5/16/2018. Amy Wixted, MPH, CHES, CIC The Villages Health

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1 Amy Wixted, MPH, CHES, CIC The Villages Health I, or my spouse, have had NO financial relationships with any commercial interests, manufacturers and/or proprietary entities involved in diabetes management and treatment or its complications. Describe why Tai Chi can be an effective form of physical activity for the prevention of diabetes related complications Identify local Tai Chi resources for patient engagement, including at home and online options Demonstrate familiarity with the basic forms of Tai Chi 1

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3 Most adults with type 1 C and type 2 B diabetes: 150+ min/wk of moderate-to-vigorous activity over at least 3 days/week with no more than 2 consecutive days without exercise. Shorter durations (minimum 75 min/week) of vigorous-intensity or interval training may be sufficient for younger and more physically fit individuals. Adults with type 1 C and type 2 B diabetes should perform resistance training in 2-3 sessions/week on nonconsecutive days American Diabetes Association Standards of Medical Care in Diabetes. Lifestyle Management. Diabetes Care 2017; 40 (Suppl. 1): S

4 All adults, and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior. B Prolonged sitting should be interrupted every 30 min for blood glucose benefits, particularly in adults with type 2 diabetes. C Flexibility training and balance training are recommended 2 3 times/week for older adults with diabetes. Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance. C American Diabetes Association Standards of Medical Care in Diabetes. Lifestyle Management. Diabetes Care 2017; 40 (Suppl. 1): S

5 Ancient Chinese exercise originally created as a fighting art Dates back over 700 years Practiced by millions of people worldwide every day Models the idea that everything consists of two opposing forces that harmonize with each other to create a whole: Every left has a right Every up has a down Tai Chi Association of Colorado Springs Gentle movements that strengthen and relax the body and mind Four major Tai Chi styles: Chen, Yang, Wu, and Hao styles The fifth major tai chi style is actually a group of styles known as Combination styles. These combine elements from different tai chi styles and may include movements from other martial arts forms. Tai Chi for Health Institute Since 1970, more than 500 trials in 21 countries and 120 systematic reviews have been published on the health benefits of tai chi In 2015, there were an average of 15 articles posted each month on PubMed 5

6 Excellent Evidence of Benefit Fall Prevention Osteoarthritis Parkinson s Disease COPD Cognitive Capacity Good Evidence of Benefit Depression Cardiac and Stroke Rehab Dementia Strength Huston and McFarlane, Canadian Family Physician Nov 2016, 62 (11) Fair Evidence of Benefit QoL for Cancer Patients Fibromyalgia Hypertension Osteoporosis Overall Well-Being Sleep No Evidence of Benefit Diabetes (A1C, FBG) Rheumatoid Arthritis Chronic Heart Failure Huston and McFarlane, Canadian Family Physician Nov 2016, 62 (11) Smaller sample sizes Lack of documentation of tai chi style, duration, forms and intensity Lack of participant blinding Lack of long-term follow-up 6

7 No studies found that Tai Chi worsened a condition Most common adverse effects were minor and primarily musculoskeletal such as mild knee and back pain No serious adverse events were reported Wayne PM, Berkowitz DL, Litrownik DE, Buring JE, Yeh GY. What do we really know about the safety of tai chi? A systematic review of adverse event reports in randomized trials. Arch Phys Med Rehabil 2014;95(12): Epub 2014 May 27. American Tai Chi and Qigong Association: Tai Chi for Health Institute: Area Agency on Aging: YMCA: 7

8 YouTube: eginners Over 388,000 results on YouTube for Tai Chi for Beginners Dr. Paul Lam: Many video options available Check libraries for free versions 8

9 The Tai Chi for Arthritis program is based on Sun style Tai Chi Fundamental set of 12 movement tai chi, plus warm-up, winddown, and Qigong breathing exercises Supported by the Centers for Disease Control and Prevention, Arthritis Foundation of America, Arthritis Foundation of Australia, and Arthritis Care of UK Amy Wixted, MPH, CHES, CIC