Aerobics

Lan, C., Chou, S., Chen, S., Lai, J. & Wong, M. (2004). The aerobic capacity and ventilator efficiency during exercise in Qigong and Tai Chi Chuan practitioners. American Journal of Chinese Medicine, 32, 141-150.

METHODS: Thirty-six community-dwelling men with a mean age of 59 years participated in this study. Each group (Qigong, TCC and control) included 12 subjects with matched age and body size. The Qigong group practiced Qigong regularly for 2 years and the Tai Chi group practiced Tai Chi for 5 years. Heart rate (HR) responses were measured during the practice of Qigong and Tai Chi. Additionally, breath-by-breath measurement of cardiorespiratory function was performed during the incremental exercise of leg cycling. RESULTS: The mean HR during Qigong and Tai Chi practice was 91 and 129, respectively. At the peak exercise and the ventilatory threshold (VeT), the Tai Chi group displayed the highest oxygen uptake (VO2), O2 pulse and work rate among the three groups. The Qigong group also showed higher oxygen uptake and O2 pulse than the control group. At the same relative exercise intensity, the Qigong group had the highest tidal volume among the three groups. In conclusion, Qigong and Tai Chi show a beneficial effect aerobic capacity in older individuals, but Tai Chi displays a better training effect than Qigong due to its higher exercise intensity. However, Qigong can enhance breathing efficiency during exercise due to the training effect of diaphragmatic breathing.


Taylor-Piliae, R. & Froelicher, E. (2004). Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis. Journal of Cardiovascular Nursing, 19, 48-57.

METHODS: A computerized search of 7 databases was done. Aerobic capacity was expressed as peak oxygen uptake (VO2peak). RESULTS: Of 441 citations obtained, only 7 focused on aerobic capacity in response to Tai Chi exercise. Aerobic capacity was higher in subjects performing classical Yang style (108 postures) Tai Chi, a 52-week Tai Chi exercise intervention, compared with sedentary subjects.


Mustian, K.M., Palesh, O.G., Flecksteiner, S.A. (2008). Tai Chi Chuan for breast cancer survivors. Medicine and Sport Science, 52, 209-217.

METHODS: 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.


Taylor-Piliae, R.E. (2008).The effectiveness of Tai Chi exercise in improving aerobic capacity: an updated meta-analysis. Medicine and Sport Science, 52, 40-53.

METHODS: A computerized search of seven databases was conducted. RESULTS: Large significant effects of Tai Chi on aerobic capacity were found for both women and men.


Hui, S.S., Woo, J., Kwok, T. (2009). Evaluation of energy expenditure and cardiovascular health effects from Tai Chi and walking exercise. Hong Kong Medicine Journal, 2, 4-7.

 

METHODS: A 12-week Tai Chi or walking exercise intervention produced significant and similar beneficial effects on body composition, aerobic fitness, muscular fitness, fasting blood glucose, resting metabolic rate, and perceived health in middle-aged. RESULTS: While Tai Chi and walking both elicited significant cardiorespiratory responses and energy expenditure to the moderate intensity level, walking exercise elicited about 46% higher metabolic cost than Tai Chi exercise.

 


Arthritis

 

Callahan, LF. (2009). Physical activity programs for chronic arthritis. Current Opinion in Rheumatology, 21, 177-182.

 

REVIEW: Different multicomponent land-based, aquatic, Tai Chi, and strength training programs report moderate benefits including increased physical activity, strength, balance, improved functional status, reduced symptoms and enhanced self-efficacy for individuals with various types of chronic arthritis.

 


Uhlig, T., Fongen, C., Steen, E., Christie, A., & Ødegård, S. (2010). Exploring Tai Chi in rheumatoid arthritis: A quantitative and qualitative study. BMC Musculoskeletal Disorders, 11, 43.

 

METHODS: Patients with rheumatoid arthritis were instructed in Tai Chi exercise twice weekly for 12 weeks. RESULTS: Tai Chi patients had improved physical condition, confidence in moving, stress reduction, increased body awareness, balance and less pain during exercise and in daily life.

 


Wang C. (2008). Tai Chi improves pain and functional status in adults with rheumatoid arthritis: results of a pilot single-blinded randomized controlled trial. Medicine and Sport Science, 52, 218-229.

 

METHODS: Patients with RA were randomly assigned to Tai Chi or attention control in twice-weekly sessions for 12 weeks. RESULTS:  Tai Chi had greater improvement in the disability index vitality and the depression index. Similar trends to improvement were also observed for disease activity, functional capacity and health-related quality of life.

 


Attention Deficit Hyperactivity Disorder

Schaller, K. J. (1996). Tai Chi Chih: An exercise option for older adults. Journal of Gerontological Nursing 22(10), 12-17.

METHODS: The purpose of this study was to determine the effects of Tai Chi on balance, flexibility, mood, health status, and blood pressure in a sample of community-dwelling elders. A quasi-experimental pretest-posttest design was used in the study. Participants were recruited from a senior center located in the suburbs of a large metropolitan area. The experimental group consisted of 24 volunteers over the age of 55 who performed 60 minutes of Tai Chi once a week for 10 weeks and practiced at home. The control group consisted of 22 volunteers who continued with their current level of activity. RESULTS: Greater balance was noted in the Tai Chi group.


Hernandez-Reif, M., Field, T., & Thimas, E. (2001). Attention deficit hyperactivity disorder: benefits from Tai Chi. Journal of Bodywork and Movement Therapies, 5, 120-123.

METHODS: Thirteen adolescents with Attention Deficit Hyperactivity Disorder (ADHD) participated in Tai Chi classes twice a week for 5 weeks. Teachers rated the children's behaviour on the Conners Scale during the baseline period, after the 5 week Tai Chi session period and 2 weeks later. RESULTS: After the 10 Tai Chi sessions the adolescents displayed less anxiety, improved conduct, less daydreaming behaviors, less inappropriate emotions, and less hyperactivity. These improved scores persisted over the 2-week follow up (no Tai Chi period).


 

Balance

 

Ballard, J., McFarland, C., Wallace, L., Holiday, D. & Robertson, G. (2004). The effect of 15 weeks of exercise on balance, leg strength, and reduction in falls in 40 women aged 65 to 89 years. Journal of American Medicine of Women Association, 59, 255-261.

METHODS: Forty women were classified by falling history and fear of falling and assigned to exercise and control groups using stratified randomization. The Berg Balance Scale, Get-up and Go, Functional Reach, and Wall-Sit Tests were used to evaluate changes in balance and leg strength before and after a supervised 15-week exercise program (31-hr sessions/week). RESULTS: Exercise subjects showed significant improvement on 5 of 14 items in the Berg Balance Scale and on the total score. Leg strength increased significantly on post-test as measured by the Wall-Sit Test. Control subjects reported 6 falls and exercise subjects no falls during the follow-up year.


Gyllensten, A.L., Hui-Chan, C.W., & Tsang W.W. (2010). Stability limits, single-leg jump, and body awareness in older Tai Chi practitioners. Archives of Physical Medicine and Rehabilitation, 91(2), 215-200.

 

METHODS: Tai Chi practitioners and control adults were compared. RESULTS: Tai Chi practitioners had better ability to lean further without losing stability, control, better ability to jump off the floor, and to maintain a longer single-leg stance after landing, and better overall body awareness.

 


Li, F., Harmer, P., Fisher, K.J. & McAuley, E. (2004). Tai Chi: improving functional balance and predicting subsequent falls in older persons. Medical Science Sports and Exercise, 36, 2046-2052.

METHODS: Two hundred fifty-six healthy, physically inactive older adults aged 70-92, participated in a 6-month randomized controlled trial, of Tai Chi or exercise stretching, followed by a 6-month post intervention follow-up. Functional balance measures included Berg balance scale, dynamic gait index, and functional reach, assessed during the 6-month intervention period (baseline, 3-month, and 6-month intervention endpoint) and again at the 6-month post intervention follow-up. Fall counts were recorded during the 6-month post intervention follow-up period. RESULTS: Tai Chi participants who showed improvements in measures of functional balance at the intervention endpoint significantly reduced their risk of falls during the 6-month post intervention period, compared with those in the control condition for Berg balance scale; for dynamic gait index; for functional reach.


Mao, D.W., Hong, Y., & Li, J.X. (2006). Characteristics of foot movement in Tai Chi exercise. Physical Therapy, 86 (2), 215-22.

 

METHODS: 42-form Tai Chi movements by Tai Chi practitioners were analyzed for supporting and stepping characteristics of the foot. RESULTS: Tai Chi movements had more double-limb support and less single-limb support in terms of total duration. The duration of each support pattern was longer, and movement from one pattern to the next was slow. The duration of each step direction was short, and changes of direction were frequent.


Tse, S. K. and Bailey, D. M. T'ai chi and postural control in the well elderly. (1998). American Journal of Occupational Therapy 46(4), 295-300.

METHODS: This study investigated the potential value of tai chi in promoting postural control of the well elderly. Tai chi, a traditional Chinese exercise, is a series of individual dancelike movements linked together in a continuous, smooth-flowing sequence. Performance on five balance tests of 9 tai chi practitioners was compared to that of 9 nonpractitioners. RESULTS: In three of the tests, the tai chi practitioners had significantly better postural control than the sedentary nonpractitioners. Men also performed significantly better than women in both the practitioner and non-practitioner groups on the same three tests.


Tsang, W. & Hui-Chan, W. (2004) Effect of 4- and 8-wk intensive Tai Chi training on balance control in the elderly. Medicine and Science for Sports Exercise, 36, 648-657.

METHODS: The objective of this study was to examine whether 4 and/or 8 weeks of intensive Tai Chi practice could improve balance control in healthy elderly subjects. Forty-nine elderly subjects voluntarily participated in an intervention program of either supervised Tai Chi or general education for 1.5 h, 6x weeks for 8 weeks. Two balance tests were administered using computerized dynamic posturography before, at 4 and 8 weeks during training, and at 4 weeks after training ended: 1) the sensory organization test measured subjects' abilities to use somatosensory, visual, and vestibular information to control their body sway during stance under six sensory conditions; and 2) the limits of stability test measured subjects' abilities to voluntarily weight shift to eight spatial positions within their base of support. These outcome measures were compared between the two intervention groups, and with those of experienced Tai Chi practitioners having means of 7 and 10 yr of practice from two previous studies. RESULTS: Statistical analysis demonstrated that, after 4 and 8 weeks of intensive Tai Chi training, the elderly subjects achieved significantly better 1) vestibular ratio in the sensory organization test and 2) directional control of their leaning trajectory in the limits of stability test, when compared with those of the control group. These improvements were maintained even at follow-up 4 weeks afterward. Furthermore, the improved balance performance from week 4 on was comparable to that of experienced Tai Chi practitioners.


Tsang, W. & Hui-Chan, W. (2004). Effects of exercise on joint sense and balance in elderly men: Tai Chi versus golf. Medicine Science for Sports Exercise, 36, 658-667.

METHODS: We compared 12 experienced elderly Tai Chi practitioners, with 11 experienced elderly golfers, 12 healthy elderly subjects, and 12 young university students, who were all males, using: 1) passive knee joint repositioning test to assess their joint proprioceptive acuity and 2) limits of stability test to assess their ability to voluntarily weight shift within their base of support. RESULTS: Both Tai Chi practitioners and golfers had better knee joint proprioceptive acuity than did the elderly control subjects. Of special interest is that their performance was similar to that of the young subjects. In the limits of stability test, Tai Chi practitioners and golfers had faster reaction time, leaned further without losing stability, and showed better control of leaning trajectory than did elderly control subjects. The latter two outcome measures were also comparable to those of the young subjects.


Wayne, P., Krebs, D., Wolf, S., Gill-Body, K., Scarborough, D., McGibbon, C., Kaptchuk, T. & Parker, S. (2004). Can Tai Chi improve vestibulopathic postural control? Archives Physical Medicine and Rehabilitation, 85, 142-152.

REVIEW: Twenty-four Tai Chi studies met screening criteria. Collectively, the 24 studies provide sometimes contradictory but generally supportive evidence that Tai Chi may have beneficial effects for balance and postural impairments, especially those associated with aging including improved balance and dynamic stability, increased musculoskeletal strength and flexibility, improved performance of activities of daily living (ADLs), reduced fear of falling, and general improvement in psychological well-being.


Xu, D., Hong, Y. & Chang, K. (2004). Effects of Tai Chi exercise on proprioception of ankle and knee joints in old people. British Journal of Sports Medicine, 38, 50-54.

METHODS: By detecting the threshold of passive movement, ankle and knee joint kinaesthesis was measured in 21 elderly long term tai chi practitioners (TC group), 20 elderly long term swimmers/runners (S/R group), and 27 elderly sedentary controls (control group). RESULTS: Ankle joint kinaesthesis differed significantly among the three groups. Subjects in the TC group could detect a significantly smaller amount of motion than those in the S/R group and control group. No significant difference was found between the S/R group and the control group. The threshold for detection of passive motion was significantly different in knee extension and flexion. For knee flexion, the TC group showed a significantly lower mean threshold for detection of passive motion than the control group. There were no significant differences between the S/R group and control group, or between the TC group and S/R group. For knee extension, no significant difference was noted among the three groups (p = 0.597). The elderly people who regularly practiced tai chi not only showed better proprioception at the ankle and knee joints than sedentary controls, but also better ankle kinaesthesis than swimmers/runners. The large benefits of tai chi exercise on proprioception may result in the maintenance of balance control in older people.


Xu, D., Li, J. & Hong, Y. (2005). Effect of regular Tai Chi and jogging exercise on neuromuscular reaction in older people. Age and Ageing, 34, 439-444.

METHODS: 21 long-term elderly TC practitioners were compared with 18 regular elderly joggers and 22 sedentary counterparts. 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: 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.


Fong, S.M. & Ng, G.Y. (2006). The effects on sensorimotor performance and balance with Tai Chi training. Archives of Physical Medicine and Rehabilitation, 87, 82-87.

METHODS: Forty-eight healthy subjects, 16 with 3 months of experience in Tai Chi training, 16 with 1 to 3 years of experience in Tai Chi training, and 16 with no experience in Tai Chi training were assessed. RESULTS: Long-term Tai Chi practitioners had a significantly faster reflex reaction time in hamstrings and gastrocnemius muscles and a longer balance time on a tilt board than short-term Tai Chi practitioners and nonpractitioners. Both long- and short-term Tai Chi practitioners had significantly less knee joint angle-repositioning error than nonpractitioners.


Gatts, S. & Woollacott, M. (2006). Neural mechanisms underlying balance improvement with short term Tai Chi training. Aging Clinical and Experimental Research, 18, 7-19.

METHODS: Twenty-two balance-impaired older adults were randomly divided into Tai Chi or control groups. Tai Chi training included repetitive exercises using Tai Chi 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 Tai Chi 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: Tai Chi subjects, but not controls, significantly reduced both TA response time and occurrence of co-contraction of antagonist muscles of the perturbed leg. Clinical balance measures also significantly improved after Tai Chi. Tai Chi enhanced neuromuscular responses controlling the ankle joint of the perturbed leg. Fast, accurate neuromuscular activation is crucial for efficacious response to slips or trips.


Mao, W., Li, J. & Hong, Y. (2006). Plantar pressure distribution during Tai Chi exercise. Archives of Physical Medicine and Rehabilitation, 87, 814-820.

METHODS: Sixteen experienced Tai Chi practitioners were measured on 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. 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, and were significantly more medial and anterior at the end of contact with the ground. The displacements of the COP were significantly wider in the mediolateral direction in the forward, backward, and sideways Tai Chi movements. The displacement was significantly larger in the anteroposterior direction in the forward movement. 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 noted.


Taylor-Piliae, R., Haskell, W., Stotts, N. & Froelicher, E. (2006). Improvement in balance, strength, and flexibility after 12 weeks of Tai Chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. Alternative Therapies Health Medicine, 12, 50-58.

METHODS: Thirty-nine adults with at least 1 cardiovascular disease (CVD) risk factor attended a 60-minute tai chi class 3 times per week for 12 weeks. Subjects were below the 50th percentile of fitness at baseline compared to age- and gender-specific normative US data. RESULTS: Statistically significant improvements were observed in all balance, muscular strength and endurance, and flexibility measures after 6 weeks, and they increased further after 12 weeks.


Tsang, W. & Hui-Chan, W. (2006). Standing balance after vestibular stimulation in Tai Chi-practicing and nonpracticing healthy older adults. Archives of Physical Medicine and Rehabilitation, 87, 546-553.

METHODS: Tai Chi practitioners and control participants were recruited. They stood on a force platform with eyes closed before and after stimulation of their horizontal semicircular canals, applied by means of whole head-and-body rotation at 80 degrees /s for 60 seconds, with subjects seated in a rotational chair. Body sway during stance was measured as total sway path, peak amplitudes, and mean velocities of sway in both anteroposterior (AP) and mediolateral (ML) directions. RESULTS: After head-and-body rotation, significant within-group increases were found in all measures in both AP and ML directions during stance with eyes closed in older control subjects but not in Tai Chi practitioners along the AP direction. In fact, significantly smaller increases in total sway path, peak amplitude, and mean velocity of body sway in the AP direction were found in the Tai Chi practitioners when compared with those of control subjects.


Maciaszek, J., Osinski, W., Szeklicki, R. & Stemplewski, R. (2007). Effect of tai chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. American Journal of Chinese Medicine, 35, 1-9.

This study was to assess the effect of 18-week Tai Chi training on body balance in dynamic trial among elderly men exercise class held for 45 min, twice a week. Body balance was assessed using a Computer Posturographic System PE. In the Tai Chi group, an increase in effectiveness of balance task performance was noted.


Blood Pressure

Channer, K. S., Barrow, D., Barrow, R., Osborne, M., and Ives, G. (1996).Changes in haemodynamic parameters following Tai Chi Chuan and aerobic exercise in patients recovering from acute myocardial infarction. Postgraduate Medical Journal, 72(848), 349-351.

METHODS: In this study, 126 patients were randomized to Tai Chi (38), aerobic exercise (41) or a non-exercise support group (47) following acute myocardial infarction. Patients attended twice weekly for three weeks and then weekly for a further five weeks. Heart rate and blood pressure were recorded before and after each session. RESULTS: Over the 11 sessions of exercise there was a negative trend in diastolic blood pressure only in the Tai Chi group. Significant trends in systolic blood pressure occurred in both exercise groups. Only four (8%) patients completed the support group eight-week programme which was less than the number completing Tai Chi (82%) and aerobic exercise groups (73%).


Tsai, J.C., Wang, W.H., Chan, P., Lin, L.J., Wang, C.H., Tomlinson, B., Hsieh, M.H., Yang, H.Y., & Liu, J.C. (2003). The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. Journal of Alternative and Complementary Medicine, 9, 747-754.

METHODS: Exercise intensity was estimated to be approximately 64% of maximal heart rate. RESULTS: After 12-weeks of Tai Chi training, the treatment group showed decrease in systolic blood pressure of 15.6 mm Hg and diastolic blood pressure 8.8 mm Hg. The serum total cholesterol level decreased 15.2 mg/dL and high-density lipoprotein cholesterol increased 4.7 mg/dL and both trait anxiety and state anxiety were decreased.


Thornton, E.W., Sykes, K.S., & Tang, W.K. (2004). Health benefits of Tai Chi exercise: improved balance and blood pressure in middle-aged women. Health Promotion International, 19, 33-38.

METHODS: Middle-aged women were recruited into a three times per week, 12-week Tai Chi exercise programme. RESULTS: Dynamic balance measured by the Functional Reach Test was significantly improved following Tai Chi, with significant decreases in both mean systolic (9.71 mmHg) and diastolic (7.53 mmHg) blood pressure.  


Verhagen, A., Immink, M., van der Meulen, A. & Bierma-Zeinstra, S. (2004). The efficacy of Tai Chi Chuan in older adults: a systematic review. Family Practice, 21, 107-113.

METHODS: A total of seven studies were included, with in total 505 participants, of whom all but 27 were healthy seniors, age between 53 and 96 years. RESULTS: In most studies, the intervention of TCC was a modified Yang style, varying from 10 to 24 forms. The intensity of TCC varied from 1 h weekly for 10 weeks to 1 h every morning for 1 year. One study used falls as outcome measure and reported a beneficial effect of 47% in the TCC group. All studies mention a beneficial effect of TCC, but in most studies this conclusion was based on a pre-post analysis.


Ko, G., Tsang, P. & Chan, H. (2006). A 10-week Tai-Chi program improved the blood pressure, lipid profile and SF-36 scores in Hong Kong Chinese women. Medical Science Monitor, 12, 196-199.

METHODS: Twenty female subjects received 2 Tai-Chi sessions per week for 10 weeks. Each session lasted for one hour. RESULTS: At the end of the study, systolic blood pressure, total cholesterol and low-density lipoprotein cholesterol levels significantly reduced. Among all SF-36 items, Vitality and Mental Health significantly improved after the 10-week Tai-Chi program.


Wolf, S., O’Grandy, M., Easley, K., Guo, Y., Kressig, R. & Kutner, M. (2006). The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail older adults. Journal of Gerontology A Biological Science and Medical Science, 61, 184-189.

METHODS: This 48-week randomized clinical trial was provided for 291 women and 20 men, who were transitionally frail, >or=70 years old, and had fallen at least once within the past year. Physical performance (freely chosen gait speed, reach, chair-rises, 360 degrees turn, picking up an object from the floor, and single limb support) and hemodynamic outcomes (heart rate and blood pressure) were obtained at baseline and after 4, 8, and 12 months. RESULTS: Mean percent change (baseline to 1 year) for gait speed increased similarly in both the tai chi and wellness education cohorts. However, time to complete three chair-rises decreased 12% for TC and increased 14% for WE. Baseline to 1 year mean percent change decreased among TC and increased within WE cohorts for: body mass index, systolic blood pressure, and resting heart rate (-6% vs 5%; p <.0001). Tai Chi significantly improved chair-rise and cardiovascular performance. Because TC training reduced fall occurrences in this cohort, factors influencing functional and cardiovascular improvements may also favorably impact fall events.


Yeh, G.Y., Wang, C., Wayne, P.M., Phillips, R.S. (2008). The effect of tai chi exercise on blood pressure: a systematic review. Preventive Cardiology, 11, 82-89.

 

Review: Twenty-six studies examining patients with and without cardiovascular conditions met inclusion criteria. Twenty-two studies (85%) reported reductions in BP with tai chi (3-32 mm Hg systolic and 2-18 mm Hg diastolic BP reductions).


Bone Mineral Density

Lui, P.P., Qin, L., & Chan, K.M. (2008). Tai Chi Chuan exercises in enhancing bone mineral density in active seniors. Clinics in Sports Medicine, 27(1), 75-86.

 

REVIEW: The benefits of Tai Chi are reviewed for the prevention of osteoporosis and falls by retarding bone loss, improving neuromuscular coordination, and promoting general health.


Shen, C.L., Williams, J.S., Chyu, M.C., Paige, R.L., Stephens, A.L., Chauncey, K.B., Prabhu, F.R., Ferris, L.T., & Yeh, J.K. (2007). Comparison of the effects of Tai Chi and resistance training on bone metabolism in the elderly: a feasibility study. The American Journal of Chinese Medicine, 35, 369-381.

 

METHODS: Adults were randomized into either Tai Chi or Resistance Training 3 sessions/week for 24 weeks. RESULTS: After 24 weeks, the urinary calcium levels were lower in the Tai Chi group, supporting that Tai Chi is beneficial for increasing bone formation.


Wayne, P.M., Kiel, D.P., Krebs, D.E., Davis, R.B., Savetsky-German, J., Connelly, M., & Buring, J.E. (2007). The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review. Archives of Physical Medicine and Rehabilitation, 88, 673-680.

 

REVIEW: Tai Chi practitioners had greater bone mineral density and slower rates of postmenopausal bone mineral density decline.


Brain Injury

 

Blake, H. & Batson, M. (2009). Exercise intervention in brain injury: a pilot randomized study of Tai Chi Qigong. Clinical Rehabilitation, 23, 589-598.

 

METHODS: Individuals with traumatic brain injury attended a Tai Chi Qigong exercise session for one hour per week while control participants engaged in non-exercise-based social and leisure activities. RESULTS: After 8 weeks, the Tai Chi group had better mood and self esteem.


Gemmell, C. & Leathem, J. (2006). A study investigating the effects of Tai Chi Chuan: individuals with traumatic brain injuries compared to controls. Brain Injury, 20, 151-156.

METHODS: Eighteen participants, with TBI assigned to a control (waiting list) group or Tai Chi group 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.


Breast Cancer

 

Mustian, K.M., Katula, J.A., Gill, D.L., Roscoe, J.A., Lang, D. & Murphy, K. (2004). Tai Chi Chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors. Support Care Cancer, 12, 871-876.

METHODS: A group of 21 women diagnosed with breast cancer, who had completed treatment within the last 30 months were randomized to receive 12 weeks of Tai Chi or Psychosocial Support. Participants in both groups met three times a week for 60 minutes. RESULTS: The Tai Chi group demonstrated significant improvements in Quality of Life, while the Psychosocial Support group reported declines in Quality of Life. Additionally, the Tai Chi group exhibited improvements in self-esteem, while the Psychosocial Support group reported declines in self-esteem.


Yeh, M., Lee, T., Chen, H. & Chao, T. (2006). The influences of chan-chuang qi-gong therapy on complete blood cell counts in breast cancer patients treated with chemotherapy. Cancer Nursing, 29, 149-155.

Methods: This study examined the effects of qi-gong therapy on complete blood counts in breast cancer patients treated with chemotherapy. The experimental group received a 21-day qi-gong therapy. Results: Significant differences in white blood cells, platelets and hemoglobin over the 3-week therapy suggested that qi-gong therapy may decrease leukopenia in breast cancer patients treated with chemotherapy.


Cardiovascular

 

 

Yeh, G.Y., McCarthy, E.P., Wayne, P.M., Stevenson, L.W., Wood, M.J., Forman, D., Davis, R.B., & Phillips, R.S. (2011). Tai chi exercise in patients with chronic heart failure: a randomized clinical trial. Archives of Internal Medicine, 171, 750-757.

 

METHODS: 100 outpatients with systolic heart failure group-based 12-week tai chi exercise program or time-matched education. Outcome measures included exercise capacity (6- minute walk test and peak oxygen uptake) and disease-specific quality of life (Minnesota Living With Heart Failure Questionnaire). RESULTS: At completion of the study, there were no significant differences in change in 6-minute walk distance and peak oxygen uptake, when comparing tai chi and control groups; however, patients in the tai chi group had greater improvements in quality of life. Improvements with tai chi were also seen in exercise self-efficacy and mood.


Chang RY, Koo M, Ho MY, Lin ZZ, Yu ZR, Lin YF, Wang BJ. Effects of Tai Chi on adiponectin and glucose homeostasis in individuals with cardiovascular risk factors. European Journal of Applied Physio1ogy,111, 57-66.

 

METHODS: Twenty-six individuals (mean age 60.2 years) with at least one cardiovascular risk factor who had been practicing Yang's style TC exercise for at least 3 months were recruited from a regional hospital in Taiwan. Participants completed a 60-min Yang's style TC exercise routine including warm up, stretching exercises, and TC followed by a 30-min resting period. After a 1-week washout period, the same group of participants underwent a control condition in which they were instructed to remain seated for 90 min at the study location. Blood samples were collected both before and after the TC intervention or the sitting condition. RESULTS: In conclusion, a single bout of TC exercise had a significant positive effect on blood adiponectin concentrations in individuals with cardiovascular risk factors.

 


Barrow, D.E., Bedford, A., Ives, G., O'Toole, L., & Channer, K.S. (2007). An evaluation of the effects of Tai Chi Chuan and Chi Kung training in patients with symptomatic heart failure: A randomised controlled pilot study. Postgraduate Medical Journal, 83(985), 717-721.

METHODS: Patients with chronic heart failure were randomly assigned to Tai Chi twice a week for 16 weeks or to standard medical care. RESULTS: Patients having Tai Chi exercise had improved symptoms scores of heart failure and depression scales.


Jin, P. (1989). Changes in heart rate, noradrenalin, cortisol and mood during Tai Chi. Journal of Psychosomatic Research, 33, 197-206.

METHODS: Changes in psychological and physiological functioning following participation in Tai Chi were assessed for 33 beginners and 33 practitioners. The variables in the three-way factorial design were experience (beginners vs practitioners), time (morning vs afternoon vs evening), and phase (before Tai Chi vs during Tai Chi vs after Tai Chi). Phase was a repeated measures variable. RESULTS: Relative to measures taken beforehand, practice of Tai Chi raised heart rate, increased noradrenaline excretion in urine, and decreased salivary cortisol concentration. Relative to baseline levels, subjects reported less tension, depression, anger, fatigue, confusion and state-anxiety, they felt more vigorous, and in general they had less total mood disturbance. The data suggest that Tai Chi results in gains that are comparable to those found with moderate exercise.


Jin, P. (1992). Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress. Journal of Psychosomatic Research , 36, 361-370.

METHODS: In this study Tai Chi was examined for its efficacy in post-stressor recovery. Tai Chi practitioners were randomly assigned to four treatment groups: Tai Chi, brisk walking, mediation and neutral reading. Mental arithmetic and other difficult tests were chosen as mental challenges, and a stressful film was used to produce emotional disturbance. Tai Chi and the other treatments were applied after these stressors. RESULTS: After all treatments, the salivary cortisol level dropped significantly, and the mood states were also improved. In general the stress-reduction effect of Tai Chi characterized moderate physical exercise. Heart rate, blood pressure, and urinary catecholamine changes for Tai Chi were found to be similar to those for walking at a speed of 6 km/hr.


Lan, C., Lai, J. S., Wong, M. K., and Yu, M. L. (1996). Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners. Archives of Physical Medicine & Rehabilitation 77, 612-616.

METHODS: A case-control study evaluated seventy-six community-dwelling senior persons in a Tai Chi group and a control group of sedentary subjects with matched age and body size. The Tai Chi group had practiced Tai Chi regularly. Each session included 20 minutes of warm-up, 24 minutes of Tai Chi training, and 10 minutes of cool-down. Exercise intensity was estimated to exceed 70% of maximal heart rate. RESULTS: The Tai Chi group showed 19% higher peak oxygen uptake in comparison with their sedentary counterparts. In addition, the Tai Chi practitioners had greater flexibility and lower percentage of body fat in comparison with their sedentary counterparts.


Liu, Y., Mimura, K., Wang, L. & Ikuda, K. (2003). Physiologial benefits of 24-style Taijiquan exercise in middle-aged women. Journal of Physiology and Anthropology Applied Human Science, 22, 219-225.

METHODS: This study examined the physiological benefits of Tai Chi exercises by comparing heart rate (HR), respiratory rate(RR), exercise intensity, electroencephalograph, surface electromyography and surface thermograph, as well as the results of physical fitness test in 20 middle-aged women (10 skilled participants and 10 novices). RESULTS: The data from the skilled participants showed greater values in sit-ups, side step and stand trunk flexion, moreover, the statistic data demonstrated not only greater HR or lower RR during exercise, but also higher beta%-power during the experiment, higher alpha%-power in the eye-closed period and central alpha dominant after exercise. These results suggest that Tai Chi is effective for psychological relaxation and mental concentration.


Wang, Y., Taylor, L., Pearl, M. & Chang, L. (2004). Effects of Tai Chi exercise on physical and mental health of college students. American Journal of Chinese Medicine, 32, 453-459.

METHODS: Thirty college students participated in a 1-hour-long Tai Chi exercise intervention twice a week for 3 months. Each practice session included 10 minutes of breathing and stretching exercises followed by 50 minutes of Tai Chi Quan 24-form practice. The SF-36v2 health survey questionnaire was given before and after the intervention. RESULTS: Physical measures of pain and general health, and mental measures of vitality and mental health were significantly improved after Tai Chi. Scores on the mental health dimension appeared to be particularly sensitive to change.


Yeh, G., Wood, M., Lorell, B., Stevenson, L., Eisenberg, D., Wayne, P., Goldberger, A., Davis, R. & Phillips, R. (2004). Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic failure: a randomized controlled trial. American Journal of Medicine, 117, 541-548.

METHODS: Thirty patients with chronic stable heart failure and left ventricular ejection fraction were randomly assigned to receive usual care, which included pharmacologic therapy and dietary and exercise counseling, or 12 weeks of tai chi training in addition to usual care. Tai chi training consisted of a 1-hour class held twice weekly. Primary outcomes included quality of life and exercise capacity. Secondary outcomes included serum B-type peptide and plasma catecholamine levels. RESULTS: At 12 weeks, patients in the tai chi group showed improved quality-of-life scores, increased distance walked in 6 minutes, and decreased serum B-type peptide levels compared with patients in the control group. A trend towards improvement was seen in peak oxygen uptake.


Chen, K., Chen, W., Wang, J. & Huang, M. (2005). Frail elders’ view of Tai Chi. Journal of Nursing Research, 13, 11-20.

METHODS: The beneficial effects of Tai Chi on an elder's well-being have been well documented; however, not many frail elders practice it. The purpose of this descriptive study was to explore the perspectives frail elders have about Tai Chi, including its movements, practice frequency and duration, and practice preferences. Using focus groups, 40 frail elders who lived in long-term care facilities were interviewed. RESULTS: Indicated that Tai Chi styles with slow and large motions were manageable. Subjects preferred to practice Tai Chi in a group of 10 to 20 people, twice a week with 31 to 60 minutes of practice in the early morning or in the afternoon after napping. The practice locations should be wide, flat, non-disturbed, and well-ventilated. Tai Chi instructors should be experienced, gentle, considerate, and have clarity in expression. Findings can be used to design a simple Tai Chi program that is specifically tailored to the needs of frail elders.


Pippa, L., Manzoli, L., Corti, I., Congedo, G., Romanazzi, L., & Parruti, G. (2007). Functional capacity after traditional Chinese medicine (qi gong) training in patients with chronic atrial fibrillation: a randomized controlled trial. Preventive Cardiology, 10, 22-25.

METHODS: Evidence indicates that low energy expenditure protocols derived from traditional Chinese medicine may benefit patients with cardiac impairment. The authors carried out a randomized controlled trial to test a 16-week medically assisted qi gong training program for the physical rehabilitation of patients with chronic atrial fibrillation. RESULTS: Trained patients walked an average 114 meters more (27%) at the end of treatment (P<.001) and 57 meters more (13.7%) 16 weeks later.


College Students

 

Caldwell, K., Harrison, M., Adams, M., & Triplett, N.T. (2009). Effect of pilates and taiji quan training on self-efficacy, sleep quality, mood, and physical performance of college students. Journal of Bodywork and Movement Therapies, 13, 155-163.

METHODS: The purpose of this investigation was to examine the effects of a semester of either Pilates or taiji quan training on perceived self-efficacy, sleep quality and mood, as well as strength and balance in college-age individuals. RESULTS: Self-efficacy was found to be improved in the Pilates and taiji quan groups and there was a trend towards improvement in sleep quality. Mood was found to be improved significantly in the Pilates group while the taiji group showed a trend towards improvement. There were no changes or group differences in the strength or balance measures. Pilates and taiji quan are effective exercise modes to improve mental parameters in college-age individuals.

 


Cholesterol

Song, R., Ahn, S., So, H.Y., Park, I.S., Kim, H.L., Joo, K.O., & Kim, J.S. (2009). Effects of Tai Chi exercise on cardiovascular risk factors and quality of life in post-menopausal women. Journal of Korean Academy of Nursing, 39, 136-144.

METHODS: Women participated in either the Tai Chi group or control group. RESULTS: After 6 months, the Tai Chi group had lower total cholesterol, LDL-cholesterol and cardiovascular disease risk and their quality of life was greater.

 


Compliance

Li, F., Harmer, P., Mack, K.A., Sleet, D., Fisher, K.J., Kohn, M.A., Millet, L.M., Xu, J., Yang, T., Sutton, B., & Tompkins, Y. (2008). Tai Chi: moving for better balance -- development of a community-based falls prevention program. Journal of Physical Activity and Health, 5, 445-455.

METHODS: A mixed qualitative and quantitative approach was used to develop a package of materials for program implementation and evaluation. Participants included a panel of experts, senior service program managers or activity coordinators, and older adults. Outcome measures involved program feasibility and satisfaction. RESULTS: The evaluation showed that the program implementation was feasible and evidenced good class attendance, high participant satisfaction, and interest in continuing Tai Chi.


Cortisol

Jin, P. (1992). Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress. Journal of Psychosomatic Research, 36, 361-370.

METHODS: Tai Chi practitioners were randomly assigned to four treatment groups: Tai Chi, brisk walking, mediation and neutral reading. Mental arithmetic and other difficult tests were chosen as mental challenges, and a stressful film was used to produce emotional disturbance. RESULTS: Salivary cortisol level dropped significantly, and the mood states were also improved. Heart rate, blood pressure, and urinary catecholamine changes for Tai Chi were found to be similar to those for walking at a speed of 6 km/hr.


Diabetes

Hung, J.W., Liou, C.W., Wang, P.W., Yeh, S.H., Lin, L.W., Lo, S.K., & Tsai, F.M. (2009). Effect of 12-week tai chi chuan exercise on peripheral nerve modulation in patients with type 2 diabetes mellitus. Journal of Rehabilitation Medicine, 41(11), 924-929.

 

METHODS: Patients with diabetes were given tai chi classes 3 times a week for 12 weeks. RESULTS: Improved fasting blood glucose and increased nerve conduction velocities in all nerves tested were noted following tai chi.


 Wang JH. (2008). Effects of Tai Chi exercise on patients with type 2 diabetes. Medicine and Sport Science, 52, 230-238.

 

METHODS: Subjects with type 2 diabetes were trained on Tai Chi exercise for 8 weeks. RESULTS: Results showed that by 8 weeks of Tai Chi the blood glucose decreased while high- and low-affinity insulin receptor numbers and low-affinity insulin receptor binding capacity increased. After the single bout Tai Chi exercise, blood glucose, high- and low affinity insulin receptor numbers and their binding capacity increased.


Elderly

Palasuwan, A., Suksom, D., Margaritis, I., Soogarun, S., & Rousseau, A.S. (2011). Effects of tai chi training on antioxidant capacity in pre- and postmenopausal women. Journal of Aging Research, doi:10.4061/2011/234696.

 

METHODS: Pre and postmenopausal sedentary women received an 8-week Tai Chi training program (2 sessions in class and 2 sessions at home per week). RESULTS: Tai chi improved balance, flexibility, leg extensor strength and increased antioxidant status and decreased homocysteine, a cardiovascular risk marker.

 


 

Chang, J.Y., Tsai, P.F., Beck, C., Hagen, J.L., Huff, D.C., Anand, K.J., Roberson, P.K., Rosengren, K.S., & Beuscher, L. (2011). The effect of tai chi on cognition in elders with cognitive impairment. Medsurg Nursing, 20, 63-69.

 

METHODS: Tai chi was assessed for effects on cognition in elders with cognitive impairment. RESULTS: A dose-response relationship was demonstrated between attendance and some cognition measures.

 


 

Barbat-Artigas, S., Filion, M.E., Dupontgand, S., Karelis, A.D., & Aubertin-Leheudre, M. (2011). Effects of tai chi training in dynapenic and nondynapenic postmenopausal women. Menopause, [Epub ahead of print].

 

METHODS: Postmenopausal women were given tai chi training. RESULTS: The women showed decreased body weight, fat mass percentage and skeletal muscle mass and handgrip strength, functional capacity and general health perception increased. In addition, systolic and diastolic blood pressure decreased.

 


 

Lavretsky, H., Alstein, L.L., Olmstead, R.E., Ercoli, L.M., Riparetti-Brown, M., St Cyr, N., & Irwin, M.R. (2011). Complementary Use of Tai Chi Chih Augments Escitalopram Treatment of Geriatric Depression: A Randomized Controlled Trial. American Journal of Geriatric Psychiatry. [Epub ahead of print].

 

METHODS: 112 older adults with major depression age 60 years and older were recruited and treated with escitalopram for approximately 4 weeks. 73 partial responders to escitalopram continued to receive escitalopram daily and were randomly assigned to 10 weeks of adjunct use of either Tai Chi Chin (TCC) for 2 hours per week or health education (HE) for 2 hours per week. All participants underwent evaluations of depression, anxiety, resilience, health-related quality of life, cognition, and inflammation at baseline and during 14-week follow-up. RESULTS: Subjects in the escitalopram and TCC condition were more likely to show greater reduction of depressive symptoms and to achieve a depression remission as compared with those receiving escitalopram and HE. Subjects in the escitalopram and TCC condition also showed significantly greater improvements in 36-Item Short Form Health Survey physical functioning and cognitive tests and a decline in the inflammatory marker, C-reactive protein, compared with the control group.


 

Huang, T.T., Yang, L.H., Liu, C.Y.. (2011). Reducing the fear of falling among community-dwelling elderly adults through cognitive-behavioural strategies and intense Tai Chi exercise: a randomized controlled trial. Journal of Advanced Nursing, 67, 961-71.

 

METHODS: Data were collected from January to December 2007. A randomized controlled trial with three groups (control, cognitive-behavioural and cognitive-behavioural with Tai Chi). Participants were assessed at baseline for demographic data, falls-related history, and fear of falling. Data on these variables plus falls, mobility, social support behaviour and satisfaction, and quality of life were also collected at 2 and 5 months after interventions. RESULTS: Participants in the three groups differed significantly in both measures of fear of falling and mobility, social support behaviour and satisfaction, and quality of life. In addition, participants who received the cognitive-behavioural intervention with Tai Chi had significantly lower fear of falling scores and higher mobility, social support satisfaction and quality of life than the cognitive-behavioural alone and control groups at 5 months.


Nomura, T., Nagano, K., Takato, J., Ueki, S., Matsuzaki, Y., & Yasumura, S. (2011). The development of a Tai Chi exercise regimen for the prevention of conditions requiring long-term care in Japan. Archives of Gerontology & Geriatrics, 52,198-203.

 

METHODS: This study was to examine an effect of such an exercise program on preventing conditions requiring long-term care in the Japanese frail elderly who participated in a Tai Chi Yuttari-exercise program. The first-intervention group  underwent an intervention program by participating in a Tai Chi Yuttari-exercise  session once a week for 3 months. Each session lasted 90 min including a break time. Moreover, the subjects received a video recording of the exercise, and instructions to carry out the exercise at home. The same program was administered to the second-intervention group. RESULTS: Physical function improved significantly in the first-intervention group, with single-leg balance (SLB) increasing, and trunk anteflexion increasing after the intervention program. Furthermore, the total score of the Motor Fitness Scale (MFS) improved significantly. A careful interpretation of the results suggests that Tai Chi Yuttari-exercise improves physical function and ability for frail elderly individuals and could reduce the need for long-term care.


Wolf, S. L., Kutner, N. G., Green, R. C., and McNeely, E. (1993). The Atlanta FICSIT study: two exercise interventions to reduce frailty in elders. Journal of the American Geriatrics Society, 41, 329-332.

METHODS: This study examined the effect of two different exercise approaches on balance and frailty measures among more than 200 community-dwelling individuals greater than 70 years of age. Exercises were provided for 15 weekly sessions on an individual basis for participants randomly assigned to a Balance Training group. Training consisted of center-of-mass feedback displayed on a motor under static conditions, or, in later sessions, as the floor surface is moved, with eyes open or closed. This high technology interface provides instantaneous information about displacement of body weight in space so that balance can be enhanced. Participants randomly assigned to this intervention met twice weekly for 15 weeks to learn a condensation of 108 Tai Chi forms into 10 that emphasize movement components often restricted or absent with aging. A third group served as a control for exercise interventions by meeting weekly for 15 sessions to discuss topics of interest such as memory loss, drug management, and nutrition. RESULTS: Grip strength declined in all groups, and lower extremity range of motion showed limited but statistically significant changes. Lowered blood pressure before and after a 12-minute walk was seen following TC participation. Fear of falling responses and intrusiveness responses were reduced after the TC intervention compared with the ED group. After adjusting for fall risk factors, TC was found to reduce the risk of multiple falls by 48%.


Lan, C., Lai, J.S., Chen, S.Y. & Wong, M.K. (1998). 12-month Tai Chi training in the elderly: its effect on health fitness. Medicine and Science in Sports and Exercise, 30, 345-351.

 

METHODS: this study evaluated the effect of Tai Chi Chuan (TCC) on health fitness in older individuals. Thirty-eight community-dwelling persons aged 58-70 years completed this study. The TCC group practiced TCC, each session included 20 minutes of warm-up, 24 minutes of TCC practice, and 10 minutes of cool down. The exercise intensity was 52-63% of the heart rate range. Cardiorespiratory function, strength, flexibility, and percent of body fat were evaluated before and at the end of this study. RESULTS: The TCC group showed 16% increase in flexibility, 18% increase in muscle strength of knee extensor, 9 degrees increase in flexibility, and 15% increase of knee flexor (P<0.05). The control group showed no significant change in these variables.


Sattin, R.W., Easley, K.A., Wolf, S.L., Chen, Y. & Kutner, M.H. (2005). Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults. Journal of the American Geriatric Society, 53, 1168-1178.


METHODS: To determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education (WE) program in older adults who had fallen previously and met criteria for transitioning to frailty. 291 women and 20 men, aged 70 to 97 were given the Activities-Specific Balance Confidence Scale (ABC). RESULTS: Tai chi led to a significantly greater reduction in fear of falling than a WE program in transitionally frail older adults.


Wu, G. & Keyes, L. (2006). Group tele-exercise for improving balance in elders. Telemedicine Journal and e-Health, 12, 561-570.

METHODS: Elderly subjects participated in a structured, interactive, and supervised exercise class from their own homes through a videoconferencing system. An Internet-based videoconferencing device was installed in each subject's home, allowing real-time video and audio communication with the exercise instructor and all other participants. The exercise was in the form of Tai Chi, three times per week for 15 weeks. The main study measures included exercise compliance, level of acceptance and satisfaction, and the effectiveness of the exercise program on balance, fear of falling, and general health. RESULTS: There were significant improvements post exercise in fear of falling score (18%), single leg stance time (43%), Up-and-Go time (21%), and body sway during quiet stance (>8%).


Exercise

Zhuo, D., Shephard, R. J., Plyley, M. J., and Davis, G. M. (1984). Cardiorespiratory and metabolic responses during Tai Chi Chuan exercise. Canadian Journal of Applied Sport Sciences, 9, 7-10.

METHODS: This study was designed to determine the physiological demands of Tai Chi. Oxygen cost and related metabolic variables, heart rate and blood pressure were collected during Long-Form of Tai Chi. Data were collected by an automated respiratory gas analyzer and ECG telemetry during a 17-25 minute performance session (X = 22 minutes). RESULTS: The average energy cost for the Long-Form Tai Chi Chuan was 4.1 Mets, the mean peak heart rate during the exercises was 134 beats per minute. These values suggest that the Long-Form Tai Chi Chuan may be classed as moderate exercise, and its intensity does not exceed 50% of the individual's maximum oxygen intake.


Chen, K., Chen, W. & Huang, M. (2006). Development of the simplified Tai Chi exercise program (STEP) for frail older adults. Complementary Therapy Medicine, 14, 200-206.

METHODS: For phase I, using a focus group, 40 frail Taiwanese older adults were interviewed to explore their viewpoints on Tai Chi. This paper emphasized on the phase II of the study in which the older adults' perspectives were validated by 10 experts using an evaluation survey. RESULTS: The newly developed simplified Tai Chi exercise program (STEP) included three stages-(1) warm-up: comprised nine exercises specifically designed to loosen up the body from head to toe; (2) Tai Chi movements: encompassed 12 easy-to-learn and easy-to-perform movements; (3) cool-down: included three activities to cease the chi and rest the body.


Experience

Mak, M. & Nq, P. (2003). Mediolateral sway in single-leg stance is the best discriminator of balance performance for Tai-Chi practitioners. Archives of Physical Medicine and Rehabilitation, 84, 683-686.

METHODS: Nineteen Tai-Chi practitioners (who practiced Tai Chi for 30-45min at least 3/wk for >1y) and 19 healthy subjects with regular exercise habits. RESULTS: Tai-Chi practitioners had better clinical test scores for functional reach, gait speed, stride length, and sway parameters during single-leg stance. Sway in mediolateral direction during single-leg stance was the balance performance variable that best discriminated the Tai-Chi group from the non-Tai-Chi group. More experience practicing Tai Chi was associated with better balance performance.


Fibromyalgia

 

Carbonell-Baeza, A., Romero, A., Aparicio, V.A., Ortega, F.B., Tercedor, P., Delgado-Fernández, M., & Ruiz, J.R. (2011). Preliminary Findings of a 4-Month Tai Chi Intervention on Tenderness, Functional Capacity, Symptomatology, and Quality of Life in Men With Fibromyalgia. American Journal of Mens Health, [Epub ahead of print].

 

METHODS: Six men with fibromyalgia followed a 4-month Tai Chi intervention. The outcome variables were tenderness, functional capacity (30-second chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8 feet up and go, and 6-minute walk tests), and self-administered questionnaires. RESULTS: A significant improvement after the intervention period for the chair sit and reach test was found, such improvement was maintained after the detraining phase. Tenderness, symptomatology, and quality of life did not significantly change after the intervention period or the detraining phase.

 


 

Taggart, H., Arslanian, C., Bae, S. & Singh, K. (2003). Effects of Tai Chi exercise on fibromyalgia symptoms and health-related quality of life. Orthopedic Nursing, 22, 353-360.

METHODS: Participants with fibromyalgia (n = 39) formed a single group for 6 weeks of 1-hour, twice weekly Tai Chi exercise classes. FM symptoms and health-related quality of life were measured before and after exercise. RESULTS: Measurements on both the Fibromyalgia Impact Questionnaire and the Short Form-36 revealed significant improvement in symptom management and health-related quality of life.


Jones, A., Dean, E. & Scudds, R. (2005). Effectiveness of a community-based Tai Chi program and implications for public health initiatives. Archives of Physical Medicine Rehabilitation, 86, 619-625.

METHODS: Phase 1: 51 subjects inexperienced in Tai Chi (novice group) were compared with those of an experienced group (n=49) who had practiced Tai Chi for at least 6 months. A Cheng 119 style program was taught by a Tai Chi master for 1.5 hours, 3 times weekly, for 12 weeks. Lung function and physical activity were evaluated before and after the completion of the program. Resting heart rate, blood pressure, oxygen saturation, handgrip strength, flexibility, and balance were measured at the program commencement, 6 weeks, and 12 weeks. RESULTS: After the program, the novice group had increased handgrip strength, flexibility, and peak expiratory flow rate. The experienced group had greater flexibility and lower resting heart rate, but higher diastolic blood pressure than the novice group prior to training.


Chau, K. & Mao, D. (2006). The characteristics of foot movements in Tai Chi Chuan. Research in Sports and Medicine, 14, 19-28.

METHODS: This study examined how the characteristics of the foot movements in Tai Chi contribute to a practitioner's health by improving his or her balance and reducing the risk of falling. Ten Tai Chi masters were videotaped, and the time spent on different support patterns (step stance) and stepping directions (footwork) while performing the 42-form Tai Chi were analyzed. RESULTS: In support patterns, a larger percentage of time was spent on the double leg stance than on the single leg stance (and one leg support with another leg partially supporting type of stance. With regard to stepping directions, the centre requires a larger percentage of time than the forward, sideway, grinding, upward, and backward footwork. The movements classified were shown to simulate balance, flexibility and proprioception, and functional training.


Gait

Ramachandran, A., Rosengren, K., Yang, Y. & Hsiao-Wecksler, E. (2006) Effect of Tai Chi on gait and obstacle crossing behaviors in middle-aged adults. Gait and Posture, 26, 248-255.

METHODS & RESULTS: Kinematic analyses performed on step-to-step gait characteristics over multiple steps revealed that TC practitioners used a more cautious strategy by using slower gait speeds and shorter and slower steps than controls. TC practitioners also spent significantly longer time in single leg support while crossing the obstacle. The deleterious effect of this typically risky behavior may be mitigated in TC practitioners because of their comfort with single leg stance due to continual practice in this posture.


Heart rate

Lan, C., Chen, S.Y., & Lai, J.S. (2008). The exercise intensity of Tai Chi Chuan. Medicine and Sport Science, 52, 12-19.

 

METHODS: Heart rate responses during Tai Chi were measured in young, middle-aged, and elderly. RESULTS: Tai Chi effects on heart rate were similar across the different ages in both genders.


Yeh, G.Y., Mietus, J.E., Peng, C.K., Phillips, R.S., Davis, R.B., Wayne, P.M., Goldberger, A.L., & Thomas, R.J. (2008). Enhancement of sleep stability with Tai Chi exercise in chronic heart failure: preliminary findings using an ECG-based spectrogram method. Sleep Medicine, 9(5), 527-536.

 

METHODS: Patients with chronic stable heart failure were randomly assigned to receive usual care or 12 weeks of Tai Chi training in addition to usual care. RESULTS: Tai Chi participants showed increased high (stable) frequency heart rate and decreased low (unstable) frequency heart rate and enhanced sleep stability.

 


HIV

Galantino, M.L., Shepard, K., Krafft, L., Laperriere, A., Ducette, J., Sorbello, A., Barnish, M., Condoluci, D., & Farrar, J.T. (2005). The effect of group aerobic exercise and T’ai Chi on functional outcomes and quality of life for persons living with acquired immunodeficiency syndrome. Journal of Alternative and Complementary Medicine, 11(6), 1085-1092.

 

METHODS: AIDS patients were randomized to a tai chi, aerobic exercise, or control group. Experimental groups exercised twice weekly for 8 weeks. RESULTS: Results showed greater improvement in the exercise groups on overall functional measures and scores on the overall health subscale of the Quality of Life measure.


Hypertension

Tsai, J., Wang, W., Chan, P., Lin, L., Wang, C., Tomlinson, B., Hsieh, M., Yang, H. & Liu, J. (2003). The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. Journal of Alternative Complementary Medicine, 9, 747-754.

METHODS: 76 healthy subjects with blood pressure at high-normal or stage I hypertension received a 12-week Tai Chi exercise training program 3 times per week. Each session included 10-minute warm-up, 30-minute Tai Chi exercises and 10-minute cool-down experience. Exercise intensity was estimated to be approximately 64% of maximal heart rate. Blood pressure, lipid profile and anxiety status (State-Trait Anxiety Inventory; STAI) were evaluated. RESULTS: After 12-weeks of Tai Chi training, the treatment group showed significant decreases in systolic blood pressure of 16 mm Hg and diastolic blood pressure of 9 mm Hg. The serum total cholesterol level decreased 15 mg/dL and high-density lipoprotein cholesterol increased 5 mg/dL. Both trait anxiety and state anxiety were decreased.


Lee, E. (2004). The effects of a tai chi exercise program on blood pressure, total cholesterol and cortisol levels in patients with essential hypertension. Taehan Kanho Hakhoe Chi, 34, 829-837.

METHODS: Twenty-eight hypertensive patients participated in a 6- week program of Tai Chi exercise. In order to evaluate the effects of the Tai Chi program, blood pressure, total cholesterol, and cortisol levels were measured before and after week 6. RESULTS: After the 6-week Tai Chi program, there were significant differences in systolic blood pressure and diastolic blood pressure in the experimental group when compared to the control group.


Immune

Goon, J.A., Aini, A.H., Musalmah, M., Anum, M.Y., Nazaimoon, W.M., & Ngah, W.Z. (2009). Effect of Tai Chi exercise on DNA damage, antioxidant enzymes, and oxidative stress in middle-age adults. Journal of Physical Activity and Health, 6(1), 43-54.

METHODS: Middle-age adults were assessed for DNA damage following tai chi at 0, 6 and 12 months. RESULTS: Regular Tai Chi exercise stimulated endogenous antioxidant enzymes and reduced oxidative damage markers.

 


Irwin, M., Pike, J., Cole, J. & Oxman, M. (2003). Effects of a behavioral intervention, Tai Chi Chih, on varicella-zoster virus specific immunity and health functioning in older adults. Psychosomatic Medicine, 65, 824-830.

METHODS: Thirty-six men and women were assigned randomly to a 15-week program of TCC instruction (three 45 minute classes per week; N = 18) or a wait list control condition (N = 18). VZV-specific CMI was measured at baseline and at 1-week postintervention. Health functioning (Medical Outcome scale: SF-36) was assessed at baseline, and at 5, 10, and 15 weeks during the intervention, and at 1-week postintervention. RESULTS: In the intent-to-treat sample, VZV-specific CMI increased 50% from baseline to 1-week postintervention in the TCC group but was unchanged in the wait list control group. In those who completed the study, 1-week postintervention SF-36 scale scores for role-physical and physical functioning were higher in the TCC group (N = 14) as compared with controls (N = 17). Older adults who had impairments of physical status at baseline showed the greatest increases of SF-36 role-physical and physical functioning during the TCC intervention.


Irwin, M.R., Olmstead, R., & Oxman, M.N. (2007). Augmenting immune responses to varicella zoster virus in older adults: A randomized, controlled trial of Tai Chi. Journal of the American Geriatrics Society, 55(4), 511-517.

 

METHODS: Adults were randomly assigned to either Tai Chi exercise or health education for 25 weeks. After 16 weeks of intervention, subjects were vaccinated with VARIVAX, the live vaccine used to prevent varicella. RESULTS: Tai Chi, together with vaccine, produced a higher immune response than vaccine alone. The Tai Chi group also showed improved scores on physical functioning, bodily pain, vitality, and mental health.


Yeh, S., Chuang, H., Lin, L., Hsiao, C. & Eng, H. (2006). Regular tai chi exercise enhances functional mobility and CD4CD25 regulatory T cells. British Journal of Sports Medicine, 40, 239-243.

METHODS: This research investigated the effect of 12 weeks of tai chi on functional mobility, beliefs about benefits of exercise on physical and psychological health, and immune regulation in middle aged volunteers. RESULTS: Tai Chi had a significant effect on functional mobility and beliefs about the health benefits of exercise. Total white blood cell and red blood cell count did not change, but a significant decrease in monocyte count occurred. A significant increase in the ratio of T helper to suppressor cells (CD4:CD8) was found, along with a significant increase in CD4CD25 regulatory T cells.


Yeh, S.H., Chuang, H., Lin, L.W., Hsiao, C.Y., & Eng, H.L. (2006). Regular Tai Chi Chuan exercise enhances functional mobility and CD4CD25 regulatory T cells. British Journal of Sports Medicine, 40(3), 239-243.

METHODS: Adults participated in a 12-week Tai Chi exercise program. RESULTS: Regular Tai Chi exercise had a positive effect on functional mobility and beliefs about the health benefits of exercise. Decreased monocyte count and increased ratio of T helper to suppressor cells were also noted. Stimulation (varicella zoster virus) was also increased after this exercise program.

 


Yeh, S.H., Chuang, H., Lin, L.W., Hsiao, C.Y., Wang, P.W., Liu, R.T., & Yang, K.D. (2009). Regular Tai Chi Chuan exercise improves T-cell helper function of patients with type 2 diabetes mellitus with an increase in T-bet transcription factor and IL-12 production. British Journal of Sports Medicine, 43(11), 845-850.

 

METHODS: A case-control study was performed on patients with type 2 diabetes and normal age-matched adults. RESULTS: Tai Chi decreased HbA1c (the amount of glycated hemoglobin ) levels along with an increase in the Th1 reaction.


Moderate Intensity Exercise

Lan, C., Chen, S., Lai, J. & Wong, M. (2001). Heart rate responses and oxygen consumption during Tai Chi Chuan practice. American Journal of Chinese Medicine, 29, 403-410.

METHODS: Subjects had practiced tai chi for 5.8 years. HR responses and VO2 were measured during practice of tai chi by using a K4 telemetry system. Blood lactate was measured before and immediately after tai chi practice. Additionally, breath-by-breath measurement of cardiorespiratory function and sequential determination of blood lactate were performed during the incremental exercise of leg cycling. Measurements obtained during the tai chi practice and exercise testing were compared to determine the exercise intensity of tai chi. Results: While performing tai chi, the mean HR of subjects was 140 +/- 10 bpm, and the mean VO2 was 21.4. Compared with the data of the exercise test, the HR during practice was 58% of the heart rate range, the VO2 during tai chi practice was 55% of the VO2peak. The results demonstrate that tai chi is an exercise with moderate intensity, and is aerobic in nature.


Lan, C., Chen, S. & Lai, J. (2004). Relative exercise intensity of Tai Chi Chuan is similar in different ages and gender. American Journal of Chinese Medicine, 32, 151-160.

METHODS: One hundred Tai Chi practitioners participated in this investigation. Men and women were separated into three groups: young (25-44 y/o), middle-aged (45-64 y/o) and elderly (65-80 y/o). Heart rate (HR) responses during Tai Chi practice were measured by using electrocardiographic telemetry. An exercise test with breath-by-breath measurements of cardiorespiratory function was also performed for each subject during the incremental exercise of leg cycling. Measurements obtained during the Tai Chi practice and exercise testing were compared to determine the exercise intensity of Tai Chi. While performing Tai Chi, the mean HR of men was 141, 132 and 120 in the young, middle-aged and elderly groups, respectively. The mean HR of women was 136, 126 and 115 in the young, middle-aged and elderly groups, respectively. RESULTS: The results demonstrate that classical Yang TCC is an exercise with moderate intensity, and its exercise intensity is similar across different ages in each gender. In conclusion, TCC is an aerobic exercise and suitable for participants of different ages and gender to improve their functional capacity.


Muscle Strength

Li JX, Xu DQ, Hong Y.( 2009). Changes in muscle strength, endurance, and reaction of the lower extremities with Tai Chi intervention. Journal of Biomechanics, 42, 967-971.

 

METHODS:  The TC group underwent a supervised TC exercise program for 16 weeks, while the control group received general education for a comparable time period. RESULTS: After 16 weeks, the TC group showed a 20% increase in muscle strength of the knee flexors and a significant decrease in semitendinosus muscle latency.

 


Tamim, H., Castel, E.S., Jamnik, V., Keir, P.J., Grace, S.L., Gledhill, N., & Macpherson, A.K. (2009). Tai Chi workplace program for improving musculoskeletal fitness among female computer users. Work: A Journal of Prevention, Assessment and Rehabilitation, 34(3), 331-338.

 

METHODS: Female computer users participated in two 50-minute Tai Chi classes per week for 12 consecutive weeks. RESULTS: Results showed that the TC program was effective in improving musculoskeletal fitness and psychological well-being.

 


Xu, D., Li, J. & Hong, Y. (2006). Effects of long term Tai Chi practice and jogging exercise on muscle strength and endurance in older people. British Journal of Sports Medicine, 40, 50-54.

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 and 120 degrees. Ankle dorsiflexors and plantar flexors were tested at 30 degrees and the dynamic endurance of the knee flexors and extensors was assessed at a speed of 180 degrees. 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.


Wu, G. (2008). Age-related differences in Tai Chi gait kinematics and leg muscle electromyography: A pilot study. Archives of Physical Medicine and Rehabilitation, 89(2), 351-357.

 

METHODS: Tai Chi practitioners were measured for spatial, temporal, and leg muscle electromyography during Tai Chi gait and normative gait. RESULTS: Compared with normative gait, elders during Tai Chi had significantly larger knee and hip flexions, and greater leg muscle strength.

 


Musculoskeletal

Hall, A., Maher, C., Latimer, J., & Ferreira, M. (2009). The effectiveness of Tai Chi for chronic musculoskeletal pain conditions: a systematic review and meta-analysis. Arthritis and Rheumatism, 61(6), 717-724.

 

REVIEW: Seven randomized controlled trials were selected for inclusion in the review. Tai Chi led to lower tension and greater satisfaction with general health.

 


Obesity

Dechamps, A., Gatta, B., Bourdel-Marchasson, I., Tabarin, A., & Roger, P. (2009). Pilot study of a 10-week multidisciplinary Tai Chi intervention in sedentary obese women. Clinical Journal of Sports Medicine, 19, 49-53.

 

METHODS: Obese women were randomized to either a 2-hour weekly session of Tai Chi or conventional exercise. RESULTS: The Tai Chi group had lower systolic blood pressure, better chair rise test and mood and less fat at week 10 and at 6 months follow-up.


Tsang, T.W., Kohn, M., Chow, C.M., & Singh, M.F. (2009). A randomized controlled trial of Kung Fu training for metabolic health in overweight/obese adolescents: the "martial fitness" study. Journal of Pediatric Endocrinology & Metabolism, 22, 595-607.

 

METHODS: Overweight/obese adolescents underwent six months of Kung Fu or Tai Chi training. RESULTS:  C-reactive protein (CRP) decreased in both groups. Reduced CRP was related to increased upper body strength. Increased lean body mass was related to reductions in insulin resistance, triglycerides, and total cholesterol.

 


Osteoarthritis

Wang, C. (2011). Tai chi and rheumatic diseases. Rheumatic Disease Clinics of North America, 37, 19-32.

 

REVIEW: Tai chi is a complex multicomponent mind-body exercise. Many studies have provided evidence that tai chi benefits patients with a variety of chronic disorders. This form of mind-body exercise enhances cardiovascular fitness, muscular strength, balance, and physical function and seems to be associated with reduced stress, anxiety, and depression and improved quality of life. Thus, despite certain limitations in the evidence, tai chi can be recommended to patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia as a complementary and alternative medical approach.


Brismee, J., Paige, R., Chyu, M., Boatright, J., Hagar, J. McCaleb, J., Quintela, M. Feng, D., Xu, K. & Shen, C. (2007). Group and home-based tai chi in elderly subjects with knee osteoarthritis: a randomized controlled trial. Clinical Rehabilitation, 21, 99-111.

METHODS: To evaluate the effects of tai chi consisting of group and home-based sessions in elderly subjects with knee osteoarthritis. RESULTS: six weeks of group tai chi followed by another six weeks of home tai chi training showed significant improvements in mean overall knee pain, maximum knee pain and the WOMAC subscales of physical function and stiffness.


Lee, H.J., Park, H.J., Chae, Y., Kim, S.Y., Kim, S.N., Kim, S.T., Kim, J.H., Yin, C.S., Lee, H. (2009). Tai Chi Qigong for the quality of life of patients with knee osteoarthritis: a pilot, randomized, waiting list controlled trial. Clinical Rehabilitation, 23, 504-511.

 

METHODS: Adults with knee osteoarthritis were randomized to a Tai Chi Qigong or a wait list control group. RESULTS: The Tai Chi group had greater improvements in quality of life and 6-m walking test.

 


Song, R., Lee, E., Lam, P. & Bae, S. (2003). Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial. Journal of Rheumatology, 30, 2039-2044.

METHODS: Seventy-two patients with OA were randomly assigned. Outcome variables were physical symptoms and fitness, body mass index, cardiovascular functioning, and perceived difficulties in physical functioning. RESULTS: Mean comparisons of the change scores revealed that the experimental group perceived significantly less pain in their joints and reported fewer perceived difficulties in physical functioning, while the control group showed no change or even deterioration in physical functioning after 12 weeks. In the physical fitness test, there were significant improvements in balance and abdominal muscle strength for the tai chi exercise group.


Song, R., Roberts, B.L., Lee, E.O., Lam, P., Bae, S.C. (2010). A randomized study of the effects of tai chi on muscle strength, bone mineral density, and fear of falling in women with osteoarthritis. Journal of Alternative and Complementary Medicine, 16, 227-233.

METHODS: Women with osteoarthritis were randomly assigned to either a tai chi group or a control group. RESULTS: After 6-months the tai chi group had greater knee extensor endurance and greater bone mineral density.

 


Wang, C., Schmid, C.H., Hibberd, P.L., Kalish, R., Roubenoff, R., Rones, R., McAlindon, T. (2009). Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis and Rheumatism, 15, 1545-1553.

 

METHODS:  Adults with knee osteoarthritis were randomly assigned to 60 minutes of Tai Chi or attention control twice weekly for 12 weeks. RESULTS: Patients assigned to Tai Chi showed greater improvement in physical function and a greater reduction in pain and depression.


Osteoporosis

Chan, K., Qin, L., Lau, M., Woo, J., Au, S., Chou, W., Lee, K. & Lee, S. (2004). A randomized, prospective study of the effects of Tai Chi Chuan exercise on bone mineral density in postmenopausal women. Archives of Physical Medicine and Rehabilitation, 85, 717-722.

METHODS: One hundred thirty-two healthy postmenopausal women were randomized into the Tai Chi group or a sedentary control group. Tai Chi exercise was performed for 45 minutes a day, 5 days a week, for 12 months. RESULTS: Measurements revealed a general bone loss in both Tai Chi and sedentary control subjects at all measured skeletal sites, but with a reportedly slower rate in the Tai Chi group. A significant 2.6- to 3.6-fold retardation of bone loss was found in the tibia in the Tai Chi group as compared with the controls.


Lee, H.Y., & Lee, K.J. (2008). Effects of Tai Chi exercise in elderly with knee osteoarthritis. Taehan Kanho Hakhoe Chi, 38, 11-18.

 

METHODS: Participants were assigned to a Tai Chi or a control group2 times per week for 12 weeks. RESULTS: The Tai Chi group had less pain and stiffness and improvements in knee joint motion on both knees, rising time, balance on the left single leg test, and fear of falling.


Qin, L., Choy, W., Leung, K., Au, P., Hung, S., Dambacher, W. & Chan, K. (2005). Beneficial effects of regular Tai Chi exercise on musculoskeletal system. Journal of Bone Mineral Metabolism, 23, 186-190.

METHODS: 99 healthy postmenopausal women were recruited. RESULTS: The Tai Chi group showed overall higher Bone Mineral Density at all measurement sites, with a significant difference found at the spine, and femur. Functional tests revealed an average 43% greater quadriceps strength, and 68% significantly longer single-stance time in the Tai Chi group as compared with the control group, as well as a greater magnitude of trunk bend-and-reach in the Tai Chi group.


Shen, C.L., James, C.R., Chyu, M.C., Bixby, W.R., Brismée, J.M., Zumwalt, M.A., & Poklikuha, G. (2008). Effects of Tai Chi on gait kinematics, physical function, and pain in elderly with knee osteoarthritis--a pilot study. The American Journal of Chinese Medicine, 36, 219-232.

 

METHODS: Participants with knee osteoarthritis had 6 weeks of Tai Chi exercise 1 hour/session, 2 sessions /week.  RESULTS: Stride length, stride frequency, and consequently gait speed increased in the participants. Physical function was improved and knee pain was decreased.

   


Parkinson

Klein, P. & Rivers, L. (2006). Taiji for individuals with Parkinson disease and their support partners: a program evaluation. Journal of Neurology and Physical Therapies, 30, 22-27.

METHODS: participants (N=15) included 8 individuals with Parkinsons and 7 support partners with no history of Parkinsons. Group tai chi instruction was offered in 45-minute weekly sessions, for 12 weeks. Post-program evaluation included administration of a survey questionnaire, thematic analysis of a focus group discussion, instructor reflections, and review of attendance records. RESULTS: Benefits were perceived by participants in physical, psychological, and social domains. Thirteen of the survey respondents, including 6 of the 8 respondents with Parkinsons reported perceiving a physical benefit attributed to tai chi practice. Improved balance was reported most frequently. Instructor observations and participant testimony suggest movement capability for individuals with Parkinsons may also be improved by performing tai chi.


Hackney ME, Earhart GM. (2008). Tai Chi improves balance and mobility in people with Parkinson disease. Gait and Posture, 28, 456-460.

 

Method: People with Parkinson disease were randomly assigned to either a Tai Chi group or a control group. The Tai Chi group participated in 20 1-h long training sessions completed within 10-13 weeks. Results: The Tai Chi group improved more than the control group on the Berg Balance Scale, UPDRS, Timed Up and Go, tandem stance test, six-minute walk, and backward walking.

 


Physical and Mental Health

Wang, Y.T., Taylor, L., Pearl, M. & Chang, L.S. (2004). Effects of Tai Chi exercise on physical and mental health of college students. American Journal of Chinese Medicine, 32, 453-459.

METHODS: Thirty college students participated in a 1-hour-long Tai Chi exercise intervention twice a week for 3 months. Each practice session included 10 minutes of breathing and stretching exercises followed by 50 minutes of Tai Chi Quan 24-form practice. The measures included physical function (PF), role physical (RP), bodily pain (BP), general health (GH), social function (SF), role mental/emotion function (RE), vitality (VT) and perceptions of mental health (MH). RESULTS: Physical measures of BP and GH, and mental measures of RE, VT and MH were significantly improved after Tai Chi.


Caldwell, K., Harrison, M., Adams, M., & Triplett, N.T. (2009). Effect of pilates and taiji quan training on self-efficacy, sleep quality, mood, and physical performance of college students. Journal of Bodywork and Movement Therapies, 13, 155-163.

METHODS: The purpose of this investigation was to examine the effects of a semester of either Pilates or taiji quan training on perceived self-efficacy, sleep quality and mood, as well as strength and balance in college-age individuals. RESULTS: Self-efficacy was found to be improved in the Pilates and taiji quan groups and there was a trend towards improvement in sleep quality. Mood was found to be improved significantly in the Pilates group while the taiji group showed a trend towards improvement. There were no changes or group differences in the strength or balance measures. Pilates and taiji quan are effective exercise modes to improve mental parameters in college-age individuals.


Pulmonary Function

Chan, A.W., Lee, A., Suen, L.K., & Tam, W.W. (2011) Tai chi Qigong improves lung functions and activity tolerance in COPD clients: a single blind, randomized controlled trial. Complement Therapy in Medicine, 19, 3-11

METHODS:  206 clients with chronic obstructive pulmonary disease were randomly assigned into one of the three groups, namely, Tai CHi Qigong (TCQ), exercise, and control group. Subjects in the TCQ group received a TCQ program consisting of two 60-min sessions each week for three months. Subjects in the exercise group were taught to practice breathing techniques combined with walking as an exercise. Subjects in the control group were instructed to maintain their usual activities. Data collection was performed at baseline and at the 6-week and 3-month marks. RESULTS: Results of repeated measures of analysis of covariance demonstrated that there were significant interaction effects between time and group in forced vital capacity , forced expiratory volume in 1s, walking distance, and exacerbation rate at 3 months. Improvements were noted in the TCQ group. No changes were observed in the exercise group, while a decline in lung functions was noticed in the control group.


Jong, S.Y., Fang, Y.Y. & Chao, Y.F. (2004). The effect of Tai-Chi-Qui-Gong exercises on patients' pulmonary function, exercise capacity, and quality of life after lobectomy. Hu Li Za Zhi, 51, 46-54.

METHODS: The purpose of this study was to evaluate the effect of Tai-Chi-Qui-Gong (TCQG) practice on patients' pulmonary function, activity capacity, and quality of life after lobectomy. Subjects in the experimental group received a training class on 10 motions of TCQG two days before surgery. They began to practice the TCQG exercises twice per day from the first postoperative day. They started with three motions on the first day, increasing to 10 on the fifth day. The control group received standard post-lobectomy care, which did not include the TCQG exercises. All subjects received measures on pulmonary function and six-minute walk distance (6MWD) two days prior to the operation, as well as one week, and one month after the operation. Quality of life was measured two days before the operation and one month after the operation. RESULTS: The results indicated that subjects in the experimental group had significant improvement in their tidal volume and 6MWD after lobectomy, while subjects in the control group did not. The 6MWD of the subjects in the experimental group reverted to the preoperative status at the end of the first week, and was even better one month later. The postoperative quality of life of the subjects in the experimental group was significantly better than that of in the control group.


Chang, Y.F., Yang, Y.H., Chen, C.C., & Chiang, B.L. (2008). Tai Chi Chuan training improves the pulmonary function of asthmatic children. Journal of Microbiology, Immunology and Infection, 41, 88-95.

METHOD: Children participated in a 12-week Tai Chi Chuan program. RESULTS: After the 12-week program, children in the Tai Chi Chuan group had a significant improvement in pulmonary function compared to the control group.


Review

Wang, C., Collet, J. & Lau, J. (2004). The effects of Tai Chi on health outcomes in patients with chronic conditions: a systematic review. Archives of Internal Medicine, 164, 493-501.

REVIEW: There were 9 randomized controlled trials, 23 nonrandomized controlled studies, and 15 observational studies in this review. Benefits were reported for balance and strength, cardiovascular and respiratory function, flexibility, immune system, symptoms of arthritis, muscular strength, and psychological effects.


Kuramoto, A. (2006). Therapeutic benefits of Tai Chi exercise: research review. Wisconsin Medical Journal, 105, 42-46.

REVIEW: 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. Studies are needed on the effects on younger and middle-aged people. More longitudinal studies are needed, since time is an important factor in 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 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.


Mansky, P., Sannes, T., Wallerstedt, D., Ge, A., Ryan, M., Johnson, L., Chesney, M. & Gerber, L. (2006). Tai Chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors. Integrative Cancer Therapies, 5, 192-201.

REVIEW: Tai chi 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 Tai Chi published from 1989 to 2006 identified 20 prospective, randomized, controlled clinical trials in a number of populations, including elderly participants, patients with cardiovascular complications, patients with chronic disease, and patients who might gain psychological benefit from Tai Chi practice. However, only the studies of Tai Chi in the elderly and 2 studies of Tai Chi for cardiovascular disease had adequate designs and size to allow conclusions about the efficacy of Tai Chi. Most were small and provided limited information on the benefit of Tai Chi in the settings tested.


Rheumatoid Arthritis

Han, A., Robinson, V., Judd, M., Taixiang, W., Wells, G. & Tugwell, P. (2004). Tai Chi for treating rheumatoid arthritis. Cochrane Database System Review, CD004849.

METHODS: Randomized controlled trials and controlled clinical trials examining the benefits and harms of exercise programs with Tai Chi instruction or incorporating principles of Tai Chi philosophy were selected. We included control groups who received no therapy, sham therapy or another type of therapy. Two reviewers determined the studies to be included in this review, rated the methodological quality and extracted data using standardized forms. RESULTS: Four trials including 206 participants were included in this review. For range of motion, Tai Chi participants had statistically significant and clinically important improvements in ankle plantar flexion.


Sleep

Li, F., Fisher, K.J., Harmer, P., Irbe, D., Tearse, R.G., & Weimer, C. (2004). Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomized controlled trial. Journal of the American Geriatrics Society, 52, 892-900.

METHODS: Participants were randomized into tai chi or low-impact exercise and participated in a 60-minute session, three times per week, for 24 consecutive weeks. RESULTS: Tai chi participants reported sleep-onset latency of about 18 minutes less per night and sleep duration of about 48 minutes more per night than low-impact exercise participants.


Kuramoto, A.M. (2006). Therapeutic benefits of Tai Chi exercise: research review. Wisconsin Medical Journal, 105, 42-46.

REVIEW: 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. 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.


Irwin MR, Olmstead R, Motivala SJ. (2008). Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Tai Chi Chih. Sleep, 31, 1001-1008.

METHODS: Randomly allocated to Tai Chi Chih or health education for 25 weeks. RESULTS: Among adults with moderate sleep complaints, as defined by PSQI global score of 5 or greater, subjects in the Tai Chi Chih condition were more likely to achieve a treatment response, as defined by PSQI less than 5. Significant improvements were noted in PSQI global score as well as in the sleep parameters of rated sleep quality, sleep duration, and sleep disturbance.


Strength

Jacobson, B. H., Chen, H. C., Cashel, C., and Guerrero, L. (1997). The effect of T'ai Chi Chuan training on balance, kinesthetic sense, and strength. Perceptual & Motor Skills, 84(1), 27-33.

METHODS: This study assessed the effect of Tai Chi training on lateral stability, kinesthetic sense, and strength of voluntary knee extension. Pre- and 12-week posttests included lateral body stability, kinesthetic sense in the glenohumeral joint for 30 degrees, 45 degrees, and 60 degrees, and strength of knee extension. Subjects performed Tai Chi three times per week for 12 weeks, learning 108 forms. RESULTS: Lateral body stability, kinesthetic sense at 60 degrees, and strength of the dominant knee extensor was enhanced in the Tai Chi group. No significant differences between the Tai Chi and the control group were found for kinesthetic sense at 30 degrees and 45 degrees rotation of the glenohumeral joint.


Stress

Jin, P. (1992). Efficacy of Tai Chi, brisk walking, medication, and reading in reducing mental and emotional stress. Journal of Psychosomatic Research, 36, 361-370.

METHODS: Tai Chi, a moving meditation, is examined for its efficacy in post-stressor recovery. Forty-eight male and 48 female Tai Chi practitioners were randomly assigned to four treatment groups: Tai Chi, brisk walking, mediation and neutral reading. Mental arithmetic and other difficult tests were chosen as mental challenges, and a stressful film was used to produce emotional disturbance. Tai Chi and the other treatments were applied after these stressors. RESULTS: After all treatments, the salivary cortisol level dropped significantly, and the mood states were also improved. In general the stress-reduction effect of Tai Chi characterized moderate physical exercise. Heart rate, blood pressure, and urinary catecholamine changes for Tai Chi were found to be similar to those for walking at a speed of 6 km/hr. Although Tai Chi appeared to be superior to neutral reading in the reduction of state anxiety and the enhancement of vigour, this effect could be partially accounted for by the subjects' high expectations about gains from Tai Chi. Approaches controlling for expectancy level are recommended for further assessment.


Taylor-Piliae, R., Haskell, W., Waters, C. & Froelicher, E. (2006). Change in perceived psychosocial status following a 12-week Tai Chi exercise programme. Journal of Advance Nursing, 54, 313-329.

METHODS: Participants attended a 60-minute Tai Chi exercise class three times per week for 12 weeks. 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: Statistically significant improvements in all measures of psychosocial status were found following the intervention. Improvement in mood state and reduction in perceived stress were found. In addition, Tai Chi exercise significantly increased self-efficacy to overcome barriers to Tai Chi, confidence to perform Tai Chi, and perceived social support.


Stroke

 

Au-Yeung, S.S., Hui-Chan, C.W., & Tang, J.C. (2009). Short-form Tai Chi improves standing balance of people with chronic stroke. Neurorehabilitation and Neural Repair 23, 515-522.

 

METHODS: Stroke victims were randomly assigned to a general exercise or a Tai Chi group for 12 weeks. RESULTS: The Tai Chi group showed greater center of gravity excursion amplitude in leaning forward, backward, and toward the affected and nonaffected sides.


Taylor-Piliae, R.E., & Haskell, W.L. (2007). Tai Chi exercise and stroke rehabilitation. Topics in Stroke Rehabilitation, 14(4), 9-22.

 

REVIEW: This article reviews the philosophy and principles of Tai Chi studies examining balance, blood pressure, and mood, and the potential application of Tai Chi exercise to stroke rehabilitation.

 


Sympathetic Activity

Motivala, S., Sollers, J., Thayer, J. & Irwin, M. (2006). Tai Chi Chih acutely decreases sympathetic nervous system activity in older adults. Journal of Gerontology a Biological Science Medicine, 61, 1177-1180.

Aging is associated with increases of sympathetic nervous system activation implicated in the onset of hypertension and cardiovascular disease. TCC practitioners performed TCC for 20 minutes, and TCC-naïve participants passively rested. TCC performance significantly decreased sympathetic activity as indexed by preejection period


Vagal Activity

Audette, J.F., Jin, Y.S., Newcomer, R., Stein, L., Duncan, G., & Frontera, W.R.  (2006). Tai Chi versus brisk walking in elderly women. Age and Ageing, 35(4), 388-393.

 

METHODS:  Women were randomly assigned to a Tai Chi group, brisk walking group, or control group. RESULTS: After 12 weeks, the Tai chi group had greater improvement in estimated VO(2)max, a greater increase in parasympathetic activity and greater decrease in sympathetic activity, and gains in non-dominant knee extensor strength and single-leg stance time.

 


Lu, W. & Kuo, C. (2003). The effect of Tai Chi Chuan on the autonomic nervous modulation in older persons. Medicine and Science in Sports Exercise, 35, 1972-1976.

METHODS: Twenty Tai Chi practitioners and 20 normal controls were included in this study. The stationary state spectral heart rate variability (HRV) measures between Tai Chi practitioners and normal controls, and the sequential changes in HRV measures after classical Yang's Tai Chi were compared. RESULTS: The total power, very low-frequency power, low-frequency power, normalized low-frequency power, and low-/high-frequency power ratios in Tai Chi practitioners were all significantly higher than those of normal controls, whereas the heart rate and systolic and diastolic blood pressures were not different between these two groups of subjects. After Tai Chi, the normalized high-frequency power increased significantly from 23 to 28 30 min after Tai Chi and to 31 60 min after Tai Chi. In contrast, the low-/high-frequency power ratio decreased significantly from 3 before Tai Chi to 2 30 min after Tai Chi and to 2 60 min after Tai Chi. The heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, and pulse pressure also decreased sequentially after Tai Chi. The short-term effect of Tai Chi was to enhance the vagal modulation and tilt the sympathovagal balance toward deceased sympathetic modulation in older persons. Tai Chi might be good health-promoting calisthenics for older persons.


Lu, W.A., & Kuo, C.D. (2006). Comparison of the effects of Tai Chi Chuan and Wai Tan Kung exercises on autonomic nervous system modulation and on hemodynamics in elder adults. The American Journal of Chinese Medicine, 34(6), 959-968.

 

METHODS: Tai Chi and Wai Tan Jung were compared for their effects on system modulation and hemodynamics. RESULTS: Both exercises enhanced vagal modulation, lowered sympathetic modulation and lowered arterial blood pressures.