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Referências sobre tai-chi chuan e saúde

Items 1 - 78 of 78

1: Am J Public Health. 2008 Jul;98(7):1195-8. Epub 2008 May 29.

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Translation of an effective tai chi intervention into a community-based falls-prevention program.

Li F, Harmer P, Glasgow R, Mack KA, Sleet D, Fisher KJ, Kohn MA, Millet LM, Mead J, Xu J, Lin ML, Yang T, Sutton B, Tompkins Y.

Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA. fuzhongl@ori.org

Tai chi--moving for better balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the re-aim framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings.

Publication Types:

Research Support, U.S. Gov't, P.H.S.

PMID: 18511723 [PubMed - indexed for MEDLINE]

PMCID: PMC2424086 [Available on 07/01/10]

2: Nurs Res. 2008 May-Jun;57(3):214-9.

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Bayesian data analysis: estimating the efficacy of T'ai Chi as a case study.

Carpenter J, Gajewski B, Teel C, Aaronson LS.

School of Nursing, University of Kansas, USA.

BACKGROUND: Bayesian inference provides a formal framework for updating knowledge by combining prior knowledge with current data. Over the past 10 years, the Bayesian paradigm has become a popular analytic tool in health research. Although the nursing literature contains examples of Bayes' theorem applications to clinical decision making, it lacks an adequate introduction to Bayesian data analysis. METHODS: Bayesian data analysis is introduced through a fully Bayesian model for determining the efficacy of tai chi as an illustrative example. The mechanics of using Bayesian models to combine prior knowledge, or data from previous studies, with observed data from a current study are discussed. RESULTS: The primary outcome in the illustrative example was physical function. Three prior probability distributions (priors) were generated for physical function using data from a similar study found in the literature. Each prior was combined with the likelihood from observed data in the current study to obtain a posterior probability distribution. In each case, the posterior distribution showed that the probability that the control group is better than the tai chi treatment group was low. DISCUSSION: Bayesian analysis is a valid technique that allows the researcher to manage varying amounts of data appropriately. As advancements in computer software continue, Bayesian techniques will become more accessible. Researchers must educate themselves on applications for Bayesian inference, as well as its methods and implications for future research.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 18496107 [PubMed - indexed for MEDLINE]

: Tai chi chuan for breast cancer survivors.

Mustian KM, Palesh OG, Flecksteiner SA.

Behavioral Medicine Unit, Department of Radiation Oncology, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, N.Y., USA.

Background/Aims: Treatment for breast cancer produces side effects that diminish functional capacity and quality of life (QOL) among survivors. Tai Chi Chuan (TCC) is a moderate form of exercise that may improve functional capacity and QOL in these individuals. Women who completed treatment for breast cancer were randomized to receive TCC or psychosocial support therapy for 12 weeks (60 min; three times weekly). Results: The TCC group demonstrated significant improvements in functional capacity, including aerobic capacity, muscular strength, and flexibility, as well as QOL; the psychosocial support therapy group showed significant improvements only in flexibility, with declines in aerobic capacity, muscular strength, and QOL. Conclusions: The TCC group exhibited significant improvements in functional capacity and QOL. These data suggest that TCC may enhance functional capacity and QOL among breast cancer survivors.

PMID: 18487900 [PubMed - in process]

: Tai chi training for patients with coronary heart disease.

Lan C, Chen SY, Wong MK, Lai JS.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.

Coronary heart disease (CHD) is the leading cause of death in the developed countries and many developing countries. Exercise training is the cornerstone of cardiac rehabilitation program for patients with CHD, and exercise intensities in the 50-70% heart rate reserve have been shown to improve functional capacity. However, recent studies found exercise with lower intensity also displayed benefits to CHD patients, and increased the acceptance of exercise program, particularly unfit and elderly patients. Tai Chi Chuan (TC) is a traditional conditioning exercise in the Chinese community, and recently it has become more popular in the Western societies. The exercise intensity of TC is low to moderate, depending on the training style, posture and duration. Participants can choose to perform a complete set of TC or selected movements according to their needs. Previous research substantiates that TC enhances aerobic capacity, muscular strength, endothelial function and psychological wellbeing. In addition, TC reduces some cardiovascular risk factors, such as hypertension and dyslipidemia. Recent studies have also proved that TC is safe and effective for patients with myocardial infarction, coronary bypass surgery and heart failure. Therefore, TC may be prescribed as an alternative exercise program for selected patients with cardiovascular diseases. In conclusion, TC has potential benefits for patients with CHD, and is appropriate for implementation in the community.

PMID: 18487898 [PubMed - in process]

: Tai chi chuan in the management of Parkinson's disease and Alzheimer's disease.

Klein PJ.

D'Youville College, Buffalo, N.Y., USA.

Background: Parkinson's disease (PD) and Alzheimer's disease (ALZ) represent later-life onset neurodegenerative disorders that gradually rob those afflicted of their quality of life. Purpose: This chapter offers practice-based recommendations on how instruction and practice of Tai Chi Chuan (TCC) can be adapted for individuals with PD and those with ALZ. Research Evidence: Practice of TCC is widely advocated as an exercise option in PD; however, little validating research exists. Even less is known about feasibility of applications of TCC for individuals with ALZ. Clinical Impressions: The slow, rhythmic pace of functionally based exercises, internal organ stimulation, flexibility maintenance, balancetraining effects, and general health benefits of TCC and Tai Chi-like exercise practice have clinical relevance for both conditions. Falls prevention, tremor reduction and motor control may be of most importance in management of PD. Behavioral and general health benefits as well as slowing of functional and cognitive decline are considerations with ALZ. Recommendations: Strategies of exercise adaptation include use of Tai Chi-like exercise for individuals with ALZ and those in middle or late stages of PD as well as providing instructional resources and training for caregivers and exercise aides to facilitate practice as a part of daily life.

PMID: 18487897 [PubMed - in process]

: Tai chi and balance control.

Wong AM, Lan C.

Department of Physical Medicine and Rehabilitation, Chang-Gung Memorial Hospital, Taipei, Taiwan, ROC.

Balance function begins to decline from middle age on, and poor balance function increases the risk of fall and injury. Suitable exercise training may improve balance function and prevent accidental falls. The coordination of visual, proprioceptive, vestibular and musculoskeletal system is important to maintain balance. Balance function can be evaluated by functional balance testing and sensory organization testing. Tai Chi Chuan (TC) is a popular conditioning exercise in the Chinese community, and recent studies substantiate that TC is effective in balance function enhancement and falls prevention. In studies utilizing functional balance testing, TC may increase the duration of one-leg standing and the distance of functional reach. In studies utilizing sensory organization testing, TC improves static and dynamic balance, especially in more challenging sensory perturbed condition. Therefore, TC may be prescribed as an alternative exercise program for elderly subjects or balance-impaired patients. Participants can choose to perform a complete set of TC or selected movements according to their needs. In conclusion, TC may improve balance function and is appropriate for implementation in the community.

PMID: 18487891 [PubMed - in process]

: The effectiveness of tai chi exercise in improving aerobic capacity: an updated meta-analysis.

Taylor-Piliae RE.

College of Nursing, The University of Arizona, Tucson, Ariz., USA.

Purpose: To determine if Tai Chi exercise is effective in improving aerobic capacity. Methods: A computerized search of seven databases was conducted using the mesh term 'Tai Ji', published between January 1, 2000, and June 1, 2007, in order to update a previous meta-analysis examining the effect of Tai Chi on aerobic capacity. Effect sizes (ESs) and 95% confidence intervals were calculated using D-STAT software. The ES for each study was weighted by the sample size and pooled variance. The effects of Tai Chi exercise on aerobic capacity were calculated including study design, gender, age, and type of comparison group. Results: A total of 170 citations were obtained, with 7 new studies meeting the inclusion criteria and added to studies from the previous meta-analysis. Large significant effects of Tai Chi on aerobic capacity were found for subjects enrolled in the cross-sectional studies (ES = 1.33), in both women and men (1.09 and 0.86, respectively), among adults =55 years old (ES = 1.07), and when comparing sedentary subjects with those in Tai Chi exercise groups (ES = 0.99). Small to moderate effects, though nonsignificant, were found for subjects enrolled in the experimental studies (ES = 0.38), adults <55 years old (ES = 0.16), and when comparing subjects participating in other physical activity with those in Tai Chi exercise groups (ES = 0.45). Conclusions: Tai Chi exercise is effective in improving aerobic capacity when practiced long term. Middle-aged and older women and men benefit most, with greater gains seen among those initially sedentary. Tai Chi can be recommended as an alternative aerobic exercise, particularly among sedentary adults >/=55 years old.

PMID: 18487885 [PubMed - in process]

: The exercise intensity of tai chi chuan.

Lan C, Chen SY, Lai JS.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.

Tai Chi Chuan (TC) is a Chinese conditioning exercise and is well-known for its graceful movement. The exercise intensity of TC depends on its training style, posture and duration. Variation in training approaches result in substantial differences in exercise intensity. We have measured heart rate (HR) and oxygen uptake (VO2) simultaneously during classical Yang TC practice in 15 male subjects, their heart rate (HR) during TC practice was 58% of the heart rate reserve (HRR), and oxygen uptake (VO2) was 55% of the peak oxygen uptake (VO2peak). The level of blood lactate immediately after TC practice was 3.8mM, which reflected the level of lactate during TC approximated the onset of blood lactate accumulation (OBLA). In order to evaluate the relative exercise intensity of classical Yang TC, we measured HR responses during TC practice in 100 subjects with age of 25-80 yrs (M/F: 54/46). They were separated into three groups: young (25-44 y/o), middle-aged (45-64 y/o) and elderly (65-80 y/o). During the TC practice, the mean HR of men was 141 +/- 12, 132 +/- 9 and 120 +/- 10 bpm in the young, middle-aged and elderly groups, respectively. Meanwhile, the mean HR of women was 136 +/- 10, 126 +/- 11 and 115 +/- 12 bpm in the young, middle-aged and elderly groups, respectively. Men practiced TC with mean HR corresponding to 57.8 +/- 3.7, 56.6 +/- 3.4 and 55.1 +/- 3.1% of heart rate reserve (HRR) in the three groups; while that of women corresponding to 52.7 +/- 2.8, 51.5 +/- 2.6, and 50.3 +/- 2.9% of HRR in the three age groups. The results demonstrate that classical Yang TC is an exercise with moderate intensity, and its exercise intensity is similar across different ages in each gender.

PMID: 18487882 [PubMed - in process]

9: Prev Cardiol. 2008 Spring;11(2):82-9.

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The effect of tai chi exercise on blood pressure: a systematic review.

Yeh GY, Wang C, Wayne PM, Phillips RS.

Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Osher Institute, Boston, MA 02215, USA. gyeh@hms.harvard.edu

A systematic review of the literature on the effect of tai chi exercise on blood pressure (BP) was performed. The authors searched Medline, CAB, Alt HealthWatch, BIOSIS previews, Science Citation Index, and EMBASE systems (inception through January 2007); researched Chinese Medical, China Hospital Knowledge, China National Knowledge Infrastructure, and China Traditional Chinese Medicine databases (inception to June 2005); and performed hand searches at the medical libraries of Beijing and Nanjing Universities. Clinical studies of tai chi examining BP as an outcome published in English or Chinese were included. Studies reporting only acute exercise effects were excluded. Data were extracted in a standardized manner and 2 independent investigators assessed methodologic quality. Twenty-six studies examining patients with and without cardiovascular conditions met inclusion criteria: 9 randomized controlled trials, 13 nonrandomized studies, and 4 observational studies. Study heterogeneity precluded formal meta-analyses. Twenty-two studies (85%) reported reductions in BP with tai chi (3-32 mm Hg systolic and 2-18 mm Hg diastolic BP reductions). Five randomized controlled trials were of adequate quality (Jadad score > or = 3). No adverse effects were reported. Tai chi exercise may reduce BP and serve as a practical, nonpharmacologic adjunct to conventional hypertension management.

Publication Types:

PMID: 18401235 [PubMed - indexed for MEDLINE]

: Regular Tai Chi Chuan exercise improves T cell helper function of type 2 DM patients with an increase in T-bet transcription factor and IL-12 production.

Yeh SH, Chuang H, Lin LW, Hsiao CY, Wang PW, Liu RT, Yang KD.

Chang Gung Institute of Technology, Taiwan.

BACKGROUND-- Exercise has been shown to be beneficial in treatment of type 2 diabetes mellitus (DM); its benefit to immune function, however, remains to be determined. OBJECTIVE-- This study investigated the effect of a 12-week course of Tai Chi Chuan (TCC) exercise on T cell helper (Th) reaction in type 2 DM patients. DESIGH AND METHODS -- This study was a case-control design. Thirty pairs of type 2 DM patients and normal age-matched adults completed this study. Fasting blood glucose, HbA1c, mediators (IL-12, IL-4 and TGFfO) and transcription factors (T-bet, GATA-3 and FoxP3) of Th1/Th2/T regulatory (Treg) reaction were measured before and after a 12-week TCC exercise program. RESULTS -- Fasting glucose and HbA1c levels in the participating type 2 DM patients were significantly higher than age-matched controls before exercise. After the TCC exercise, HbA1c levels in type 2 DM patients significantly decreased (7.59 inverted exclamation mark&Oacute 0.32 vs. 7.16 inverted exclamation mark&Oacute 0.22 %; P= 0.047), along with a significant increase of blood IL-12 levels (5.96 inverted exclamation mark&Oacute 1.10 vs. 12.96 inverted exclamation mark&Oacute 3.07; P = 0.035). To probe molecular Th1/Th2/Treg reaction, we found that type 2 DM patients had lower T-bet, but not GATA-3 or FoxP3 expression than normal controls before TCC exercise. After the 12-week TCC exercise, T-bet expression significantly increased in type 2 DM patients. CONCLUSIONS -- A 12-week TCC exercise program decreases HbA1c levels, along with increase of the Th1 reaction. A combination of TCC with medication may provide even better in both metabolism and immunity of type 2 DM patients.

PMID: 18385192 [PubMed - as supplied by publisher]

11: J Am Geriatr Soc. 2008 Apr;56(4):776-7; author reply 777.

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Comment on:

J Am Geriatr Soc. 2007 Aug;55(8):1185-91.

Reduced falls in the elderly: tai chi or placebo or Hawthorne effect?

Katz AR.

Publication Types:

PMID: 18380691 [PubMed - indexed for MEDLINE]

: Integrative perspectives: the role of body movement in psychotherapy.

La Torre MA.

malinvis@yahoo.com

PMID: 18366368 [PubMed - indexed for MEDLINE]

: Joint kinetics during Tai Chi gait and normal walking gait in young and elderly Tai Chi Chuan practitioners.

Wu G, Millon D.

Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05401, USA.

BACKGROUND: Tai Chi Chuan is becoming a popular exercise among elders. This study measured the inter-segmental forces and moments at the lower extremity joints during a Tai Chi gait as compared to those during normal walking gait, in both apparently healthy young and elderly Tai Chi Chuan practitioners. METHODS: Three-dimensional inter-segmental joint reaction force and moment were computed using the Inverse Dynamic Approach based on the kinematics and ground reaction force measurements in a laboratory setting in six young (two females, mean age 28; SD 6years) and six elderly (five females, mean age 72; SD 8years) subjects who had previous training of Yang style Tai Chi Chuan. FINDINGS: The results showed significant gait differences in both age groups, with significantly smaller peak compressive forces, larger peak shear forces in the ankle, knee and hip joints, and larger peak moments in the knee and hip joints during Tai Chi gait as compared to normal gait. Moreover, the peak shear force was oriented more in the medial-lateral direction at the ankle and knee joints, and the peak moment was in the frontal plane at the knee and hip joints. The results also showed significant age differences, with significantly smaller peak shear forces in all three joints in the elderly group than in the young group during Tai Chi gait. INTERPRETATION: Tai Chi gait has an increased shear force and frontal plane torque at lower extremity joints than normal gait. The shear force at all three lower extremity joints during Tai Chi gait is lower in the elderly subjects than young subjects. This data suggest that, in Tai Chi Chuan training, elderly people with degenerative joint diseases in the lower extremity should use caution when practicing Tai Chi Chuan.

PMID: 18342415 [PubMed - in process]

: Tai Chi Chuan training improves the pulmonary function of asthmatic children.

Chang YF, Yang YH, Chen CC, Chiang BL.

Department of Pediatrics, Hsin Chu General Hospital, Hsin Chu, Taiwan.

BACKGROUND AND PURPOSE: Tai Chi Chuan, a traditional Chinese exercise, is thought to improve cardiopulmonary function in patients with chronic disease. This study investigated the effect of Tai Chi Chuan on the pulmonary function and daily symptoms of asthmatic children. METHODS: Thirty asthmatic children were enrolled into the study. Fifteen of the 30 children participated in a 12-week Tai Chi Chuan program and the remaining 15 constituted the control group. Prior to study participation, the pulmonary function of all enrolled children was assessed at rest, after exercise, and after exercise plus iced water. A 3-day symptoms questionnaire was also completed and a score obtained after each pulmonary function test. RESULTS: There were no significant differences between the two groups in baseline pulmonary function and severity of asthmatic symptoms before study commencement, at rest, after exercise, or after exercise plus iced water. However, after the 12-week program, children in the Tai Chi Chuan group had a significant improvement in pulmonary function compared to the control group. Although there were no significant differences in post-training symptom scores at rest and after exercise between the two groups, under the stronger challenge of exercise plus iced water, children in the Tai Chi Chuan group had milder symptoms than those in the control group. CONCLUSION: Our data show that Tai Chi Chuan can improve the pulmonary function of asthmatic children. However, long-term follow-up is required to determine the impact of Tai Chi Chuan on the severity of asthmatic symptoms.

PMID: 18327432 [PubMed - in process]

15: J Formos Med Assoc. 2008 Feb;107(2):103-10.

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Eye-hand coordination of elderly people who practice Tai Chi Chuan.

Pei YC, Chou SW, Lin PS, Lin YC, Hsu TH, Wong AM.

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

BACKGROUND/PURPOSE: The objective of this study was to evaluate the effect of motor control from Tai Chi Chuan (TCC) on eye-hand coordination in the elderly. METHODS: Forty-two elderly people were recruited into this study. People in the TCC group (n = 22) had been practicing TCC regularly for more than 3 years. The control group (n = 20) comprised healthy and active elderly people. Subjects were asked to stroke target sensors in a test device with computer recording. There were three different target sensor sizes (1 cm, 1.5 cm and 2 cm in diameter) for different tests. For each target stroking, the following were recorded and calculated: start and end positions, duration of movement, pause time, peak velocity, and the time to reach peak velocity. RESULTS: The TCC group showed significantly better results in decrease of displacement (p = 0.003), movement time (p = 0.002), pause time (p < 0.001), number of submovements (p = 0.001), and better skewness coefficients (p < 0.001) than the control group. However, the difference in the peak velocity of the TCC and control groups did not reach statistical significance (p = 0.026). CONCLUSION: The elderly TCC group had better results on the eye-hand coordination test than the control elderly group.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 18285242 [PubMed - indexed for MEDLINE]

16: Arch Phys Med Rehabil. 2008 Feb;89(2):351-7.

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Age-related differences in Tai Chi gait kinematics and leg muscle electromyography: a pilot study.

Wu G.

Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05401, USA. ge.wu@uvm.edu

OBJECTIVE: To compare the biomechanic features of Tai Chi gait by elders with those by young adults, and with those of normative gait. DESIGN: Cross-sectional study. SETTING: Laboratory-based testing. PARTICIPANTS: Young (n=6; 3 women) and old (n=6; 5 women) Tai Chi practitioners. INTERVENTION: All subjects had practiced Tai Chi for at least 4 months. MAIN OUTCOME MEASURES: Spatial, temporal, and leg muscle electromyography during Tai Chi gait and normative gait. RESULTS: The primary age-related differences in Tai Chi gait were during single stance, with elders having significantly shorter single-stance time (-50%), less lateral displacement (-30%), knee flexion (-42%), hip flexion (-39%), activation time in the tibialis anterior (-13%), soleus (-39%), and tensor fascia lata (TFL) (-21%), activation magnitude in the tibialis anterior (-39%), and coactivation time of the tibialis anterior and soleus (-47%). Compared with normative gait, elders during Tai Chi gait had significantly larger knee (139%) and hip (66%) flexions, longer duration (90%-170%) and higher magnitude (200%-400%) of the tibialis anterior, rectus femoris, and TFL muscle activities, and longer duration of coactivation of most leg muscle pairs (130%-380%). CONCLUSIONS: The elders practice Tai Chi gait in higher posture than younger subjects. The Tai Chi gait poses significantly higher challenges to elder's balance and muscular system than does their normative gait.

Publication Types:

PMID: 18226662 [PubMed - indexed for MEDLINE]

17: Diabet Med. 2008 Feb;25(2):240-1. Epub 2080 Nov 21.

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Tai chi for Type 2 diabetes: a systematic review.

Lee MS, Pittler MH, Kim MS, Ernst E.

Publication Types:

PMID: 18215176 [PubMed - indexed for MEDLINE]

18: Clin Sports Med. 2008 Jan;27(1):75-86, viii.

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Tai Chi Chuan exercises in enhancing bone mineral density in active seniors.

Lui PP, Qin L, Chan KM.

CUHK-WHO Collaborating Centre for Sports Medicine and Health Promotion, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.

Osteoporosis is a silent, systemic, chronic disease characterized by low bone mass and structural deterioration of bone tissue. Its clinical and public health implications are substantial because of the mortality, morbidity, and medical care cost associated with osteoporotic fractures. Although estrogen-replacement therapy or anti-bone resorptive drugs can prevent postmenopausal bone loss, they also show side effects. Physical activity is an nonpharmacological approach for prevention of osteoporosis. Among different types of physical activities, Tai Chi Chuan (TCC) is a low- to moderate-intensity exercise particularly suitable for the elderly, and has been practiced by Chinese for centuries. This article reviews the benefits of TCC for the prevention of osteoporosis and falls by retarding bone loss, improving neuromuscular coordination, and promoting general health.

Publication Types:

Review

PMID: 18206569 [PubMed - indexed for MEDLINE]

19: J Altern Complement Med. 2008 Jan-Feb;14(1):95-102.

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Challenges inherent to t'ai chi research: part I--t'ai chi as a complex multicomponent intervention.

Wayne PM, Kaptchuk TJ.

Osher Institute, Harvard Medical School, Boston, MA 02215, USA. peter_wayne@hms.harvard.edu

In this, the first of 2 companion papers, we present a framework for viewing t'ai chi as a complex, multicomponent intervention that integrates numerous physical, cognitive, and ritualistic components. We discuss how the richness and complexity of t'ai chi poses challenges related to the traditional distinction between specific versus nonspecific effects, the development and interpretation of valid sham controls, and more generally, to the reductionist causal approach of attributing observed outcomes to single, independent component factors. We also discuss parallels between t'ai chi research and the emerging field of whole systems research, and how t'ai chi research may benefit from the use of an ecologic framework. In a second, companion paper, we discuss additional challenges inherent in defining the t'ai chi intervention itself, and more comprehensively outline the benefits and limitations of commonly used clinical research designs to evaluate the efficacy and safety of t'ai chi.

Publication Types:

PMID: 18199021 [PubMed - indexed for MEDLINE]

20: J Altern Complement Med. 2007 Dec;13(10):1077-83.

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Comment in:

J Altern Complement Med. 2007 Dec;13(10):1053.

Health-related quality of life in the elderly practicing T'ai Chi Chuan.

Ho TJ, Liang WM, Lien CH, Ma TC, Kuo HW, Chu BC, Chang HW, Lai JS, Lin JG.

Chinese Medical Science, China Medical University, Taichung, Taiwan.

OBJECTIVE: Previous studies have shown health benefits of T'ai Chi Chuan (TCC). In Taiwan, TCC is a form of exercise that is widely practiced by the elderly. The aim of this cross-sectional study was to investigate the effects of TCC on the health-related quality of life (HRQOL) in the senior population. METHODS: Subjects who regularly practiced TCC in Taiwan were selected by random sampling and included 140 seniors (77 males and 63 females, aged 40-70 years). The questionnaire was separated into 2 parts: demographic information and the SF-36 questionnaire, which used 8 domains to evaluate the subjects' HRQOL. The results were compared with those of 560 age- and sex-matched control subjects that were taken from the general population (308 males and 252 females). Multiple regression analysis was used to compare the quality of life in each of the 8 domains between the 2 groups. RESULTS: The TCC group showed significantly higher quality-of-life scores than the control group in each of the 8 domains with the exception of the bodily pain scales. Using multiple linear regression adjusted for covariates, the TCC group had significantly higher scores in physical functioning, physical roles, general health, vitality, and social-functioning scales than the control group. In most of the domains in both the TCC group and the control group, quality of life became worse with increased age, whereas the scores in vitality and social-functioning domains of the TCC group showed a reverse trend; they remained unchanged or even improved with increased age. CONCLUSIONS: Our study supports the hypothesis that TCC improves quality of life among the elderly in Taiwan, but further study must be conducted to more conclusively show the link between TCC and health-related QOL.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 18166118 [PubMed - indexed for MEDLINE]

21: MMW Fortschr Med. 2007 Nov 8;149(45):14, 16.

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[Strength training and tai-chi to prevent accidental falls]

[Article in German]

[No authors listed]

Publication Types:

News

PMID: 18062004 [PubMed - indexed for MEDLINE]

: Emerging therapies to treat frailty syndrome in the elderly.

Cherniack EP, Florez HJ, Troen BR.

Division of Geriatrics and Gerontology, Miller School of Medicine, University of Miami and the Miami VA Health Care System, 1201 NW 16 St, Miami, FL 33125, USA. evan.cherniack@med.va.gov

Frailty syndrome (FS) has become increasingly recognized as a major predictor of co-morbidities and mortality in older individuals. Interventions with the potential to benefit frail elders include nutritional supplementation (vitamins D, carotenoids, creatine, dehydroepiandrosterone (DHEA), and beta-hydroxy-beta-methylbutyrate) and exercise modalities (tai chi and cobblestone walking). While these have not been explicitly tested for their impact on FS, vitamin D supplementation appears to offer significant promise in enhancing long-term health of the elderly. Exercise modalities such as tai chi and cobblestone walking, because of probable low risk and ease of participation, may also confer benefit. Additional studies are needed to investigate interventions that directly prevent, delay, and/or ameliorate frailty. Successful therapies may well involve multi-component approaches utilizing a combination of medication, nutritional supplementation, and exercise.

PMID: 18072820 [PubMed - indexed for MEDLINE]

23: Postgrad Med J. 2007 Nov;83(985):717-21.

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An evaluation of the effects of Tai Chi Chuan and Chi Kung training in patients with symptomatic heart failure: a randomised controlled pilot study.

Barrow DE, Bedford A, Ives G, O'Toole L, Channer KS.

Department of Cardiology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.

OBJECTIVE: To study the effect of Tai Chi on exercise tolerance in patients with moderate heart failure. DESIGN: Randomised parallel group study balanced for baseline variables. SETTING: Cardiology Department, Royal Hallamshire Hospital. PATIENTS AND METHODS: 52 patients (42 men, mean age (68.9 years), range (46-90 years), and 10 women, mean age (70.0 years), range (58-82)) with chronic heart failure (New York Heart Association symptom class II-III) were studied. Patients were randomised to Tai Chi Chuan twice a week for 16 weeks or to standard medical care without exercise rehabilitation. MAIN OUTCOME MEASURES: The primary outcome measure was the change in the distance walked in the shuttle walk test. Secondary outcome measures were changes in symptom scores and quality of life indices. RESULTS: Objective measures of exercise tolerance did not improve significantly with Tai Chi, but patients having Tai Chi exercise had an improvement in symptom scores of heart failure measured by the Minnesota Living with Heart Failure Questionnaire (comparison of deltas, -2.4 control vs -14.9; p = 0.01), and depression scores measured by the SCL-90-R questionnaire (-2.9 vs -6.8; p = 0.12) compared with those patients in the control group. CONCLUSION: In patients with chronic heart failure, 16 weeks of Tai Chi training was safe, with no adverse exercise related problems. It was enjoyed by all taking part and led to significant improvements in symptoms and quality of life.

Publication Types:

PMID: 17989272 [PubMed - indexed for MEDLINE]

: Mind/body techniques for physiological and psychological stress reduction: stress management via Tai Chi training - a pilot study.

Esch T, Duckstein J, Welke J, Braun V.

Division of Integrative Health Promotion, Coburg University of Applied Sciences, Coburg, Germany. esch@hs-coburg.de

BACKGROUND: Stress can affect health. There is a growing need for the evaluation and application of professional stress management options, i.e, stress reduction. Mind/body medicine serves this goal, e.g, by integrating self-care techniques into medicine and health care. Tai Chi (TC) can be classified as such a mind/body technique, potentially reducing stress and affecting physical as well as mental health parameters, which, however, has to be examined further. MATERIAL/METHODS: We conducted a prospective, longitudinal pilot study over 18 weeks for the evaluation of subjective and objective clinical effects of a Yang style TC intervention in young adults (beginners) by measuring physiological (blood pressure, heart rate, saliva cortisol) and psychological (SF-36, perceived stress, significant events) parameters, i.e, direct or indirect indicators of stress and stress reduction, in a non-randomised/-controlled, yet non-selected cohort (n=21) by pre-to-post comparison and in follow-up. SF-36 values were also compared with the age-adjusted norm population, serving as an external control. Additionally, we measured diurnal cortisol profiles in a cross-sectional sub-study (n=2+2, pre-to-post), providing an internal random control sub-sample. RESULTS: Only nine participants completed all measurements. Even so, we found significant (p<0.05) reductions of saliva cortisol (post and follow-up), which seems to be an indicator of general stress reduction. A significant decrease in perceived mental stress (post) proved even highly significant (p<0.01) in the follow-up, whereas physical stress perception declined to a much lesser degree. Significant improvements were also detected for the SF-36 dimensions general health perception, social functioning, vitality, and mental health/psychological well-being. Thus, the summarized mental health measures all clearly improved, pointing towards a predominantly psychological impact of TC. CONCLUSIONS: Subjective health increased, stress decreased (objectively and subjectively) during TC practice. Future studies should confirm this observation by rigorous methodology and by further combining physical and psychological measurements with basic research, thereby also gaining knowledge of autoregulation and molecular physiology that possibly underlies mind/body medicine.

PMID: 17968296 [PubMed - indexed for MEDLINE]

25: Age Ageing. 2008 Jan;37(1):64-71. Epub 2007 Oct 25.

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Effects of Tai Chi on glucose homeostasis and insulin sensitivity in older adults with type 2 diabetes: a randomised double-blind sham-exercise-controlled trial.

Tsang T, Orr R, Lam P, Comino E, Singh MF.

School of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Australia. ttsa6920@mail.usyd.edu.au

BACKGROUND: a large proportion of adults with type 2 diabetes remain sedentary despite evidence of benefits from exercise for type 2 diabetes. Simplified Yang Tai Chi has been shown in one study to have no effect on insulin sensitivity in older adults. However, a modified Tai Chi form, Tai Chi for Diabetes (TCD) has recently been composed, claiming to improve diabetes control. METHODS: subjects were randomised to Tai Chi or sham exercise, twice a week for 16 weeks. Primary outcomes were insulin resistance 72 h post-exercise (HOMA2-IR), and long-term glucose control (HbA(1c)). RESULTS: thirty-eight subjects (65 +/- 7.8 years, 79% women) were enrolled. Baseline BMI was 32.2 +/- 6.3 kg/m(2), 84% had osteoarthritis, 76% hypertension, and 34% cardiac disease. There was one dropout, no adverse events, and median compliance was 100 (0-100)%. There were no effects of time or group assignment on insulin resistance or HbA(1c) ( -0.07 +/- 0.4% Tai Chi versus 0.12 +/- 0.3% Sham; P = 0.13) at 16 weeks. Improvement in HbA(1c) was related to decreased body fat (r = 0.484, P = 0.004) and improvement in insulin resistance was related to decreased body fat (r = 0.37, P = 0.03) and central adiposity (r = 0.38, P = 0.02), as well as increased fat-free mass (r = -0.46, P = 0.005). CONCLUSIONS: TCD did not improve glucose homeostasis or insulin sensitivity measured 72 h after the last bout of exercise. More intense forms of Tai Chi may be required to produce the body composition changes associated with metabolic benefits in type 2 diabetes.

Publication Types:

PMID: 17965035 [PubMed - indexed for MEDLINE]

26: Issues Ment Health Nurs. 2007 Oct;28(10):1141-55.

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The effectiveness of Tai Chi, yoga, meditation, and Reiki healing sessions in promoting health and enhancing problem solving abilities of registered nurses.

Raingruber B, Robinson C.

University of California-Davis Medical Center, 2315 Stockton Boulevard, Sacramento, CA 95817, USA. Bonnie.raingruber@ucdmc.ucdavis.edu

Given the current necessity of retaining qualified nurses, a self-care program consisting of Yoga, Tai Chi, Meditation classes, and Reiki healing sessions was designed for a university-based hospital. The effectiveness of these interventions was evaluated using self-care journals and analyzed using a Heideggerian phenomenological approach. Outcomes of the self-care classes described by nurses included: (a) noticing sensations of warmth, tingling, and pulsation which were relaxing, (b) becoming aware of an enhanced problem solving ability, and (c) noticing an increased ability to focus on patient needs. Hospitals willing to invest in self-care options for nurses can anticipate patient and work related benefits.

Publication Types:

Research Support, N.I.H., Extramural

PMID: 17957554 [PubMed - indexed for MEDLINE]

27: Sports Biomech. 2007 Sep;6(3):453-64.

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Biomechanics of Tai Chi: a review.

Hong Y, Li JX.

Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong. youlianhong@cuhk.edu.hk

Tai Chi Chuan is a favourite form of exercise throughout the world and has drawn increasing research interest from international scientists. Biomechanical research into Tai Chi has grown substantially and has provided evidence of the beneficial effects of Tai Chi exercise on health, fitness, and prevention of falls. This paper reviews studies that have explored the biomechanical aspects of Tai Chi, such as balance, kinematics, kinetics, strength, and neuromuscular activities.

Publication Types:

Review

PMID: 17933204 [PubMed - indexed for MEDLINE]

28: Clin Rheumatol. 2008 Feb;27(2):211-8. Epub 2007 Sep 14.

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Tai chi for osteoarthritis: a systematic review.

Lee MS, Pittler MH, Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK. myeong.lee@pms.ac.uk

The aim of this study was to evaluate data from controlled clinical trials testing the effectiveness of tai chi for treating osteoarthritis. Systematic searches were conducted on MEDLINE, AMED, British Nursing Index, CINAHL, EMBASE, PsycInfo, The Cochrane Library 2007, Issue 2, the UK National Research Register and ClinicalTrials.gov, Korean medical databases, the Qigong and Energy database and Chinese medical databases (until June 2007). Hand searches included conference proceedings and our own files. There were no restrictions regarding the language of publication. All controlled trials of tai chi for patients with osteoarthritis were considered for inclusion. Methodological quality was assessed using the Jadad score. Five randomised clinical trials (RCTs) and seven non-randomised controlled clinical trials (CCTs) met all inclusion criteria. Five RCTs assessed the effectiveness of tai chi on pain of osteoarthritis (OA). Two RCTs suggested significant pain reduction on visual analog scale or Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to routine treatment and an attention control program in knee OA. Three RCTs did not report significant pain reduction on multiple sites pain. Four RCTs tested tai chi for physical functions. Two of these RCTs suggested improvement of physical function on activity of daily living or WOMAC compared to routine treatment or wait-list control, whilst two other RCTs failed to do so. In conclusion, there is some encouraging evidence suggesting that tai chi may be effective for pain control in patients with knee OA. However, the evidence is not convincing for pain reduction or improvement of physical function. Future RCTs should assess larger patient samples for longer treatment periods and use appropriate controls.

Publication Types:

PMID: 17874172 [PubMed - indexed for MEDLINE]

29: Evid Rep Technol Assess (Full Rep). 2007 Jun;(155):1-263.

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Meditation practices for health: state of the research.

Ospina MB, Bond K, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, Bialy L, Hooton N, Buscemi N, Dryden DM, Klassen TP.

OBJECTIVES: To review and synthesize the state of research on a variety of meditation practices, including: the specific meditation practices examined; the research designs employed and the conditions and outcomes examined; the efficacy and effectiveness of different meditation practices for the three most studied conditions; the role of effect modifiers on outcomes; and the effects of meditation on physiological and neuropsychological outcomes. DATA SOURCES: Comprehensive searches were conducted in 17 electronic databases of medical and psychological literature up to September 2005. Other sources of potentially relevant studies included hand searches, reference tracking, contact with experts, and gray literature searches. REVIEW METHODS: A Delphi method was used to develop a set of parameters to describe meditation practices. Included studies were comparative, on any meditation practice, had more than 10 adult participants, provided quantitative data on health-related outcomes, and published in English. Two independent reviewers assessed study relevance, extracted the data and assessed the methodological quality of the studies. RESULTS: Five broad categories of meditation practices were identified (Mantra meditation, Mindfulness meditation, Yoga, Tai Chi, and Qi Gong). Characterization of the universal or supplemental components of meditation practices was precluded by the theoretical and terminological heterogeneity among practices. Evidence on the state of research in meditation practices was provided in 813 predominantly poor-quality studies. The three most studied conditions were hypertension, other cardiovascular diseases, and substance abuse. Sixty-five intervention studies examined the therapeutic effect of meditation practices for these conditions. Meta-analyses based on low-quality studies and small numbers of hypertensive participants showed that TM(R), Qi Gong and Zen Buddhist meditation significantly reduced blood pressure. Yoga helped reduce stress. Yoga was no better than Mindfulness-based Stress Reduction at reducing anxiety in patients with cardiovascular diseases. No results from substance abuse studies could be combined. The role of effect modifiers in meditation practices has been neglected in the scientific literature. The physiological and neuropsychological effects of meditation practices have been evaluated in 312 poor-quality studies. Meta-analyses of results from 55 studies indicated that some meditation practices produced significant changes in healthy participants. CONCLUSIONS: Many uncertainties surround the practice of meditation. Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality. Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence. Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results.

Publication Types:

Review

PMID: 17764203 [PubMed - indexed for MEDLINE]

30: Am J Chin Med. 2007;35(4):597-607.

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Effects of a Taiji and Qigong intervention on the antibody response to influenza vaccine in older adults.

Yang Y, Verkuilen J, Rosengren KS, Mariani RA, Reed M, Grubisich SA, Woods JA.

Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA. yyang5@uiuc.edu

Previous studies have suggested that Taiji practice may improve immune function. This study was intended to examine whether 5 months of moderate Taiji and Qigong (TQ) practice could improve the immune response to influenza vaccine in older adults. Fifty older adults (mean age 77.2 +/- 1.3 years) participated in this study (TQ N = 27; wait-list control [CON] N = 23). Baseline pre-vaccine blood samples were collected. All subjects then received the 2003-2004 influenza vaccine during the first week of the intervention. Post-vaccine blood samples were collected 3, 6 and 20 weeks post-intervention for analysis of anti-influenza hemagglutination inhibition (HI) titers. We found a significant (p < 0.05) increase in the magnitude and duration of the antibody response to influenza vaccine in TQ participants when compared to CON. The vaccination resulted in a 173, 130, and 109% increase in HI titer at 3, 6, and 20 weeks post-vaccine, respectively, in the TQ group compared to 58, 54, and 10% in CON. There was a significant between group difference at 3 and 20 weeks post-vaccine and at 20 weeks the TQ group had significantly higher titers compared to the pre-vaccine time point, whereas the CON group did not. A higher percentage of TQ subjects also responded to the influenza A strains with a protective (> 40HI) antibody response (37% TQ vs. 20% CON for the H1N1 strain and 56% TQ vs. 45% CON for the H3N2 strain), but the differences between groups were not statistically significant. Traditional TQ practice improves the antibody response to influenza vaccine in older adults, but further study is needed to determine whether the enhanced response is sufficient to provide definitive protection from influenza infection.

Publication Types:

Controlled Clinical Trial

PMID: 17708626 [PubMed - indexed for MEDLINE]

31: Top Stroke Rehabil. 2007 Jul-Aug;14(4):9-22.

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Tai Chi exercise and stroke rehabilitation.

Taylor-Piliae RE, Haskell WL.

School of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, California, USA.

According to reported global estimates, 15 million people suffer from a stroke each year, resulting in 5.5 million deaths, with 5 million left permanently disabled. Typical disabilities following stroke include poor neuromuscular control, hemodynamic imbalance, and negative mood state. Tai Chi (TC) is associated with better balance, lower blood pressure, and improved mood, which are important for stroke survivors. An overview of the philosophy and principles of TC exercise is provided, followed by a literature review of reported TC studies examining balance, blood pressure, and mood. Finally, the potential application of TC exercise to stroke rehabilitation is discussed.

Publication Types:

PMID: 17698454 [PubMed - indexed for MEDLINE]

32: J Am Geriatr Soc. 2007 Aug;55(8):1185-91.

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Comment in:

A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial.

Voukelatos A, Cumming RG, Lord SR, Rissel C.

Health Promotion Service, Sydney South West Area Health Service, Sydney, Australia.

OBJECTIVES: To determine the effectiveness of a 16-week community-based tai chi program in reducing falls and improving balance in people aged 60 and older. DESIGN: Randomized, controlled trial with waiting list control group. SETTING: Community in Sydney, Australia. PARTICIPANTS: Seven hundred two relatively healthy community-dwelling people aged 60 and older (mean age 69). INTERVENTION: Sixteen-week program of community-based tai chi classes of 1 hour duration per week. MEASUREMENTS: Falls during 16 and 24 weeks of follow-up were assessed using a calendar method. Balance was measured at baseline and 16-week follow-up using six balance tests. RESULTS: Falls were less frequent in the tai chi group than in the control group. Using Cox regression and time to first fall, the hazard ratio after 16 weeks was 0.72 (95% confidence interval (CI)=0.51-1.01, P=.06), and after 24 weeks it was 0.67 (95% CI=0.49-0.93, P=.02). There was no difference in the percentage of participants who had one or more falls. There were statistically significant differences in changes in balance favoring the tai chi group on five of six balance tests. CONCLUSION: Participation in once per week tai chi classes for 16 weeks can prevent falls in relatively healthy community-dwelling older people.

Publication Types:

PMID: 17661956 [PubMed - indexed for MEDLINE]

33: Med Sci Monit. 2007 Aug;13(8):CR339-48.

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Comment in:

Med Sci Monit. 2007 Dec;13(12):LE19-20.

Effect of combined Taiji and Qigong training on balance mechanisms: a randomized controlled trial of older adults.

Yang Y, Verkuilen JV, Rosengren KS, Grubisich SA, Reed MR, Hsiao-Wecksler ET.

Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA. yyang5@uiuc.edu

BACKGROUND: Taiji (T'ai Chi) has been shown to have generally positive effects on functional balance. However, few studies have investigated the mechanisms by which Taiji may improve balance. The goal of this study was to evaluate changes in sensory and biomechanical balance mechanisms as a consequence of a traditional Taiji exercise program for healthy older adults that intentionally emphasized both Taiji forms and Qigong meditation. MATERIAL/METHODS: This was a randomized controlled trial with blind testers. Forty-nine healthy older adults (mean age 80.4, SD. 8.6) were randomized to participate in Taiji-Qigong (TQ) training (N=33) or a wait-list control group (WC, N=16). TQ instruction was provided 1 hour/session, 3 sessions a week for six months. Somatosensory, visual, and vestibular ratios of the Sensory Organization Test, and quiet stance Base of Support (BoS) and feet opening angle measures were collected prior to instruction (T0), at two months (T2), and six months (T6). RESULTS: TQ group vestibular ratio scores (normalized to T0) were +22% and +47% greater than WC at T2 and T6, respectively. The TQ group exhibited an increase in quiet stance BoS over time but not feet opening angle, indicating that the increase in BoS was due to the adoption of wider stances. CONCLUSIONS: Improved use of vestibular input and wider stances are two mechanisms by which Taiji-Qigong training may improve healthy older adults' balance. Further study is needed to evaluate other balance mechanisms and the individual and combined effects of different aspects of traditional Taiji practice.

Publication Types:

PMID: 17660722 [PubMed - indexed for MEDLINE]

34: J Clin Nurs. 2007 Aug;16(8):1580-2.

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Erratum in:

J Clin Nurs. 2007 Sep;16(9):1592.

Effect of Tai Chi on state self-esteem and health-related quality of life in older Chinese residential care home residents.

Lee LY, Lee DT, Woo J.

Nursing Team, School of Science & Technology, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong, China. yklee@ouhk.edu.hk

Publication Types:

PMID: 17655547 [PubMed - indexed for MEDLINE]

35: Harv Health Lett. 2007 Jun;32(8):7.

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Tai chi gives immune system a boost.

[No authors listed]

Publication Types:

News

PMID: 17639624 [PubMed - indexed for MEDLINE]

36: Pain Med. 2007 May-Jun;8(4):359-75.

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Mind-body interventions for chronic pain in older adults: a structured review.

Morone NE, Greco CM.

Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. moronene@upmc.edu

STUDY DESIGN: We conducted a structured review of eight mind-body interventions for older adults with chronic nonmalignant pain. OBJECTIVES: To evaluate the feasibility, safety, and evidence for pain reduction in older adults with chronic nonmalignant pain in the following mind-body therapies: biofeedback, progressive muscle relaxation, meditation, guided imagery, hypnosis, tai chi, qi gong, and yoga. METHODS: Relevant studies in the MEDLINE, PsycINFO, AMED, and CINAHL databases were located. A manual search of references from retrieved articles was also conducted. Of 381 articles retrieved through search strategies, 20 trials that included older adults with chronic pain were reviewed. RESULTS: Fourteen articles included participants aged 50 years and above, while only two of these focused specifically on persons aged >or=65 years. An additional six articles included persons aged >or=50 years. Fourteen articles were controlled trials. There is some support for the efficacy of progressive muscle relaxation plus guided imagery for osteoarthritis pain. There is limited support for meditation and tai chi for improving function or coping in older adults with low back pain or osteoarthritis. In an uncontrolled biofeedback trial that stratified by age group, both older and younger adults had significant reductions in pain following the intervention. Several studies included older adults, but did not analyze benefits by age. Tai chi, yoga, hypnosis, and progressive muscle relaxation were significantly associated with pain reduction in these studies. CONCLUSION: The eight mind-body interventions reviewed are feasible in an older population. They are likely safe, but many of the therapies included modifications tailored for older adults. There is not yet sufficient evidence to conclude that these eight mind-body interventions reduce chronic nonmalignant pain in older adults. Further research should focus on larger, clinical trials of mind-body interventions to answer this question.

Publication Types:

PMID: 17610459 [PubMed - indexed for MEDLINE]

37: Am J Chin Med. 2007;35(3):369-81.

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Comparison of the effects of Tai Chi and resistance training on bone metabolism in the elderly: a feasibility study.

Shen CL, Williams JS, Chyu MC, Paige RL, Stephens AL, Chauncey KB, Prabhu FR, Ferris LT, Yeh JK.

Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA. Leslie.Shen@ttuhsc.edu

This feasibility study compared the effects of Tai Chi (TC) and resistance training (RT) on bone metabolism in the elderly. Twenty eight sedentary, elder adults, were randomized into either TC (n = 14, 78.8 +/-1.3 years) or RT (n = 14, 79.4 +/-2.2 years) to participate in 40 min of exercise per session, 3 sessions/week for 24 weeks. The outcome measures assessed were the concentrations of serum bone-specific alkaline phosphatase (BAP), pyridinoline (PYD), parathyroid hormone (PTH) and calcium, and urinary calcium. The TC group had a higher compliance rate than the RT group. After 6 weeks, (i) both TC and RT resulted in higher level of serum BAP relative to the baseline and the TC group exhibited a greater increase in serum BAP than the RT group; (ii) there was an increase of serum PYD in the RT group only, not in the TC group; and (iii) the BAP/PYD ratio was higher than baseline only in the TC group, and the increase of the ratio in the TC group was greater than that in the RT group. After 12 weeks, the increase in serum PTH in the TC group was higher than the RT group. After 24 weeks, there was a reduction of the urinary calcium level in the TC group relative to the baseline. In conclusion, these findings support that TC is beneficial for increasing bone formation in elderly, and long-term application is needed to substantiate the effect of TC as an alternative exercise in promotion of bone health.

Publication Types:

Randomized Controlled Trial

PMID: 17597496 [PubMed - indexed for MEDLINE]

38: Chang Gung Med J. 2007 Mar-Apr;30(2):128-34.

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Comparison of the effects of swimming and Tai Chi Chuan on body fat composition in elderly people.

Yu TY, Pei YC, Lau YC, Chen CK, Hsu HC, Wong AM.

Department of Rehabilitation, Chang Gung Memorial Hospital. 5, Fushing St., Gueishan Township, Taoyuan County 333, Taiwan, ROC.

BACKGROUND: Accumulation of fat and substantial loss of muscle mass are common phenomena in the elderly. In this study, we observed the effects of Tai Chi Chuan (TCC) and swimming, two exercises suitable for elderly people, on the percentage body fat and fat distribution by measuring subcutaneous adipose tissue thickness and body composition. METHODS: Subjects were divided into three groups: regular swimmers (n = 20), regular TCC practitioners (n = 32), and age-matched control subjects (n = 31). Subcutaneous adipose tissue thickness was taken using a Lange skinfold caliper at the chests, abdomens, and thighs in the men, and the triceps, suprailium, and thighs in the women. Mid-arm circumference (MAC) was measured on the non-dominant upper arm using fiberglass tape. Body composition was analyzed using the Inbody 3.0 logo, a bioelectrical impedance analysis (BIA) system. RESULTS: No significant differences were found between the three test groups in relation to total body adiposity and arm muscle circumference in the men and women. There was significantly less subcutaneous adipose tissue at the abdomen (p = 0.011) and thigh (p < 0.001) of TCC-group men and at the thighs (p < 0.001) of the swimming group compared with the control group. In women, only the thigh skinfold (p = 0.002) showed a decrease in the TCC group compared with the control group. CONCLUSION: Swimming and TCC may not decrease total fat adiposity in elderly men and women, however, they may change body fat distribution due to certain muscle group usage. The differences observed in the effects of exercise on body fat distribution between elderly women and men may be gender-related.

Publication Types:

PMID: 17596001 [PubMed - indexed for MEDLINE]

39: Diabetes Technol Ther. 2007 Jun;9(3):276-86.

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Does Tai Chi improve plantar sensory ability? A pilot study.

Richerson S, Rosendale K.

Biomedical Engineering Program, Milwaukee School of Engineering, Milwaukee, Wisconsin 53202, USA. richerss@msoe.edu

BACKGROUND: Aging adversely affects balance and increases the propensity to slip and fall. Loss of plantar sensation due to diabetic peripheral neuropathy and other diseases has been shown to further increase this propensity to fall. The ancient Chinese art of Tai Chi has been previously shown as a method to improve balance in healthy elderly adults. METHODS: The aim of this study was to determine if Tai Chi intervention improved both balance and plantar sensory perception in healthy elderly adults and elderly adults with diabetes and plantar sensory loss. Elderly subjects (mean +/- SD age = 73.1 +/- 5.9 years, n = 18) were tested for plantar sensory ability and several balance metrics before Tai Chi training and again after 6 months of weekly sessions. Participants were grouped by initial sensory perception scores (as measured by a vibrometer) in order to make inferences on the effects of Tai Chi on sensory perception. RESULTS: Plantar sensation results show all participants showed significant improvement in sensory ability with the 6 months of Tai Chi training. All groups also had a general improvement in all balance measures, with the greatest improvement seen in those subjects with large sensory losses. Hemoglobin A1C measurements also decreased as a result of the intervention. CONCLUSION: This study demonstrates the effectiveness of Tai Chi training as a method of improving plantar sensation and balance in elderly adults and elderly adults with diabetes with a large plantar sensation loss.

Publication Types:

PMID: 17561798 [PubMed - indexed for MEDLINE]

40: J Aging Phys Act. 2007 Apr;15(2):139-51.

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Tai Chi-based exercise for older adults with Parkinson's disease: a pilot-program evaluation.

Li F, Harmer P, Fisher KJ, Xu J, Fitzgerald K, Vongjaturapat N.

Oregon Research Institute, Eugene, OR 87403, USA.

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson's disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p < .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.

Publication Types:

Research Support, N.I.H., Extramural

PMID: 17556781 [PubMed - indexed for MEDLINE]

41: Arch Phys Med Rehabil. 2007 May;88(5):673-80.

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The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review.

Wayne PM, Kiel DP, Krebs DE, Davis RB, Savetsky-German J, Connelly M, Buring JE.

New England School of Acupuncture, Watertown, MA, USA. peter_wayne@hms.harvard.edu

OBJECTIVE: To evaluate the evidence for Tai Chi as an intervention to reduce rate of bone loss in postmenopausal women. DATA SOURCES: Literature search using Medline, Science Citation Index, Cochrane databases, China Biological Medicine Database, and additional manual reference searches of retrieved articles and personal libraries. STUDY SELECTION: Randomized controlled trials (RCTs), prospective cohort studies, and cross-sectional studies that included Tai Chi as an intervention, and had at least 1 outcome related to measurement of bone mineral density (BMD). DATA EXTRACTION: Authors critically reviewed studies, evaluated methodologic quality, and synthesized study results in a summary table. DATA SYNTHESIS: Six controlled studies were identified by our search. There were 2 RCTs, 2 nonrandomized prospective parallel cohort studies, and 2 cross-sectional studies. The 2 RCTs and 1 of the prospective cohort studies suggested that Tai Chi-naive women who participated in Tai Chi training exhibited reduced rates of postmenopausal declines in BMD. Cross-sectional studies suggested that long-term Tai Chi practitioners had higher BMD than age-matched sedentary controls, and had slower rates of postmenopausal BMD decline. No adverse effects related to Tai Chi were reported in any trial. CONCLUSIONS: Conclusions on the impact of Tai Chi on BMD are limited by the quantity and quality of research to date. This limited evidence suggests Tai Chi may be an effective, safe, and practical intervention for maintaining BMD in postmenopausal women. In combination with research that indicates Tai Chi can positively impact other risk factors associated with low BMD (eg, reduced fall frequency, increased musculoskeletal strength), further methodologically sound research is warranted to better evaluate the impact of Tai Chi practice on BMD and fracture risk in postmenopausal women.

Publication Types:

PMID: 17466739 [PubMed - indexed for MEDLINE]

42: Arthritis Rheum. 2007 Apr 15;57(3):407-14.

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Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes.

Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J.

The George Institute for International Health, University of Sydney, Sydney, Australia. mfransen@thegeorgeinstitute.org

OBJECTIVE: To determine whether Tai Chi or hydrotherapy classes for individuals with chronic symptomatic hip or knee osteoarthritis (OA) result in measurable clinical benefits. METHODS: A randomized controlled trial was conducted among 152 older persons with chronic symptomatic hip or knee OA. Participants were randomly allocated for 12 weeks to hydrotherapy classes (n = 55), Tai Chi classes (n = 56), or a waiting list control group (n = 41). Outcomes were assessed 12 and 24 weeks after randomization and included pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (Medical Outcomes Study Short Form 12 Health Survey [SF-12], version 2), psychological well-being, and physical performance (Up and Go test, 50-foot walk time, timed stair climb). RESULTS: At 12 weeks, compared with controls, participants allocated to hydrotherapy classes demonstrated mean improvements (95% confidence interval) of 6.5 (0.4, 12.7) and 10.5 (3.6, 14.5) for pain and physical function scores (range 0-100), respectively, whereas participants allocated to Tai Chi classes demonstrated improvements of 5.2 (-0.8, 11.1) and 9.7 (2.8, 16.7), respectively. Both class allocations achieved significant improvements in the SF-12 physical component summary score, but only allocation to hydrotherapy achieved significant improvements in the physical performance measures. All significant improvements were sustained at 24 weeks. In this almost exclusively white sample, class attendance was higher for hydrotherapy, with 81% attending at least half of the available 24 classes, compared with 61% for Tai Chi. CONCLUSION: Access to either hydrotherapy or Tai Chi classes can provide large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA.

Publication Types:

PMID: 17443749 [PubMed - indexed for MEDLINE]

43: J Am Geriatr Soc. 2007 Apr;55(4):511-7.

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Augmenting immune responses to varicella zoster virus in older adults: a randomized, controlled trial of Tai Chi.

Irwin MR, Olmstead R, Oxman MN.

Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, University of California at Los Angeles, Los Angeles, California, USA. mirwin1@ucla.edu

OBJECTIVES: To evaluate the effects of a behavioral intervention, Tai Chi, on resting and vaccine-stimulated levels of cell-mediated immunity (CMI) to varicella zoster virus (VZV) and on health functioning in older adults. DESIGN: A prospective, randomized, controlled trial with allocation to two arms (Tai Chi and health education) for 25 weeks. After 16 weeks of intervention, subjects were vaccinated with VARIVAX, the live attenuated Oka/Merck VZV vaccine licensed to prevent varicella. SETTING: Two urban U.S. communities between 2001 and 2005. PARTICIPANTS: A total of 112 healthy older adults aged 59 to 86. MEASUREMENTS: The primary endpoint was a quantitative measure of VZV-CMI. Secondary outcomes were scores on the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). RESULTS: The Tai Chi group showed higher levels of VZV-CMI than the health education group (P<.05), with a significant rate of increase (P<.001) that was nearly twice that found in the health education group. Tai Chi alone induced an increase in VZV-CMI that was comparable in magnitude with that induced by varicella vaccine, and the two were additive; Tai Chi, together with vaccine, produced a substantially higher level of VZV-CMI than vaccine alone. The Tai Chi group also showed significant improvements in SF-36 scores for physical functioning, bodily pain, vitality, and mental health (P<.05). CONCLUSION: Tai Chi augments resting levels of VZV-specific CMI and boosts VZV-CMI of the varicella vaccine.

Publication Types:

PMID: 17397428 [PubMed - indexed for MEDLINE]

44: Phys Ther. 2007 May;87(5):525-35. Epub 2007 Apr 3.

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Tai chi and perceived health status in older adults who are transitionally frail: a randomized controlled trial.

Greenspan AI, Wolf SL, Kelley ME, O'Grady M.

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-63, Atlanta, GA 30341, USA. AGreenspan@cdc.gov

BACKGROUND AND PURPOSE: Tai chi, a Chinese exercise derived from martial arts, while gaining popularity as an intervention for reducing falls in older adults, also may improve health status. The purpose of this study was to determine whether intense tai chi (TC) exercise could improve perceived health status and self-rated health (SRH) more than wellness education (WE) for older adults who are transitionally frail. SUBJECTS: Study subjects were 269 women who were >or=70 years of age and who were recruited from 20 congregate independent senior living facilities. METHODS: Participants took part in a 48-week, single-blind, randomized controlled trial. They were randomly assigned to receive either TC or WE interventions. Participants were interviewed before randomization and at 1 year regarding their perceived health status and SRH. Perceived health status was measured with the Sickness Impact Profile (SIP). RESULTS: Compared with WE participants, TC participants reported significant improvements in the physical dimension and ambulation categories and borderline significant improvements in the body care and movement category of the SIP. Self-rated health did not change for either group. DISCUSSION AND CONCLUSION: These findings suggest that older women who are transitionally frail and participate in intensive TC exercise demonstrate perceived health status benefits, most notably in ambulation.

Publication Types:

PMID: 17405808 [PubMed - indexed for MEDLINE]

45: J Sports Med Phys Fitness. 2007 Mar;47(1):96-102.

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Martial arts as sport and therapy.

Burke DT, Al-Adawi S, Lee YT, Audette J.

Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, USA. dburke1@partners.org

The term Martial Arts is often used as general phrase to describe many of the combat arts, which have developed in eastern cultures over the past millennium. This paper reviews the Martial Arts from the original context of a trio of life skills. This trio includes the healing arts such as acupuncture, the self-exploration arts such as yoga, and the vital life skills such as meditation. As Martial Arts suggests the waging of combat, the origins of the most common combat arts are reviewed, with an overview of the difference between the hard and the soft styles. The arts developed not only in the eastern, but also in all parts of the world, with references of these types of combats arts in the writings of the ancient Egyptians and Greeks. In modern times, the combat arts are performed for both exercise and sport. A review of the injuries that occur, and the health benefits that might be expected are discussed. A review of the medical literature that demonstrates some of these health benefits is included, with Tai Chi Chuan as the most studied of these. The health benefits discussed include strengthen and self-efficacy of the elderly, reduced falls, increased exercise capacity, and benefits to the immune system and autonomic nervous system. The paper emphasized the breadth of the Martial Arts and the import of these to the sports and health community.

Publication Types:

Review

PMID: 17369805 [PubMed - indexed for MEDLINE]

46: Age Ageing. 2007 May;36(3):262-8. Epub 2007 Mar 13.

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A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people.

Woo J, Hong A, Lau E, Lynn H.

Chinese University of Hong Kong, Department of Medicine and Therapeutics, Department of Community and Family Medicine, Shatin, NT, Hong Kong. jeanwoowong@cuhk.edu.hk

BACKGROUND: The beneficial role of exercise in improving bone mineral density, muscle strength and balance, has been documented predominantly in younger populations. These findings may not apply to elderly populations with limited ability to perform exercises of high intensity. OBJECTIVE: To examine the effects of Tai Chi (TC) and resistance exercise (RTE) on bone mineral density (BMD), muscle strength, balance and flexibility in community living elderly people. DESIGN: Randomised controlled trial, using blocked randomization with stratification by sex. SETTING: A community in the New Territories Region of Hong Kong, China. SUBJECTS: One hundred eighty subjects (90 men, 90 women) aged 65-74, were recruited through advertisements in community centres. METHODS: Subjects were assigned to participate in TC, RTE three times a week, or no intervention (C) for 12 months. Measurements were carried out at baseline, 6 and 12 months. Analyses of covariance (ANCOVA) adjusted for age, and baseline values of variables that were significantly different between groups: i.e. smoking and flexibility for men; quadriceps strength for women. RESULTS: Compliance was high (TC 81%, RTE 76%). In women, both TC and RTE groups had less BMD loss at total hip compared with controls. No effect was observed in men. No difference in either balance, flexibility or the number of falls was observed between either intervention or controls after 12 months. CONCLUSION: The beneficial effects of TC or RTE on musculoskeletal health are modest and may not translate into better clinical outcomes.

Publication Types:

PMID: 17356003 [PubMed - indexed for MEDLINE]

47: Diabetes Care. 2007 Mar;30(3):716-8.

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Tai chi chuan exercise decreases A1C levels along with increase of regulatory T-cells and decrease of cytotoxic T-cell population in type 2 diabetic patients.

Yeh SH, Chuang H, Lin LW, Hsiao CY, Wang PW, Yang KD.

Department of Nursing, Chang Gung Institute of Technology, Kwei-Shan, Taoyuan, Taiwan.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 17327347 [PubMed - indexed for MEDLINE]

48: Support Care Cancer. 2007 Jun;15(6):597-601. Epub 2007 Feb 21.

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Is Tai Chi an effective adjunct in cancer care? A systematic review of controlled clinical trials.

Lee MS, Pittler MH, Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK. myeong.lee@pms.ac.uk

BACKGROUND: Tai chi is a form of complementary and alternative medicine with similarities to aerobic exercises, which has been recommended for relieving cancer-related symptoms. The aim of this systematic review is to summarize and critically evaluate the evidence available from controlled clinical trials of tai chi as a supportive therapy for cancer patients. METHODS: We have searched the literature using 19 databases from their respective inceptions through October 2006, without language restrictions. Methodological quality was assessed using Jadad score. RESULTS: The searches identified 27 potentially relevant studies. Three randomised clinical trials (RCTs) and one non-randomised controlled trial (CCT) met our inclusion criteria. All of these trials assessed patients with breast cancer. Two RCTs reported significant differences in psychological and physiological symptoms compared to psychosocial support control. Most trials suffered from methodological flaws such as small sample size, inadequate study design and poor reporting. CONCLUSION: The evidence is not convincing enough to suggest that tai chi is an effective supportive treatment for cancer. Further research should attempt to answer the many open questions related to the usefulness of tai chi for supportive cancer care.

Publication Types:

Review

PMID: 17318592 [PubMed - indexed for MEDLINE]

49: Am J Chin Med. 2007;35(1):1-9.

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Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis.

Maciaszek J, Osiński W, Szeklicki R, Stemplewski R.

Institute of Theory of Physical Education and Anthropomotorics, University School of Physical Education, Poznań, Poland. jmaciaszek@awf.poznan.pl

The purpose of this study was to assess the effect of 18-week Tai Chi training on body balance in dynamic trial among elderly men. The study covered 49 subjects from age 60 to 82.1 years, who had osteopenia or osteoporosis. The subjects were recruited from the community by direct mailings and community efforts to participate in studies. The participants were randomly assigned to either the exercise intervention (n = 25) or control groups (n = 24). The Tai Chi group participated in an 18-week exercise class held for 45 min, twice a week. Body balance was assessed using a Computer Posturographic System PE 90 produced by the Military Institute of Aviation Medicine in Warsaw with modified software made in Pro-Med. During the measurement of body balance, the capacity to perform specific tasks was analyzed (deflections in the set scope and direction). In the Tai Chi group, an increase (p < or = 0.01) in effectiveness of balance task performance was noted from 80.95% to 84.45% after the training. In the control group, no statistically significant improvement in the level of body balance was found in the same period. Thus, an 18-week period of Tai Chi exercises twice a week for 45 min is beneficial for dynamic balance. It can be important for reducing fall risk factors.

Publication Types:

Randomized Controlled Trial

PMID: 17265545 [PubMed - indexed for MEDLINE]

50: Int J Nurs Stud. 2008 Apr;45(4):501-7. Epub 2007 Jan 11.

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The effects of a Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults living in long-term care facilities: a single group design with multiple time points.

Chen KM, Lin JN, Lin HS, Wu HC, Chen WT, Li CH, Kai Lo S.

School of Nursing, Fooyin University, 151 Chin-Hsueh Rd., Taliao Township, Kaohsiung 831, Taiwan. ns148@mail.fy.edu.tw

BACKGROUND: Studies support the positive effects that Tai Chi has on the physical health of older adults. However, many older adults residing in long-term care facilities feel too weak to practice traditional Tai Chi, and a more simplified style is preferred. OBJECTIVE: To test the effects of a newly-developed, Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults who resided in long-term care facilities. DESIGN: A single group design with multiple time points: three pre-tests, one month apart; four post-tests at one month, two months, three months, and six months after intervention started. SETTINGS: Two 300-400 bed veteran homes in Taiwan. PARTICIPANTS: The 51 male older adults were recruited through convenience sampling, and 41 of them completed six-month study. Inclusion criteria included: (1) aged 65 and over; (2) no previous training in Tai Chi; (3) cognitively alert and had a score of at least eight on the Short Portable Mental Status Questionnaire; (4) able to walk without assistance; and (5) had a Barthel Index score of 61 or higher. Participants who had dementia, were wheel-chair bound, or had severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses were excluded. METHODS: The STEP was implemented three times a week, 50 min per session for six months. The outcome measures included cardio-respiratory function, blood pressure, balance, hand-grip strength, lower body flexibility, and physical health actualization. RESULTS: A drop in systolic blood pressure (p=.017) and diastolic blood pressure (p<.001) was detected six months after intervention started. Increase in hand-grip strength from pre to post intervention was found (left hand: p<.001; right hand: p=.035). Participants also had better lower body flexibility after practicing STEP (p=.038). CONCLUSIONS: Findings suggest that the STEP be incorporated as a floor activity in long-term care facilities to promote physical health of older adults.

Publication Types:

PMID: 17222413 [PubMed - indexed for MEDLINE]

51: J Am Geriatr Soc. 2006 Dec;54(12):1825-31.

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Dynamic balance and stepping versus tai chi training to improve balance and stepping in at-risk older adults.

Nnodim JO, Strasburg D, Nabozny M, Nyquist L, Galecki A, Chen S, Alexander NB.

Mobility Research Center, Division of Geriatric Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.

OBJECTIVES: To compare the effect of two 10-week balance training programs, Combined Balance and Step Training (CBST) versus tai chi (TC), on balance and stepping measures. DESIGN: Prospective intervention trial. SETTING: Local senior centers and congregate housing facilities. PARTICIPANTS: Aged 65 and older with at least mild impairment in the ability to perform unipedal stance and tandem walk. INTERVENTION: Participants were allocated to TC (n = 107, mean age 78) or CBST, an intervention focused on improving dynamic balance and stepping (n = 106, mean age 78). MEASUREMENTS: At baseline and 10 weeks, participants were tested in their static balance (Unipedal Stance and Tandem Stance (TS)), stepping (Maximum Step Length, Rapid Step Test), and Timed Up and Go (TUG). RESULTS: Performance improved more with CBST than TC, ranging from 5% to 10% for the stepping tests (Maximum Step Length and Rapid Step Test) and 9% for TUG. The improvement in TUG represented an improvement of more than 1 second. Greater improvements were also seen in static balance ability (in TS) with CBST than TC. CONCLUSION: Of the two training programs, in which variants of each program have been proven to reduce falls, CBST results in modest improvements in balance, stepping, and functional mobility versus TC over a 10-week period. Future research should include a prospective comparison of fall rates in response to these two balance training programs.

Publication Types:

PMID: 17198486 [PubMed - indexed for MEDLINE]

52: J Gerontol A Biol Sci Med Sci. 2006 Nov;61(11):1177-80.

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Tai Chi Chih acutely decreases sympathetic nervous system activity in older adults.

Motivala SJ, Sollers J, Thayer J, Irwin MR.

Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience & Human Behavior, 300 Medical Plaza, Suite 3148, Los Angeles, California 90095-7057, USA. smotivala@mednet.ucla.edu

BACKGROUND: Aging is associated with increases of sympathetic nervous system activation implicated in the onset of hypertension and cardiovascular disease. The purpose of this study was to examine whether the practice of Tai Chi Chih (TCC), a movement-based relaxation practice, would acutely promote decreases of sympathetic activity in elderly persons. METHOD: The sample included two groups of older men and women (age > or = 60 years): TCC practitioners (n = 19) and TCC-naïve participants (n = 13). Participants were recruited after completing a 25-week randomized trial of TCC or health education. TCC practitioners performed TCC for 20 minutes, and TCC-naïve participants passively rested. Preejection period, blood pressure, and heart rate were measured before and after the task. A subsample (n = 8) returned for a second evaluation and performed videotape-guided stretching for 20 minutes to evaluate the effects of slow-moving physical activity on sympathetic activity. RESULTS: Results showed that TCC performance significantly decreased sympathetic activity as indexed by preejection period (p =.01). In contrast, there was no change in preejection period following passive rest or slow-moving physical activity. Neither blood pressure nor heart rate changed after TCC performance. DISCUSSION: This study is the first to our knowledge to assess the acute effects of TCC practice on sympathetic activity in older adults. TCC performance led to acute decreases in sympathetic activity, which could not be explained by physical activity alone. Further study is needed to determine whether the acute salutary effects of TCC on autonomic functioning are sustained with ongoing practice in older adults.

Publication Types:

PMID: 17167159 [PubMed - indexed for MEDLINE]

53: Am J Chin Med. 2006;34(6):959-68.

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Comparison of the effects of Tai Chi Chuan and Wai Tan Kung exercises on autonomic nervous system modulation and on hemodynamics in elder adults.

Lu WA, Kuo CD.

Department of Traditional Medicine, Ren-Ai Branch, Taipei City Hospital, Institute of Traditional Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.

The health of the middle-aged and elderly people is a major concern given the rapid aging population and rising costs of medical care. Low-impact exercise on a regular basis is ideal for maintaining the well-being of an aging population. Tai Chi Chuan (TCC) is the most well-known and most widely practiced form of low-impact martial arts therapy and has been shown to have positive health effects. A lesser-known form of martial arts therapy is Wai Tan Kung (WTK), which our previous study found to have positive health effects as well. The present study compares the effects of TCC and WTK on autonomic nervous system modulation and on hemodynamics in adults among non-exercising control (30), TCC practitioners (30) and WTK practitioners (30). Our study found that in a short-term, WTK and TCC exercises enhanced the vagal modulation, lowered the sympathetic modulation and lowered arterial blood pressures in the practitioners. It was also observed that the forced vital capacity of TCC practitioners was significantly higher than that of WTK practitioners before exercise. There were no significant differences in the percentage changes in HRV measures and hemodynamics between WTK and TCC practitioners 30 and 60 min after exercise, indicating that the effects of WTK and TCC were similar in magnitude. In conclusion, TCC and WTK are comparable to each other in terms of their effects on autonomic nervous system modulation and hemodynamics, thus suggesting that WTK can be just as beneficial as TCC as a form of low-impact exercise for elderly adults.

Publication Types:

PMID: 17163585 [PubMed - indexed for MEDLINE]

54: WMJ. 2006 Oct;105(7):42-6.

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Therapeutic benefits of Tai Chi exercise: research review.

Kuramoto AM.

University of Wisconsin-Milwaukee College of Nursing, WI, USA. alicek@uwm.edu

The majority of studies on Tai Chi conducted between 1996 and 2004 had focused on health and well being of Tai Chi exercise for senior adults. The results show that Tai Chi may lead to improved balance, reduced fear of falling, increased strength, increased functional mobility, greater flexibility, and increased psychological well-being, sleep enhancement for sleep disturbed elderly individuals, and increased cardio functioning. Wang, Collet, and Lau did a systematic review on Tai Chi research and found some limitations or biases existing in some of the studies, and it was difficult to draw firm conclusions about the benefits reported. Therefore, more well-designed studies are needed in the future. There need to be studies on the effects on younger and middle-aged people. More longitudinal studies are needed, since time is an important factor of physical and psychological interventions. Studies on the effects of Tai Chi on the immune system and bone loss reduction are still very exploratory and will be especially useful for arthritis patients and others with immune disorders. Future studies should investigate outcomes associated with Tai Chi training as a function of different instructional techniques, different Tai Chi styles, different diagnostic groups, and different age groups. It is not yet clear which of the components in Tai Chi makes the exercise form especially effective for seniors. Tai Chi exercise is a relatively "low tech" approach to preventing disability and maintaining physical performance in older adults. The positive effects of Tai Chi may be due solely to its relaxing, meditative aspects. The current data suggest that Tai Chi can influence older individuals' functioning and well being and provide some appreciation for why this exercise form has been practiced by older Chinese for more than 3 centuries.

Publication Types:

Review

PMID: 17163086 [PubMed - indexed for MEDLINE]

55: J Altern Complement Med. 2006 Nov;12(9):841-2.

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Erratum in:

J Altern Complement Med. 2006 Dec;12(10):1041. McCrum, Sarah [added].

Comment on:

J Altern Complement Med. 2006 May;12(4):351-3.

Qigong: life energy and a new science of life.

Hankey A, McCrum S.

Publication Types:

PMID: 17109573 [PubMed - indexed for MEDLINE]

: Using Tai Chi to teach gerontology.

Schafer PA.

University of Arkansas for Medical Sciences, College of Nursing, USA. SchaferPatricia@uams.edu

Pedagogically, this program included discussing attitudes about aging, learning-by-doing of new skills, and experiencing active older adults as peers during the tai chi class. Students reported gaining insight into the aging process by comparing and contrasting their movements with those of the older adults. Students' clinical logs included positive comments about the experience. They expressed a global concept of the needs of healthy and unhealthy older adults and an exploration of nurses' role in geriatric health promotion.

PMID: 17058699 [PubMed - indexed for MEDLINE]

57: Phys Ther. 2006 Sep;86(9):1189-201.

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Community-based tai chi and its effect on injurious falls, balance, gait, and fear of falling in older people.

Lin MR, Hwang HF, Wang YW, Chang SH, Wolf SL.

Institute of Injury Prevention and Control, Taipei Medical University, 250 Wu-Hsing St, Taipei 110, Taiwan, Republic of China. mrlin@tmu.edu.tw

BACKGROUND AND PURPOSE: It is important to determine the effect of adherence to a tai chi program on falls and related functional outcomes in older people. This study examined the effect of a community-based tai chi program on injurious falls, balance, gait, and fear of falling among people aged 65 years and older in Taiwan. SUBJECTS AND METHODS: In 6 rural villages in Taichung County, 1,200 subjects participated in the initial assessment. During a 1-year intervention period, all study villages were provided with education on fall prevention. Two villages had been provided tai chi exercise (n=472 participants or "tai chi villagers"), and 4 villages served as control villages (n=728 participants or "control villagers"). Injurious falls were ascertained by telephone interviews every 3 months over a 2-year study period; additionally, balance, gait, and fear of falling were assessed in 2 follow-up assessments. RESULTS: Eighty-eight subjects, 83 from the tai chi villages and 5 from the control villages, participated and practiced in the tai chi program (the group labeled "tai chi practitioners"). After the tai chi program, injurious falls among the control villagers significantly declined by 44% (adjusted rate ratio [RR]=0.56; 95% confidence interval [CI]=0.36-0.92). Compared with the results for the control villagers, the decline was 31% greater (RR=0.69; 95% CI=0.30-1.56) among the tai chi villagers and 50% greater (RR=0.5; 95% CI=0.11-2.17) among the tai chi practitioners; the results did not reach statistical significance. Furthermore, compared with the scores for the control villagers, the scores for the tai chi practitioners increased by 1.8 points (95% CI=0.2-3.4) on the Tinetti Balance Scale and increased by 0.9 point (95% CI=0.1-1.8) on the Tinetti Gait Scale. No significant changes in the fear of falling were detected among the tai chi practitioners, tai chi villagers, and control villagers. DISCUSSION AND CONCLUSION: Tai chi can prevent a decline in functional balance and gait among older people. However, the reduction in injurious falls attained with tai chi did not reach statistical significance; the statistical inefficiency may have resulted partly from the large decline in injurious falls in control villagers. Finally, the unexpected effect of educational intervention on reducing injurious falls in different settings needs to be further examined.

Publication Types:

PMID: 16959668 [PubMed - indexed for MEDLINE]

58: Diabetes Care. 2006 Sep;29(9):2120-2.

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Mobility impairment in type 2 diabetes: association with muscle power and effect of Tai Chi intervention.

Orr R, Tsang T, Lam P, Comino E, Singh MF.

Exercise and Sport Science Department, University of Sydney, P.O. Box 170, Lidcombe, Sydney, NSW 1825, Australia. r.orr@fhs.usyd.edu.au

Publication Types:

PMID: 16936164 [PubMed - indexed for MEDLINE]

59: Int J Cardiol. 2007 May 2;117(3):293-5. Epub 2006 Aug 9.

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Tai Chi: the Chinese ancient wisdom of an ideal exercise for cardiac patients.

Cheng TO.

Publication Types:

PMID: 16904211 [PubMed - indexed for MEDLINE]

60: Integr Cancer Ther. 2006 Sep;5(3):192-201.

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Tai chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors.

Mansky P, Sannes T, Wallerstedt D, Ge A, Ryan M, Johnson LL, Chesney M, Gerber L.

Division of Intramural Research, National Center for Complementary and Alternative Medicine, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-1302, USA. manskyp@mail.nih.gov

Tai chi chuan (TCC) has been used as a mind-body practice in Asian culture for centuries to improve wellness and reduce stress and has recently received attention by researchers as an exercise intervention. A review of the English literature on research in TCC published from 1989 to 2006 identified 20 prospective, randomized, controlled clinical trials in a number of populations, including elderly participants (7 studies), patients with cardiovascular complications (3 studies), patients with chronic disease (6 studies), and patients who might gain psychological benefit from TCC practice (2 studies). However, only the studies of TCC in the elderly and 2 studies of TCC for cardiovascular disease had adequate designs and size to allow conclusions about the efficacy of TCC. Most (11 studies) were small and provided limited information on the benefit of TCC in the settings tested. There is growing awareness that cancer survivors represent a population with multiple needs related to physical deconditioning, cardiovascular disease risk, and psychological stress. TCC as an intervention may provide benefit to cancer survivors in these multiple areas of need based on its characteristics of combining aspects of meditation and aerobic exercise. However, little research has been conducted to date to determine the benefit of TCC in this population. We propose a model to study the unique characteristics of TCC compared to physical exercise that may highlight characteristic features of this mind-body intervention in cancer survivors.

Publication Types:

PMID: 16880423 [PubMed - indexed for MEDLINE]

: Feasibility of computer-assisted Tai Chi education.

Li J, Sharma K, Finkelstein J.

Department of Epidemiology and Preventive MedicineUniversity of Maryland, Baltimore, MD, USA.

This study is an initial effort to examine the efficiency of a computer assisted Tai Chi educational model for learning the basics of Tai Chi, a Chinese exercise regime.

PMID: 16779314 [PubMed - indexed for MEDLINE]
PMCID: PMC1560746

62: Arch Phys Med Rehabil. 2006 Jun;87(6):814-20.

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Plantar pressure distribution during Tai Chi exercise.

Mao de W, Li JX, Hong Y.

Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, NT, Hong Kong.

OBJECTIVES: To describe and quantify the plantar pressure distribution characteristics during Tai Chi exercise and to explain the beneficial effect of Tai Chi on balance control and muscle strength when compared with normal walking. DESIGN: Description and within-subject design. SETTING: A biomechanics laboratory. PARTICIPANTS: Sixteen experienced Tai Chi practitioners. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Pressure-time integral, ground reaction force, and displacement of center of pressure (COP). RESULTS: During Tai Chi movements, the loading of the first metatarsal head and the great toe were significantly greater than in other regions (P<.05). The ground reaction forces varied between the Tai Chi movements and normal walking. Compared with normal walking, the locations of the COP in the Tai Chi movements were significantly more medial and posterior at initial contact (P<.05), and were significantly more medial and anterior at the end of contact with the ground (P<.05). The displacements of the COP were significantly wider (P<.05) in the mediolateral direction in the forward, backward, and sideways Tai Chi movements. The displacement was significantly larger (P<.05) in the anteroposterior direction in the forward movement. CONCLUSIONS: The plantar pressure characteristics of Tai Chi movements found in this study may be one of the important factors that Tai Chi exercise improves balance control and muscle strength.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 16731217 [PubMed - indexed for MEDLINE]

63: J Electromyogr Kinesiol. 2007 Jun;17(3):372-80. Epub 2006 May 24.

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Muscle activation profiles about the knee during Tai-Chi stepping movement compared to the normal gait step.

Tseng SC, Liu W, Finley M, McQuade K.

Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA.

The purpose of this study was to investigate knee muscle activity patterns in experienced Tai-Chi (TC) practitioners during normal walking and TC stepping. The electromyographic (EMG) activity of vastus lateralis (VL), vastus medialis (VM), bicep femoris (BF), and gastrocnemius (GS) muscles of 11 subjects (five females and six males) during the stance phase of normal walking was compared to stance phase of a TC step. Knee joint motion was also monitored by using an Optotrak motion analysis system. Raw EMG was processed by root-mean-square (RMS) technique using a time constant of 50 ms, and normalized to maximum of voluntary contraction for each muscle, referred to as normalized RMS (nRMS). Peak nRMS and co-contraction (quantified by co-contraction index) during stance phase of a gait cycle and a TC step were calculated. Paired t-tests were used to compare the difference for each muscle group peak and co-contraction pair between the tasks. The results showed that only peak values of nRMS in quadriceps and co-contraction were significantly greater in TC stepping compared to normal walking (Peak values of nRMS for VL were 26.93% for normal walking and 52.14% for TC step, p=0.001; VM are 29.12% for normal walking and 51.93% for TC stepping, p=0.028). Mean co-contraction index for VL-BF muscle pairs was 13.24+/-11.02% during TC stepping and 9.47+/-7.77% in stance phase of normal walking (p=0.023). There was no significant difference in peak values of nRMS in the other two muscles during TC stepping compared to normal walking. Preliminary EMG profiles in this study demonstrated that experienced TC practitioners used relatively higher levels of knee muscle activation patterns with greater co-contraction during TC exercise compared to normal walking.

Publication Types:

Comparative Study

PMID: 16723260 [PubMed - indexed for MEDLINE]

64: J Altern Complement Med. 2006 May;12(4):351-3.

Related Articles, Links

Comment in:

J Altern Complement Med. 2006 Nov;12(9):841-2.

Comment on:

J Altern Complement Med. 2006 May;12(4):373-8.

Qigong: where did it come from? Where does it fit in science? What are the advances?

Shinnick P.

Publication Types:

PMID: 16722782 [PubMed - indexed for MEDLINE]

: The characteristics of foot movements in Tai Chi Chuan.

Chau KW, Mao DW.

Physiotherapy Department, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR. hkkawai@hotmail.com

This study examines how the characteristics of the foot movements in Tai Chi Chuan (TCC) contribute to a practitioner's health by improving his or her balance and reducing the risk of fall. Ten TCC masters are video-taped, and the time spent on different support patterns (step stance) and stepping directions (footwork) while performing the 42-form TCC is analyzed. In support patterns, it is found that a larger percentage of time is spent on the double leg stance (35.08 +/- 4.92) than on the single leg stance (Left: 17.67 +/- 7.71; Right: 17.29 +/- 2.23) and one leg support with another leg partially supporting type of stance (6.51 +/- 8.77). With regard to stepping directions, the centre footwork (25.25 +/- 10.20) requires a larger percentage of time than the forward (18.29 +/- 3.36), sideway (20.80 +/- 4.76), grinding (20.42 +/- 7.61), upward (11.55 +/- 1.49), and backward footwork (3.67 +/- 1.33). The movements classified are shown to simulate balance, flexibility and proprioception, and functional training. The findings partially explain the relationship between practising TCC and its health benefits. Further studies are suggested to investigate the health benefits that can be derived from other specific TCC movements.

PMID: 16700402 [PubMed - indexed for MEDLINE]

66: Gait Posture. 2007 Feb;25(2):205-14. Epub 2006 May 2.

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How Tai Chi improves balance: biomechanics of recovery to a walking slip in impaired seniors.

Gatts SK, Woollacott MH.

Department of Human Physiology, University of Oregon, Eugene, OR 97403, United States. sgatts@uic.edu

BACKGROUND AND AIMS: This study examined the effect of Tai Chi (TC) training on biomechanical responses to large, fast walking perturbations in balance-impaired seniors. METHODS: Twenty-two seniors (age 68-92, BERG 44 or less) with surgical interventions to knees, hips, and back were randomly divided into control or TC groups. Groups trained 1.5h/day, 5 days/week for 3 weeks. Controls received TC training after post-control testing. Subjects walked across a force plate triggered to move forward 15cm at 40cm/s at right heel strike (RHS). Kinematics, center of pressure (COP) and center of mass (COM) responses were measured. RESULTS: TC but not control training significantly reduced tripping (p<or=0.005), medial cross-step distance (p<or=0.038), and increased use of swing leg heel strike (p<or=0.001). COM anterior-posterior (A/P) path significantly increased after TC (p<or=0.017) but not control training. TC training showed a trend toward increased COM-COP A/P angular separation at RHS (p<0.067). CONCLUSIONS: Tai Chi training significantly enhanced balance responses by more efficacious use of mechanisms controlling stepping strategies of the swing leg. COM A/P path significantly increased after TC implying improved ability to tolerate unsteadiness. COM-COP A/P separation angle at RHS increased suggesting a longer step and increased mechanical loading at the hip.

Publication Types:

Randomized Controlled Trial

PMID: 16672187 [PubMed - indexed for MEDLINE]

67: Age Ageing. 2006 Jul;35(4):388-93. Epub 2006 Apr 19.

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Tai Chi versus brisk walking in elderly women.

Audette JF, Jin YS, Newcomer R, Stein L, Duncan G, Frontera WR.

Spaulding Rehabilitation Hospital, Department of Physical Medicine & Rehabilitation, Harvard Medical School, 125 Nashua Street, Boston, MA 02114, USA. jaudette@partners.org

PURPOSE: to compare the effects of a short style of Tai Chi versus brisk walking training programme on aerobic capacity, heart rate variability (HRV), strength, flexibility, balance, psychological status and quality of life in elderly women. METHODS: nineteen community-dwelling, sedentary women (aged 71.4 +/- 4.5 years) were randomly assigned to Tai Chi Chuan (TCC; n = 11) or brisk walking group (BWG; n = 8). A separate group of elderly women was recruited from the same population to act as a sedentary comparison group (SCG; n = 8). The exercise groups met for 1 h, three days per week for 12 weeks. Outcomes measured before and after training included estimated VO2max, spectral analysis of HRV (high-frequency, low-frequency power as well as high- and low-frequency power in normalised units) as a measure of autonomic control of the heart, isometric knee extension and handgrip muscle strength, single-leg stance time, the State Trait Anxiety Inventory (STAI), Profile of Mood States (POMS) and Short Form-36 (SF-36) questionnaires. RESULTS: significant improvement was seen in estimated VO(2)max in the TCC group (TCC versus SCG P = 0.003, TCC versus BWG P = 0.08). The mean within-person change of high-frequency power in normalised units (HFnu) increased [8.2 (0.14-16.3)], representing increased parasympathetic activity, and low-frequency power in normalised units (LFnu) decreased [-8.7 (-16.8-0.5)], representing decreased sympathetic activity, in the TCC group only. Significant gains were also seen in the non-dominant knee extensor strength and single-leg stance time (TCC versus BWG P < 0.05). CONCLUSIONS: a short style of TCC was found to be an effective way to improve many fitness measures in elderly women over a 3-month period. TCC was also found to be significantly better than brisk walking in enhancing certain measures of fitness including lower extremity strength, balance and flexibility.

Publication Types:

PMID: 16624847 [PubMed - indexed for MEDLINE]

68: J Adv Nurs. 2006 May;54(3):313-29.

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Change in perceived psychosocial status following a 12-week Tai Chi exercise programme.

Taylor-Piliae RE, Haskell WL, Waters CM, Froelicher ES.

Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, California 94305-5705, USA. rpiliae@stanford.edu

AIM: This paper reports a study to examine change in psychosocial status following a 12-week Tai Chi exercise intervention among ethnic Chinese people with cardiovascular disease risk factors living in the United States of America. BACKGROUND: Regular participation in physical activity is associated with protection against cardioavascular disease, and improvements in physical and psychological health. Increasing amounts of scientific evidence suggests that mind-body exercise, such as Tai Chi, are related to improvements in mental health, emotional well-being, and stress reduction. No prior study has examined the effect of a Tai Chi exercise intervention on psychosocial status among people with cardiovascular disease risk factors. METHODS: This was a quasi-experimental study. Participants attended a 60-minute Tai Chi exercise class three times per week for 12 weeks. Data were collected at baseline, 6 and 12 weeks following the intervention. Psychosocial status was assessed using Chinese versions of Cohen's Perceived Stress Scale, Profile of Mood States, Multidimensional Scale of Perceived Social Support, and Tai Chi exercise self-efficacy. RESULTS: A total of 39 participants, on average 66-year-old (+/-8.3), married (85%), Cantonese-speaking (97%), immigrants participated. The majority were women (69%), with < or =12 years education (87%). Statistically significant improvements in all measures of psychosocial status were found (P < or = 0.05) following the intervention. Improvement in mood state (eta2 = 0.12), and reduction in perceived stress (eta2 = 0.13) were found. In addition, Tai Chi exercise statistically significantly increased self-efficacy to overcome barriers to Tai Chi (eta2 = 0.19), confidence to perform Tai Chi (eta2 = 0.27), and perceived social support (eta2 = 0.12). CONCLUSIONS: Tai Chi was a culturally appropriate mind-body exercise for these older adults, with statistically significant psychosocial benefits observed over 12-weeks. Further research examining Tai Chi exercise using a randomized clinical trial design with an attention-control group may reduce potential confounding effects, while exploring potential mechanisms underlying the relaxation response associated with mind-body exercise. In addition, future studies with people with other chronic illnesses in all ethnic groups are recommended to determine if similar benefits can be achieved.

Publication Types:

PMID: 16629916 [PubMed - indexed for MEDLINE]

69: Aging Clin Exp Res. 2006 Feb;18(1):7-19.

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Neural mechanisms underlying balance improvement with short term Tai Chi training.

Gatts SK, Woollacott MH.

Department of Human Physiology and Institute of Neuroscience, University of Oregon, Eugene, OR 97403, USA. sgatts@uoneuro.uogregon.edu

BACKGROUND AND AIMS: Though previous research has shown that Tai Chi reduces falls risk in older adults, no studies have examined underlying neural mechanisms responsible for balance improvement. We aimed to determine the efficacy of Tai Chi training in improving neuromuscular response characteristics underlying balance control in balance-impaired older adults. METHODS: Twenty-two balance-impaired older adults were randomly divided into Tai Chi (TC) or control groups. Nineteen subjects (age 68-92, BERG 44 or less) completed the study. TC training included repetitive exercises using TC motor and biomechanical strategies, techniques, and postural elements. Control training included axial mobility exercises, balance/awareness education and stress reduction. Groups trained 1.5 hours/day, 5 days/week for 3 weeks. After post-testing the control group received TC training. Subjects walked across a force plate triggered to move forward 15 cm at 40 cm/sec at heel strike. Tibialis anterior (TA) and medial gastrocnemius (GA) responses during balance recovery were measured with electromyograms (EMGs). Four clinical measures of balance were also recorded. RESULTS: TC subjects, but not controls, significantly reduced both TA response time from 148.92 +/- 45.11 ms to 98.67 +/- 17.22 ms (p < or = 0.004) and occurrence of co-contraction of antagonist muscles (p < or = 0.003) of the perturbed leg. Clinical balance measures also significantly improved after TC. CONCLUSIONS: TC enhanced neuromuscular responses controlling the ankle joint of the perturbed leg. Fast, accurate neuromuscular activation is crucial for efficacious response to slips or trips.

Publication Types:

Randomized Controlled Trial

PMID: 16608131 [PubMed - indexed for MEDLINE]

70: BMC Geriatr. 2006 Mar 30;6:6.

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The effect of Tai Chi Chuan in reducing falls among elderly people: design of a randomized clinical trial in the Netherlands [ISRCTN98840266].

Zeeuwe PE, Verhagen AP, Bierma-Zeinstra SM, van Rossum E, Faber MJ, Koes BW.

Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. p.zeeuwe@erasmusmc.nl

BACKGROUND: Falls are a significant public health problem. Thirty to fifty percent of the elderly of 65 years and older fall each year. Falls are the most common type of accident in this age group and can result in fractures and subsequent disabilities, increased fear of falling, social isolation, decreased mobility, and even an increased mortality. Several forms of exercise have been associated with a reduced risk of falling and with a wide range of physiological as well as psychosocial health benefits. Tai Chi Chuan seems to be the most promising form of exercise in the elderly, but the evidence is still controversial.In this article the design of a randomized clinical trial is presented. The trial evaluates the effect of Tai Chi Chuan on fall prevention and physical and psychological function in older adults. METHODS/DESIGN: 270 people of seventy years and older living at home will be identified in the files of the participating general practitioners. People will be asked to participate when meeting the following inclusion criteria: have experienced a fall in the preceding year or suffer from two of the following risk factors: disturbed balance, mobility problems, dizziness, or the use of benzodiazepines or diuretics. People will be randomly allocated to either the Tai Chi Chuan group (13 weeks, twice a week) or the no treatment control group.The primary outcome measure is the number of new falls, measured with a diary. The secondary outcome measures are balance, fear of falling, blood pressure, heart rate, lung function parameters, physical activity, functional status, quality of life, mental health, use of walking devices, medication, use of health care services, adjustments to the house, severity of fall incidents and subsequent injuries. Process parameters will be measured to evaluate the Tai Chi Chuan intervention. A cost-effectiveness analysis will be carried out alongside the evaluation of the clinical results. Follow-up measurements will be collected at 3, 6 and 12 months after randomization. DISCUSSION: As far as we know this is the first trial in Europe considering Tai Chi Chuan and fall prevention. This project will answer a pragmatic research question regarding the efficacy of Tai Chi Chuan regarding fall reduction.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 16573825 [PubMed - indexed for MEDLINE]

PMCID: PMC1513573

71: J Support Oncol. 2006 Mar;4(3):139-45.

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A pilot study to assess the influence of tai chi chuan on functional capacity among breast cancer survivors.

Mustian KM, Katula JA, Zhao H.

University of Rochester School of Medicine and Dentistry, James P Wilmot Cancer Center, Department of Radiation Oncology, Behavioral Medicine Unit, Rochester, NY 14642, USA. Karen_Mustian@urmc.rochester.edu

Treatment of breast cancer can significantly diminish functional capacity in patients months and even years after the completion of treatments. Tai chi chuan (TCC) is a moderate form of exercise that may be an effective therapy for improving functional capacity among breast cancer survivors. We sought to provide pilot data comparing the efficacy of TCC and psychosocial therapy (PST; physical activity control) for improving functional capacity among breast cancer survivors post treatment. Twenty-one women who had completed treatment of breast cancer were randomized to receive TCC or PST 3 times/wk for 12 weeks. Functional capacity was assessed at baseline and at 12 weeks. The TCC group demonstrated significant improvement in functional capacity (specifically aerobic capacity, muscular strength, and flexibility) whereas the PST group showed significant improvement in flexibility only. These data suggest that TCC may be an efficacious intervention for enhancing functional capacity among breast cancer survivors and may support the need for larger randomized, controlled clinical trials to further elucidate these relationships.

Publication Types:

PMID: 16553140 [PubMed - indexed for MEDLINE]

72: Br J Sports Med. 2006 Mar;40(3):239-43.

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Regular tai chi chuan exercise enhances functional mobility and CD4CD25 regulatory T cells.

Yeh SH, Chuang H, Lin LW, Hsiao CY, Eng HL.

Chang Gung Institute of Technology, Kaohsiung, Taiwan. y470912@adm.cgmh.org.tw

BACKGROUND: The duration and vigour of physical exercise are widely considered to be critical elements that may positively or negatively affect physical health and immune response. OBJECTIVES: To investigate the effect of a 12 week programme of regular tai chi chuan exercise (TCC) on functional mobility, beliefs about benefits of exercise on physical and psychological health, and immune regulation in middle aged volunteers. METHODS: This quasi-experimental research design involving one group with testing before and after the programme was conducted to measure the effect of 12 weeks of TCC exercise in 14 men and 23 women from the normal community. RESULTS: Regular TCC exercise had a highly significant positive effect on functional mobility (p = 0.001) and beliefs about the health benefits of exercise (p = 0.013) in the 37 participants. Total white blood cell and red blood cell count did not change significantly, but a highly significant (p<0.001) decrease in monocyte count occurred. A significant (p = 0.05) increase in the ratio of T helper to suppressor cells (CD4:CD8) was found, along with a significant (p = 0.015) increase in CD4CD25 regulatory T cells. Production of the regulatory T cell mediators transforming growth factor beta and interleukin 10 under specific antigen stimulation (varicella zoster virus) was also significantly increased after this exercise programme. CONCLUSIONS: A 12 week programme of regular TCC exercise enhances functional mobility, personal health expectations, and regulatory T cell function.

Publication Types:

Research Support, Non-U.S. Gov't

PMID: 16505081 [PubMed - indexed for MEDLINE]

73: Appl Nurs Res. 2006 Feb;19(1):2-9.

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Research on psychoneuroimmunology: tai chi as a stress management approach for individuals with HIV disease.

Robins JL, McCain NL, Gray DP, Elswick RK Jr, Walter JM, McDade E.

Integrating Wellness, Inc., Richmond, VA 23235, USA.

Psychoneuroimmunology is a framework for mind-body practice and research that combines cutting-edge scientific exploration with holistic philosophy to appreciate and understand stress responses. The rapidly growing research literature provides a foundation for building an integrative stress management model with the potential to positively influence the stress-disease relationship and, ultimately, health outcomes. This article introduces a novel tai chi intervention and provides quantitative and qualitative data from a randomized clinical trial indicating its effects on psychosocial variables in individuals living with various stages of HIV disease.

Publication Types:

PMID: 16455435 [PubMed - indexed for MEDLINE]

PMCID: PMC2211366

74: Brain Inj. 2006 Feb;20(2):151-6.

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A study investigating the effects of Tai Chi Chuan: individuals with traumatic brain injury compared to controls.

Gemmell C, Leathem JM.

Massey University, Wellington, New Zealand.

OBJECTIVE: To explore the effects of a 6-week course in Tai Chi associated with traumatic brain injury (TBI) symptoms. METHOD: Eighteen participants, with TBI assigned to a control (waiting list) group (n = 9) or Tai Chi group (n = 9) completed the Medical Outcome Scale Short Form 36 (SF-36) and Rosenberg Self-Esteem Scale (RSES) before, during, immediately after and 3 weeks after completion of the Tai Chi course. The Tai Chi group completed the Visual Analogue Mood Scales (VAMS) before and after each class. RESULTS: Tai Chi was associated with significant improvement on all VAMS scores (except fatigue) with decreases in sadness, confusion, anger, tension, fear and increases in energy and happiness. There were no significant between-group differences on the SF-36 or RSES. CONCLUSIONS: Tai Chi provides short-term benefits after TBI, with rigorous outcome measurement needed to examine long-term benefits.

Publication Types:

Randomized Controlled Trial

PMID: 16421063 [PubMed - indexed for MEDLINE]

: Psychoneuroimmunology, spirituality, and cancer.

McCain NL.

School of Nursing and Massey Cancer Center, Virginia Commonwealth University, 1220 E. Broad St., Richmond, VA 23298-0567, USA. nlmccain@vcu.edu

PMID: 16419188 [PubMed - indexed for MEDLINE]

: Effects of long term Tai Chi practice and jogging exercise on muscle strength and endurance in older people.

Xu DQ, Li JX, Hong Y.

The Chinese University of Hong Kong, Shatin N T, Hong Kong.

OBJECTIVES: To investigate the influence of regular Tai Chi (TC) practice and jogging on muscle strength and endurance in the lower extremities of older people. METHODS: Twenty one long term older TC practitioners were compared with 18 regular older joggers and 22 sedentary counterparts. Maximum concentric strength of knee flexors and extensors was tested at angular velocities of 30 degrees/s and 120 degrees/s. Ankle dorsiflexors and plantar flexors were tested at 30 degrees/s and the dynamic endurance of the knee flexors and extensors was assessed at a speed of 180 degrees/s. RESULTS: The differences in the muscle strength of the knee joint amongst the three experimental groups were significant at the higher velocity. The strengths of knee extensors and flexors in the control group were significantly lower than those in the jogging group and marginally lower than those in the TC group. For the ankle joint, the subjects in both the TC and jogging groups generated more torque in their ankle dorsiflexors. In addition, the muscle endurance of knee extensors was more pronounced in TC practitioners than in controls. CONCLUSION: Regular older TC practitioners and joggers showed better scores than the sedentary controls on most muscle strength and endurance measures. However, the magnitude of the exercise effects on muscles might depend on the characteristics of different types of exercise.

PMID: 16371491 [PubMed - indexed for MEDLINE]

77: Int J Cardiol. 2006 Feb 8;107(1):119.

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Chi in Tai Chi does not mean energy.

Cheng TO.

Publication Types:

Letter

PMID: 16337510 [PubMed - indexed for MEDLINE]

: Effect of regular Tai Chi and jogging exercise on neuromuscular reaction in older people.

Xu DQ, Li JX, Hong Y.

Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.

OBJECTIVES: to investigate the effects of regular Tai Chi (TC) or jogging exercise on neuromuscular reaction in older people. DESIGN: cross-sectional study. SETTING: university biomechanics laboratory. SUBJECTS: 21 long-term elderly TC practitioners were compared with 18 regular elderly joggers and 22 sedentary counterparts. MEASUREMENTS: electromyography (EMG) was used to detect the neuromuscular reaction of the leg muscles to an unexpected ankle inversion perturbation. The latency of the muscles, which was defined as the time that the moment of perturbation began to the onset of the EMG response, was evaluated. RESULTS: a one-way ANOVA revealed that there were significant differences in the latency of the rectus femoris (R) and anterior tibialis (T) muscles between the three groups, but that there were no differences in the latency of the semitendinosus (S) and gastrocnemius (G) muscles. Further tests indicated that the R and T muscles in the TC and jogging groups were activated significantly faster than those in the control group. No significant difference was found for the muscle onset latencies between the TC and jogging groups. CONCLUSION: maintaining information processing speed during ageing is important, because of the role that it plays in many everyday events. The R and T muscles in the regular TC and jogging groups showed faster responses to unexpected ankle inversion perturbations, which is helpful for the timely correction of postural disturbances, than those in the sedentary control group.

PMID: 15919758 [PubMed - indexed for MEDLINE]

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