8617895
references.citation: Am J Prev Med. 2008 Dec;35(6):578-88
references.pmid: 19000846
references.citation: Exerc Sport Sci Rev. 2012 Jul;40(3):133-7
references.pmid: 22653276
references.citation: N Engl J Med. 2012 Feb 9;366(6):511-9
references.pmid: 22316445
references.citation: Schmerz. 2012 Jun;26(3):311-7
references.pmid: 22760464
references.citation: Parkinsonism Relat Disord. 2008 Dec;14(8):589-94
references.pmid: 18374620
references.citation: J Clin Epidemiol. 2006 Nov;59(11):1125-6
references.pmid: 17027421
references.citation: J Am Geriatr Soc. 2007 Aug;55(8):1185-91
references.pmid: 17661956
references.citation: Rheumatol Int. 2013 Jan;33(1):193-207
references.pmid: 22350253
references.citation: Heart Lung. 2012 Sep-Oct;41(5):469-83
references.pmid: 22938627
references.citation: Curr Aging Sci. 2012 Feb;5(1):19-27
references.pmid: 21762093
references.citation: N Engl J Med. 2010 Sep 30;363(14):1296-9
references.pmid: 20879876
references.citation: Arch Gerontol Geriatr. 2012 Sep-Oct;55(2):460-7
references.pmid: 22386602
references.citation: Ann Intern Med. 2012 Aug 7;157(3):213-4
references.pmid: 22868841
references.citation: J Gerontol A Biol Sci Med Sci. 2005 Feb;60(2):187-94
references.pmid: 15814861
references.citation: Res Sports Med. 2012 Jan;20(1):37-58
references.pmid: 22242736
references.citation: Ann Behav Med. 2001 Spring;23(2):139-46
references.pmid: 11394556
references.citation: Geriatr Nurs. 2010 Jul-Aug;31(4):272-80
references.pmid: 20682405
references.citation: PLoS Med. 2009 Jul 14;6(7):e1000110
references.pmid: 19597537
references.citation: Am J Phys Med Rehabil. 2012 Aug;91(8):701-14
references.pmid: 22286895
references.citation: Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007146
references.pmid: 22972103
references.citation: J Am Geriatr Soc. 2010 Jan;58(1):136-41
references.pmid: 20122044
references.citation: J Safety Res. 2008;39(3):259-67
references.pmid: 18571566
references.citation: Am J Public Health. 2008 Jul;98(7):1195-8
references.pmid: 18511723
references.citation: Arthritis Care Res (Hoboken). 2012 Apr;64(4):465-74
references.pmid: 22563589
references.citation: J Am Geriatr Soc. 1993 Mar;41(3):329-32
references.pmid: 8440859
references.citation: Perit Dial Int. 2003 Dec;23 Suppl 2:S99-S103
references.pmid: 17986569
references.citation: J Am Geriatr Soc. 2004 Jun;52(6):892-900
references.pmid: 15161452
references.citation: Clin Calcium. 2013 May;23(5):653-60
references.pmid: 23628677
references.citation: J Phys Act Health. 2008 May;5(3):445-55
references.pmid: 18579921
references.citation: Reg Anesth Pain Med. 2012 Jul-Aug;37(4):372-82
references.pmid: 22609642
references.citation: Evid Based Complement Alternat Med. 2013;2013:215254
references.pmid: 23986780
references.citation: Br J Sports Med. 2012 Aug;46(10):713-8
references.pmid: 21586406
references.citation: N S W Public Health Bull. 2011 Jun;22(3-4):60-8
references.pmid: 21632001
references.citation: Pflege Z. 2012 Aug;65(8):486-7
references.pmid: 22930858
references.citation: Hu Li Za Zhi. 2013 Feb;60(1):69-77
references.pmid: 23386527
references.citation: Altern Ther Health Med. 2012 May-Jun;18(3):16-22
references.pmid: 22875558
references.citation: Am J Public Health. 1999 Sep;89(9):1322-7
references.pmid: 10474547
references.citation: Rheumatology (Oxford). 2012 Sep;51(9):1707-13
references.pmid: 22661556
references.citation: Curr Rheumatol Rep. 2012 Dec;14(6):598-603
references.pmid: 23055009
references.citation: Rev Med Suisse. 2013 Jan 9;9(368):62-5
references.pmid: 23367707
references.citation: Rev Neurosci. 2013;24(2):139-52
references.pmid: 23492553
references.citation: J Physiother. 2013 Sep;59(3):159-68
references.pmid: 23896331
references.citation: Phys Sportsmed. 2013 Feb;41(1):58-65
references.pmid: 23445861
references.citation: Phys Ther. 1997 Apr;77(4):371-81; discussion 382-4
references.pmid: 9105340
references.citation: Int J Behav Med. 2014 Aug;21(4):605-17
references.pmid: 24078491
references.citation: Eur J Heart Fail. 2013 Mar;15(3):316-23
references.pmid: 23099355
references.citation: Aust N Z J Public Health. 2012 Jun;36(3):241-8
references.pmid: 22672030
references.citation: Best Pract Res Clin Rheumatol. 2012 Jun;26(3):387-98
references.pmid: 22867933
references.citation: Evid Based Complement Alternat Med. 2011;2011:383245
references.pmid: 19351709