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 1996 Lan
"Cardiorespiratory Function, Flexibility, and Body Composition Among Geriatric Tai Chi Chuan Practitioners,"
Ching Lan, MD, Jin-Shin Lai, MD, May-Kuen Wong, MD, Mei-Li Yu. Archives of Physical Medicine and Rehabilitation,
June, 1996.
ABSTRACT. Lan C, Lai J-S, Wong M-K, Yu M-L. Cardiorespiratory function, flexibility,
and body composition among geriatric Tai Chi Chuan practitioners. Arch Phys Rehabil 1996; 77:612-6.
Objective: To evaluate the health-related fitness of geriatric Tai Chi Chuan (TCC)
practitioners.
Design: Case-control study of a TCC group and a group of sedentary controls.
Setting: Research project at a hospital-based exercise physiology laboratory.
Participants: Seventy-six community-dwelling senior persons (mean age 69.3 ± 3.9 yr), a TCC group that included
22 men and 19 women and a control group of sedentary subjects that included 18 men and 17 women with matched age
and body size.
Intervention: The TCC group had practiced TCC regularly for 11.8 ± 5.6 years,
with an exercise frequency of 4.3 ± 1.3 times per week. Each session included 20 minutes of warm-up, 24
minutes of TCC training, and 10 minutes of cool-down. Exercise intensity was estimated to exceed 70% of maximal
heart rate (HRmax).
Main Outcome Measure: Breath-by-breath measurement of cardiorespiratory function was
obtained during the incremental exercise of leg cycling. Flexibility of thoracic/lumbar spine was measured by an
electronic inclinometer. Percentages of body fat were calculated from biceps and subscapular skinfolds.
Results: In the peak exercise, men in the TCC group showed 19% higher peak oxygen
uptake (Vo2peak) in comparison with their sedentary counterparts (26.9 ± 4.7mL/kg/min vs 21.8 ± 3.1mL/kg/min).
Women in the TCC group also showed 18% higher Vo2peak than in the sedentary group (20.1 ± 2.9mL/kg/min vs
16.5 ± 2.0mL/kg/min). The TCC group also showed higher oxygen uptake at the ventilatory threshold. In addition,
the TCC practitioners were characterized by greater flexibility and lower percentage of body fat in comparison
with their sedentary counterparts.
Conclusion: It is concluded that TCC training has benefits for health-related fitness, and it may be prescribed
as a suitable conditioning exercise for the elderly.
© 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and
Rehabilitation.
Another study of serious Tai Chi practitioners in Taipei. Practitioners
showed higher peak oxygen uptake and higher oxygen uptake at the ventilatory threshold (better oxygen utilization)
than their sedentary counterparts. This study also demonstrated an aerobic benefit for these practitioners, something
few studies have shown:
"During the performance of classical Yang TCC, the mean HR of these subjects increased steadily in the
first 10 minutes, then achieved a nearly steady state to the end of the exercise. In the nearly steady state, mean
HR was 122 ± 12 beats/min in the men and 117 ± 11 beats/min in the women. If HR during TCC practice
is compared with HR responses during the exercise test, two important findings are discerned. First, mean HR during
the steady-state performance exceeded 70% of the HRmax (75% of HRmax for the men and 71% of HRmax for the women).
Second, while performing TCC, the subjects' mean HR was approximated to respective values at the ventilatory threshold.
The results demonstrated that the exercise intensity of classical TCC is moderate and aerobic in nature."
"Ventilatory threshold was used initially to assess the exercise tolerance of individuals with cardiopulmonary
disease. In recent years, it has been used to evaluate the individual's aerobic potential and the effect of training.
For the clinical application, VeT is thought to be a noninvasive measurement of the lactic threshold (LT), and
LT represents the work load at which the cardiovascular system fails to supply adequate O2 to the tissue. When
assessing one's endurance, the LT or VeT is considered to be a sensitive indicator of physical performance. In
the present study, the TCC group showed significantly higher VO2, O2 pulse, and work rate at the VeT. The result
implied that long-term TCC training might improve endurance during exercise at submaximal work rates."
"Gong and colleagues reported that the mean HR of subjects from ages 48 to 80 was 104 beats/min while performing
simplified TCC [Yang Short form]. In the present study, the mean HR of subjects in the nearly steady-state performance
of classical Yang TCC [Yang Long form] was 126 ± 12 beats/min in the men, and 119 ± 11 beats/min
in the women. From this comparison of HR data, it can reasonably be concluded that the exercise intensity of classical
Yang TCC is greater than that of the simplified form."
{{Stury #18, PRACTITIONERS, Serious; Physiological, cardioresp, definitions of cardiorespiratory fitness, improved
oxygen utilization, speculation of cardiorespiratory effects of short form vs. long form}}
1996 Janer EFFECT OF TAI-CHI ON BONE MINERAL DENSITY: A CLINICAL INVESTIGATION Edgard
Janer, Joanne Valeriano, Noreen M. Aziz, Frank B. Vasey, Li-Tsun Chen, Zhi Liu, Kathy Walls. University of South
Florida College of Medicine, Tampa, Florida, 33612 and James A. Haley Veteran's Hospital, Tampa Florida, 33612.
Arthritis and Rheumatism, v.39 (#6), pp. R21-R21, June 1996. (Poster presentation)
We investigated the role of Tai-Chi, a traditional Chinese weight bearing exercise, as an intervention
to increase bone mineral density (BMD) in a healthy female population. Of these, 15 comprised the Tai-Chi group
(mean age 52), three were pre-menopausal and 12 post-menopausal. The control population consisted of 11 females
(mean age 53), of whom two were pre-menopausal and nine post-menopausal.
The intervention consisted of one hour of Tai-Chi three times a week for six months. The control
group did not practice Tai-Chi or any other form of regular exercise. Both groups were screened by history and
physical and met all inclusion criteria.
DEXA (Hologic QDR 2000) scanning of the hip and lumbar spine was utilized for assessing bone
mineral density of both groups at baseline and at six month follow up.
The mean yearly % of BMD change of the total hip was compared across the two groups by stedent
t-test and was statistically significant, (p=0.01, 95% C.I. = 1.592-6.500). The Tai-Chi group demonstrated an overall
increase in total hip BMD (+1.82%/yr) whereas the control group decreased in total hip BMD by 0.66%/yr, consistent
with age-related loss.
We conclude that in our study sample regular Tai-Chi exercise improved total hip BMD.
{{Study #19, BEGINNERS, Physiological, increased bone density}}
1996 Eds. of Geriatrics "Tai Chi: A prescription for improving balance and reducing falls", Geriatrics,
Vol. 51 No. 6 June 1996, p.11. Source: Journal of the American Geriatrics Society, May 1996.
(No Abstract--cites studies by Wolfson and Wolf, abstracts follow)
"Tai Chi is a low-tech, simple mechanism for training balance and--according to our study--is beneficial
in maintaining the gains made through balance and strength training," Leslie Wolfson, MD, lead author of one
of the studies, told GERIATRICS. "The slow, vertical movements are useful in training balance, which is an
important factor in falls."
"The other study, by Steven Wolf, PhD, and colleagues, evaluated the effects of Tai Chi and computerized
balance training in 200 subjects (mean age, 76.2). Subjects were assigned to one of three groups: Tai Chi training,
computerized balance training, or education for a duration of 15 weeks. Researchers reported that patients who
took part in the 15-week Tai Chi program reduced their risk of falling by 47.5%."
{{Study #20, TC for seniors, discussion of other studies}}
1996 Wolf "Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi
and Computerized Balance Training," Steven L. Wolf, PhD, FAPTA, Huiman X. Barnhart, PhD, Nancy G. Kutner,
PhD, Elizabeth McNeely, PhD, Carol Coogler, ScD, PT, Tingsen Xu, PhD, and the Atlanta FICSIT Group, Journal of
the American Geriatrics Society, Vol.44, pp 489-497, 1996. © 1996 by the American Geriatrics Society.
OBJECTIVE: To evaluate the effects of two exercise approaches, Tai Chi (TC) and computerized
balance training (BT), on specified primary outcomes (biomedical, functional, and psychosocial indicators of frailty)
and secondary outcomes (occurrence of falls).
DESIGN: The Atlanta FICSIT (Frailty and Injuries: Cooperative Studies of Intervention
Techniques), a prospective, randomized, controlled clinical trial with three arms (TC, BT, and education [ED]).
Intervention length was 15 weeks, with primary outcomes measured before and after intervention and at 4-month follow-up.
Falls were monitored continuously throughout the study.
SETTING: Persons aged 70 and older living in the community.
PARTICIPANTS: A total of 200 participants, 162 women and 38 men; mean age was 76.2.
MEASUREMENTS: Biomedical (strength, flexibility, cardiovascular endurance, body composition),
functional (IADL [Instrumental Activities of Daily Living]), and psychosocial well-being (CES-D scale, fear of
falling questionnaire, self-perception of present and future health, mastery index, perceived quality of sleep,
and intrusiveness) variables.
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 (P= .046 and P= .058, respectively). After adjusting for fall risk factors,
TC was found to reduce the risk of multiple falls by 47.5%.
CONCLUSIONS: A moderate TC intervention can impact favorably on defined biomedical
and psychosocial indices of frailty. This intervention can also have favorable effects upon the occurrence of falls.
Tai Chi warrants further study as an exercise treatment to improve the health of older people.
J Am Geriatr Soc 44:489-497, 1996. ©1996 by the American Geriatrics Society.
This study got national media attention because of its finding that Tai Chi training reduced
the risk of multiple falls by 47.5%. Remember, participants were in their 70's, and learned a vastly simplified
form of Tai Chi--10 forms over 15 weeks. Subjects were encouraged to practice at least 15 minutes twice a day,
but home practice was not monitored. Just as interesting to me is the level of sustained interest in Tai Chi after
the study was over (see quote below). Other items of interest:
"A group by time interaction was also observed for distance ambulated over 12 minutes. Interestingly, the
BT and ED groups increased their walking distance (.01mile), whereas the TC group reduced the didstance they traveled
by .02 mile."
"Subjects who participated in the TC intervention had less loss in left hand grip strength, reduced ambulation
speed, and lowered systolic blood pressure after a 12-minute walk. Fear of falling and intrusiveness improved in
the TC group compared with the ED group. Finally, TC participants had a substantial reduction in the rate of falls'
occurrences."
Less loss of left hand grip strength is an interesting result, given that Tai Chi is performed
with the upper body as relaxed as possible. Evidence of enhanced neuromuscular coordination?
"Compared with the practice of TC in China, our intervention intensity was quite modest, and this may explain
why we did not observe changes in strength and flexibility similar to changes reported when TC is practiced routinely."
"Many TC participants provided anecdotal testimony on aborted falls' events, independently reporting awareness
of both the environment and appropriate body maneuvers in the presence of unexpected perturbations. Moreover, almost
half of all TC subjects chose to continue meeting as an informal group to practice TC after conclusion of the follow-up
assessment. (emphasis mine)."
{{Study #21, BEGINNERS, TC for seniors, FICSIT; reduced blood pressure, less loss of left hand grip strength than
controls, continued interest after study}}
1996 Wolfson "Balance and Strength Training in Older Adults: Intervention Gains and
Tai Chi Maintenance," Leslie Wolfson, MD, Robert Whipple, MA, PT, Carol Derby, PhD, James Judge, MD,
Mary King, MD, Paula Amerman, MS, Julia Schmidt, and Donna Smyers, MS, PT, Journal of the American Geriatrics Society,
Vol. 44:498-506, 1996. © 1996 by the American Geriatrics Society.
OBJECTIVE: To determine the effect on balance and strength of 3 months of intensive
balance and/or weight training followed by 6 months of low intensity Tai Chi training for maintenance of gains.
DESIGN: Randomized control intervention. Four groups in 2 x 2 design: Control, Balance,
Strength, Balance + Strength, using blinded testers.
SETTING: Exercise and balance laboratory at University of Connecticut Health Center.
PARTICIPANTS: Subjects were 110 healthy community dwellers (mean age 80) who were
free of dementia, neurological disease, and serious cardiovascular or musculoskeletal conditions.
INTERVENTIONS: Short-term training (3 months) occurred 3 times/week (45 minutes Balance
and Strength, 90 minutes Balance + Strength). Balance training included equilibrium control exercises on firm and
foam surfaces and center-of-pressure biofeedback. Strengthening consisted of lower extremity weight-lifting. All
subjects then received long-term group Tai Chi instruction (6 months, 1 hour, 1 time/week).
MEASUREMENTS: Losses of balance during Sensory Organization Testing (LOB) = -2.0 0.3
(adjusted paired differences, P <.005 ANOVA); SST = 7.0 ± 1.2 sec; and FBOS = 9.0 ± 2.0% of foot
length (P <.05). Strengthening increased ISOK by 1.1 ± 0.1 Nm/kg (P <.005). There was no interaction
between balance and strength training. Significant gains persisted after 6 months of Tai Chi, although there was
some decrement.
RESULTS AND CONCLUSIONS: Balance training meaningfully improved all balance measures
by restoring performance to a level analogous to an individual 3 to 10 years younger: LOB= -2.0 ± 0.3 (adjusted
paired differences, P < .005 ANOVA); SST= 7.0 ±1.2 sec; and FBOS = 9.0 ± 2.0% of foot length (P
< .05 ). Strengthening increased ISOK by 1.1 ± 0.1 NM/kg (P < .005 ) There was no interaction between
balance and strength training. Significant gains persisted after 6 months of Tai Chi, although there was some decrement.
J Am Geriatr Soc 44:498-506, 1996. © 1996 by the American Geriatrics Society.
This study found that laboratory-based computer balance training could improve measures of
strength and balance, partially reversing age-related declines. Tai Chi was used to maintain these gains.
"There is a 20 to 40% decrease in strength from the 20s to the 70s."
"The balance intervention improved three outcome measures representing a spectrum of balance function. The
improvements were meaningful when compared with declines observed with age, thus suggesting that balance of healthy
75 to 90-year-old people, if trained, may be suffiently plastic to recoup losses that would otherwise be considered
age-related."
{{Study #22, BEGINNERS, TC for seniors, FICSIT; age-related losses of strength & flexibility}}
1995 Lai/ Lan "Two-Year Trends in Cardiorespiratory Function Among Older Tai Chi Chuan
Practitioners and Sedentary Subjects," Jin-Shin Lai, MD, Ching Lan, MD, May-Kuen Wong, MD, and Shi-Hai
Teng, PhD. Journal of the American Geriatric Society, Vol. 43: 1222-1227, 1995. © 1995 by the American Geriatrics
Society.
OBJECTIVE: To evaluate the training effects of Chinese shadow boxing, Tai Chi Chuan
(TCC), on the maintenance of cardiorespiratory function in older individuals.
DESIGN: Prospective study of a cohort of TCC practitioners and a group of sedentary
controls examined 2 years after initial examination.
SETTING: Research project at a hospital-based exercise physiology laboratory.
PARTICIPANTS: Eighty-four community-dwelling older adults (mean age: 64 ± 9
years) with no significant cardiovascular, pulmonary, and musculoskeletal disease completed this study. The TCC
group, 23 male and 22 female subjects, had been practicing TCC regularly for 6.7 ±3.3 years. The control
group included 21 male and 18 female sedentary subjects with age and body size matched to the TCC group.
INTERVENTION: During the period of the study, the TCC practitioners practiced TCC
5.0 ± 1.1 times per week. Each session included 20 minutes of warm up, 24 minutes of TCC training, and 10
minutes of cool down. The baseline cardiorespiratory function was recorded in the initial exercise test. The same
measurements were repeated 2 years later to determine the rate of decline of cardiorespiratory function. Furthermore,
heart rates (HR) were monitored in 18 men and 16 women during the performance of TCC to determine the exercise
intensity of TCC.
MAIN OUTCOME MEASURE: The study measured 2-year trends of cardiorespiratory function
in both groups.
RESULTS: In the TCC group, the males showed a 2.8% decrease in maximal oxygen uptake
(VO2max) from 31.6 ± 7.6 mL/kg/min to 30.7 ± 7.1 mL/kg/min; the females showed a 2.9% decrease in
VO2max from 20.7 ± 2.3 mL/kg/min to 20.1 ± 2.5 mL/kg/min. In contrast, the male control group showed
a 6.6% decrease in VO2max from 24.4 ± 4.4 mL/kg/min to 22.8 ± 4.4 mL/kg/min; the females showed a
7.4% decrease in VO2max from 16.2 ± 2.3 mL/kg/min to 15.0 ± 2.7 mL/kg/min. At the ventilatory threshold
(VeT), the sedentary group also showed a significant decrease in V02. During the steady-state performance of TCC,
subjects' mean HR was approximately the HR at the VeT (53-57% of HRmax reserve).
CONCLUSION: The data substantiate that practicing Tai Chi Chuan regularly may delay
the decline of cardiorespiratory function in older individuals. In addition, TCC may be prescribed as a suitable
aerobic exercise for older adults. J Am Geratr Soc 43:1222-1227, 1995.
One of the few studies to focus on serious Tai Chi practitioners, as opposed to beginners.
Subjects were drawn from a Tai Chi group in Taipei, Taiwan. Mostly people in their 60's, who had been practicing
the full Yang Long form for 3-10 years, 23 males and 22 females. They practiced 3-7 times a week, with an average
frequency of 5 times a week. A fairly rigorous practice: 20 minutes of warm-up exercises, 24 minutes of practicing
the form paced by the Master, and 10 minutes of cool-down. This study compares these Tai Chi practitioners to a
group of sedentary peers matched for age and body size, and looks at cardiorespiratory declines over a two-year
period. It has some heart rate profiles that seem to indicate moderate aerobic benefit in older practitioners (this
benefit has not been demonstrated in younger practitioners).
{{Study #15, PRACTITIONERS, serious; Physiological, cardioresp; improved oxygen utilization; TC for seniors}}
1995 Brown "Chronic psychological effects of exercise and exercise plus cognitive strategies,"
David R. Brown, Youde Wang, Ann Ward, Cara B Ebbeling, Laurie Fortlage, Elaine Puleo, Herbert Benson, and James
M. Rippe, Medicine and Science in Sports and Exercise, Vol. 27, No. 5, 1995, p. 765-775. © 1995 by the American
College of Sports Medicine
ABSTRACT. Brown, D.R., Y. Wang, A. Ward, C.B. Ebbeling, L. Fortlage, E. Puleo, H. Benson, and J.M. Rippe. Chronic
psychological effects of exercise and exercise plus cognitive strategies. Med. Sci. Sports Exerc., Vol. 27, No.
5, pp. 765-775, 1995. Psychological changes associated with 16-wk moderate and low intensity exercise training
programs, two of which possessed a cognitive component, were evaluated. Subjects were healthy, sedentary adults,
69 women (mean age = 54.8 ± 8.3 yr) and 66 men (mean age = 50.6 ± 8.0 yr). Participants were randomly
assigned to a control group (C), moderate intensity walking group (MW), low intensity walking group (LW), low intensity
walking plus relaxation response group (LWR), or mindful exercise (ME) group--a Tai Chi type program. Women in
the ME group experienced reductions in mood disturbance (tension, P < 0.01; depression, P < 0.05; anger,
P < 0.008; confusion, P < 0.02; and total mood disturbance, P < 0.006) and an improvement in general mood
(P <0.04). Women in the MW group noted greater satisfaction with physical attributes (body cathexis, P <
0.03), and men in MW reported increased positive affect (P < 0.006). No other differences were observed between
groups on measures of mood, self-esteem, personality, or life satisfaction. Equivocal support is provided for the
hypothesis that exercise plus cognitive strategy training programs are more effective than exercise programs lacking
a structured cognitive component in promoting psychological benefits.
{{Study #16, BEGINNERS, Psychology, TC & stress, TC & mood}}
1995 Province "The Effects of Exercise on Falls in Elderly Patients; A Preplanned Meta-analysis
of the FICSIT Trials," Michael A. Province, PhD; Evan C. Hadley, MD; Mark C. Hornbrook, PhD; Lewis
A. Lipsitz, MD; J. Philip Miller; Cynthia D. Mulrow, MD; Marcia G. Ory, PhD, MPH; Richard W. Sattin, MD; Mary E.
Tinetti, MD; Steven L. Wolf, PhD, for the FICSIT Group, Journal of the American Medical Association (JAMA), Vol.
273, No. 17, May 3, 1995, pp. 1341-1347.
ABSTRACT.
Objective.--To determine if short-term exercise reduces falls and fall-related injuries in the elderly.
Design.--A preplanned meta-analysis of the seven Frailty and Injuries: Cooperative Studies of Intervention Techniques
(FICSIT)--independent, randomized, controlled clinical trials that assessed intervention efficacy in reducing falls
and frailty in elderly patients. All included an exercise compontnt for 10 to 36 weeks. Fall and injury follow-up
was obtained for up to 2 to 4 years.
Setting.--Two nursing home and five community-dwelling (three health maintenance organizations) sites. Six were
group and center based; one was conducted at home.
Participants.--Numbers of participants ranged from 100 to 1323 per study. Subjects were mostly ambulatory and cognitively
intact, with minimum ages of 60 to 75 years, although some studies required additional deficits, such as functionally
dependent in two or more activities of daily living, balance deficits or lower extremity weakness, or high risk
of falling.
Interventions.--Exercise components varied across studies in character, duration, frequency, and intensity. Training
was performed in one area or more of endurance, flexibility, balance platform, Tai Chi (dynamic balance), and resistance.
Several treatment arms included additional nonexercise components, such as behavioral components, medication changes,
education, functional activity, or nutritional supplements.
Main Outcome Measures.--Time to each fall (fall-related injury) by self-report and/or medical records.
Results.--Using the Andersen-Gill extension of the Cox model that allows multiple fall outcomes per patient, the
adjusted fall incidence ratio for treatment arms including general exercise was 0.90 (95% confidence limits [CL],
0.81, 0.99) and for those including balance was 0.83 (95% CL, 0.70, 0.98). No exercise component was significant
for injurious falls, but power was low to detect this outcome.
Conclusions.--Treatments including exercise for elderly adults reduce the risk of falls.
(JAMA. 1995; 273:1341-1347)
The introduction to this study is a concise summary of the cost of falls:
"FALLS and the resulting injuries are among the most serious and common medical problems suffered by the elderly
in the United States. Each year, approximately 30% of persons over 65 years of age sustain a fall with about half
of them having multiple events. About 10% to 15% of falls result in serious injuries, with 0.2% to 1% of them resulting
in hip fracture, 5% in fractures at other sites, and 5% in soft-tissure injuries. The morbidity and mortality resulting
from these falls is substantial in the elderly. Unintentional injury is the sixth leading cause of death in persons
over 65 years of age, with the majority of these deaths attributed to falls, especially in persons aged 85 years
or older. Fall survivors experience greater functional decline in activities of daily living (ADLs) and in physical
and social activities than nonfallers, and have a greater risk of subsequent institutionalization. Even 2 months
after a fall, 40% of elderly patients seen in an emergency department for a fall injury report continued pain or
activity restriction, and 40% of these continue to complain for a median of 7 months after the fall. The costs
associated with falls and fall injuries are also high. The National Center for Health Services Research and Health
Care Technology Assessment estimates that in 1977, over 6% of all medical care dollars for persons aged 65 years
and older were spent on unintentional injury, with the majority spent for fall injuries. This was estimated to
have reached $3.7 billion by 1984, and the prospect is that these figures will likely increase into the next century
as the average age of the US population increases."
{{Study #17, BEGINNERS, TC for seniors, FICSIT; falls statistics, FICSIT trials background}}
1993 Judge "Balance Improvements in Older Women: Effects of Exercise Training,"
James O. Judge, Carleen Lindsey, Michael Underwood, and David Winsemius, Physical Therapy Vol. 73, No. 4: April,
1993.
Background and Purpose. Loss of lower-extremity strength increases the risk of falls in older persons. The purpose
of this study was to test the hypotheses that a vigorous program of lower-extremity strengthening, walking, and
postural control exercises would improve the single-stance balance of healthy older women and lower their risk
of falls and fall-associated injuries. Subjects. From a total of 38 respondents, 21 women were randomly assigned
to either a treatment group (combined training, n=12) or a control group (flexibility training, n=9). The subjects
ranged in age from 62 to 75 years (X=68, SD=3.5). Methods. A randomized control trial compared the effects of two
exercise programs on static balance. The combined training group exercised three times per week on knee extension
and sitting leg press machines, walked briskly for 20 minutes, and performed postural control exercises, which
included simple tai chi movements. The flexibility training group performed postural control exercises weekly.
Measurements of balance were obtained on a force platform in double and single stance, at baseline and following
6 months of exercise training. Results. Double-stance measurements were unchanged after training. The mean displacement
of the center of pressure in single stance improved 17% in the combined training group and did not change in the
flexibility training group. A repeated-measures analysis of variance revealed that the difference in improvement
between the combined training and flexibility training groups was not significant. Discussion and Conclusion. This
is the first intervention trial to demonstrate improvements in single-stance postural sway in older women with
exercise training. Additional studies with more subjects will be needed to determine whether a combined training
program of resistance training, walking, and postural exercises can improve balance more than a program of postural
control exercises alone. [Judge JO, Lindsey C, Underwood M, Winsemius D. Balance improvements in older women: effects
of exercise training. Phys Ther. 1993:; 73:254-265.]
Key Words: Aged; Equilibrium; Exercise, general; Posture, general; Women.
"Single-stance time (time able to stand on one foot) declines with age, and in advanced age, few persons are
able to stand on one leg for more than several seconds."
"Because the majority of falls occur during walking or turning on stairs, we hypothesized that improved single-stance
control may lower the risk of falls and fall-associated injuries."
The researchers devised a balanced but rigorous program to improve single-stance strength and balance. The program
combined resistence training, walking, stretching and balance exercises similar to Yoga, and simplified Tai Chi
forms:
"Simplified tai chi exercises, which involve slow and controlled movements of the body, were performed. Correct
trunk and lower-body alignment in the standing position was stressed, and subjects were taught to focus on how
weight was distributed on the feet. Subjects exercised in a large room with floor-length mirrors, which provided
visual feedback to their posture during the movements. Slow, controlled forward and backward steps were performed
as a warm-up. Other movements included lateral and anterior-posterior weight shifts, single-stance postures, and
turning and pivoting with weight on the heel or forefoot, while keeping the torso upright and the knees slightly
flexed. Arm movements were added after subjects were proficient in leg movements."
{{Study #12, BEGINNERS, TC for seniors; balance, age-related declines (single stance), falls}}
1993 Wolf "The Atlanta FICSIT Study: Two Exercise Interventions to Reduce Frailty in
Elders," Steven L. Wolf, PhD, FAPTA, Nancy G. Kutner, PhD, Robert C. Green, MD, and Elizabeth McNeely,
PhD, RN, Journal of the American Geriatrics Society , Vol. 41: 329-332, 1993.
ABSTRACT: This study examines 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 are provided for 15 weekly
sessions on an individual basis for participants randomly assigned to a Balance Training group. Training consists
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. An alternative procedure is comparatively simple and requires
little expense or space. Tai Chi Quan was originally developed as a martial arts form but has been used for centuries
in China as an exercise among elderly citizens. Participants randomly assigned to this intervention meet 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 serves 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. All subjects
are screened prior to assignment, and a host of physical, behavioral, and functional measures are assessed before
and after the intervention as well as 4 months later. Measurements unique to the Atlanta site include: balance
with eyes closed, programmed force-distribution changes when stance is perturbed, cardiovascular assessments, WAIS,
Affects Balance Scale, and a survey of home environment. J Am Geriatr Soc 41:329-332, 1993
"We have identified seven therapeutic elements in Tai Chi. These elements are (1) continuous movement, performed
slowly; (2) small to large degrees of motion; (3) knee flexion and weight shifting; (4) straight and extended head
and trunk; (5) combined rotation of head, trunk and extremities; (6) asymmetrical diagonal arm and leg movements
about the waist; and (7) unilateral weight bearing with constant shifting."
{{Study #13, BEGINNERS, TC for seniors, FICSIT; therapeutic elements of TC}}
1993 Wolfson "Training Balance and Strength in the Elderly to Improve Function,"
L. Wolfson, MD, R. Whipple, MA, J. Judge, MD, P. Amerman, RN, MSN, C. Derby, PhD, and M. King, MD, Journal of the
American Geriatric Society, Vol. 41, pp 341-343, 1993. ©1993 by the American Geriatrics Society
Abstract:
Short-term exposure to altered sensory input or destabilizing platform movement results in significant improvement
in sway control and inhibition of inappropriate motor responses, resulting in improved balance during repetitive
testing. In addition, there is recent evidence that strength and function can be increased in both active and frail
elderly who participate in strength training programs. Therefore, the hypotheses to be tested are that (1) balance
training alone, or (2) strength training alone will each be capable of significantly improving balance, gait, and
functional mobility, and that (3) a combined program of balance and strength training will be more effective than
either approach alone. These hypotheses will be tested relative to a control group, using a 2 x 2 design (30 subjects
per group), in a community-dwelling elderly (sic) at least 75 years of age. Intervention sessions of at least 45
minutes will occur three times per week for 3 months, with 6 months of follow-up, home based Tai Chi training.
The primary outcome variable is a basic measure of functional balance, ie, the occurrence of loss of balance during
tilts of the support and/or movement of the visual surround. J Am Geratr Soc 41:341-343, 1993 ©1993 by the
American Geriatrics Society
Some observations of age-related declines are noteworthy:
"Strength increases throughout childhood and adolescence, peaking in the mid-twenties, then declining modestly
to age 50, and more steeply thereafter. Cross-sectional studies demonstrate a one-third [sic--decrease?] of lower
extremity strength by age 70. A prior study in elderly subjects with impaired balance and a history of falls has
showed a severe decrement of strength in ankle muscles. Ankle movement regulates the interaction of the foot and
the ground and is, therefore, critical for both walking and balance."
{{Study #14, BEGINNERS, TC for seniors, FICSIT; age-related declines}}
1992 Jin "Efficacy of Tai Chi, Brisk Walking, Meditation, and Reading in Reducing Mental
and Emotional Stress," Putai Jin, Journal of Psychosomatic Research, Vol. 36, No. 4, pp. 361-370, 1992.
© 1992 Pergamon Press plc
Abstract--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, meditation
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.
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 the subjects' high expectations about gains from Tai Chi.
Approaches controlling for expectancy level are recommended for further assessment.
This study compares the stress-reducing attributes of Tai Chi to those of brisk walking, meditation, and sitting
and reading. Subjects were drawn from a Tai Chi group in Melbourne, Australia, and randomized to the various experimental
groups.
"In the present experimental design, Tai Chi performance, as a treatment after mental and emotional stress
is compared with brisk walking, Tai Chi meditation, and neutral reading, in terms of cardiovascular, hormonal,
and mood changes. This approach makes it possible to examine whether the presumed effects of Tai Chi are due to
expenditure of physical energy, cognitive processing, or an interaction of both."
Study participants attended two experimental sessions 24 hours apart. They endured one hour of stress, then practiced
Tai Chi, brisk walking, meditation, or sitting and reading for another hour. Heart rate was monitored throughout
and saliva and urine specimens were taken before and after the stressors and following the experimental treatment.
Scientists love stark contrast, because stark contrast produces effects that are easy to measure. The stressors
are noteworthy: The first day, they were subjected to mental stress, alternately performing 10 min of mental arithmetic
and 10 min of difficult tests selected from Eysenck under high time pressure and noisy conditions for 1 hour. During
emotional stress, the subjects watched an hour-long stressful film 'Horrible Experiences: A True Story' edited
from a pool of stressful videotapes used by researchers at La Trobe University. Both events proved "stressful"
in terms of elevated heart rate and stress hormone levels in all participants. I would predict that any activity
following mental arithmetic in a boiler room under time pressure or an hour of "Horrible Experiences: A True
Story" would exhibit stress-reducing attributes, simply as a matter of contrast.
"Since there is no difference in the magnitude of cortisol reduction between the Tai Chi group and the other
three groups, an additive effect of the physical exercise component and the cognitive exercise component in the
practice of Tai Chi is not evident."
{{Study #11, PRACTITIONERS, Physiological, TC & stress}}
1991 Schneider "Metabolic and Cardiorespiratory Responses to the Performance of Wing
Chun and T'ai Chi Chuan Exercise," D. Schneider and R. Lueng, International Journal of Sports Medicine,
Vol. 12: 319-323, 1991.
Abstract:
D. Schneider and R. Leung, Metabolic and Cardiorespiratory responses to the Performance of Wing Chun and T'ai Chi
Chuan Exercise. Int J Sports Med, Vol 12, No 3, pp 319-323, 1991. Accepted: September 10, 1990.
The primary purpose of this study was to examine the metabolic and cardiorespiratory responses to the continuous
performance of Wing Chun and T'ai Chi Chuan exercise. No significant differences in VO2max or HRmax obtained during
treadmill exercise were found between the practitioners of the two styles. Average values for oxygen uptake (VO2)
were 23.3 ± 7.5 ml/kg/min (6.6 METS) and 16.0 ± 3.9ml/kg/min (4.6METS) for Wing Chun and T'ai Chi
Chuan exercise, respectively. Mean heart rates obtained during exercise were 137 ± 25 beats/min for Wing
Chun and 116 ± 22 beats/min for T'ai Chi Chuan exercise. These exercise values corresponded to 52.4% of
VO2max and 70.5% of HRmax for Wing Chun and only 36.4% of VO2max and 59.8% of HRmax for T'ai Chi Chuan exercise.
Thus, only the continuous performance of Wing Chun exercise elicited VO2 and HR responses that would be expected
to bring about a cardiorespiratory training effect in subjects with a relatively low initial VO2max. The ventilatory
equivalent for oxygen (VE/VO2) obtained during T'ai Chi Chuan exercise (21.7) was significantly lower than for
Wing Chun exercise (24.2), suggesting that T'ai Chi practitioners utilize efficient breathing patterns during exercise.
Both Wing Chun and T'ai Chi Chuan styles may have a small static component that produces a slightly elevated heart
rate relative to metabolic load when compared to traditional aerobic activities. However, the effect was not severe
and these forms of exercise should not be considered dangerous for individuals at high risk for cardiovascular
disease.
Key words: Oxygen uptake, martial arts, T'ai Chi Chuan, Wing Chun
{{Study #9, PRACTITIONERS, Physiological, Cardioresp, TC & Wing Chun compaired; TC elicits efficient breathing
patterns during exercise}}
1991 Kirsteins "Evaluating the Safety and Potential Use of a Weight-Bearing Exercise,
Tai-Chi Chuan, for Rheumatoid Arthritis Patients," Andrew E. Kirsteins, MD, Frederick Dietz, MD and
Shie-Ming Hwang, PhD, American Journal of Physical Medicine & Rehabilitation, Vol. 70, No. 3, June 1991.
ABSTRACT. The safety of a traditional Chinese exercise, Tai-Chi Chuan, on rheumatoid arthritis (RA) patients was
evaluated. RA patients, who received 1 h of Tai-Chi Chuan instruction once (n = 20) and twice (n = 15) a week for
10 consecutive wk in two separate studies, showed no deterioration in their clinical disease activities compared
with the corresponding controls (n= 11 and 9, respectively). Testing parameters included joint tenderness, joint
swelling, time to walk 50 feet, handgrip strength and a written functional assessment. No significant exacerbation
of joint symptoms using this weight-bearing form of exercise was observed. Tai-Chi Chuan exercise appears to be
safe for RA patients and may serve as an alternative for their exercise therapy and part of their rehabilitation
program. Weight-bearing exercises have the potential advantages of stimulating bone growth and strengthening connective
tissue, but this effect needs to be documented in long-term studies.
Key Words: Tai-Chi Chuan, Rheumatoid Arthritis, Exercise Therapy, Rehabilitation
{{Study #10, BEGINNERS, Therapeutic TC, Rheumatiod arthritis}}
1990 Channer "Changes in haemodynamic parameters following Tai Chi Chuan and aerobic
exercise in patients recovering from acute myocardial infarction," KS Channer, D Barrow, R Barrow,
M Osborne, G Ives, Postgraduate Medical Journal 1990, pp 349-351.
Abstract.
In this study, 126 patients (90 males, average age 56 years, range 39-80) were randomised to Wu Chian-Ch'uan style
Tai Chi (38), aerobic exercise (41) or a non-exercise support group (47) following acute myocardial infarction.
Patients attended twice weekly for three weeks then weekly for a further five weeks. Heart rate and blood pressure
were recorded before and after each session. Over the 11 sessions of exercise there was a negative trend in diastolic
blood pressure only in the Tai Chi group (RS-0.79, p <0.01). Significant trends in systolic blood pressure occurred
in both exercise groups (Rs =0.64 and 0.63, both p < 0.05). Only four (8%) patients completed the support group
eight-week programme which was less than the number completing Tai Chi (82%; p < 0.001) and aerobic exercise
groups (73%; p < 0.001).
Keywords: haemodynamics, Tai Chi Chuan, exercise, acute myocardial infarction
This study examined the effects of Tai Chi vs. aerobic exercise for victims of heart attacks, comparing them to
a cardiac support group as control. Observations of note:
"Heart rate increased in all patients undergoing aerobic exercises but in 13 (34%) of the Tai Chi group heart
rate was unchanged or decreased after exercise."
"Over the 11 sessions of exercise there was a negative trend in diastolic blood pressure in the Tai Chi group
but no trend was seen following aerobic exercise. Significant trends in systolic blood pressure occurred for both
Tai Chi and aerobic exercise. Tai Chi was associated with a negative trend in resting heart rate, but aerobic exercise
showed no trend. Only 4/47 (8%) patients completed the eight-week non-exercise programme which was significantly
fewer than completed the Tai Chi (82%) and aerobic exercise (73%)."
Resting heart rate declined in the Tai Chi group, but curiously, not in the aerobics group in this study. Both
the Tai Chi and aerobics groups showed a drop on systolic blood pressure,but only the Tai Chi group showed a drop
in diastolic blood pressure. Implications? Maybe Tai Chi affects the elasticity of the blood vessels. Reducing
the amount of strain in the system.
{{Study #8, BEGINNERS, Therapeutic TC (post-cardiac patients); Physiological, cardioresp; reduced BP, reduced resting
HR}}
1989 Jin "Changes in Heart Rate, Noradrenaline, Cortisol and Mood During Tai Chi,"
Putai Jin, Journal of Psychosomatic Research, Vol. 33, No. 2 pp. 197-206, 1989. ©1989 Pergamon Press plc
Abstract--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. 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. There is need for research concerned with whether
participation in Tai Chi has effects over and above those associated with physical exercise.
One of the first studies to examine the effects of Tai Chi on the endocrine system. It measured cardiorespiratory
response, hormonal levels indexing stress, and mood states before, during, and after a session of Tai Chi practice.
Sixty-six healthy volunteer subjects aged between 16 and 75 yr were recruited from two Tai Chi schools in Melbourne.
Those with more than a year's experience practicing Tai Chi constituted the "Practitioners" group; those
with 8 months or less experience constituted the "Beginners" group. 25 practitioners and 23 beginners
practiced the Yang Long Form, while 8 practitioners and 10 beginners practiced the Wu Style--pilot testing did
not reveal any marked difference in heart rate between the performance of these two forms. Circadian variation
in heart rate and hormonal levels was controlled by randomly assigning participants to morning, afternoon, and
evening testing sessions. The experiment consisted of 3 phases, with heart rate monitored throughout and saliva
and urine specimens collected at the end of each phase. Participants answered questions to assess baseline mood
state in the first phase, then performed Tai Chi for 60 minutes, with two 3-minute breaks, after which they answered
the same mood-state questionnaire. Participants then sat and rested for an hour before answering the mood-state
questionnaire once again.
Heart rate for practitioners was higher than that for beginners. Jin attributes this effect to the lower stance
and more controlled form of experienced practitioners, echoing Galante, who found that heart rate was elevated
up to 60-80% of maximum heart rate when Tai Chi was practiced in the 'low' position (knees bent as much as possible),
but was less than 60% of maximum heart rate in the 'high' position (knees only slightly bent). These findings call
into question conclusions drawn from cardiovascular studies of inexperienced Tai Chi practitioners.
Salivary cortisol levels reflect the levels of stress hormones circulating in the blood. Cortisol levels during
Tai Chi were lower than baseline measures, and remained lower an hour after practicing Tai Chi.
{{Study #5, PRACTIONERS & BEGINNERS, Physiological, TC & stress, - stress hormones, explains cardiorespiratory
discrepancy between deep & shallow stances;
Wu & Yang place similar demands on cardiovascular system}}
1989 Xusheng "Determination of E-Rosette-Forming Lymphocytes in Aged Subjects with Taichiquan
Exercise," Sun Xusheng, Xu Yugi, and Xia Yunjian, International Journal of Sports Medicine v.10 (1989)
217-219.
© Georg Thieme Verlag Stuttgart--New York.
Abstract:
Sun Xusheng, Xu Yugi, Xia Yunjian, Determination of E-Rosette-Forming Lymphocytes in Aged Subjects with Taichiquan
Exercise," Sun Xusheng, Xu Yugi, and Xia Yunjian, Int J Sports med, Vol.10, No 3, pp 217-219, 1989. Accepted
after revision: December 5, 1988.
T-lymphocytes were determined by rosette formation with sheep erythrocytes in the peripheral blood obtained from
30 healthy aged subjects who were practicing Taichiquan (88 style) exercise and 30 age-matched normal aged who
served as a control group. At rest the total number of T-lymphocytes and the number of active T-lymphocytes were
increased significantly in the exercise group compared with the controls. Immediately after a bout of Taichiquan
exercise, a marked increase of active T-lymphocytes occurred. In conclusion, the results indicate that frequent
Taichiquan exercise causes an increase of T-lymphocytes in the blood.
Key words: E rosette, T-lymphocyte, immunity, Taichiquan exercise, elderly.
{Study #6, PRACTITIONERS, Physiological, Immunity, increased peripheral t-lymphocytes following practice}}
1989 Harries "Symmetry in the movements of T'ai Chi Chuan," J.G. Harries,
Computers & Mathematics With Applications, Vol. 17, No. 4-6, pp. 827-835, 1989. © 1989 Pergamon Press
plc.
Abstract: The inherent reflective symmetry of the human body allows the orientation of positions and movements
relative to its median plane. In addition, the body may be oriented symmetrically in space, relative to defined
directions. Such orientations are easily definable in EW movement notation. A number of types of symmetry are distinguished,
and these are demonstrated through notation, pictures and verbal descriptions. These relatively simple symmetries
are applied to the Chinese martial art of T'ai Chi Chuan, with the aim of obtaining a clearer idea of "how
symmetrical" it is; a contribution to the comparison of styles. A similar treatment could be employed in relation
to other kinds of human movement, including dance. A more sophisticated analysis would result from the fuller exploitation
of the concepts of EW movement notation.
This article describes an unfathomable (for me) notation system for describing symmetries in movement, in this
case, Tai Chi. Those who like mathematics and puzzles may enjoy it.
{{Study #7, Other; symmetry in TC}}
1982 Koh "Tai Chi and Ankylosing Spondylitis--a Personal Experience," T.C.
Koh, M.B.B.S., F.F.A.R.A.C.S, American Journal of Chinese Medicine, Vol. X, No. 1-4, pp. 59-61. 1982
Abstract: On the suggestion of a Chinese physician the author took up Tai Chi, a traditional Chinese exercise,
in an attempt to relieve symptoms from his moderately severe ankylosing spondylitis. Conventional medical therapy,
used over a 15 year period, had proven of only limited benefit. Tai Chi consists of a series of intricate exercise
sequences, and after 2 1/2 years of daily practice the author now feels stronger and healthier than before. Pain,
weakness and general malaise return if practice is neglected for as little as one week. It is felt that Tai Chi
is of value in minimizing the flexion deformity of the spine. Improved skeletal muscle strength, limb co-ordination,
balance, chest movement and ability to relax are further benefits.
Koh is one of the first western medical researchers to study and write about Tai Chi. He suffered from Ankylosing
Spondylitis, a painful and debilitating swelling affecting the spine, hips, and sometimes the shoulders, neck,
ribs, and jaw; in severe cases the joints fuse together and lose all mobility. Pharmaceutical therapy helped somewhat
but carried undesirable side-effects. On the recommendation of a traditional Chinese physician, he took up Tai
Chi.
In the 1981 article, he introduces Tai Chi to the scientific community, providing historical background and enumerating
the elements of the Yang Short Form. In the 1982 article, he describes his experience with Tai Chi and Ankylosing
Spondylitis:
"Blood pressure, measured under basal conditions and on many occasions, was reduced from 130/90mmHg to 120/80
mmHg. The other benefits came gradually. The first noticeable effect, after about six months, was an improvement
in muscle power. The quadriceps, gastrocnemius, and erector spinae muscles in particular were appreciably stronger.
There was also a gradual reduction in pain, enabling the dosage of indomethacin to be reduced from 75 mg. a day
to 25 mg. a day. The frequency of spinal muscle spasm was considerably reduced, and incidents of stumbling and
falling ceased.
Prior to commencing Tai Chi, pain and muscle spasm frequently resulted in serious loss of sleep. With daily Tai
Chi, however, loss of sleep is no longer a problem.
If the author neglects his Tai Chi practice for as little as seven days, he is conscious of a return of pain, weakness,
muscle spasm and general malaise."
Koh also credits improved balance, leg strength, and upright stance for reducing his risk of falling, and the deep
breathing of Tai Chi for keeping his respiratory muscles strong and his thoracic cage flexible. Koh is a sample
size of one, but as a scientist observing his own transformation, his testimony is useful.
{{Study #3, BEGINNER, Therapeutic TC (ankylosing spondylitis), Physiological, cardioresp; reduced bp}}
1982 Tsao "Energy Cost of Performing Tai-Chi" Wen-yuan Tsao and Ronald A.
Ratliff, Medicine and Science in Sports and Exercise, v. 14 (#2) pp.174-174, 1982. (Poster presentation)
Tai-chi is an ancient chinese form of exercise which includes aspects of both the martial arts and meditation.
In the United States, increasing numbers of people are practicing this form of exercise. Although Tai-chi is purported
to improve physical fitness by its advocates, there is no scientific documentation of energy demands during performance
of Tai-chi. Therefore, the purpose of this study was to determine the energy cost of performing Tai-chi. Ten volunteers
(7 male, 3 female) with a mean (±SD) age of 29.4 ± 8.6 years served as subjects. Each subject had
been practicing Tai-chi for at least 2 years prior to their participation in the study. The mean (±SD) oxygen
uptake (V02) for the group, while performing Yang style Tai-chi was 10.4 ± 3.2 ml/kg/min. This value was
24.8% of their measured V02 max. Interestingly, the more masterful performers had a significantly (p<0.01) greater
mean (±SD) V02 (14.3 ±1.8 ml/kg/min) as compared to their less skillful counterparts (8.7 ±1.8
ml/kg/min). Since all subjects performed a similar routine, the difference in V02 may be due to the phenomenon
described by Tai-chi philosophers as the ability of masterful practitioners to perform "Chi," i.e., internal
work. The mean (±SD) HR for the group was 107.6 ±10.3 bpm, this value was 55.7% of the subjects measured
HR max. In conclusion, these data suggest that it is unlikely that Tai-chi effectively contributes to the development
of cardiovascular fitness in the traditional sense. However, this form of exercise may be valuable for some development
and maintenance of cardiovascular fitness when a high intensity level of exercise is contraindicated.
{{Study #4, PRACTITIONERS & BEGINNERS, Physiological, cardioresp; improved oxygen utilization}}
1981 Koh "Tai Chi Chuan", T.C. Koh, M.B.B.S., F.F.A.R.A.C.S. American Journal
of Chinese Medicine, Vol. IX, No. 1, pp. 15-22. 1981.
Abstract: Tai Chi Chuan, a mind-body relaxation exercise, was devised by Chang San Feng for meditation and self-defense
in the thirteenth century AD. The 108 forms are performed in a slow relaxed manner, taking 30 minutes altogether.
Practitioners of Tai Chi claim that it promotes health and cures certain illnesses but this has not been substantiated
and therefore further research into its health benefits is warranted.
{{Study #1, General, Tai Chi introduced to scientific community}}
1981 Lansheng "Changes in Heart Rate and Electrocardiogram During Taijiquan Exercise;
Analysis by telemetry in 100 subjects," Gong Lansheng, Qian Jianan, Zhang Jisheng, Yang Qi, Jiang Jian,
and Tao Qing, Chinese Medical Journal 94(9): 589-592, 1981.
Abstract.
Changes in heart rate and electrocardiogram were recorded by telemetry in 100 volunteers who were regularly doing
taijiquan. During the exercise, the change in heart rate is not very marked and no important electrocardiographic
changes are recorded. It is thus speculated that the possible beneficial effect of taijiquan on the cardiovascular
system cannot be attributed solely to the amount of exercise provided by taijiquan and additional mechanisms must
be sought.
This study examined 100 Yang Simplified (Short) form practitioners in Shanghai. It found no significant effect
of Tai Chi on blood pressure as measured before, during, and after practice, but the author notes that "16
male and 10 female hypertensives reported a gradual normalization in blood pressure cutting the need for medication
entirely or reducing the doses."
{{Study #2, PRACTITIONERS, Yang Short form; Physiological, cardioresp, no appreciable change in bp during practice,
but 26 hypertensives reported normalization of bp
Short form HR profiles}}
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