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Tai Chi's Health Benefits

 A recent article from TIme:  http://time.com/4758683/tai-chi-exercise/  
                          
 July 2017 article from Consumer Reports: " For Fall Prevention--Try Tai Chi "     
                                     

               What follows is a LONG document -- please use the green headers to find the sections you want!


INTRODUCTION

Those of us studying and teaching tai chi can tell you of the benefits we see in ourselves and others who regularly practice this form of “meditation in motion” (sometimes now referred to as medication in motion since we see so many therapeutic outcomes). But such anecdotal information is widely supported by more and more clinical studies.

The Harvard Medical School Guide to Tai Chi provides a wonderful primer on how tai chi works and its benefits, citing multiple clinical trials of tai chi for fall prevention, bone density, arthritis and fibromyalgia, low back pain, and Parkinson Disease. In addition, this book contains considerable information on HOW tai chi works on the body, the mind, the neurological and musculoskeletal systems, and more.

Another fine source of information is http://www.worldtaichiday.org/WTCQDHlthBenft.html, which provides a way to search health conditions and studies about tai chi’s effects on them.

Peter M. Wayne, primary author of The Harvard Medical School Guide to Tai Chi (2013) perceives eight “active ingredients” within tai chi:
Awareness: The opportunities integral to tai chi to develop self-awareness while breathing deeply and moving slowly foster mindfulness and focused attention.
Intention: The imagery and visualization, along with cognitive engagement required in tai chi create a sense of direction, expectation, belief in the efficacy of learning.
Structural integration: Tai chi develops coordination between upper and lower body, between breathing and movement, between mind and body. Proprioception improves.
Active relaxation: A basic principle of all tai chi styles is to relax into the slow, gentle movements. This is why many refer to tai chi as “meditation in motion.”
Strengthening and flexibility: Tai chi’s slow, continuous movements, often in a lowered stance, build up lower body strength, and since the arms are often raised above the waist, some upper body strength can result as well. While the movements are gentle, they do increase range of motion and provide some stretching.
Natural, freer breathing: Many forms of tai chi emphasize meaningful breathing. This not only oxygenates the entire system, but boosts mood, assists balance, and can lead to better breathing even when not practicing tai chi.
Social support: The personal interactions and mutual support common to tai chi classes assist in aiding those with depression, cancer, heart disease, anxiety, arthritis, and many other conditions.
Embodied spirituality: Tai chi can be a philosophy and lead to spiritual awareness. At a minimum it lifts the spirits and improves outlook.

SAFETY: One of the great things about tai chi is that its gentle, slow movements are very low-risk. Compared to yoga, for instance, tai chi is much safer. This may be because in tai chi instructors stress that participants should stay within their comfort zone and make adjustments to suit their own abilities.

FALL PREVENTION

Fifty million Americans over 50 years old have low bone density; every year 30% of Americans 65 and older fall and from 55-70 percent of them are injured, about half that number seriously injured. One in five will die within a year from falling! And the cost to the health system is huge--about $20 billion in 2000 (Harvard Guide).

The CDC (Center for Disease Control) lists three evidence-based tai chi programs that can help older adults reduce falls.  Among them is Tai Chi for Arthritis (TCA), a program developed by Dr. Paul Lam, world-renowned health expert and tai chi champion.  The Tai Chi for arthritis program is based on the Sun style of Sun Lu-tang, and was developed by Dr. Lam in consultation with other doctors and tai chi experts.  It is designed to help people living with arthritis find relief from the pain of arthritis so that their lives improve.  In studies conducted with folks practicing the TCA program, it was discovered that when done correctly and with proper instruction, Tai Chi for Arthritis can increase flexibility and muscle strength; improve balance, posture, and situational awareness; and help people avoid falling.

A few of the relevant research studies:

Carande-Kulis, V., et al , A cost—benefit analysis of three older adult fall prevention interventions, Journal of Safety Research (2015), http: dx.doi.org/1O.1 01 6/j,jsr.2014.12.007.
This analysis concludes that each intervention has value but shows longest lasting and greatest fall prevention (55% reduction) from Tai Chi.
Voukelatos, Alexander et al., “Largest Fall Prevention Study in the World,” Journal of American Geriatric Society 55: 1185-1191, 2007.
This largest fall prevention study in the world involved 702 people in the community. After 16 weeks of learning and practicing a Tai Chi program (80% of the participants did the Tai Chi for Arthritis program), the results showed that Tai Chi significantly reduced the number of falls. Tai Chi also significantly reduced the risk of multiple falls by approximately 70%. The study concludes: "the findings from this study indicates that participation in weekly community-based tai chi classes can reduce falls in relatively healthy, community-dwelling older people. Given that the tai chi program used existing community facilities, the study suggests that tai chi is an effective and sustainable public health intervention for falls prevention for older people living in the community."

“Bone Health and Osteoporosis: A Report of the Surgeon General.” Rockville, Md. : U.S. Department of Health and Human Services, 2004. Specifically recommends tai chi as a good exercise for fall prevention.

I.H. Logghe et al., “The Effects of Tai Chi on Fall Prevention, Fear of Falling and Balance in Older People: A Meta-Analysis,” Preventive Medicine 51, nos. 3-4 (2010):222-27.

Lui and A. Frank, “Tai Chi as a Balance iImprovement Exercie for Older Adults: A Systematic Review,” Journal of Geriatric Physical Therapy 33, (2010): 103-9.

Low et al., “A Systematic Review of the Effectiveness of Tai Chi on Fall Reduction among the Elderly,” Archives of Gerontology and Geriatrics 48, no. 3 (2009)325-31.

Li et al., “Tai Chi and Fall Reductions in Older Adults: A Randomized Controlled Trial,” Journal of Gerontology 60A, no 2 (2005): 187-194.
Li et al., “Translation of an Effective Tai Chi Intervention into a Community-Based Falls-Prevention Program,” American Journal of Public Health 98, no. 7 (2008): 1195-98.
LOW BACK PAIN

Americans spend about $150 billion each year on pain medication--many for low back pain specifically. Increasingly people are turning with success to complementary or alternative practices to reduce such pain--yoga, meditation, tai chi and quigong. At the University of Vermont Drs. Helene Langevin and Karen Sherman have been studying the connection between the health of connective tissue and chronic low-back pain.

H.M. Langevin et al., “Reduced Thoracolumbar Fascia Shear Strain in Human Chronic Low Back Pain,” BMC Musculoskeletal Disorders 19, no. 12 (2011): 203.

H.M. Langevin and K.J. Sherman, “Pathophysiological Model for Chronic Low Back Pain Integrating Connective Tissue and Nervous System Mechanisms,” Medical Hypotheses 68, no. 1 (2007): 74-80.

A.M. Hall et al., “Tai Chi Exercise for Treatment of Pain and Disability in People with Persistent Low Back Pain: A Randomized Controlled Trial,” Arthritis Care and Research 3, no. 11 (2011):1576-83. (Hall’s trial used Dr. Paul Lam’s Tai Chi for Back Pain vs. a control group.)

ARTHRITIS

According to the CDC, in 2011 osteoarthritis affected over 26 million people with arthritis related problems, including knee and hip replacements accounting for huge medical expenditures.

Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J ., “Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai chi classes,” Arthritis Care & Research, April 2007, 57:3, 407-414. This study found that both hydrotherapy and Tai Chi for Arthritis classes can provide large and sustained improvements in physical function for older, sedentary people with chronic osteoarthritis (OA) of the knee or hip.
The researchers carried out a randomized controlled trial among 152 older people with chronic OA of the hip or knee. Participants attended either Tai Chi for Arthritis classes or hydrotherapy twice per week for 12 weeks. At 12 weeks, compared with controls, the exercise group participants demonstrated significant improvements for pain and physical function scores. These improvements were maintained at 24 weeks. "This study shows the health benefits of the Tai Chi for Arthritis program, these benefits don't necesarily translate to other forms of tai chi" Dr Marlene Fransen, chief investigator of this study.

Wang et al., “Tai Chi is Effective in Treating Knee Osteoarthritis: A Randomized Controlled Trial,” Arthritis and Rheumatism 61, no. 11 (2009):1543-53.

Wang et al., “A Randomized Trial of Tai Chi for Fibromyalgia,” New England Journal of Medicine 363, no. 8 (2010):743-54.

R. Song et al., “Effects of Tai Chi Exercise on Pain, Balance, Muscel Strength, and Perceived Difficulties in Physical Functioning in Older Women with Osteoarthritis: A aClinical Trial,” Journal of Rheumatology 30, no. 9 (2003): 2039-44.


OSTEOPOROSIS

Tai chi is a low-impact, weight-bearing exercise--very useful for those with weakened bones.

Woo et al., “A Randomised Controlled Trial of Tai Chi and Resistance Exercise on Bone Health, Muscle Strength and Balance in Community-Living Elderly People,” Age and Ageing 36, no 3 (2007): 262-268.

M.S. Lee, “Tai Chi for Osteoporosis: A Systematic Review,” Osteoporosis International 19, no. 2 (2008):139-46.

DIABETES

E S. Ahn and Rhayun Song, Chungnam National University, College of Nursing, Daejeon, South Korea. “Effects of Tai Chi Exercise on Glucose Control, Neuropathy Scores, Balance, and Quality of Life in Patients with Type 2 Diabetes and Neuropathy.” Journal of Alternative & Complementary Medicine,18, no. 12 (2012), 1172-8.
This study demonstrated that a 12-week course of tai chi, twice a week, among a study population of participants age 64 and up who had been diagnosed with type 2 diabetes for more than 12 years, proved beneficial. Tai Chi improved glucose control, balance, neuropathic symptoms, and some dimensions of quality of life in diabetic patients with neuropathy. Studies involving larger samples and longer term follow up are needed. 

S. H. Yeh et al. Regular Tai Chi Chuan exercise improves T cell helper function of patients with type 2 diabetes mellitus with an increase in T-bet transcription factor and IL-12 production
British Journal of Sports Medicine, 43:11 (2009).
This study demonstrated that a 12-week TCC exercise program decreases HbA1c levels along with an increase in the Th1 reaction. A combination of TCC with medication may provide an even better improvement in both metabolism and immunity of patients with type 2 diabetes.

L. Li and B. Banor, “Long Term Tai Chi Exercise Improves Physical Performance among People with Peripheral Neuropathy,” American Journal of Chinese Medicine 38, no. 3 (2010), 449-59.

PARKINSON DISEASE

An NIH-funded study, reported in the February 9, 2012 issue of the New England Journal of Medicine evaluated three different forms of exercise – resistance training, stretching, and tai chi – and found that tai chi led to the greatest overall improvements in balance and stability for patients with mild to moderate Parkinson’s disease.

P.J. Klein and L. Rivers, “Taiji for Individuals with Parkinson Disease and their Support Partners: A Program Evaluation,” Journal of Neurological Physical Therapy 30, no. 1 (March 2006): 22-27.

M.E. Hackney and G.M. Earhart, “Tai Chi Improves Balance and Mobility in People with Parkinson Disease,” Gait and Posture 28 (2008): 456-60.


MENTAL HEALTH/DEPRESSION/ALZHEIMER’S

Depression:
Meta-Analysis Study by Japan Geriatrics Society published in Geriatrics Gerontology International, June, 2012, “Tai chi and reduction of depressive symptoms for older adults: A meta-analysis of randomized trials,” depression is a significant mental health problem. Worldwide, depression ranks second only to heart disease in terms of impact on disability-adjusted life years ... The review in question aimed to overcome some limitations of existing reviews by analyzing the effectiveness of tai chi on reducing depressive symptoms among older adults using the vigorous systematic review method detailed in the Cochrane Handbook. Tai chi appeared to have a significant impact on reducing self-reported depressive symptoms compared with the waiting list control groups. Wang, W. C. et al., “The Effect of Tai Chi on Psychosocial Well-being: A Systematic Review of Randomized Controlled Trials,” Journal of Acupuncture and Meridian Studies 2, no. 3 (2009): 171-181. Concerns reduction of depression in tai chi participants with fibromyalgia, rheumatoid arthritis, and knee osteo-arthritis.
Yeh, G.Y. et al, “Tai Chi Exercise in Patients with Chronic Heart Failure: A Randomized Clinical Trial,” Archives of internal Medicine 171, no. 8 (2011): 750-57. Concerns reduction of depression in tai chi participants with chronic heart failure.

Wang, C. et al., “Tai Chi on Psychological Well-being: Systematic Review and Meta-analysis,” BMC Complementary and Alternative Medicine 10 (2010): 23. Concerns stress, anxiety, and depression.

Alzheimer’s Disease:
An eight-month study conducted jointly by researchers at the University of South Florida and Fudan University in Shanghai concluded that healthy, randomly selected Chinese adults in their 60s and 70s who practiced tai chi for 30 minutes three times a week experienced significant increases in brain volume, along with improved memory and cognitive function, compared to a control group who did not practice tai chi (the control group’s brain volume decreased as expected with people in this age range) .Given that brain shrinkage is associated with Alzheimer’s disease, this study may have useful applications. See Journal of Alzheimer’s Disease, June 19, 2012.

Various studies have shown that exercise in general, retards brain shrinkage. However, in a large Chinese trial, tai chi participants showed greater cognitive improvement compared to the control group doing stretching and toning. L.C.W. Lam et al, “Interim Follow-up of a Randomized Controlled Trial Comparing Chinese Style Mind-Body (Tai Chi) and Stretching Exercises on Cognitive Function in Subjects at Risk of Progressive Cognitive Decline,” International Journal of Geriatrics Psychology 26 (2011): 733-40.