Tai Chi and Health
The industrial and information revolutions changed the world. Although they brought many advances to civilization, they also brought many social problems, including competition and its related stress and increased isolation among people. Their negative effects on health and well-being are significant and well documented. Fortunately, tai chi can be used to buffer these negative effects. For example, tai chi can help young people achieve relaxation and bring their bodies and minds into balance, and for older adults who practice together, as many do every morning in China, tai chi serves as a social network, a place and time to make new friends and provide social support.
Tai chi is part of TCM, and its significant impact on health has been well documented. Although tai chi was introduced to the United States in the 1970s, an interest in its health benefits did not start until Dr. Steven L. Wolf and his team published their balance study in 1996 (Wolf, Barnhart, Kutner, McNeely, Coogler, & Xu, 1996). Their subjects were 162 women and 38 men with an average age of 76.2 who were free of debilitating conditions such as crippling arthritis, Parkinson’s disease, and stroke. The researchers divided the subjects into three groups: One group performed a simplified 10-form version of tai chi, one group received biofeedback-based training in balance on a movable platform, and one group received education about falls but no physical training. The tai chi and biofeedback groups were given 15 weeks of training, and researchers kept track of the participants’ reported falls for four months.
After the intervention, the tai chi subjects reduced their falling risk by an average of 47.5 percent compared with the other groups. Since the publication of that study, interest in tai chi and its health benefits has continued to grow. Hundreds of studies have now been published and interest has extended to many other health areas, such as the impact of tai chi on physical function, quality of life, and cardiovascular diseases. In addition, many tai chi books have been published, including some with a research focus (e.g., Hong, 2008).
According to a recent review (Zhu et al., 2010) of 25 reviews, which included hundreds of studies from around the world, tai chi has been demonstrated to be a useful exercise for a variety of chronic diseases and conditions, including Parkinson’s disease, osteoarthritis, rheumatoid arthritis, high blood pressure, cancer, cardiovascular disease, diabetes, a propensity toward falling, and so on. In addition, tai chi practice has been shown to be beneficial to overall health, balance and control, bone mineral density, psychological and mental status, and aerobic capacity. A few highlights are summarized here.
Tai chi has the potential to improve many of the physiological and psychological aspects of chronic conditions, and it is also a safe and effective intervention for promoting balance, cardiorespiratory fitness, and flexibility in older adults. Tai chi has been shown to be effective as an aerobic exercise in reducing blood pressure, reducing the risk of falls, and increasing function in older adults.
Balance and Control
Moderate evidence supports using tai chi to improve balance and postural stability, indicating that it is a reasonable intervention for clinical use. It has also been found that tai chi improves balance in older adults, although it was not shown to be effective at reducing the rate of falls in older populations. Studies have shown that health outcomes associated with postural control could benefit from tai chi practice.
Although not all studies supported tai chi in fall prevention for older adults, a number of studies found tai chi to be effective in reducing the fear of falling, meaning that interventions aimed at improving older adults’ self-efficacy regarding falls could use tai chi. Meanwhile, tai chi was found to be useful for preventing falls in relatively young, prefrail older adults. In addition, although more rigorous studies are needed to make any assertions about the use of tai chi for Parkinson’s patients, there is favorable evidence in support of using tai chi to help people with Parkinson’s disease.
There is promising evidence in support of using tai chi to reduce pain associated with osteoarthritis, and there are even larger effect sizes in pain reduction from tai chi compared with other popular interventions, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Also, the review found that tai chi may be beneficial for improving the balance and physical function of people with osteoarthritis.
Tai chi improved ankle plantar flexion in people with rheumatoid arthritis, but most other measures, such as activities of daily living and swollen joints, showed no improvements after tai chi interventions. None of the studies indicated any harmful effects of tai chi practice, and the review reported that adherence rates in the tai chi interventions were higher than in the controls, indicating that subjects may enjoy participating in tai chi over other exercises. Some studies also found that tai chi interventions could improve the pain, fatigue, mood, depression, vitality, and disability index of people with rheumatoid arthritis.
Bone Mineral Density
Tai chi has been found to be a promising intervention for maintaining bone mineral density in postmenopausal women. No significant adverse effects of practicing tai chi were reported, and research also indicates that tai chi may improve other risk factors associated with low bone mineral density. Additionally, it was found that tai chi interventions did increase bone mineral density in postmenopausal women compared with a no-treatment control group.
Tai chi has been found to increase well-being and self-efficacy as well as improve overall mood. Tai chi was also a safer choice of exercise for those who were deconditioned or had exercise intolerance.
Many studies have reported that a tai chi intervention could lead to lower blood pressure. In all the studies, tai chi was shown to be safe and had no adverse effects.
Tai chi has been useful as a complement to traditional cancer treatment. Tai chi helped improve the self-esteem and health-related quality of life, function in activities of daily life, and shoulder range of motion of cancer survivors. In addition, tai chi has been shown to increase the immune response as well as psychological function of cancer survivors.
Most studies for this population reported improvement with tai chi interventions, such as lower blood pressure and greater exercise capacity. In addition, no adverse effects were reported. These studies concluded that tai chi may be a beneficial adjunctive therapy for patients with cardiovascular disease.
Tai chi is an effective exercise to improve aerobic capacity. Statistically significant and large effect sizes (ES = 1.33) were noted in the cross-section studies, meaning that subjects experienced significant aerobic improvements from practicing tai chi. On the other hand, small effect sizes were found within the experimental studies (ES = 0.38). Studies comparing sedentary people with tai chi participants also noted larger effects when tai chi was practiced for at least a year. It has been concluded that tai chi could be used as an alternative form of aerobic exercise, and further inquiry is recommended in this area.