"For the aged population, t'ai chi can serve as a low-impact form of exercise for the entire body. It can
improve range of motion, flexibility, strength, and balance."
"T'ai chi can help alleviate joint pain and increase strength, flexibility, and balance in older patients
with osteoarthritis."
"Van Deusen and Harlowe documented self-reports of enjoyment in patients with arthritis, who were enrolled
in a range-of-motion dance program that included t'ai chi. According to the study results significant differences
were found between 17 experimental and 16 control participants in range of motion, frequency of activity, and perceived
benefits. The 17 experimental patients continued in t'ai chi after completing the dance program and noted continued
improvement in activity level and enjoyment of the t'ai chi activity with daily practice (emphasis mine)."
{{Study #27, Therapeutic TC (Osteoarthritis); increased range of motion, flexibility, & strength, continued
interest after study}}
1998 Lan "12-month Tai Chi training in the elderly: its effect on health fitness,"
Ching Lan, Jin-Shin Lai, Ssu-Yuan Chen, and May-Kuen Wong, Medicine & Science in Sports & Exercise , v.30
(#3), pp. 345-351, March 1998
Abstract:
LAN, C., J.-S. LAI, S.-Y. CHEN, and M.-K. WONG. 12-month Tai Chi
training in the elderly: its effect on health fitness. Med. Sci. Sports Exerc., Vol. 30, No. 3, pp. 345-351, 1998.
Purpose: The objective of this study was to evaluate the effect of Tai Chi Chuan (TCC) on health fitness in older
individuals. Methods: Thirty-eight community-dwelling persons aged 58 to 70 yr completed this study. The TCC group
included 9 men and 11 women; the control group included 9 men and 9 women. The TCC group practiced TCC for 11.2
± 1.4 months, with the attendance of 4.6 ±1.3 times/week. Each session included 20 min of warm-up,
24 min of TCC practice, and 10 min of cooldown. The exercise intensity was 52-63% of the heart rate range. Cardiorespiratory
function, strength, flexibility, and percent of body fat were evaluated before and at the end of this study. Results:
The male TCC group showed a 16.1% increase in VO2max (P < 0.01) , 11° increase in thoracic/lumbar flexibility
(P < 0.05 ), 18.1% increase in muscle strength of knee extensor (P < 0.01 ), and 15.4% increase of knee flexor
(P < 0.05 ). The female TCC group showed 21.3% increase in VO2max (P < 0.01 ), 8.8° increase in flexibility
(P < 0.05 ), 20.3% increase in muscle strength of knee extensor (P < 0.05 ), and 15.9% increase of knee flexor
(P < 0.05 ). The control group showed no significant change in these variables.
Conclusions: The results indicate that a 12-month Tai Chi Chuan program is effective
for improving health fitness of the elderly. Key Words: AGING, PHYSICAL TRAINING, HEALTH-RELATED FITNESS, CARDIORESPIRATORY
FUNCTION, MUSCLE STRENGTH, FLEXIBILITY, BODY COMPOSITION. Copyright © 1998 by the American College of Sports
Medicine.
Submitted for publication February 1997.
Accepted for publication June 1997.
Another study by Ching Lan's group in Taipei, using the same Tai Chi instructor and rigorous
practice,but this time focusing on beginners, instead of practitioners. After 3 months of training, the novice
practitoners were led by the Tai Chi master and practiced a whole set of Classic Yang Style Tai Chi (108 postures).
It couldn't have been pretty, at first: the Yang Long usually takes 8 months to a year to learn, but these beginners
were serious, meeting 3-5 times (mean 4.6) per week for an hour of practice.
After a year of practice, the Tai Chi group showed a significant improvement in cardiorespiratory
function, knee strength, and flexibility, while the control group showed no such improvements.
"In the present study, our data indicated that TCC training could result in an increase of 15-20% in strength
of knee extensor/flexor. Although TCC practice needs no instrument and employs only postural change, it can significantly
enhance the strength of lower limbs."
{{Study # 28, BEGINNERS, rigorous practice; TC for seniors; cardiorespiratory improvements--improved oxygen utilization,
increased knee strength & flexibility}}
1998 Young, DR "The Effects of Aerobic Exercise and T'ai Chi on Blood Pressure in the
Elderly," Deborah R. Young, Lawrence J. Appel, Sun-Ha Jee, Circulation v. 97(#8), pp. P54-P54, March
3, 1998. Abstracts of the 38th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
Prior studies suggest that moderate-intensity aerobic exercise may lower blood pressure. Whether
light intensity activity is sufficient to confer this benefit is unknown. In a randomized trial, we compared the
effects over 12 weeks of a moderate-intensity aerobic exercise (AE) program with a Tai Chi (TC) program of light
activity on blood pressure (BP). Participants were 62 sedentary older-aged adults (45% African American, 79% women,
age _ 60 years) with systolic BP 130-159 mm Hg and diastolic BP < 95 mm Hg (not on medication). Exercise heart
rate goal was 40%-60% heart rate reserve for AE and < 100 beats/min for TC. Duplicate BPs were measured every
2 weeks during intervention. BP change was the mean of all follow-up measurements. Analyses were adjusted for baseline
BP.
Systolic BP decreased over the 12 weeks for both AE (-8.4 ± 1.6, p <0.001) and TC
(-7.0 ± 1.6, p <0.001). Diastolic BP showed a similar drop: AE (-3.2 ± 1.0, p <0.002), TC (-2.4
± 1.0, p <0.02).
Body weight did not change in either group. Estimated maximal aerobic capacity tended to increase
in AE (p = 0.06) but not in TC (p = 0.24). These results suggest that light activity and moderate intensity aerobic
exercise have similar effects on BP in previously sedentary elderly individuals. If future trials with large sample
size and a no-exercise control group confirm these results, promoting light intensity activity could have substantial
public health benefits as a means to reduce BP.
{{Study # 29, BEGINNERS; Physiological, cardiorespiratory, reduced blood pressure}}
1997 Achiron "Electrical sensation during Tai-Chi practice as the first manifestation
of multiple sclerosis," A. Achiron, Y. Barak, Y. Stern, S. Noy, Clinical Neurology and Nuerosurgery
99 (1997), 280-281. © 1997 Elsevier Science B.V.
Abstract
We report a patient with a 3-year history of brief episodes of electrical sensations over her
back and upper limbs that occurred during Tai-Chi practicing. This appearance of Lhermitte's sign was later followed
by additional neurologic symptoms, and the patient was diagnosed as suffering from multiple sclerosis. Though the
patient related the Lhermitte's sign to her ability to achieve full relaxation in Tai-Chi exercises, we think it
was the first manifestation of the disease. © 1997 Elsevier Science B.V.
Keywords: Multiple sclerosis; Tai-Chi; Sensory impairment; Lhermitte's sign
"The common form of Lhermitte's sign which occurs in about a third of multiple sclerosis (MS) patients,
consists of a feeling of an electric current moving down the back to the legs on flexion of the neck. The spread
of the sensation is usually downwards, terminating either at the lower end of the spine or passing down both legs.
However, all four limbs may be affected or less frequently the arms alone.. .Even in the absence of any other symptoms
or signs, Lhermitte's sign is a strong indication of MS."
"In our patient electrical sensation compatible with Lhermitt'es sign occurred during bow stance (cervical
extension) and push hand practicing (flexion). These positions represent the classical postures of flexion or extension
that are associated with Lhermitte's sign. They evoke, due to mechanical deformation of the cord, impulses in demyelinated
sensory fibers."
"The appearance of Lhermitte's sign during Tai-Chi movements may be the first symptom of MS and not necessarily
indicates channels of vital energy."
{{Study # 30, aberrant electrical sensations, Lhermitte's sign, Multiple sclerosis}}
1997 Wolf "Exploring the Basis for Tai Chi Chuan as a Therapeutic Exercise Approach",
Steven L. Wolf, PhD, PT, Carol Coogler, ScD, PT, and Tingsen Xu, PhD, Archives of Physical and Medical Rehabilitation,
Vol. 78, August, 1997.
ABSTRACT. Wolf SL, Coogler C, Xu t. Exploring the basis for Tai Chi Chuan
as a therapeutic exercise approach. Arch Phys Med Rehabil 1997; 78:886-92.
For many centuries Tai Chi has been a martial art form, practiced primarily in Oriental cultures.
For the past 300 years this movement approach has been used as an exercise form, practiced by millions of Chinese
elderly people. To date, virtually no information exists about the therapeutic elements of this intriguing movement
sequence. This article provides a historical review of existing documentation of reputed Tai Chi benefits. The
108 "forms" of Tai Chi Chuan are reduced to 10 composite forms for ease of application of these forms
to older individuals within a reasonable time frame. An effort is set forth to identify the potential therapeutic
elements within these forms.
© 1997 by the American Congress of Rehabilitation Medicine and the American
Academy of Physical Medicine and Rehabilitation.
The best summary of the health benefits of Tai Chi in the scientific literature. The article
provides a concise summary of Chinese and American research on Tai Chi, mentioning many of the studies cited below.
]>>>>>Link to journal article, if possible. For this article only. (Archives of Physical Medicine
and Rehabilitation Home page: www.archives-pmr.org)
{{Study #23, General TC, Best overall summary of research}}
1997 Wolf "The effect of Tai Chi Quan and Computerized Balance Training on Postural
Stability in Older Subjects," Wolf, Steven L., Barnhart, Huiman X., Ellison, Gary L., Coogler, Carol
E., Atlanta FICSIT Group, Physical Therapy , Vol. 77, No. 4, April 1997.
Background and Purpose. This study explored whether two exercise programs would affect
the ability to minimize postural sway of 72 relatively inactive, older subjects who participated in the Atlanta
FICSIT trial.
Subjects. Subjects were randomly assigned to (1) a computerized balance training
group, (2) a tai chi group, or (3) an educational group serving as a control for exercise. Each group consisted
of 24 members.
Methods. All subjects were evaluated under four postural conditions before, immediately
after, and 4 months following their respective interventions, each of which was given over 15 weeks. Results. Platform
balance measures revealed greater stability after training among subjects in the balance training group but little
change in stability among subjects in the tai chi and educational group. Subjects in the tai chi group were less
afraid of falling after training compared with subjects in other groups with similar covariates. Conclusion and
Discussion. Unlike computerized balance training, tai chi does not improve measures of postural stability. Because
tai chi delayed onset to first or multiple falls in older individuals, this effect does not appear to be associated
with measures of enhanced postural stability. Tai chi may gain its success, in part, from promoting confidence
without reducing sway rather than primaily facilitating a reduction in sway-based measures. [Wolf SL, Barnhart
HX, Ellison GL, et al. The effect of tai chi quan and computerized balance training on postural stability in older
subjects. Phys Ther. 1997; 77:371-381.]
Key words: Balance, Exercise, Geriatrics, Movement, Tai chi.
It's interesting that subjects engaged in Computerized Balance Training showed decreased sway,
but increased fear of falling, while those engaged in Tai Chi training showed greater sway but reduced fear of
falling. Wolf postulates that Tai Chi practitioners develop "greater total body displacement capabilities"--that
they may sway more, but they fall less. It's also interesting to note the continued interest displayed by the Tai
Chi group:
"Approximately 40% of the subjects in the TC group, however, continued to meet weekly for TC practice after
completion of the 4-month follow-up, and 30% of these subjects continued to meet weekly for TC practice 2 years
after completion of this study."
The Atlanta FICSIT group also seems to be moving in the right direction:
"A more detailed and extended training interval should be studied, particularly among relatively healthy
elderly individuals, to assess the extent of psychosocial and physical benefits and the degree to which this exercise
form is integrated into routine lifestyles. The influence that both the trainers and the practice intensity between
sessions may have on these and other outcome measures also needs to be studied."
In Tai Chi, progress depends on practice outside of class, and the skill of the teacher
in conveying subtleties of the form. The teacher is particulatly important when the Tai Chi form is modified for
therapeutic reasons; the teacher determines the transitions between forms, and the transitions are as important
as the elements of the form itself.
{{Study #24, BEGINNERS, TC for seniors, FICSIT; improved body control, continued interest after study}}
1997 Horak "The effect of Tai Chi Quan and Computerized Balance Training on Postural
Stability in Older Subjects: Invited Commentary," Horak, FB, Physical Therapy V. 77 (#4) pp. 382-383,
April 1997.
(No Abstract).
Horak's criticism of the Wolf study centers on measures of sway as surrogates for postural
stability. She notes that "Athletes and dancers tend to have larger-than-normal postural sway in response
to surface perturbations," and that "People who stand with very small body sway, small body movements,
and small force excursions at the surface are not necessarily stable. Immobility should not be confused with stability;
however, it may be a natural compensation for fear of falling. This study showed that increased fear of falling
in the computerized balance training group was associated with decreased sway and that decreased fear of falling
in the tai chi group was associated with increased sway. Fear of falling may prevent people from moving and learning
to control their center of body mass over the entire extent of their base of support and beyond, and thus reduce
their sway but make them more vulnerable for a fall." Most significantly, she notes that Tai Chi develops
an internal sense of body position and motion, while most computerized balance training focuses on visual feedback
on a computer screen.
{{Study #25, critique of Study #24}}
1997, Horak, "The effect of Tai Chi Quan and Computerized Balance Training on Postural
Stability in Older Subjects: Response," Horak, FB, Physical Therapy V. 77 (#4) pp. 383-384, April 1997.
(No Abstract)
In reply to Horak: "We contend that the many step-like movements subjects take in executing
advanced tai chi "forms" emphasizing uniped positions are aborted falls. These advanced forms serve the
purposes of destabilizing the individual in a controlled fashion, engaging new movement strategies, and facilitating
the confidence level of the participant. So stability is not the issue here, but rather learning corrective strategies
for instability, or what we define as balance control."
{{Study #26, Reply to #25}}
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