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Yili Zhang,1,2 Yan Chai,3 Xiaojie Pan,4 Hao Shen,1 Xu Wei,5 Yanming Xie1 1Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China; 2School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; 3Department of Epidemiology, University of California, Los Angeles, CA, USA; 4Department of Human Nutrition and Health, Wageningen University and Health, Wageningen, The Netherlands; 5Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China Purpose: The aim of this meta-analysis was to evaluate the efficacy of Tai chi (TC) as an adjuvant treatment for osteopenia and primary osteoporosis. Methods: We went through eight databases to identify relevant randomized controlled trials that compared TC with a control group. The primary outcome was osteoporosis-related fractures (fracture incidence). Meta-analyses and trial sequential analyses (TSA) were conducted using RevMan 5.3 and TSA 0.9. Results: Fifteen randomized controlled trials involving a total of 857 patients were included in the analyses. No trials reported primary outcome; however, bone mineral density (BMD) values differed significantly in subgroup 1 (TC vs no treatment; weighted mean difference [WMD] =0.05 g/cm2, 95% CI 0.03 to 0.07; P |