The Science of Tai chi
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1 The Science of Tai chi Source: Tai chi University of Maryland Medical Center University of Maryland Medical Center Overview What is tai chi? Tai chi is a gentle exercise program that is a part of Traditional Chinese Medicine (TCM). Derived from the martial arts, tai chi is composed of slow, deliberate movements, meditation, and deep breathing, which enhance physical health and emotional well being. As are many practices from the East, tai chi is based on spiritual and philosophical ideas that advocate a need for balance in the body, mind, and spirit. Central to tai chi is the idea that qi (pronounced "chee"), or life energy, flows throughout the body. Qi must be able to move freely for good health. The principle of yin/yang is important, too. Yin and yang are opposite and complementary forces in the universe, in the same way as light and dark are. Tai chi is meant to harmonize these pairs of opposites. Finally, tai chi imitates motion found in nature, such as the movements of animals, thereby uniting human beings with the natural world. What is the history of tai chi? Zhang Sanfeng, a martial artist who lived in China in the late 16th century, created the practice of tai chi. According to legend, Sanfeng had a dream about a snake and a crane engaged in battle. Their graceful movements inspired his noncombative style of martial arts. This ancient form of movement has been practiced in China for centuries and is still a daily routine for tens of thousands of people there, especially the elderly. It was first introduced to the United States in the early 1970s and has since grown in popularity. How does tai chi work? There are various perspectives on how tai chi works. Eastern philosophy holds that tai chi unblocks the flow of qi. When qi flows properly, the body, mind, and spirit are in balance and health is maintained. Others believe that tai chi works in the same way as other mind-body therapies, and there is ample evidence that paying attention to the connection between the mind and the body can relieve stress, combat disease, and enhance physical well being. Tai chi has 3 major components -- movement, meditation, and deep breathing. Movement -- All of the major muscle groups and joints are needed for the slow, gentle movements in tai chi. Tai chi improves balance, agility, strength, flexibility, stamina, muscle tone, and coordination. This low impact, weight bearing exercise strengthens bones and can slow bone loss, thus preventing the development of osteoporosis. Meditation -- Research shows that meditation soothes the mind, enhances concentration, reduces anxiety, and lowers blood pressure and heart rate.
2 Deep breathing -- Exhaling stale air and toxins from the lungs while inhaling a plentitude of fresh air increases lung capacity, stretches the muscles involved in breathing, and releases tension. It also enhances blood circulation to the brain, which boosts mental alertness. At the same time, the practice supplies the entire body with fresh oxygen and nutrients. What does a tai chi session entail? Tai chi sessions are usually group classes that last about an hour. Each session begins with a warm up exercise. Then the instructor guides the class through a series of tai chi movements that together comprise a "form." A form can take up to 20 minutes to complete. Each form has a nature based name that describes its overall action -- such as "wave hands like clouds" or "grasp the bird's tail." At the same time, students are asked to focus on the point just below their navels, believed to be the center from which qi flows. The teacher encourages the class to perform all movements in a slow, meditative manner, and to focus on deep breathing. At the end of the class, there is usually a wind down exercise, relaxation, and meditation. How many sessions will I need? Classes are usually taught on a weekly basis. Many practitioners recommend practicing tai chi for about minutes twice daily at home, since regular practice is essential for mastering the forms and achieving lasting results. Before beginning a tai chi program, you should check with your doctor and discuss your health needs with the tai chi instructor. Exercises can be modified depending on your mobility, history of injuries, chronic pain, joint swelling (if present), and medication that may affect balance. What conditions respond well to tai chi? Tai chi improves overall fitness, coordination, and agility. People who practice tai chi on a regular basis tend to have good posture, flexibility, and range of motion, are more mentally alert, and sleep more soundly at night. Tai chi is both a preventive and complementary therapy for a wide range of conditions. Specifically, it is beneficial for chronic pain, gout, heart disease, high blood pressure, arthritis, osteoporosis, diabetes, headaches, fibromyalgia, rheumatoid arthritis, osteoarthritis, and sleep disorders. Tai chi is also beneficial for the immune system and the central nervous system, which makes it especially good for people with a chronic illness, anxiety, viral infections, depression, or any stress related conditions. The deep breathing of tai chi regulates the respiratory system, helping to treat respiratory ailments such as asthma, bronchitis, and emphysema. It also stimulates the abdomen, which aids digestion and helps relieve constipation and gastrointestinal conditions. Many clinical studies indicate that elderly people who practice tai chi have better hand eye coordination, and are much less prone to falls, both serious health risks to people in that age group. Are there conditions that should not be treated with tai chi? Tai chi is safe for everyone, regardless of age or athletic ability, and can be modified for most health problems. People with limited mobility -- even those in wheelchairs -- can learn and successfully use tai chi. In one study of 256 sedentary adults years of age, tai chi
3 decreased the number of falls and the fear of falling compared to stretching. Those who practiced tai chi also had improved functional balance and physical performance after 6 months. However, it is not meant to replace medical care for a serious condition. Talk to your doctor and your instructor about any health problems or recent injuries you may have, or if you are pregnant. Is there anything I should look out for? Tai chi exercises muscles in areas of your body that may have been neglected. Therefore, you may feel sore in the beginning. It takes time to develop the posture, flexibility, and agility needed for tai chi, so don't get discouraged. As with any exercise program, safety is affected by proper stretching and warm up exercises, as well as correct alignment. If you experience dizziness, shortness of breath, headaches, or severe pain, stop practicing and talk to your instructor right away, and consult your doctor. References Adler PA, Roberts BL. The use of Tai Chi to improve health in older adults. Orthop Nurs. 2006;25(2): Barbat-Artigas S, Filion ME, Dupontgand S, Karelis AD, Aubertin-Leheudre M. Effects of tai chi training in dynapenic and nondynapenic postmenopausal women. Menopause. 2011;18(9): Cheung SY, Tsai E, Fung L, Ng J. Physical benefits of Tai Chi Chuan for individuals with lower-limb disabilities. Occup Ther Int. 2007;14(1):1-10. Field T. Tai Chi research review. Complement Ther Clin Pract. 2011;17(3): 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 Rheum. 2007;57(3): Greenspan AI, Wolf SL, Kelley ME, O'Grady M. Tai chi and perceived health status in older adults who are transitionally frail: a randomized controlled trial. Phys Ther. 2007;87(5): Irwin MR, Olmstead R, Oxman MN. Augmenting immune responses to varicella zoster virus in older adults: a randomized, controlled trial of Tai Chi. J Am Geriatr Soc. 2007;55(4): Irwin MR, Olmstead R, Motivala SJ. Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Ta Chi Chih. Sleep. 2008;31(7): Kuramoto AM. Therapeutic benefits of Tai Chi exercise: research review. WMJ. 2006;105(7):42-6. Lam P. Tai chi. Diabetes Self Manag. 2004;21(4):7-10, 12, 14.
4 Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatology (Oxford). 2007; [Epub ahead of print]. Li Y, Devault CN, Van Oteghen S. Effects of extended tai chi intervention on balance and selected motor functions of the elderly. Am J Chin Med. 2007;35(3): Li F, Fisher KJ, Harmer P, Irbe D, Tearse RG, Weimer C. Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomized controlled trial. J Am Geriatr Soc. 2004;52(6): Li F, Harmer P, Fisher KJ, et al., Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2005;60(2): Liu H, Frank A. Tai chi as a balance improvement exercise for older adults: a systematic review. Geriatr Phys Ther. 2010;33(3): Maciaszek J, Osinski W, Szeklicki R, Stemplewski R. Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. Am J Chin Med. 2007;35(1):1-9. Morris Docker S. Tai Chi and older people in the community: a preliminary study. Complement Ther ClinPract. 2006;12(2): Orr R, Tsang T, Lam P, Comino E, Singh MF. Mobility impairment in type 2 diabetes: association with muscle power and effect of Tai Chi intervention. Diabetes Care. 2006;29(9): Rakel D. Rakel Integrative Medicine, 2nd ed. Philadelphia, PA: Saunders Elsevier. 2007; 38. Richerson S, Rosendale K. Does Tai Chi improve plantar sensory ability? A pilot study. Diabetes Technol Ther. 2007;9(3): Shen CL, Williams JS, Chyu MC, et al., Comparison of the effects of tai chi and resistance training on bone metabolism in the elderly: a feasibility study. Am J Chin Med. 2007;35(3): Taylor-Piliae RE, Haskell WL, Stotts NA, Froelicher ES. Improvement in balance, strength, and flexibility after 12 weeks of Tai chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. Altern Ther Health Med. 2006;12(2):50-8. Taylor-Piliae RE, Froelicher ES. Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis. J Cardiovasc Nurs. 2004;19(1): Thornton EW, Sykes KS, Tang WK. Health benefits of Tai Chi exercise: improved balance and blood pressure in middle-aged women. Health Promot Int. 2004;19(1):33-8. Tsang WW, Hui-Chan CW. Effects of exercise on joint sense and balance in elderly men: Tai Chi versus golf. Med Sci Sports Exerc. 2004;36(4):
5 Tsang WW, Hui-Chan CW. Effect of 4- and 8-wk intensive Tai Chi Training on balance control in the elderly. Med Sci Sports Exerc. 2004;36(4): Verhagen AP, Immink M, van der Meulen A, Bierma-Zeinstra SM. The efficacy of Tai Chi Chuan in older adults: a systematic review. Fam Pract. 2004;21(1): Wang C. Tai Chi improves pain and functional status in adults with rheumatoid arthritis: results of a pilot single-blinded randomized controlled trial. Med Sports Sci. 2008;52: Wang C, Collet JP, Lau J. The effect of Tai Chi on health outcomes in patients with chronic conditions: a systematic review.arch Intern Med. 2004;164(5): Wang C. Tai Chi and Rheumatic Disease. Rheumatic Diseases Clinics of North America. 2011;37(1). Wayne PM, Kiel DP, Krebs DE, et al., The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review. Arch Phys Med Rehabil. 2007;88(5): Wong AM, Chou SW, Huang SC, Lan C, Chen HC, Hong WH, Chen CP, Pei YC. Does different exercise have the same effect of health promotion for the elderly? Comparison of training-specific effect of Tai Chi and swimming on motor control. Arch Gerontol Geriatr. 2011;53(2):e Woo J, Hong A, Lau E, Lynn H. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing. 2007;36(3): Yeh GY, Wang C, Wayne PM, Phillips RS. The effect of tai chi exercise on blood pressure: a systematic review. Prev Cardiol. 2008;11(2):82-9. Yu TY, Pei YC, Lau YC, Chen CK, Hsu HC, Wong AM. Comparison of the effects of swimming and Tai Chi Chuan on body fat composition in elderly people. Chang Gung Med J. 2007;30(2):
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