Tai Chi Abstracts (2015-2017)
Sharma M, Haider T. Tai Chi as an alternative and complementary therapy for anxiety: a systematic review. J Evid Based Complement Altern Med. 2015;20:143-53.
Method: the studies were non- randomized controlled trials that featured small sample sizes, non-standardized tai chi interventions and many different outcome measures.
Result: Surprisingly, only one paper could be found in the recent literature on tai chi for anxiety. This was a review paper on 17 articles that met inclusion criteria with eight of them being from the US, two from Australia, two from Japan, two from Taiwan and one each from Canada, Spain and China . Reduced anxiety was noted in at least 12 of the studies reviewed. However, the authors noted several limitations of this body of research.
Callahan LF, Cleveland RJ, Altpeter M, Hackney B. Evaluation of Tai Chi program effectiveness for people with arthritis in the community: a randomized controlled trial. J Aging Phys Act. 2016;24:101-10.
Method: In an assessment of the Arthritis Foundation tai chi program, those with arthritis were randomly to the tai chi group or a waitlist control group.
Result: Following this eight week program balance was improved. At one year improvements in pain, fatigue and stiffness were noted, suggesting long-term effects in at least 30% of those who continued tai chi practice following the end of the program.
Varghese R, Hui-Chan CW, Bhatt T. Reduced Cognitive-motor interference on voluntary balance control in older Tai Chi practioners. J Geriatr Phys Ther. 2015; [Epub ahead of print].
Method: In one study on 10 elderly tai chi practitioners and 10 age matched non-practitioners, the participants were asked to shift their weight to reach a target with and without performing the cognitive task of counting backwards.
Result: The Tai chi practitioners had shorter reaction times and faster movements than the non-tai chi practitioners.
Wayne PM, Hausdorff JM, Lough M, Gow BJ, Lipsitz L, Novak V, Macklin EA, Peng CK, Manor B. Tai Chi training may reduce dual task gait variability, a potential mediator of fall risk, in healthy older adults: cross-sectional and randomized trial studies. Front Hum Neurosci. 2015;9.
Method: In a similar dual-task study, tai chi experts and non-experts were compared on their walking time while they performed serial subtractions.
Result: Walking or stride time variability was lower in the tai chi expert group. Walking time variability has been considered a potential mediator of the risk for falling. Although comparisons of tai chi practitioners versus non-practitioners would be expected to reveal greater effects for the practitioners given their greater activity levels, but the two groups may also differ on baseline motivation, physical fitness and other variables, making their comparison tenuous at best.
Zhou J, Chang S, Cong Y, Qin M, Sun W, Lian J, Yao J, Li W, Hong Y. Res Sports Med. 2015;23:302-14.
Method: Another way of testing balance is the sway paths both to each side and from the front to the back. In a sway path balance study, a tai chi group was compared to a no regular exercise group.
Result: The tai chi group showed shorter sway paths both forward and back and to each side after 24 weeks of tai chi.
Rahal MA, Alonso AC, Andrusaitis FR, Rodrigues TS, Speciali DS, Greve Jm, Leme LE. Analysis of static and dynamic balance in healthy elderly practitioners of Tai Chi Chuan versus ballroom dancing. Clinics (Sao Paulo). 2015;70:157-61.
Method: In one study tai chi was compared to ballroom dancing. In this randomized controlled trial, the tai chi group had a lower sway velocity both with open and with closed eyes on a firm surface as well as a foam surface.
Result: The tai chi group also had faster walking speed and shorter times moving from a sitting to a standing position with less sway in the final standing position.
Yildirim P, Ofluoglu D, Aydogan S, Akyuz G. Tai Chi vs. combined exercise prescription: a comparison of their effects on factors related to falls. J Back Musculoskelet Rehabil. 2015; [Epub ahead of print].
Method: In another study, tai chi was compared to regular exercise that was performed three times a week for 12 weeks.
Result: Both exercise groups showed better results on dynamic balance assessments. However, the tai chi group showed better performance on the single leg stance eyes open task and on a survey of activities and fear of falling scale.
Huang Y, Liu X. Improvement of balance control ability and flexibility in the elderly Tai Chi Chuan (TCC) practioners: a systematic review and meta-analysis. Arch. Gerontol Geriatr. 2015;60:233-8.
Method: A meta-analysis of seven randomized controlled trials including 1088 participants, tai chi was compared with other interventions.
Result: Tai chi was shown to have significantly shorter time on get up and go, prolonged time on single leg stand and improved balance. Other meta-analyses on a greater number of randomized controlled trials need to be conducted to confirm these data.
Pan Y, Yang K, Shi X, Liang H, Zhang F, Lv Q. Tai Chi Chuan exercise for patients with breast cancer: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2015.
Method: In a systematic review/meta-analysis study, nine randomized controlled trials including 322 breast cancer patients met criteria.
Result: .In these trials, comparisons between tai chi and control therapies yielded only changes in upper limb functional mobility. These included increased handgrip dynamometer strength and limb elbow flexion. No differences were noted for pain, IL – 6, physical, social or emotional well-being. It is surprising that IL -6 was the only immune measure common across the studies that met criteria.
Cancer in General
Campo RA, Light KC, O’Connor K, Nakamura Y, Lipschitz D, La Stayo PC, Pappas LM, Boucher KM, Irwin MR, Hill HR, Martins TB, Agarwal N, Kinney AY. Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a Tai Chi Chih randomized controlled trial. J Cancer Surviv. 2015;9:115-25.
Method: A randomized controlled trial of tai chi effects on cancer, specifically senior female cancer survivors, tai chi was compared to a health education class. Tai chi was practiced and the health education classes were held for 60 minutes three times a week for 12 weeks.
Result: The tai chi group had significantly lower systolic blood pressure and cortisol levels at the end of the study. There were, however, no changes in inflammatory cytokines.
Cardio Respiratory Disease
Holmes ML, Manor B, Hsieh WH, Hu K, Lipsitz LA, Li L. Tai Chi training reduced coupling between respiration and postural control. Neurosci Lett. 2016;610:60-5.
Method: In the aging process apparently respiration affects postural sway, and by tai chi improving respiratory function it can also improve postural control. This relationship was shown in a study on a 12 week tai chi intervention versus an educational control group.
Result: While the tai chi training did not alter standing postural control or respiration, the coupling between respiration and postural control was reduced. For some reason as in many other tai chi studies, the sample sizes for the two groups were unequal which may reflect a self-selection bias and which may have contributed to these null findings.
Zheng G, Li S, Huang M, Liu F, Tao J, Chen L. The effect of Tai Chi on cardiorespiratory fitness in healthy adults: a systematic review and meta-analysis. PloS One. 2015;10.
Method: A systematic review and meta-analysis 20 studies with 1868 participants. These included systolic and diastolic blood pressure, heart rate, stroke volume, cardio output, lung capacity, cardio respiratory endurance and stair test index.
Result: participants suggested that tai chi had positive effects on the majority of cardio function outcomes.
Chronic Obstructive Pulmonary Disease
Qiu ZH, Guo HX, Lu G, Zhang N, He BT, Zhou L, Luo YM, Polkey MI. Physiological responses to Tai Chi in stable patients with COPD. Respir Physiol Neurobiol. 2016;221-30-4.
Method: A randomized controlled study comparing tai chi with treadmill exercise.
Result: COPD has also benefited from tai chi. The respiratory rate during tai chi was significantly lower than during treadmill exercise even though the mean values of oxygen uptake did not differ across the two exercises.
Guo JB, Chen BL, Lu YM, Zhang WY, Zhu ZJ, Yang YJ, Zhu Y. Tai Chi for improving cardiopulmonary function and quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Clin Rehabil. 2015; [Epub ahead of print].
Method: A systematic review and meta-analysis on the effects of tai chi on chronic obstructive pulmonary disease, 15 articles involving 1354 participants met criteria. Compared to an inactive control group.
Result: Compared to an inactive control group tai chi was more effective in improving exercise on six – minute walking test, on forced expiratory volume in the first second and on forced vital capacity. The tai chi group also scored better on the dyspnea score, fatigue score and total score of the Chronic Respiratory Disease Questionnaire. However, once again, it is not surprising that tai chi effects would be more positive than those of an inactive control group. Future studies need to compare different styles of tai chi or at least compare tai chi with active exercise groups to determine reliable treatment effects.
Cognitive and Physical Function
Zacharia S, Taylor EL, Hofford CW, Brittain DR, Branscum PW. The effect of an 8-week Tai Chi exercise program on physical functional performance in middle-aged women. J Appl Gerontol. 2015;34:573-89.
Method: Several researchers have conducted studies on cognitive and physical functions in various age groups. In a quasi-experimental design with a non-equivalent comparison group, healthy and active women were assigned to a tai chi program (twice a week for 8 weeks) or a control group.
Result: By the end of the program the tai chi group was showing better physical performance.
Sun J, Kanagawa K, Sasaki J, Ooki S, Xu H, Wang L. Tai Chi improves cognitive and physical function in the elderly: a randomized controlled trial. J Phys Sci. 2015;27:1467-71.
Method: In a study with an elderly sample, tai chi was provided twice per week for six months and that group was compared to a control group who participated in “other non-athletic activities”.
Result: Assessments made at three and six months suggested that the tai chi group performed better on the Mini–mental state examination, on grip strength and on walking speed.
Lu X, Siu KC, Fu SN, Hui-Chan CW, Tsang WW. Effects of Tai Chi training on postural control and cognitive performance while dual tasking- a randomized clinical trial. J complement Integr Med. 2016; [Epub ahead of print].
Method: In a randomized controlled study older women were randomly assigned to a 12–form Yang style tai chi training or a general interest class control group.
Result: At the end of 16 weeks the tai chi group showed superior performance on a dual task cognitive exercise and better balance during the dual task condition.
Toa J, Liu J, Egorova N, Chen X, Sun S, Xue X, Huang J, Zheng G, Wang Q ChenL, Kong J. Increased hippocampus-medical prefrontal cortex resting-state functional connectivity and memory function after Tai Chi Chuan practice in elder adults. Front Aging Neurosci. 2016; [Epub ahead of print].
Method: In a functional magnetic resonance imaging (fMRI) study that measures activation of different parts of the brain and functional connectivity between different parts of the brain, a tai chi group was compared to a qui gong (seated tai chi) group .
Result: Both groups showed significant improvement on a memory quotient test, and their fMRIs showed Increased functional connectivity between the hippocampus and the medial prefrontal cortex, suggesting that both forms of exercise may prevent memory decline during the aging process. This, however, was the only study that appeared in the recent literature that compared standing tai chi with sitting tai chi (qui gong), so it is unclear whether standing or sitting tai chi is more effective.
Walsh JN, Manor B, Hausdorff J, Novak V, Lipsitz L, Gow B, Macklin EA, Peng CK, Wayne PM. Impact of short-and long-term Tai Chi mind-body exercise training on cognitive function in healthy adults: results from a hybrid observational study and randomized trial. 2015; 4:38-48.
Method: In a study comparing tai chi experts with tai chi–naïve adults, the tai chi experts showed better performance on six cognitive tasks.
Result: Typically, tai chi experts or tai chi practitioners have performed better than tai chi naïve adults which is not surprising.
Zheng G, Liu F, Li S, Huang M, Tao J, Chen L. Tai Chi and the protection of cognitive ability: a systematic review of prospective studies in healthy adults. Am J Prev Med. 2015;49:89-97.
Method: A systematic review of nine studies including 632 participants.
Result: The tai chi groups compared to “usual activities groups” showed better performance on several cognitive tasks. The problems with this review are that only five of the nine studies were randomized controlled trials and as many as 12 different tests were used, making it difficult to measure the consistency across studies.
Coronary Heart Disease Risk
Xu F, Letendre J, Bekke J, Beebe N, Mahler L, Lofgren IE, Delmonico MJ. Impact of a program of Tai Chi plus behaviorally based dietary weight loss on physical functioning and coronary heart disease risk factors: a community-based study in obese older women. J Nutr Gerontol Geriatr. 2015;34:50-65.
Method: In a quasi-experimental design, a 16-week tai chi plus a weight loss program were compared to a control group who were asked to maintain their normal lifestyle.
Result: The tai chi group lost weight and improved on body mass index, waist circumference, systolic blood pressure, diastolic blood pressure and sit and reach flexibility, suggesting that tai chi can ameliorate coronary heart disease risk.
Zamparo P, Zorzi E, Marcantoni S, Cesari P. Is beauty in the eyes of the beholder? Aesthetic quality versus technical skill in movement evaluation of Tai Chi. PLoS One. 2015; 10.
Method: Tai chi practitioners and non-practitioners have viewed videotapes of tai chi sequences.
Result: The practitioners were able to discriminate the technical from the aesthetic components of the actions.
Smith LL, Wherry SJ, Larkey LK, Ainsworth BE, Swan PD. Energy expenditure and cardiovascular responses to Tai Chi Easy. Complement Ther Med. 2015;23:802-5.
Method: The exercise intensity of tai chi has been evaluated by oxygen consumption and heart rate.
Result: These cardiorespiratory and energy expenditure measures suggest that tai chi is a low intensity exercise. When the safety of tai chi was evaluated in a systematic review, only 33% of 153 eligible randomized controlled trials (RCTs) included the reporting of adverse events and of those, only 12% overall noted a monitoring protocol for adverse events
Manson JD, Tamim H, Baker J. Barriers and promoters for enrollment to a community-based Tai Chi program for older, low-income, and ethnically diverse adults. J Appl Gerontol. 2015;[Epub ahead of print].
Method: These data came from a study in which 87 lower socioeconomic older adults from multiple ethnic backgrounds were interviewed before starting a 16–week tai chi program.
Result: Barriers as well as promoters for participation in tai chi have included physical and mental health, time of day, socialization, accessibility and availability of teachers
Shah S, Ardern C, Tamim H. Predictors of adherence in a community-based Tai Chi program. Can J Aging. 2015;34:237-46.
Method: Another study measured adherence to a 16-week tai chi program for multi-ethnic middle-aged and older adults living in a low socioeconomic environment.
Result: In this sample of 210 participants (mean age=68) greater adherence was associated with older age, greater perceived stress, higher education and higher scores on mental and physical scales. In contrast, lower adherence was associated with higher baseline weekly physical activity.
Yang GY, Wang LQ, Ren J, Zhang Y, Li ML, Zhu YT, Luo J, Cheng YJ, Li WY, Wayne PM, Liu JP. Evidence base of clinical studies on Tai Chi: a bibliometric analysis. PLoS One. 2015;10.
Method: A bibliometric analysis on 507 tai chi studies included 8% systematic reviews, 50% randomized clinical trials, 18% randomized current controlled clinical studies and 23% single-arm (pre-post) studies. The most frequent diseases/conditions studied were hypertension, diabetes, osteoarthritis, osteoporosis, breast cancer, heart failure, chronic obstructive pulmonary disease, coronary heart disease, schizophrenia and depression. The primary reason given for practicing tai chi was for health promotion. The most common tai chi style was the Yang style, and typically tai chi was practiced 2 to 3 one-hour sessions per week for 12 weeks. Tai chi was combined with other therapies including medications, physical therapies and health education in 41 % of the studies and was practiced alone in 59% of them.
Result: At least 95% of the studies reported positive effects while 5% of the studies noted uncertain effects, and no serious adverse events were mentioned. These data are highly suggestive, although only half the studies reviewed were randomized clinical trials. This
Hui SS, Xie YJ, Woo J, Kwok TC. Effects of Tai Chi and walking exercises on weight loss, metabolic syndrome parameters, and bone mineral density: a cluster randomized controlled trial. Evid. Based Complement Alternat Med. 2015.
Method: In a study on Hong Kong Chinese adults 374 middle-age diabetes patients were randomly assigned to a 12 week training 45 minutes per day, five days per week of tai chi or self –paced walking or a control group.
Result: Both exercise groups experienced moderate weight loss and significantly improved their waist circumference and fasting blood glucose.
Lee MS, Jun JH, Lim HJ, Lim HS. A systematic review and meta-analysis of Tai Chi for treating type 2 diabetes. Maturitas. 2015;80:14-23.
Method: A systematic review revealed mixed findings with four RCTs that compared various types of exercise and tai chi.
Result: Meta-analysis failed to show group differences on fasting blood glucose which was not surprising in that tai chi and exercise frequently have similar effects. However, surprisingly, the meta-analysis of the five RCTs that compared tai chi with antidiabetic medication showed more favorable effects of tai chi than medication on fasting blood glucose. The authors concluded that these tai chi effects on fasting blood glucose in diabetes clearly need replication studies.
breakdown is consistent with that of the current review.
Fear of Falling
Hwang HF, Chen SJ, Lee-Hsieh J, Chien DK, Chen CY, Lin MR. Effects of home-based Tai-Chi and lower extremity training and self-practice on falls and functional outcomes in older fallers from the emergency department- a randomized controlled trial. J Am Geriatr Soc. 2016;64:518-25.
Method: In another randomized controlled trial, home – based tai chi training was compared to lower extremity training in elderly who had fall – related emergency room visits at least six months before being recruited for the study.
Result: After a six month intervention, the tai chi group was less likely to experience any falls, had a longer time to the first fall and a lower number of “fallers “as compared to the lower extremity training group.
Zeng R, Lin J, Wu S, Chen S, Gao H, Zheng Y, Ma H. A randomized controlled trial: preoperative home-based combined Tai Chi and strength training (TCST) to improve balance and aerobic capacity in patients with total hip arthroplasty (THA). Arch Gerontol Geriatr. 2015;60:265-71.
Method: Individuals with hip osteoarthritis were randomly assigned to a tai chi or a control group for six weeks.
Result: After six weeks of the program the tai chi group walked farther in the 6-minute walk test and they were faster in the get up and go test.
Robins JL, Elswick RK Jr, Sturgill J, McCain NL. The effects of Tai Chi on cardiovascular risk in women. Am J Health Promot. 2015; [Epub ahead of print].
Method: A randomized controlled trial that included a waitlist control group and eight weeks of tai chi.
Result: Tai chi led to reduced cardiovascular risk in middle-age women. In this study the cardiovascular-risk women who experienced tai chi had less fatigue and showed a down-regulation of pro-inflammatory cytokines including interferon gamma, tumor necrosis factor, and interleukins 4 and 8. In addition, the women showed increased mindfulness, spiritual thoughts and behaviors and self-compassion.
Sun J, Buys N. Community-based mind-body meditative Tai Chi program and its effects on improvement of blood pressure, weight, renal function, serum lipoprotein, and quality of life in Chinese adults with hypertension. Am J Cardiol. 2015;116:1076-81.
Method: A randomized controlled study on adults with hypertension.
Result: Blood pressure and body mass index were reduced, but metabolic syndrome and lipid levels did not improve.
Pan X, Zhang Y, Tao S. Effects of Tai Chi exercise on blood pressure and plasma levels of nitric oxide, carbon monoxide and hydrogen sulfide in real-world patients with essential hypertension. Clin Exp Hypertens. 2015;37:8-14.
Method: A study comparing hypertensives receiving tai chi, a hypertensive usual care group and a healthy non-hypertensive group.
Result: Low density lipoprotein cholesterol levels decreased, high density lipoprotein cholesterol levels decreased and both systolic and diastolic blood pressure decreased by the end of the 12 week treatment period. A unique finding was an increase in nitric oxide, which is significant because of its anti-inflammatory effects. Further research is needed to confirm the nitric oxide effects in a larger cohort.
Irwin MR, Olmstead R, Breen EC, Witarama T, Carrillo C, Sadeghi N, Arevalo JM, Nicassio P, Bootzin R, Cole S. Cognitive behavioral therapy and Tai Chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial. Biol Psychiatry. 2015;78:721-9.
Method: A randomized controlled trial on tai chi and immune markers, 123 older adults with insomnia were randomly assigned to cognitive behavioral therapy (CBT), tai chi or a sleep seminar control group for two hour sessions weekly over a four-month period.
Result: Given that sleep disturbances are associated with inflammation, several pro-inflammatory cytokines were measured. Both the CBT and tai chi groups experienced reduced levels of C-reactive protein, pro-inflammatory cytokines and pro-inflammatory gene expression. These results were surprising inasmuch as CBT is a physically inactive therapy. However, a potential underlying mechanism common to CBT and tai chi may be the facilitation of sleep which would in turn improve immune function in both groups.
Lee LY, Tam KW, Lee ML, Lau NY, Lau JC, Lam CH, Kwan WK, Chan B, Chan PZ. Sleep quality of middle-aged Tai Chi practioners. Jpn J Nurs Sci. 2015;12:27-34.
Method: Comparison of different styles of Tai Chi.
Result: For insomnia, tai chi was surprisingly ineffective. In one study, linear regression analysis suggested that the duration of practicing tai chi and the style of tai chi did not make a significant contribution to sleep quality. In this null finding study, however, most of the participants were good sleepers which would reduce the likelihood of sleep being altered. In addition, it is surprising that the duration of practicing tai chi did not make a difference as longer-term practitioners typically experience greater benefits. Different styles of tai chi are rarely compared, so the finding that different styles did not have different effects needs to be replicated.
Knee Osteoarthitis Pain
Tsai PF, Chang JY, Beck C, Kuo YF, Keefe FJ, Rosengren K. A supplemental report to a randomized cluster trial of a 20-week Sun-style Tai Chi for osteoarthritic knee pain in elders with cognitive impairment. Complement Ther Med. 2015;23:570-6.
Method: For knee osteoarthritis the only recent tai chi papers featured a randomized controlled trial and a review. In the randomized controlled trial, older adults were recruited from eight study sites and then the sites were randomly assigned to participate in either a 20 week Sun – style tai chi or an education program.
Result: The active tai chi groups experienced a greater reduction in pain than the inactive education group.
Field T. Knee osteoarthritis pain in the elderly can be reduced by massage therapy, yoga and Tai Chi: a review. Complement Ther Clin Pract. 2016;22:87-92.
Method: In our recent review of tai chi for knee osteoarthritis, pain was assessed by the WOMAC scale in most of the studies reviewed.
Result: Range of motion and range of motion pain are highly affected by knee osteoarthritis, but those measures were not assessed in most of the studies. This was surprising given that tai chi predominantly exercises the hamstrings and quadriceps which are both involved in flexion and extension of the knee. Range of motion and range of motion pain would need to be measured to determine the primary effects of tai chi on knee osteoarthritis.
Zhang LL, Wang SZ, Chen HL, Yuan AZ. Tai chi exercise for cancer-related fatigue in patients with lung cancer undergoing chemotherapy: a randomized controlled trial. J Pain Symptom Manage. 2016;51:504-11.
Method: In a randomized controlled trial on tai chi effects on patients with lung cancer undergoing chemotherapy, tai chi was compared with low impact exercise . The groups practiced every other day for one hour for 12 weeks.
Result: At six and at 12 weeks the tai chi group had lower physical fatigue and general fatigue scores, although no differences were noted on the emotional subscale.
Lui J, Chen P, Wang R, Yuan Y, Wang X, Li C. Effect of Tai Chi on mononuclear cell functions in patients with non-small cell lung cancer. BMC Complement Altern Med. 2015;15.
Method: A randomized controlled study on tai chi effects on cell functions in lung cancer patients, tai chi was simply compared with a treatment as usual control group. In this study, Tai chi 24 – form was practiced for 60 minutes three times a week for 16 weeks.
Result: Immune cell number and immune cell activity increased in the tai chi group as compared to the control group. Again this finding may result from comparing an active group (tai chi) with an inactive group (treatment as usual), highlighting the importance of comparing active treatment groups to determine the efficacy of tai chi.
Zhou M, Peng N, Dai Q, Li HW, Shi RG, Huang W. Effect of Tai Chi on muscle strength of the lower extremities in the elderly. Chin J integr Med. 2015; [Epub ahead of print].
Method: In a study on muscle strength of the lower extremities in the elderly, long-term tai chi practitioners were compared to those who did not practice tai chi.
Result: The strength of several muscle groups including the quadriceps and hamstrings was greater in the tai chi practitioner than the non-practitioner group. Further, muscle strength and the duration of tai chi practice were significantly correlated.
Sun J, Kanagawa K, Sasaki J, Ooki S, Xu H, Wang L. Tai Chi improves cognitive and physical function in the elderly: a randomized controlled trial. J Phys Ther Sci. 2015;27:1467-71.
Method: Muscle strength is typically measured in the lower extremities following tai chi, at least two studies have assessed upper limb strength. In one of these studies, elderly participants were randomly assigned to a tai chi group that practiced for six months as compared to a control group who participated in other non-athletic activities.
Result: After 3 months there was no difference between the groups on one leg standing time with eyes open. However, grip strength was greater and both the five minute fast walking speed and 10 minute normal walking speed were significantly greater in the tai chi group.
Lin SF, Sung HC, Li TL, Hsieh TC, Lan HC, Perng SJ, Smith GD. The effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength among community-based older people. J Clin Nurs. 2015;24:1357-66
Method: Researchers used resistance training with the upper extremities in conjunction with tai chi as compared to a group that did not receive tai chi or resistance exercise. Therabands (wide rubber strips) were used for the resistance training which was held for 60 minutes twice weekly for a period of 16 weeks.
Result: After this training, the intervention group showed a significant increase in muscle strength in both upper and lower extremities. These effects are not surprising inasmuch as the tai chi exercise would be expected to strengthen the lower limbs while the Theraband resistance training is focused on increasing upper limb strength.
Azimzadeh E, Hosseini MA, Nourozi K, Davidson PM. Effect of Tai Chi Chuan on balance in women with multiple sclerosis. Complement Ther Clin Pract. 2015;21:57-60.
Method: A randomized controlled study, 36 women with multiple sclerosis were randomly assigned to a tai chi or a control group.
Result: After 12 weeks of twice a week Yang style tai chi sessions, the tai chi group had better balance scores on the Berg balance scale. Unfortunately this was assessed by self-report rather than objectively observed.
Nery RM, Zanini M, de Lima JB, Buhler RP, da Silveira AD, Stein R. Tai Chi Chuan improves functional capacity after myocardial infarction: a randomized clinical trial. Am Heart J. 2015;169:854-60.
Method: A single–blind randomized controlled clinical trial, patients assigned to the tai chi group participated in three weekly sessions of tai chi for 12 weeks while the control group participated in full–body stretching exercises.
Result: Patients with myocardial infarction typically show decreased peak oxygen consumption. At the end of the study the tai chi group showed a significant increase in peak oxygen consumption while the control group showed a nonsignificant decline.
Obesity with Depression Symptoms
Liu X, Vitetta L, Kostner K, Crompton D, Williams G, Brown WJ, Lopez A, Xue CC, Oei TP, Byrne G, Martin JH, Whiteford H. The effects of Tai Chi in centrally obese adults with depression symptoms. Evid Based Complement Alternat Med. 2015.
Method: In a study on obese people with elevated depression symptoms, 213 participants were randomly assigned to a 24-week tai chi intervention or a waitlist control group.
Result: The tai chi group showed a significant decrease in depression and stress and an increase in leg strength. These improvements were maintained for the tai chi group over the second 12 weeks of follow-up.
Hsu WH, Hsu RW, Lin ZR, Fan CH. Effects of circuit exercise and Tai Chi on body composition in middle-aged and older women. Geriatr Gerontol Int. 2015; 15:282-8.
Method: In still another study on body composition, a Yang style tai chi group was compared to an exercise group, with both groups exercising 60 minutes three times per week for 12 weeks.
Result: The tai chi group showed a decrease in systolic blood pressure. However, the exercise group showed greater benefits included increases in basal metabolic rate, total body muscle mass, lean body mass and bone mineral content and decreases in body mass index, body fat and diastolic pressure. These results perhaps are not surprising in that the tai chi group practiced with the same frequency but with only 50 to 60% the intensity of that of the exercise group.
Wang H, Yu B, Chen W, Lu Y Yu D. Simplified Tai Chi resistance training versus traditional Tai Chi in slowing bone loss in postmenopausal women. Evid Based Complement Alternat Med. 2015.
Method: one randomized controlled trial and one systematic review on osteoporosis were located. In the randomized controlled trial, 119 postmenopausal women were randomly assigned to a Yang style tai chi resistance training, a traditional tai chi or a routine activity group.
Result: Although the routine activity group had lower L2 – L4 bone density, neither the tai chi nor the resistance training groups experienced bone loss.
Zhang TY, Hu Y, Nie ZY, Jin RX, Chen F, Guan Q, Hu B, Gu CY, Zhu L, Jin LJ. Effects of Tai Chi and multimodal exercise training on movement and balance function in mild to moderate idiopathic Parkinson disease. Am J Phys Med Rehabil. 2015;94:921-9.
Method: In still another randomized controlled trial, tai chi was compared to multimodal exercise training and the groups were assessed after 12 weeks of the program.
Result: In this study, both groups improved on movements, balance and on Parkinson’s Disease Rating Scale-motor examination scores.
Zhou J, Yin T, Gao Q, Yang XC. A meta-analysis on the efficacy of Tai Chi in patients with Parkinson’s disease between 2008 and 2014. Evid Based Complement Alternat Med. 2015.
Method: Meta-analysis, of the aggregated results of 9 studies.
Result: Results favored tai chi on improving motor function and balance. Once again, gate velocity, stride length and quality of life were not affected. However, the authors interpreted these findings cautiously because of the small treatment effects, the methodological flaws of the eligible studies and the insufficient follow-up.
Rheumatoid Arthritis Pain
Shin JH, Lee Y, Kim SG, Choi BY, Lee HS, Bang SY. The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis. Arthritis Res Ther. 2015;17.
Method: Given that rheumatoid arthritis is a risk factor for cardiovascular disease, several measures of that risk were taken in a tai chi study on rheumatoid arthritis . Patients were randomly assigned to either a tai chi group receiving once a week sessions for 3 months or a control group who received general information about the benefits of exercise.
Result: Endothelial function increased and arterial stiffness and cholesterol decreased in the tai chi group. Surprisingly, pain was not assessed in this study.
Ho RT, Fong TC, Wan AH, Au-Yeung FS, Wong Cp, Ng WY, Chueng IK, Lo PH, Ng SM, Chan CL, Chen EY. A randomized controlled trial on the psychophysiological effects of physical exercise and Tai-Chi in patients with chronic schizophrenia. 2016;171:42-9.
Method: Patients were randomized to tai chi, exercise or waitlist control groups. Both exercise groups received 12 weeks of the intervention and assessments were made at 3 and 6-month follow-ups.
Result: Both exercise groups showed significant decreases in motor deficits and increases in backward digit span, and the exercise group also showed fewer negative schizophrenic symptoms (such as lethargy and apathy) as well as fewer depression symptoms.
Seated Tai Chi
Lee KY, Hui-Chan CW, Tsang WW. The effects of practicing sitting Tal Chi on balance control and eye-hand coordination in the older adults: a randomized controlled trial. Disabil Rehabil. 2015;37:790-4.
Method: In a randomized controlled study on seated tai chi, sitting balance and eye hand coordination were assessed. In this study, the tai chi group was compared to an exercise group who underwent three months of training for a total of 36 sessions including one hour sessions three times per week.
Result: The tai chi group improved on weight shifting while sitting and on maximum reaching distance from the seated position.
Hsu CY, Moyle W, Cooke M, Jones C. Seated Tai Chi versus usual activities in older people using wheelchairs: a randomized controlled trial. Complement Ther Med. 2016;24:1-6.
Method: In another seated tai chi randomized controlled study, older people in wheelchairs were randomly assigned to a group receiving seated tai chi versus a group engaging in their usual activity.The tai chi group had 40 minutes of seated tai chi three times a week for 26 weeks.
Result: The seated tai chi group had lower depression scores and higher quality of life scores including general health, physical health, psychological health, and social relations. Unfortunately, once again, only self-report measures were taken.
Spinal Cord Injury Pain
Shem K, Karasik D, Carufel P, Kao MC, Zheng P. Seated Tai Chi to Alleviate and improve quality of life in individuals with spinal cord disorder. J Spinal Cord Med. 2016; [Epub ahead of print].
Method: Seated tai chi has been used with those who have spinal cord injuries. In a single arm study, 26 participants were enrolled for a 12 week seated tai chi course consisting of weekly sessions.
Result: After each session the patients reported less pain, better sense of emotional well-being, mental distraction, physical well-being and a sense of spiritual connection. However, attrition was high with only nine participants completing half of the 12 sessions and once again this was not a randomized controlled study with a comparison group to validate the effects of tai chi on spinal cord injury pain. However, this is a rare example of the use of seated tai chi.
Tsang WW, Gao KL, Chan KM, Purves S, Macfarlane DJ, Fong SS. Sitting Tai Chi improves the balance control and muscle strength of community-dwelling persons with spinal cord injuries: a pilot study. Evid Based Complement Alternat Med. 2015.
Method: In another seated tai chi study, patients with spinal cord injuries were given 90 minute sessions two times a week for 12 weeks or assigned to a control group.
Result: At the end of the intervention, the seated tai chi group showed improved dynamic sitting balance and greater hand grip strength. However, the groups did not differ on quality of life measures. Once again, this is a small sample and the groups were not randomly assigned. Further, seated tai chi is rarely practiced, although it would clearly be the tai chi of choice for patients who are immobilized with spinal cord injuries.
Zheng G, Huang M, Liu F, Li S, Chen L. Tai Chi Chuan for the primary prevention of stroke in middle-aged and elderly adults: a systematic review. Evid Based Complement Alternat Med. 2015.
Method: In a systematic review 36 eligible studies with a total of 2393 participants were identified.
Result: When the risk factors for stroke were considered, the analysis revealed that tai chi was correlated with lower body weight, body mass index, as well as lower systolic and diastolic blood pressure and lower low density lipoprotein levels even for less than a half year of intervention. However, when tai chi was compared to similar exercises, the primary effect was only lower blood pressure.
Bao X, Jin K. The beneficial effect of Tai Chi on self-concept in adolescents. Int J Psychol. 2015;50:101-5.
Method: A control group comparison, a randomized controlled trial and a systematic review were found in the recent literature on tai chi for student stress (see table 1). In the non-controlled group comparison 160 middle school students were given a one-year tai chi program comprised of 60 minute sessions given five times a week .
Result: The tai chi group showed improvement in behavior, intellectual and school status and popularity as well as reduced anxiety as compared to the control group.
Zheng G, Lan X, Li M, Ling K, Lin H, Chen L, Tao J, Li J, Zheng X, Chen B, Fang Q. Effectiveness of Tai Chi on physical and psychological health of college students: Results of a Randomized controlled trial. PLoS. 2015;10.
Method: In a study on college students, 206 participants were randomly assigned to a 12-week tai chi group or to a control group that was instructed to continue their original activities.
Result: The tai chi group showed significant improvements in flexibility on the sit and reach test and on balance, and no adverse events were noted.
Webster CS, Luo AY, Krageloh C, Moir F, Henning M. A systematic review of the health benefits of Tai Chi for students in higher education. Prev Med Rep. 2015;3:103-12.
Method: A systematic review on tai chi with university students including 68 reports on a sample of 9,263 students.
Result: Four primary and eight secondary outcomes were noted. These included increased flexibility, reduced depression symptoms, decreased anxiety and improved interpersonal sensitivity. The secondary outcomes were improved lung capacity, better balance, faster running time, better quality sleep, reduced symptoms of compulsion, somatization and phobia and decreased hostility. The authors suggested that universities may provide tai chi as a means of promoting the well-being of their students.
Vagal Activity Studies
Wei GX, Li YF, Yue XL, Ma X, Chang YK, Yi LY, Li JC, Zuo XN. Tai Chi Chuan modulates heart rate variability during abdominal breathing in elderly adults. Psych J. 2015; [Epub ahead of print].
Method: A comparison between tai chi practitioners with approximately 20 years’ experience and controls matched by age, sex and education.
Result: Suggested increased vagal activity for the tai chi group and greater balance between parasympathetic and sympathetic activity during tai chi. Vagal activity has been noted to increase even after only five minutes of tai chi exercise by inexperienced individuals.
Fong SS, Wong JY, Chung LM, Yam TT, Chung LM, Lee YM, Chow LP Luk WS, Ng SS. Changes in heart-rate variability of survivors of nasopharyngeal cancer during Tai Chi Qigong practice. J Phys Ther Sci. 2015;27:1577-9.
Method: Monitoring of vagal activity.
Result: In this study, during the fourth and fifth minutes of tai chi exercise increased high-frequency power and decreased low-frequency power were noted. It is not clear, however, whether these effects were transient or maintained as the monitoring of vagal activity was too short. It would also be important to compare the effects of tai chi and other forms of exercise on vagal activity.