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1 Tai Chi Chuan

2 Medicine and Sport Science Vol. 52 Series Editors J. Borms, Brussels M. Hebbelinck, Brussels A.P. Hills, Brisbane T. Noakes, Cape Town

3 Tai Chi Chuan State of the Art in International Research Volume Editor Youlian Hong, Hong Kong 38 figures, and 26 tables, 2008 Basel Freiburg Paris London New York Bangalore Bangkok Singapore Tokyo Sydney

4 Medicine and Sport Science Founder and Editor from 1969 to 1984: E. Jokl, Lexington, Ky. Prof. Youlian Hong Department of Sports Science and Physical Education The Chinese University of Hong Kong Shatin, Hong Kong (China) Library of Congress Cataloging-in-Publication Data Tai chi chuan : state of the art in international research / volume editor, Youlian Hong. p. ; cm. (Medicine and sport science, ISSN ; v. 52) Includes bibliographical references and indexes. ISBN (hard cover : alk. paper) 1. Tai chi Health aspects. I. Hong, Youlian, 1946 II. Series. [DNLM: 1. Tai Ji. 2. Exercise Therapy methods. W1 ME649Q v / WB 541 T ] RA T dc Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents and Index Medicus. Disclaimer. The statements, options and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 2008 by S. Karger AG, P.O. Box, CH 4009 Basel (Switzerland) Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel ISSN ISBN

5 Contents VIII Preface Hong, Y. (Hong Kong) Biomechanical and Physiological Characteristics of Tai Chi 1Temporal Characteristics of Foot Movement in Tai Chi Exercise Hong, Y. (Hong Kong); Mao, D.W. (Hong Kong/Jinan); Li, J.X. (Hong Kong/Ottawa) 12 The Exercise Intensity of Tai Chi Chuan Lan, C.; Chen, S.-Y.; Lai, J.-S. (Taipei) 20 Tai Chi Exercise and Muscle Strength and Endurance in Older People Xu, D.Q. (Hong Kong/Tianjin); Hong, Y.(Hong Kong); Li, J.X. (Hong Kong/Ottawa) 30 Muscle Action Pattern and Knee Extensor Strength of Older Tai Chi Exercisers Wu, G. (Burlington, VT.) 40 The Effectiveness of Tai Chi Exercise in Improving Aerobic Capacity: An Updated Meta-Analysis Taylor-Piliae, R.E. (Tucson, Ariz.) 54 Tai Chi Exercise in Improving Cardiorespiratory Capacity Thornton, E.W. (Liverpool) V

6 64 Effects of a Traditional Taiji/Qigong Curriculum on Older Adults Immune Response to Influenza Vaccine Yang, Y. (Urbana-Champaign, Ill./Champaign, Ill.); Verkuilen, J.; Rosengren, K.S.; Mariani, R.A. (Urbana-Champaign, Ill.); Reed, M. (Urbana-Champaign, Ill./ Champaign, Ill.); Grubisich, S.A. (Champaign, Ill.); Woods, J.A. (Urbana-Champaign, Ill.); Schlagal, B. (Champaign, Ill.) Balance Control and Falls Prevention and Tai Chi 77 Tai Chi Exercise and Proprioception Behavior in Old People Li, J.X. (Ottawa/Tianjin); Xu, D.Q. (Hong Kong/Tianjin); Hong, Y. (Hong Kong) 87 Neural Mechanisms Underlying Balance Control in Tai Chi Gatts, S. (Chicago, Ill.) 104 Sensorimotor Control of Balance: A Tai Chi Solution for Balance Disorders in Older Subjects Tsang, W.W.N.; Hui-Chan, C.W.Y. (Hong Kong) 115 Tai Chi and Balance Control Wong, A.M.K.; Lan, C. (Taipei) 124 Tai Chi and Falls Prevention in Older People Harmer, P.A. (Salem, Oreg.); Li, F. (Eugene, Oreg.) Mental Health and Social Aspects of Tai Chi 135 Tai Chi Exercise and the Improvement of Mental and Physical Health among College Students Wang, Y.T. (Atlanta, Ga.) 146 Effect of Tai Chi on Depressive Symptoms amongst Chinese Older Patients with Major Depression: The Role of Social Support Chou, K.-L. (Hong Kong) 155 Tai Chi Exercise and the Improvement of Health and Well-Being in Older Adults Yau, M.K. (Hong Kong) 166 Teaching Tai Chi with Mindfulness-Based Stress Reduction to Middle School Children in the Inner-City: A Review of the Literature and Approaches Wall, R.B. (Boston, Mass.) Contents VI

7 Clinical Applications of Tai Chi 173 Tai Chi Chuan in the Management of Parkinson s Disease and Alzheimer s Disease Klein, P.J. (Buffalo, N.Y.) 182 Tai Chi Training for Patients with Coronary Heart Disease Lan, C.; Chen, S.-Y.; Wong, M.-K.; Lai, J.-S. (Taipei) 195 T ai Chi Exercise in Patients with Chronic Heart Failure Yeh, G.Y.; Wayne, P.M.; Phillips, R.S. (Boston, Mass.) 209 Tai Chi Chuan for Breast Cancer Survivors Mustian, K.M.; Palesh, O.G.; Flecksteiner, S.A. (Rochester, N.Y.) 218 Tai Chi Improves Pain and Functional Status in Adults with Rheumatoid Arthritis: Results of a Pilot Single-Blinded Randomized Controlled Trial Wang, C. (Boston, Mass.) 230 Effects of Tai Chi Exercise on Patients with Type 2 Diabetes Wang, J.H. (Guangzhou) 239 Author Index 240 Subject Index Contents VII

8 Preface Tai Chi Chuan (TCC, TC, T ai Chi, or Taiji) was originally developed as a form of martial arts. It has been used for centuries in China as a health exercise for a wide age range but has particularly been popular among the elderly. The basic exercise involved in TCC is a series of individual movements that are linked together in a continuous manner and that flow smoothly from one movement to another. Deep breathing and mental concentration are also required to achieve harmony between the body and the mind in TCC. Thus, TCC is not only a physical activity, but it also involves the training of the nervous system. In particular, people practice TCC for the development of mind-body interaction, breath regulation with body movement, eye-hand coordination, and a peaceful state of mind. In addition, TCC can be practiced any time and in any place because it needs neither wide space nor any equipment. The simple, soft, and fluid movements of TCC are ideal for older people regardless of previous exercise experience. Today, it has spread to many countries worldwide, and millions of people in both Eastern and Western countries and cultures are practicing TCC. More importantly, it has been widely accepted as an exercise form for health and fitness benefits. To our knowledge, the first paper in English that presented an experimental study on TCC was published in the 1980s. With the prevalence of an aging population worldwide and with the concomitant increases in expenditure for the relief of chronic disease and disability, interest in TCC has continued to grow. Published results from well-controlled studies about the effects of TCC, particularly those focusing on the elderly, have added to an understanding of the characteristics of TCC movement and its impact on health. Based on the published VIII

9 literature, TCC can seemingly equal all of the exercise demands that elderly people require. Additionally, TCC seems to have the potential to considerably reduce expenditure associated with poor health because it facilitates a lifestyle that promotes the well-being of people of all ages. However, before endorsing these broad observations, two relevant questions must be addressed. What evidence actually exists to suggest that TCC affords any health benefits? Then, if such benefits indeed exist, what are their underlying mechanisms? In light of these, the aim of this book is to reflect current studies focusing on the characteristics of this intriguing form of exercise, their impact on the participants health, and the scientific basis of the beneficial effects of TCC on health and fitness. This book is the first collection of scientific studies on TCC in the world. It is organized into four sections, each containing four to seven chapters, totaling to twenty-two chapters. The first section addresses the biomechanical and physiological characteristics of Tai Chi in seven chapters. The opening chapter highlights the temporal characteristics of foot movement in TCC by Youlian Hong and colleagues, which is followed by the chapter exploring heart rate responses and oxygen consumption during TCC practice by Ching Lan and colleagues. The third chapter, by Dong Qing Xu and colleagues, introduces TCC and muscle strength and endurance in older people. Then Ge Wu discusses the muscle action patterns and isokinetic knee extensor strength of older TCC practitioners. The fifth chapter, contributed by Ruth Taylor-Piliae and colleagues, describes how TCC aids in improving aerobic capacity, while in the sixth chapter, Everard W. Thornton discusses on how TCC helps in improving cardiorespiratory capacity. The section concludes with the chapter that describes the effects of a traditional taiji/qigong curriculum on older adults immune response to influenza vaccine as contributed by Yang Yang and colleagues. The second section highlights the benefits of TCC in terms of balance control and fall prevention in five chapters. The section begins with the chapter on TCC and proprioceptive behavior in older people as contributed by Jing Xian Li and colleagues. The second chapter, written by Strawberry Gatts, addresses the issue of neural mechanism underlying balance control in TCC. Then William W.N. Tsang and Christina W.Y. Hui-Chan discuss how repeated practice of Tai Chi can improve limb joint proprioception, integration of neural signals in the central nervous system for balance control, and motor output at the level of knee muscles. The fourth chapter, contributed by Alice M.K. Wong and Ching Lan, discusses the effects of TCC on balance and posture control in elderly people. Finally, Peter A. Harmer and Fuzhong Li describe TCC and fall prevention in older people. The third section focuses on the mental health and social aspects of TCC and consists of four chapters. Yong Tai Wang addresses TCC and the improvement Preface IX

10 of mental and physical health among college students, which is followed by the chapter on the effects of TCC on depressive symptoms in elderly people by Kee-Lee Chou. In the third chapter, Matthew Kwai-sang Yau discusses TCC and the improvement of health and wellbeing in older adults. The section ends with the chapter written by Robert B. Wall who focuses on teaching TCC with mindfulness-based stress reduction to middle school children in the inner city, which is a review of related literature and approaches. Six chapters in the fourth or the last section demonstrate the application of TCC in clinical intervention. For this purpose, Penelope J. Klein introduces TCC in the management of Parkinson s disease and Alzheimer s disease, and Ching Lan and colleagues address TCC training for individuals with coronary heart disease. Then, Gloria Y. Yeh and colleagues describe TCC in individuals with chronic heart failure, and Karen M. Mustian and colleagues show the effects of TCC on functional capacity and quality of life among breast cancer survivors. The fifth chapter, contributed by Chenchen Wang, is focused on the topic Tai Chi Improves Pain and Functional Status in Adults with Rheumatoid Arthritis: Results of a Pilot Single-Blinded Randomized Controlled Trial. Finally, the book ends with the chapter on the effects of TCC on diabetic individuals as reported by Jing Hao Wang. The contributors to this book are recognized scholars who have all provided original and relevant research articles to the international TCC literature. The chapters they contributed not only provide good examples of how to use TCC in health promotion but also explore the underlying mechanism of the beneficial effects of TCC. The editor is indebted to them for their high-quality contributions. Youlian Hong Preface X

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