T AI CHI FUNDAMENTALS

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Caitlin Russell
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1 T AI CHI FUNDAMENTALS 1. T ai Chi Overview What is T ai Chi? What does the term T ai Chi Mean? Alternative spellings of T ai Chi How is T ai Chi related to Qigong? T ai Chi is a form of mindful movement that originated as a graceful and health-giving ancient exercise that promotes a relaxed, energized body and a peaceful mind. 1 T ai Chi coordinates the focus of the mind with deep breathing and non-impact, flowing movements that build in complexity and balance. The regular practice of T ai Chi will develop leg and core strength, endurance, flexibility, coordination, and help reduce stress. There are many benefits to the whole person- body, mind, and spirit. T ai Chi is considered a holistic complementary exercise form that is a nice adjunct to traditional therapies. The term T ai Chi means Supreme Ultimate. This refers to the common source that unifies all apparent opposites; it connects the heavens and earth. There are many alternative spellings of T ai Chi. Some of the variations are: Taiji, T ai Chi, Taijiquan, T ai Chi Ch uan, T ai Chi Ch uan, or T ai Chi Quan. Some capitalize T ai Chi, many do not. Qigong refers to energy cultivation for healing, which can also involve meditation, massage, and sitting, standing, or moving postures. T ai Chi could be thought of as a form of Qigong. Summary: Long ago in thirteenth century China, fathers would teach their sons certain exercises for good health. These exercises, called T ai Chi, are martial art movements with a meditative mind. They are good for a person s body and mind. Sometimes the exercises were done outdoors. They felt it was healthy to be near a tree, breathing the fresh air filled with oxygen. The exercises were also thought to help keep one safe from dangers and were practiced with kicks, punches, and blocks.

2 2. T ai Chi Lineage Background and History of T ai Chi T ai Chi s Three Main Branches (or Lineages) T ai Chi Fundamentals Program (TCF) Lineage. In the 1800s master Yang Lu Shan was the first person to teach T ai Chi openly in China. He learned the Chen style, but then founded the Yang form. It was taught to the Chinese army. In the 20 th century, his grandson, Yang Cheng Fu, continued teaching to the public as well. In the 1960s, a teacher who was well-known all over China and Taiwan, Grand Master Cheng man Ch ing, came to the United States and opened up his exercise to non-chinese students. He was a student of Yang Cheng Fu. Today, two of his students, great grandmasters Benjamin Lo and William CC Chen, continue teaching to many people in the United States. Tricia Yu has studied under both of these grandmasters. T ai Chi s Three Main Branches (or Lineages) are Yang, Chen or Wu. They are named after their most famous teachers. Yang is the most popular style. Therefore the T ai Chi Fundamentals Program (TCF) lineage is from the Yang style, the Cheng Man Ch ing (CMC) lineage. Summary: Many forms of T ai Chi developed and changed over the centuries. Some forms merged into the Western medical model as therapeutic mindful exercise, while limiting the aspects of selfdefense or martial arts. Today, these exercises are passed down from instructors to students and patients all over the world. 3. The T ai Chi Fundamentals Program History Basic Components of the TCF Program Rationale and Applications for the TCF Program Similarities and Differences with Traditional T ai Chi forms. The ROM Dance Program was authored in 1981 by Tricia Yu and Jill Johnson. T ai Chi Warm Ups are another component. On the shores of Lake Monona in 1996, not far from Olbrich Park, Tricia Yu developed the component called the T ai Chi Fundamentals program. Tricia is a

3 master teacher who had studied under Lo and Chen. She broke down the Yang T ai Chi form into smaller pieces so that people could understand it easier. She felt it could be helpful for even people with medical challenges. Each basic move is clearly defined and demonstrated. So when the movement pattern is taught in therapy with a patient, it can be documented and repeated by others in the same specific way for therapeutic exercise consistency. And it can be replicated for research and proving effects. The rationale for the TCF program is that it progresses from simplified to more complex movements. This allows it to be universally applied to all populations and ability levels. It is limited only by the practitioner s imagination or ability to modify. TCF is similar to traditional T ai Chi in the mind-body principles and the need for practice and learning from a master teacher. Both forms teach practical wisdom of this ancient exercise and its applications into daily life. It is different from traditional T ai Chi in that it is not for martial arts, but for simple exercise. One set of traditional T ai Chi may include complicated movements that last 12 to 20 minutes. TCF is easier to follow and learn because it is broken down into smaller steps which are exactly the same from practitioner to practitioner. It is designed to use right away with clients, but to teach, one must go through daily practice and a certification test. The comprehensive continuing education courses include laboratory manuals and handouts, and often professionals share their viewpoint and experience with cases. There is also Western analysis of the exercise form from physical therapists in two books. Summary: Tricia Yu s 16 slow, low-impact movements of TCF will help you to relax as you focus on your breathing and hands. The guided practice DVD will help adults and older children gain confidence in doing an 11-minute routine of all of the movement patterns. There is also a form, which is based on the movement patterns. There are DVD sets that are recommended for those wishing to practice T ai Chi. Teachers are encouraged to take courses and become certified. 2 Younger children will benefit from just working on a pattern or two in a playful manner or they may also wish to get the DVD called T ai Chi Animal Frolics. 3

4 4. Some Researched Health Effects of T ai Chi as Published in Peer Reviewed Journals *Pain Management *Reduces tension headaches. (Evid Based Complement Alternat Med Mar;4(1): Abbott, Hui, Hays, Li, Pan). *Reduces pain in adults with hip and knee osteoarthritis. (J Back Musculoskelet Rehabil. 2010;23(4): Escalante, Saavedra,, García-Hermoso, et. al.) *Improved Cognitive Functioning and Memory (Medical Surgical Nursing, 20(3):63-9. Chang, Tsai, Beck, et.al.) *Cardiovascular *Improved aerobic capacity. (J Cardiovasc Nurs. 2004;19: Taylor-Piliae, Froelicher.) *Respiratory *Balance *Reduces Falls (Cochrane Database Syst Rev Apr 15;(2):CD Gillespie, Robertson, Gillespie, et.al.) *Emotional Health *Augments pharmacological therapy of depression in seniors. (Am J Geriatr Psychiatry Oct;19(10): Lavretsky,, Alstein, Olmstead, et. al.) *Lower stress hormones *Improved Quality of Life *Immune Response *Improved antibody response to influenza vaccine. (Med Sport Sci. 2008;52: Yang, Verkuilen, Rosengren, Mariani, et.al.) *Increased Flexibility *Bone Mineral Density and Strength *Increased BDM in spine and nondominant femur, increased strength, improved one leg stand. (Bone Miner Metab;23(2): Qin et. al.) *Sleep *(J Am Geriatr Soc. 2004;52(6): Li at. Al.)

5 Summary: The above is just a sampling of some of the literature available on the health benefits for T ai Chi demonstrating reduction in falls, less fear, and increased leg strength. T ai Chi has been shown to enhance heart, lung, and immune function. It can lower blood pressure, cortisol (stress hormone) levels, and reduce pain. T ai Chi can promote better sleep, cognitive function, and feelings of wellbeing. Similar results would most likely be found in children, and especially children with medical challenges, if T ai Chi becomes more popular in schools and community recreation centers and then ultimately gets researched. Another website where I like to look for studies is the National Institutes for Health, the National Center for Complementary and Alternative Medicine (NCCAM) at There are links on this page to all new random controlled studies and systematic reviews (the gold standard in physical therapy for the effectiveness of an intervention in relation to a disease or healthcare problem). 5. Guidelines for T ai Chi Practice Be mindful - Be present in the moment; present in the body. Sense your body. Perceive your surroundings. Clear, calm state of mind. Maintain a neutral posture Each body part aligns over the one below. Equal weight on both feet. Breath awareness Belly expands like a balloon during inhalation. Coordinate breathing with movement, inhale when moving up or out. Relaxed but alert Focus while moving. Minimal effort. Let Qi flow (life force). Move slowly Controlled, balanced movement over stable base of support. Separate your weight Adjust your feet, slowly shift weight to the other foot, then realign your body over the base of support. Putting weight on one leg intensifies balance, strength, and muscular endurance. Move from your center The core is always engaged yet joints are not locked. Knees are soft, rib cage opened (shoulder girdles engage). In general, the principles of T ai Chi exercise are to focus on your breathing and your hands while you move. The movements are slow and flow continuously, looking effortless but filled with

6 postural strength. Weight shifts off the center are always done with the body in good alignment with the body moving as a column. Arm movements flow off of the central core body movement, they are not isolated. The body moves as a free-flowing unit. 6. The Mind/Body Principles of T ai Chi ACTIVE RELAXATION -Centering. Awareness of hands and feet and breath. Body upright. Be present. -Relaxed Alertness. Quiet. Aware. Responsive. -Stillness within Movement. Movement with inner tranquility. EFFECTIVE ACTION -Body Mechanics. Heel comes down first when stepping. Great for gait training. Pelvis always stays neutral. Arm motion is determined by trunk/pelvic rotation. -Spontaneous Action. Be aligned and firm and circular. The three treasures are in every moment. -Moving Around Obstacles. Move with the flow, not against. T AI CHI ENERGETICS -The Heavy and the Light. One part sinks, the other lifts. The 3 Lights: Crown, Eyes, Fingers. The 3 Heavies: Tailbone, Knees, Elbows. -Flexible and Rooted. Strong legs and back, yet can withstand jolts because joints are bent and body floats with water wings on. -String of Pearls. Everything is interconnected. Wholistic movement. The Qi energy can flow throughout. Body posture is a moving whole entity and dynamic- not static. Summary: The mind and the body are both expressions of our healthy life force, or Qi energy. T ai Chi s goal is that the mind, body, and spirit live in harmony with the external world. A calm, alert mind while in motion promotes the flow of Qi throughout the whole body. All of these concepts I continue to think about and read about. I have felt that energy concepts are not very teachable to

7 most of the students with disabilities that I work with, but I do talk about them. With adults, it is much easier to talk about and demonstrate mind-body principles. 7. Reviews of TCF in Professional Journals

8 Summary: The above information on professional reviews came directly from Tricia Yu. I did not find any other reviews. There are a lot of physical therapists and gerontologists who have written favorably about T ai Chi Fundamentals and I am sure many more will come in the future. 8. TCF Programs in the Fox Valley and Central Lakeshore Areas of Wisconsin T ai Chi is an exercise form that is growing in popularity. In Madison, Wisconsin it is used at the VA Hospital for veterans, and in Milwaukee it is used in hospice programs. There are fitness centers in larger cities (Wauwautosa and Madison) where you can go regularly to practice with healthy adults. It is also practiced in homes alone with a DVD. In Appleton, Wisconsin there is a group that meets weekly at the Thompson Community Center taught by Shelly Van Ess that moves outdoors to Pierce Park in the summer on Thursdays at 5 p.m. I am aware of one therapist using T ai Chi in her practice in Manitowoc (Bonin). There is one teacher who is semi-retired that is open to teaching and practicing with me (Driessen). Other forms of T ai Chi are much easier to access at the YMCAs and in fitness centers in my area of Wisconsin. I took one of those courses, but did not like it very much. Unfortunately the course stopped meeting at a spa in Appleton due to lack of interest. I have not found a practice group with middle-aged women doing TCF, but I have heard that there is a group that meets on the top floor of a shopping mall, but is doing a different version of T ai Chi. Summary: There are four master teachers of TCF in the country teaching and certifying others. In my area of Wisconsin, I recommend physical education teachers, adapted PE teachers, special education or regular education teachers go to a basic course in Milwaukee (Culotti) or Madison (Yu, Hallisy). In the future perhaps there will be more places to get certified. 9. Applications of TCF in School-Based Pediatric Physical Therapy Currently, since I work in the public schools with children, one of the most valuable pieces of T ai Chi for me is the T ai Chi stance for falls prevention. The stance widens the base of support, lowers the center of gravity, bends and softens the joints to allow for balance reactions and shifts in weight. As I work and practice with students, we can gradually widen their stance, get more bend

9 to the legs, and continue to work on keeping their arms out and ready to protect or catch themselves. Students with walkers and crutches get bumped all the time in the crowded school hallways, and T ai Chi practice is perfect to help them learn to be more defensive, aware, and to go with the flow. In the future, I think pediatric PTs could gather and share experiences and discuss TCF in pediatric physical therapy. It would be awesome for PTs currently using T ai Chi in adult practice and pediatric practice to collaborate together as well. I anticipate future studies demonstrating improved gait, self-reported focus, cognition, and coordination with children. For students especially, I believe that the increased large muscle input that T ai Chi demands leads to calming in the nervous system; that the structured movement is organizing to the brain and could lead to improved memory and learning on cognitive tests, and that the mind and body in sync will lead to calmness, less violence, better behavior, and improved selfreport measures of quality of life. 10. Other Case Examples of TCF as an Adjunct to Traditional Pediatric PT One student returned to school after several months of being off due to having a cardiac arrest, which resulted in an anoxic brain injury and cortical visual impairment. He was legally blind and was very rigid as he tried to walk with help. When I thought of trying some T ai Chi moves as a fun therapeutic exercise, I determined that I would probably have to teach him the moves by helping him to move his arms and legs first. I was a little reluctant. But I did a little reading and ran across an article that encouraged me. With "assisted movement technique the T ai Chi instructor places the participant's hand or arm on the instructor's arm and then performed the movement while the participant's hand or arm followed the movement. This technique allowed the participant to feel the actual movement, thus creating a memory of the movement pattern that could be replicated when the instructor was not present." 4 So I tried it and decided to use the softball pitch move for underhand bocce ball throwing. Together we practiced the rhythmic movements of "softball pitch" in the 70/30 stance. Then we went to a game of pitching the bocce balls. I also used cues that our vision therapist was encouraging such as "try to throw the ball as far as you can towards 10 o'clock." As his visual

10 impairment was a cortical impairment, his eyes and brain were actually seeing much more than he was able to understand and acknowledge at this point. He would pick up about half of the bocce balls thrown onto the grass while stating that he could not see them. But more importantly, he was working on weight shifting and balance in a functional, fun way. He was doing gait training via one of the TCF basic movement patterns. Thank you. Sources 1. Yu T, J Johnson J. T ai Chi Fundamentals for Health Professionals and Instructors. Madison, Wi: Uncharted Country Publishing, T ai Chi Fundamentals: for Mastering T ai Chi Basics (DVD) 3. T ai Chi Animal Frolics, Gerri Gurman, Accessed May 23, 2011 at Miszko TA, Ramsey VK, Blasch BB, T ai Chi for People with Visual Impairments: A Pilot Study, Orientation and Mobility, Jan 2004, Vol Yu T. T ai Chi Mind and Body. New York: DK Publishing, Shumway-Cook A, et al. Exercise and aging, attention and cognition. J Gerontol (Med) 52A; M , Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and Children: United States, 2007 (299 KB PDF). CDC National Health Statistics Report # Wolf SL, O'Grady MJ, Xu T, T ai Chi Chuan, Alternative Medicine and Rehabilitation: A Guide for Practitioners, (Steven Wolf and Shumway-Cook explain ideas on multiple processing and that more research is needed regarding the critical interface between attention, memory, and postural control. ) 9. There are many references for T ai Chi with adults by Steven Wolf, PhD. These made me really think about motor control and motor learning for my young students with disabilities. PT related

11 reading, click bottom of page for PubMed articles. Accessed October 19, 2013 at Yu T, Hallisy K. Deconstructing T ai Chi: Biomechanics, Kinesiology, Therapeutic and Functional Applications. Poster Presentation.

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