Tai Chi as medicine

[taai gihk yahn]

This study sounds pretty uncontrolled so far, but I do hope they get funding to pursue it more.

it's a good idea; and what it also is trying to look at is to see if not only the qualitative components of taiji practice make a difference, but also the pattern in which they are arranged has impact; you would need 3 groups to control for this: a group doing taiji in a pattern; a group doing taiji movements in more of a "qigong" manner (do same move each side, in isolation; a group doing some other type of exercise (e,g, - treadmill fast walk); the intersting thing, to me, is that the taiji form is asymmetrical; IMPO, asymmetrical types of practice engage the cognitive / memory system more so than symmetrical ones, simply because as being aymmetrical, there is more "contrast" of sorts; so they may be onto something here...

would be curious to see how this pans out

[Scott R. Brown]

I would prefer to see something similar to the activity of tai chi, but not tai chi, like ballroom dancing, or tap dancing or ballet or jazzercise or some other such activity.

[taai gihk yahn]

I would prefer to see something similar to the activity of tai chi, but not tai chi, like ballroom dancing, or tap dancing or ballet or jazzercise or some other such activity.

I don't know - I think that you want to have simple contrasts at first: taiji as such, taiji movements taken out of the sequence (since they are positing that the pattern-memorization might be a significant factor), and then some sort of regular, easily defined exercise of a similar nature in terms of its effect on aerobic capacity; dancing of any sort has a large number of variables that can impact outcome, and I don't know what it would demonstrate in terms of taiji per se; it might be a follow-up study, if it was shown that memorizing the sequence was the key factor, then contrast it to people having to learn a taiji vs. dance sequence and see if there was a difference...

[Scott R. Brown]

That is why I think dance would be perfect. Have a movement routine that is memorized, requires coordination, is fun to perform and about as long as a tai chi form and just about as active, so for example, swing dance or salsa would be out. Then compare the results. If the results are the same or similar we know it isn't tai chi, or the way the movements are performed, but the activity and mental stimulation.

If there is a gross variation, then we have something really interesting going on!

I suspect there will me similar findings though!

[GeneChing]

This is more tai chi as therapy...prison therapy.

Taiwan ensemble inspires violent inmates and drug offenders with Zen drumming lessons
By Associated Press, Published: August 10 | Updated: Thursday, August 11, 3:26 AM

CHANGHUA, Taiwan — Twenty inmates pound barrel-sized drums in a Taiwanese prison courtyard until they are so drenched with sweat that colorful tattoos show through their thin cotton T-shirts.

The convicts range in age from 18 to 25 and most of their records include violence or serious drug abuse. They beat out their energetic rhythms under a blazing summer sun during their midday session at the Changhua Prison.

The prison, 150 miles (250 kilometers) south of the capital Taipei, is one of the latest proving grounds for rehabilitation programs involving dance or other performing arts. Prisons in Japan, the U.S. and several other countries have experimented with them in recent years. A Philippines prison wowed the world when a YouTube video went viral in 2009 with 1,600 of its inmates dancing to Michael Jackson.

None of the programs are quite like the one led by Taiwan’s U-Theater Ensemble of drummers and Chinese operatic dancers. It leverages the spirituality of Zen Buddhism and Tai Chi Chuan exercises to try to instill a new sense of equanimity among the convicts.

Ensemble dancer I Bau spends one day a week working in the prison, and is convinced she’s making headway with the troupe’s “mind to body” approach.

“At first the inmates were easily distracted,” she said. “But I taught them to bring their minds back and focus on the rhythm. They show a different temperament now. Everyone sits still like the Buddha meditating.”

One of her students is a sturdy 24-year-old man surnamed Chou, who settled a dispute at his former school two years ago by pulling out a pistol and shooting a rival. Because the victim survived, he received only a six-year sentence.

“The lessons give me peace of mind,” Chou says with a coy smile. “I can release my anger and all my other negative emotions by beating the drum very hard.”

Chou said he meditates in his prison dormitory at night and tries to recite by heart the choreographed drumming lessons he has learned from the ensemble.

U-Theatre founder and artistic director Liu Ruo-yu says the group’s spiritual approach emphasizes teamwork over ego.

“As each performer becomes progressively calmer, he can hear his and his partners’ drumbeats achieve a kind of harmony,” she says. “After finding their inner tranquility, they will progress from their former state of restlessness to gain maturity and stability.”

U-Theatre also works with school dropouts and runs a summer camp for wayward students amid the lush mountains of suburban Taipei. But its highest-profile endeavor is the prison program, which began two years ago as part of attempts in Taiwan to expand rehabilitation efforts beyond handicrafts and carpentry.

Changhua warden Tai Shou-nan has been so impressed with the results that he recently took the unprecedented step of allowing inmates to perform before 10,000 spectators at a local stadium. He wasn’t disappointed, saying the audience’s enthusiastic response helped boost the inmates’ confidence.

“They realized they were not inferior to other people and they too had great potential,” he said.

Tai noted with pride that U-Theatre recently hired two freed inmates to join its professional ranks.

“This gives other inmates hope that they too will have a bright future when they are released,” he said.

[blackjesus]

Mahjong is good too.

[GeneChing]

Fortunately, there's tai chi!

Tai Chi Benefits People With COPD
Graceful Exercise Increases Endurance, Balance, and Quality of Life
By Matt McMillen
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 9, 2012 -- The gentle movements of Sun-style tai chi (SSTC) can improve the lives and boost the exercise endurance of people with chronic obstructive pulmonary disease, according to a new study by Australian researchers.

After 12 weeks, practitioners of this form of tai chi could walk longer distances and reported better quality of life compared to those whose treatment did not include any exercise training.

This is good news for people with COPD because it gives them more fitness choices, according to researcher Regina Wai Man Leung of Concord Repatriation General Hospital and the University of Sydney.

"With increasing numbers of people being diagnosed with COPD, it is important to provide different options for exercise that can be tailored to suit each individual," Leung, a cardiorespiratory physiotherapist, said in a news release that accompanied the study.

Forty-two people with COPD participated in the study. Their average age was 73. Half of them received standard rehab. The others, meanwhile, attended twice-weekly, hour-long sessions of a modified version of SSTC, which was comprised of 21 exercises, or forms, as well as controlled breathing. They practiced tai chi at home for 30 minutes on days when they did not have a class.

This type of tai chi, the researchers write, is an excellent choice for their COPD patients.

"Each form can be broken down into several movements which are easy to teach and learn. Compared to some other styles of tai chi, SSTC involves less difficult movements, such as less deep-knee bending and single-leg standing, which may make it more suitable for older people," the researchers write.

Each of the participants underwent several tests before and after the 12-week study period. The primary test evaluated how far and for how long they were able to walk at progressively faster speeds before becoming breathless.

The researchers also measured their balance, the strength of their quadriceps, and overall physical performance. Finally, the participants completed questionnaires to determine if they had symptoms of depression and/or anxiety and to gauge how highly they rated their quality of life.
Practice Leads to Improvements

The tai chi group showed significant improvements across the board. By the end of the 12 weeks, they were, on average, able to walk about 60 yards ****her and for 348 seconds longer than the group that did not practice tai chi. They were also steadier on their feet and showed greater quad strength, both of which are important for COPD patients.

"Impairment in balance and lower limb muscle strength are common in people with COPD and are some of the major risk factors for falls," the researchers write. "Interestingly, conventional pulmonary rehabilitation has not been shown to improve balance in people with COPD."

The researchers also found that, in addition to getting the benefits of a good workout, the tai chi group was significantly less anxious and that they felt better in general than the other study participants.

"This study," they conclude, "provides compelling evidence that tai chi training achieved an appropriate training intensity and that it may be an effective alternative training modality in people with COPD."

COPD is the third leading cause of death in the United States. As many as 90% of cases are caused by smoking. In 2008, more than 13 million American adults had COPD, a blanket term for emphysema and chronic bronchitis. Both make breathing progressively more difficult. In 2007, nearly 125,000 U.S. adults died of COPD.

The study is published in the online edition of the European Respiratory Journal.

[GeneChing]

Good to see more research here.

Curr Rheumatol Rep. 2012 Dec;14(6):598-603. doi: 10.1007/s11926-012-0294-y.
Role of tai chi in the treatment of rheumatologic diseases.
Wang C.

Source
Division of Rheumatology, Tufts Medical Center/Tufts University School of Medicine, Box 406, Boston, MA, 02111, USA, cwang2@tuftsmedicalcenter.org.

Abstract
Rheumatologic diseases (e.g., fibromyalgia, osteoarthritis, and rheumatoid arthritis) consist of a complex interplay between biologic and psychological aspects, resulting in therapeutically challenging chronic conditions to control. Encouraging evidence suggests that Tai Chi, a multi-component Chinese mind-body exercise, has multiple benefits for patients with a variety of chronic disorders, particularly those with musculoskeletal conditions. Thus, Tai Chi may modulate complex factors and improve health outcomes in patients with chronic rheumatologic conditions. As a form of physical exercise, Tai Chi enhances cardiovascular fitness, muscular strength, balance, and physical function. It also appears to be associated with reduced stress, anxiety, and depression, as well as improved quality of life. Thus, Tai Chi can be safely recommended to patients with fibromyalgia, osteoarthritis, and rheumatoid arthritis as a complementary and alternative medical approach to improve patient well-being. This review highlights the current body of knowledge about the role of this ancient Chinese mind-body medicine as an effective treatment of rheumatologic diseases to better inform clinical decision-making for our patients.

Best Pract Res Clin Rheumatol. 2012 Jun;26(3):387-98. doi: 10.1016/j.berh.2012.05.006.
Tai Chi and yoga as complementary therapies in rheumatologic conditions.
Uhlig T.

Source
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. til.uhlig@diakonsyk.no

Abstract
Tai Chi and yoga are complementary therapies which have, during the last few decades, emerged as popular treatments for rheumatologic and musculoskeletal diseases. This review covers the evidence of Tai Chi and yoga in the management of rheumatologic diseases, especially osteoarthritis of the knee, hip and hand, and rheumatoid arthritis. There is evidence that Tai Chi and yoga are safe, and some evidence that they have benefit, leading to reduction of pain and improvement of physical function and quality of life in patients. Recommendations for Tai Chi in knee osteoarthritis have recently been issued by the American College of Rheumatology. To allow broader recommendations for the use of Tai Chi and yoga in rheumatic diseases, there is a need to collect more evidence researched with larger randomised controlled trials.

J Clin Nurs. 2012 Oct;21(19-20):2812-22. doi: 10.1111/j.1365-2702.2011.04058.x. Epub 2012 Jul 25.
Tai Chi exercise and auricular acupressure for people with rheumatoid arthritis: an evaluation study.
Lee HY, Hale CA, Hemingway B, Woolridge MW.

Source
Nursing Policy Research Institute, Korean Nurse Association, Seoul, Korea.
Abstract

AIMS AND OBJECTIVES:
(i) To assess the effectiveness of Tai Chi exercise in people with rheumatoid arthritis (RA). (ii) To ascertain if Tai Chi and auricular acupressure have a potentiation effect in controlling pain. (iii) To evaluate the acceptability and enjoyment of the classes.

BACKGROUND:
Tai Chi has been suggested as a suitable exercise for people with arthritis and specific programmes have been developed. Auricular acupressure is a therapeutic method by which points on the ear are stimulated to treat various disorders.

DESIGN:
A pragmatic non-randomised before/after study to compare the effects of the interventions.

METHODS:
People with RA (n=21) were recruited and allocated into two groups. Both groups followed a Tai Chi exercise programme, twice a week for 12 weeks, but one group (n=14) had, in addition, the auricular acupressure. Physical symptoms and function, pain, quality of life and self-efficacy were measured in both groups before and after the programme. Acceptability and enjoyment were assessed at the end.

RESULTS:
At 12 weeks, both groups had achieved statistically significant improvements in balance, grip strength, pinch strength, 50 foot walk time self reported joint pain, swollen joint count, tender joint count and in self efficacy in relation to pain control. All participants stated that they enjoyed the classes. There was no evidence to suggest that the auricular acupressure enhanced the effects of the Tai Chi intervention.

CONCLUSION:
The classes appeared to be mentally as well as physically helpful to participants.

RELEVANCE TO CLINICAL PRACTICE:
People with a chronic debilitating disease such as RA should be encouraged to undertake gentle strengthening exercise such as Tai Chi because of its potential for physical and psychological improvements.

[GeneChing]

Try this Ancient “Art” for a Healthy Brain

Tai chi can aid those with schizophrenia.Mental health problems are real, and they deserve treatment and support. Brushing them away and hoping they won’t come back isn’t always the wisest course of action to take. While most of us would rather not take medication to treat depression and anxiety (many of these drugs actually list depression and anxiety as side effects!), it can be difficult to find effective alternative treatments. Here’s one you might want to consider: tai chi. Researchers at The University of Hong Kong tested the therapeutic martial art on patients suffering from schizophrenia.

The researchers noted that patients with schizophrenia residing at institutions often suffer from negative symptoms in excess of what those who live at home do. In particular, they have trouble with movement coordination and social interaction.

The researchers found 30 Chinese patients with schizophrenia who were residing in a rehab residency. Each was assigned to receive either a six-week tai chi program and standard residential care, or only the latter. The researchers assessed movement coordination, negative symptoms, and functional disabilities at baseline, following intervention, and six weeks after intervention.

How much did the tai chi sessions help? According to the research team, the tai chi group was buffered from deteriorations in movement coordination and interpersonal functioning for six weeks after the intervention. In contrast, the controls showed marked deteriorations in those areas. The tai chi group also experienced fewer disruptions to life activities at the six-week mark.

Tai chi has been proven to help with the challenging symptoms of schizophrenia. If you suffer from much milder symptoms of depression or anxiety, tai chi may just be your ticket to improved mental health and soothing stress relief.

This amuses me because I know a few people that practice tai chi who I would consider borderline schizophrenic.

[GeneChing]

My dad is a stroke survivor and he had a fall last year. It was pretty rough. He was hospitalized for several days and took many weeks to recover. Tai Chi can't help him however, as the stroke left him as a severe aphasiac so he can't learn it.

Public release date: 6-Feb-2013
Contact: Karen Astle
karen.astle@heart.org
214-706-1173
American Heart Association

Tai Chi exercise may reduce falls in adult stroke survivors
Abstract: P362

Tai Chi may reduce falls among adult stroke survivors, according to research presented at the American Stroke Association's International Stroke Conference 2013.

Compared to survivors receiving usual care or participating in a national fitness program for Medicare-eligible adults called SilverSneakers®, those practicing Tai Chi had the fewest falls.

Tai Chi is a martial art dating back to ancient China. It includes physical movements, mental concentration and relaxed breathing.

"Learning how to find and maintain your balance after a stroke is a challenge," said Ruth E. Taylor-Piliae, Ph.D., R.N., the study's principal investigator and assistant professor at the University of Arizona College of Nursing in Tucson, Ariz. "Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls. Tai Chi is readily available in most U.S. cities and is relatively inexpensive."

Stroke survivors experience seven times as many falls each year than healthy adults, Taylor-Piliae said. These falls can cause fractures, decrease mobility and increase fear of falling that can result in social isolation or dependence. Tai Chi has significantly reduced falls in healthy older adults. Researchers recruited 89 stroke survivors — most of whom had ischemic strokes — for a randomized prospective study outside of a hospital setting. Participants were an average 70 years old, 46 percent were women and most Caucasian, college educated and living in the Tucson area, and suffered a stroke on average three years prior to beginning the study.

Among the participants, 30 practiced Tai Chi, 28 took part in usual care and 31 participated in SilverSneakers®. The Tai Chi and SilverSneakers® groups participated in a one-hour exercise class three times each week for 12 weeks. The usual care group received a weekly phone call and written material about participating in community-based physical activity.

During the 12-week trial, there were a total of 34 reported falls in participants' homes mainly from slipping or tripping: five falls in the Tai Chi group; 15 falls in the usual care group; and 14 falls in the Silver Sneakers group. Only four people sought medical treatment.

Yang-style Tai Chi, as practiced in the study, is the most popular of five styles used in the United States because of its emphasis on health benefits, both physical and psychosocial benefits, researchers said.

"The main physical benefits of Tai Chi are better balance, improved strength, flexibility and aerobic endurance," Taylor-Piliae said. "Psycho-social benefits include less depression, anxiety and stress, and better quality of life."

###

Co-authors are: Tiffany Hoke, R.N.; Bijan, Najafi, Ph.D.; and Bruce Coull, M.D. Author disclosures are on the abstract.

An American Heart Association Scientist Development Grant and a Robert Wood Johnson Foundation Nurse Faculty Scholars Grant funded the study.

[Scott R. Brown]

My dad is a stroke survivor and he had a fall last year. It was pretty rough. He was hospitalized for several days and took many weeks to recover. Tai Chi can't help him however, as the stroke left him as a severe aphasiac so he can't learn it.

Most of them can't stand or use half of their body. Many can't eat. Those that can usually can't feed themselves, clothe themselves, toilet themselves, etc.

On the other hand, once in awhile someone will have a stroke and suffer no lasting ill effects.

[GeneChing]

I've learned a lot about strokes due to my dad. That was learning the hard way, but when you learn the hard way, you learn it well.

[Scott R. Brown]

The worst kind of stroke is the one that hits your cognitive center. As long as you have some cognitive function you can improve over time with the proper guidance and determination.

Most people give up trying. But I had one patient that the Doctors wanted to pull the plug on 3 times and her husband said no.

Then they put in a stomach tube. He stayed with her 20 hrs a day for 5 or 6 months until I started to care for her. Then he was comfortable enough to go home at night.

She improved dramatically until last Thanksgiving and then went down hill almost over night. She was walking, swallowing and saying words, then she withdrew and couldn't function.

The P.T., S.T. and Doctor gave up on her again. But he insisted on finding out what was wrong. He finally harassed the Doctor into sending her to the Emergency room.

There they couldn't find specifically what was wrong, but they put her on a series of Antibiotics and within a week she was back to talking, walking with assistance and reading words, recognizing family members, etc.

If her husband hadn't bullied the Doctor she probably would be dead now, because everyone wanted to give up on her but her husband.

[Tame The Tiger]

This is an interesting thread.

It seems that it can be summarized into a simple statement: Tai Chi and Qigong are good exercises, but there's no evidence that they're better than regular activities, such as ballroom dancing.

Basically, any activity will increase bone density, lower blood pressure, improve the immune system etc.

But Tai Chi and Qigong are more than just a collection of physical movements like dancing, walking, or aerobics. The physical side is only half the story - the rest is the meditative state that higher level practitioners attain. This is not aimed for or attained (so far as I know) by any western exercise or sport.

The meditative state has been proven to lower cortisol production and consequently increase HDL (good cholesterol). Although any exercise can raise HDl, it seems that Tai Chi and Qigong provide a dual mechanism for it, whereas western exercises only the one.

Of course, you could do sitting mediation in the morning and ballroom dancing in the evening and perhaps achieve the same result. But slow as it as, Tai Chi will get you there faster.

[GeneChing]

That's a great point about tai chi - cost effectiveness. You just need to pay a teacher and for the elderly, it doesn't have to be some great grand master, just someone who is competent in the discipline and sensitive to elderly needs.

Tai Chi Cost-Effective to Reduce Falls in Parkinson's
Megan Brooks
Jun 20, 2013

SYDNEY, Australia — Training patients with Parkinson's disease (PD) in the ancient art of tai chi is a cost-effective way to cut the risk for falls, new research shows.

In an earlier randomized controlled study, Fuzhong Li, PhD, from the Oregon Research Institute in Eugene and colleagues, found that tai chi reduced balance impairments, improved function, and reduced falls in patients with PD. The findings were published in the New England Journal of Medicine in 2012, as reported by Medscape Medical News.

This week at the Movement Disorder Society (MDS) 17th International Congress of Parkinson's Disease and Movement Disorders, the researchers reported a preliminary cost-effectiveness analysis of the data from the trial.

The data indicate a "significant potential return on investment value" of tai chi in PD, they said in a meeting abstract. "As treatment costs for injury falls continue to rise these results have important implications for reducing overall healthcare costs while protecting patient health and independence."

Significant Return on Investment

There is increasing evidence of the benefits of exercise for PD but, until now, meager information on cost-effectiveness of various exercise-based modalities, the researchers note.

Dr. Li and colleagues calculated all expenditures related to the tai chi intervention used in their earlier trial, including program promotion, patient enrollment, instructor teaching/training fees and travel expenses, classroom rental, training equipment, participant incentives and transportation, and printing of instructional materials.

The trial included 195 patients with PD at Hoehn and Yahr scale stages 1 to 4 who participated in tai chi, resistance training, or stretching. The Hoehn and Yahr scale ranges from 1 to 5, with higher stages indicating more severe disease. Patients attended two 60-minute exercise sessions per week for 24 weeks.

During the study, the fewest falls were recorded in the tai chi group (n = 62). There were186 falls in the stretching group and 133 in the resistance group.

By their calculations, total implementation cost to prevent 124 falls (stretching vs. tai chi) was $102,872 ($791/patient; $830/fall prevented); to prevent 71 falls (resistance vs tai chi) the total cost was $107,557 ($827/patient; $1515/fall prevented).

To put their findings in perspective, the researchers note that current estimates indicate 20% to 30% of falls in community-dwelling older adults result in injury, with an average healthcare cost of a fall injury being approximately $18,470.

Therefore, for the total of 124 falls prevented, approximately 25 to 37 would have resulted in injury that would cost between $461,750 and $683,390 for medical care. For 71 falls prevented, 14 to 21 would have been injury falls generating $258,580 to $387,870 in treatment costs.

"I think the key take-home message for clinicians is that tai chi exercises not only reduce falls or risk of falling but does so at a lower cost (ie, cost-effective)," Dr. Li told Medscape Medical News.

"With the multiple health outcomes reported in our trial published in the New England Journal of Medicine, we believe it is safe to recommend tai chi to patients with mild-to-moderate level of severity. Unlike drugs which induce significant side-effects, tai chi is safe to perform for patients without introducing any significant adverse events or muscular-skeletal discomfort," Dr. Li said.

An Argument for Greater Use

"One perceivable downside is that it has to be initially taught by an instructor or clinician, suggesting some level of time and practice commitment is needed," Dr. Li added.

But Tao Liu, MD, from Jilin University, Changchun, China, who was not involved in the study, told Medscape Medical News, "it should be noted that class delivery is necessary only for early-stage-tai chi-learners. After this initial stage, tai chi can be self-performed at home at almost no expense, which can make it much more cost-effective."

Dr. Liu also noted that this study used fall reduction as a measure to analyze cost-effectiveness of tai chi. "In addition to motor functions, however, substantial evidence shows that tai chi has positive effects on other health outcomes, such as cognitive performance, sleep quality, etc. If this is taken into account, tai chi will become more cost-effective," Dr. Liu commented.

"While there is evidence supporting its potential efficacy and lack of adverse effects, this study adds to the argument for more extensive use of tai chi for treating PD and other like conditions," Dr. Liu concluded.

The study had no funding. The authors and Dr. Liu have disclosed no relevant financial relationships.

Movement Disorder Society (MDS) 17th International Congress of Parkinson's Disease and Movement Disorders. Abstract 280. Presented June 17, 2013.