Tai Chi
Tai Chi is a traditional martial art that emphasizes gentle, flowing movements to promote physical health and well-being. Originating from Daoist principles, it is believed to enhance the body's energy, improve balance, and increase physical stamina. Although its historical roots trace back to the Middle Ages, diverse schools of Tai Chi have evolved over the centuries, with the Yang style being particularly popular in the West. The practice is commonly associated with older adults, especially in Asian communities, as it is often used to improve balance and reduce the risk of falls.
Research indicates that Tai Chi may provide various health benefits, including potential support for conditions like high blood pressure, osteoarthritis, and fibromyalgia. While some studies suggest it can improve balance and decrease fall risks in the elderly, and even enhance overall health, the scientific evidence remains inconclusive due to challenges in study design. Classes typically involve progressive training, where students learn a series of movements under the guidance of an instructor. Overall, Tai Chi offers a holistic approach to exercise that can foster physical and mental well-being.
Tai Chi
DEFINITION: Technique that uses gentle movements to strengthen and balance the body’s energy.
PRINCIPAL PROPOSED USES: Improving balance and preventing falls in the elderly
OTHER PROPOSED USES: Cancer treatment support, fibromyalgia, high blood pressure, improving overall health, osteoarthritis, osteoporosis, enhancing immunity
Overview
Tai Chi is a traditional form of martial art used to promote health. Its gentle, dancelike moves are said to strengthen and balance the body’s energy. The net results, according to tradition, include increased physical stamina, enhanced sense of well-being and comfort, and improved resistance to illness.
Tai Chi is said to have been developed by the Daoist monk Chang San-Feng sometime in the Middle Ages. (The exact dates and even the existence of this monk are disputed.) Various schools of Tai Chi developed over subsequent centuries, each with its own particular movements and postures, but all conforming to the same underlying principles.
In the 1950s, the Chinese government began to develop a series of standardized Tai Chi forms. One of these has become the most popular form of Tai Chi in the West, a thirty-seven-posture form abbreviated from a traditional approach to Tai Chi called the Yang style. There are five traditional schools and modern applications, including Chen, Yang, Wu (Hao), Sun, and modern, which merges the Chen and Yang styles together.
Uses and Applications
Tai Chi is an extremely popular form of exercise among older Asians in China and other Asian countries. In the United States, it has gained widespread use as a method of improving balance and preventing falls among the elderly. The slow movements of Tai Chi provide a gentle framework for enhancing physical control and improving balance. Tai Chi is also thought to improve overall health and enhance immunity, but this has not been evaluated scientifically to any significant extent.
Scientific Evidence
Although there is some evidence that Tai Chi may offer medical benefits, in general this evidence lacks conclusive results. There are several reasons for this (including funding obstacles), but one is fundamental: even with the best of intentions, it is difficult to properly ascertain the effectiveness of an exercise therapy like Tai Chi.
Only one form of study can truly prove that a treatment is effective: the double-blind, placebo-controlled trial. However, it is not possible to fit Tai Chi into a study design of this type. While it might be possible to design a placebo form of Tai Chi, it would be quite difficult to keep participants and researchers “blinded” regarding who is practicing real Tai Chi and who is practicing fake Tai Chi.
Therefore, some compromise with the highest research standards is inevitable. The compromise used in most studies, however, is less than optimal. In these trials, Tai Chi was compared to no treatment. The problem with such studies is that a treatment, any treatment, frequently appears to be better than no treatment, due to a host of factors. It would be better to compare Tai Chi to generic forms of exercise, such as daily walking, but thus far this method has not seen much use. Given these caveats, the following is a summary of what science knows about Tai Chi.
Most controlled trials of Tai Chi published in English have evaluated its potential benefits for improving balance in the elderly. Falling is one of the most common causes of injury in older people, leading to fractures, head injuries, and even death. Recovery from fall-related injuries may involve extensive immobilization in bed, which in turn increases the risk of osteoporosis, pneumonia, and depression. According to most studies, Tai Chi can improve balance and decrease the risk of falling.
For example, in a ten-week study, twenty-four older persons practiced Tai Chi (one class weekly, plus daily home practice), while a control group of twenty-two volunteers did not change their activity. The results showed that people practicing Tai Chi experienced substantially improved balance (measured by the ability to stand on one leg) compared to the control group. Some studies failed to find benefit; however, this is typical of treatments for which all studies have been small in size. For statistical reasons, small studies commonly fail to identify benefits even when there are some.
According to the National Center For Complementary and Alternative Medicine, a 2019 review of several studies found that Tai Chi could improve balance and reduce the risk of falling among the elderly by about 19 to 20 percent. A 2021 review of three studies found that Tai Chi could also reduce the risk of falling in patients with Parkinson’s disease.
In addition to balance, Tai Chi may mildly improve flexibility and cardiovascular health, presumably because it is a form of moderate exercise. However, one fairly large (207-participant) and long-term (one-year) study that compared Tai Chi to resistance exercise (weight lifting) found that while resistance exercises measurably improved one measure of cardiovascular risk (insulin sensitivity), Tai Chi did not affect any measures of cardiovascular risk. In a review of twenty-six published studies examining the effectiveness of Tai Chi for high blood pressure, 85 percent demonstrated a reduction in blood pressure. However, only five of these twenty-six studies were of acceptable quality.
One study found that persons with congestive heart failure can benefit from Tai Chi, but the study had no adequate control group. In two controlled studies, Tai Chi produced some benefit in bone density, suggesting the possibility that it might be helpful for preventing osteoporosis. A few studies provided evidence for the usefulness of Tai Chi as a treatment for osteoarthritis, and a preliminary study suggests it may be beneficial for mild to moderate rheumatoid arthritis. In 2019, the American College of Rheumatology and the Arthritis Foundation issued guidelines strongly recommend Tai Chi for managing both knee and hip osteoarthritis.
A 2019 review of six studies with more than 650 participants also found evidence that Tai Chi appeared to improve symptoms, function, and quality of life for those with fibromyalgia. Another 2019 review of seven studies with 656 participants found that Tai Chi may improve overall cognition in older adults in the early stages of dementia. A 2020 review of sixteen studies with more than 1,200 participants found Tai Chi improved the quality of life for people three months after being diagnosed with breast cancer. The exercises helped reduce fatigue and combat depression. However, the review also found that Tai Chi was no more likely to affect quality of life than conventional care from three to six months.
In one single-blinded randomized clinical trial published in 2024 that examined the effects of Tai Chi on patients with prehypertension, Tai Chi was shown to be more effective than aerobic exercise in reducing blood pressure after twelve months. The study also found reduced twenty-four hour and nighttime ambulatory systolic blood pressure (SBP) compared with patients who practiced aerobic exercise.
What to Expect During a Class
A Tai Chi class consists of progressive training in the movements of a Tai Chi form. Each subsequent class adds more moves to the repertoire, until finally one knows how to perform the entire series. The Tai Chi instructor will gently correct the student’s movements, helping to make stances and transitions between them more precise, graceful, and balanced.
Bibliography
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Lee, M. S., M. H. Pittler, and E. Ernst. “Tai Chi for Osteoarthritis.” Clinical Rheumatology 27 (2008): 211–18. Print.
Li X, Chang P., et al. "Effect of Tai Chi vs Aerobic Exercise on Blood Pressure in Patients with Prehypertension: A Randomized Clinical Trial." JAMA Network Open, vol. 7, no. 2, 2024. doi:10.1001/jamanetworkopen.2023.54937. Accessed 20 Sept. 2024.
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"Tai Chi: What You Need To Know." National Center For Complementary and Alternative Medicine, March 2022, www.nccih.nih.gov/health/tai-chi-what-you-need-to-know. Accessed 20 Sept. 2024.
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Wayne, P. M., et al. “The Effects of Tai Chi on Bone Mineral Density in Postmenopausal Women.” Archives of Physical Medicine and Rehabilitation 88 (2007): 673–80. Print.
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