Tai Chi Treatment

Tai Chi

What is tai chi?

Tai chi, pronounced "tie chee," is a gentle exercise program that is a part of Traditional Chinese Medicine. Derived from the martial arts, tai chi is composed of slow, deliberate movements, meditation, and deep breathing, which enhance physical health and emotional well-being.

As are many practices from the East, tai chi is based on spiritual and philosophical ideas that advocate a need for balance in the body, mind, and spirit. Central to tai chi is the idea that qi (pronounced "chee"), or life energy, flows throughout the body. Qi must be able to move freely for good health. The principle of yin/yang is important, too. Yin and yang are opposite and complementary forces in the universe, such as light and dark. Tai chi is meant to harmonize these pairs of opposites. Finally, tai chi imitates motion found in nature, such as the movements of animals, thereby uniting human beings with the natural world.

What is the history of tai chi?

Zhang Sanfeng, a martial artist who lived in China in the late 16th century, created the practice of tai chi. According to legend, Sanfeng had a dream about a snake and a crane engaged in battle; their graceful movements inspired his non-combative style of martial arts. This ancient form of movement has been practiced in China for centuries and is still a daily routine for tens of thousands of people there, especially the elderly. It was first introduced to the United States in the early 1970s and has since grown in popularity.

How does tai chi work?

There are various perspectives on how tai chi works. Eastern philosophy holds that tai chi unblocks the flow of qi; when qi flows properly, the body, mind, and spirit are in balance and health is maintained. Others believe that tai chi works in the same way as other mind-body therapies, and there is ample evidence that paying attention to the connection between the mind and the body can relieve stress, combat disease, and enhance physical well-being.

Tai chi has three major components—movement, meditation, and deep breathing.

	Movement -- all the major muscle groups and joints are needed for the slow, gentle movements in tai chi. Tai chi improves balance, agility, strength, flexibility, stamina, muscle tone, and coordination. This low-impact, weight-bearing exercise strengthens bones and can slow bone loss, thus preventing the development of osteoporosis.
	Meditation -- research shows that meditation soothes the mind, enhances concentration, reduces anxiety, and lowers blood pressure and heart rate.
	Deep breathing -- exhaling stale air and toxins from the lungs while inhaling a plentitude of fresh air increases lung capacity, stretches the muscles involved in breathing, and releases tension. It also enhances blood circulation to the brain, which boosts mental alertness. At the same time, the entire body is supplied with fresh oxygen and nutrients.

What does a tai chi session entail?

Tai chi sessions are usually group classes that last about an hour. Each session begins with a warm-up exercise. Then the instructor guides the class through a series of 20 to 100 tai chi movements that together comprise a "form." A form can take up to 20 minutes to complete. Each form has a nature-based name that describes its overall action—such as "wave hands like clouds" or "grasp the bird's tail." At the same time, students are asked to focus on the point just below their navels, believed to be the center from which qi flows. The teacher encourages the class to perform all movements in a slow, meditative manner and to focus on deep breathing. At the end of the class, there is usually a wind-down exercise, relaxation, and meditation.

How many sessions will I need?

Classes are usually taught on a weekly basis. Many practitioners recommend practicing tai chi for about 15 to 20 minutes twice daily at home, since regular practice is essential for mastering the forms and achieving lasting results. Before beginning a tai chi program, you should check with your doctor and discuss your health needs with the tai chi instructor. Exercises can be modified depending on your mobility, history of injuries, chronic pain, joint swelling (if present), and medication that may affect balance.

What conditions respond well to tai chi?

Tai chi improves overall fitness, coordination, and agility. People who practice tai chi on a regular basis tend to have good posture, flexibility, and range of motion, are more mentally alert, and sleep more soundly at night.

Tai chi is both a preventive and a complementary therapy for a wide range of conditions. Specifically, it is beneficial for chronic pain, gout, heart disease, high blood pressure, arthritis, osteoporosis, headaches, and sleep disorders. Tai chi is also beneficial for the immune system and the central nervous system, which makes it especially good for people with a chronic illness, anxiety, depression, or any stress-related conditions. The deep breathing of tai chi regulates the respiratory system, helping to treat respiratory ailments such as asthma, bronchitis, and emphysema. It also stimulates the abdomen, which aids digestion and helps relieve constipation and gastrointestinal conditions. Many studies indicate that elderly people who practice tai chi are much less prone to falls, a serious health risk to people in that age group.

Are there conditions that should not be treated with tai chi?

Tai chi is safe for everyone, regardless of age or athletic ability, and can be modified for most health problems. People with limited mobility—even those in wheelchairs—can learn and successfully use tai chi. However, it is not meant to replace medical care for a serious condition. Talk to your doctor and your instructor about any health problems or recent injuries you may have, or if you are pregnant.

Is there anything I should look out for?

Tai chi exercises muscles in areas of your body that may have been neglected for a while. Therefore, you may feel sore in the beginning. It takes time to develop the posture, flexibility and agility needed for tai chi, so don't get discouraged. As with any exercise program, safety is affected by proper stretching and warm-up exercises, as well as correct alignment. If you experience dizziness, shortness of breath, headaches, or severe pain, stop practicing and talk to your instructor right away, and consult your doctor.

How can I find a qualified tai chi practitioner?

For information on how to find a tai chi class in your area, contact your local health club or YMCA. Ask to sit in on a class before signing up, so that you can observe the instructor and the atmosphere of the class.

There are also many resources on the Web; www.chebucto.ns.ca/Philosophy/Taichi/other has links to a wide variety of interesting tai chi sites and organizations. You can also contact Wayfarer Publications (on the Web at www.tai-chi.com or by phone at 1-800-888-9119) for information on tai chi books, videos, and publications.

Supporting Research

Beling J. 12-month tai chi training in the elderly: its effect on health fitness. Physical Therapy. 1999;79(2):208.

Castleman M. Nature's Cures: from Acupuncture & Aromatherapy to Walking & Yoga, the Ultimate Guide to the Best Scientifically Proven, Drug-Free Healing Methods. Emmaus, Pa: Rodale Press, Inc; 1996:352-359.

Chen KM, Snyder M, Krichbaum K. Clinical use of tai chi in elderly populations [review]. Geriatr Nurs. 2001;22(4):198-200.

Chen KM, Snyder M, Krichbaum K. Facilitators and barriers to elders' practice of t'ai chi. A mind-body low-intensity exercise. J Holist Nurs. 2001;19(3):238-255.

Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2001;(3):CD000340.

Hain TC. Effects of tai chi on balance. JAMA. 2000;283(7):864.

Jin P. Efficacy of tai chi, brisk walking, meditation, and reading in reducing mental and emotional stress. J Psychosom Res. 1992;36:361-370.

Kreitzer MJ, Snyder M. Healing the heart: integrating complementary therapies and healing practices into the care of cardiovascular patients. Prog Cardiovas Nurs. 2002;17(2):73-80.

Lan C, Chen SY, Lai JS, Wong MK. Heart rate responses and oxygen consumption during Tai Chi Chuan practice. Am J Chin Med. 2001;29(3-4):403-410.

Learning about tai chi chuan. Feeling stressed? Give this quiet exercise a try.

Nursing. 2002;32(12):86.

Li F, Fisher KJ, harmer P, McAuley E. Delineating the impact of tai chi training on physical function among the elderly. Am J Prev Med. 2002;23(2 Suppl):92-97.

Li F, Harmer P, McAuley E, et al. An evaluation of the effects of Tai Chi exercise on physical function among older persons: a randomized controlled trial. Ann Behav Med. 2001;23(2):139-146.

Li JX, Hong Y, Chan KM. Tai chi: physiological characteristics and beneficial effects on health. Br J Sports Med. 2001;35(3):148-156.

LoBuono C, Pinkowish MD. Moderate exercise, tai chi improve BP in older adults. Patient Care. 1999;33(18):230.

Lumsden DB, Baccala A, Martire J. T'ai chi for osteoarthritis: an introduction for primary-care physicians. Geriatrics. 1998;53(2):84-87.

Novey DW, ed. Clinician's Complete Reference to Complementary/Alternative Medicine. St. Louis, Mo: Mosby; 2000:219-230.

Qin L, Au S, Choy W, et al. Regular Tai Chi Chuan exercise may retard bone loss in postmenopausal women: A case-control study. Arch Phys Med Rehabil. 2002;83(10):1355-1359.

Pelletier KR. The Best Alternative Medicine: What Works? What Does Not? New York, NY: Simon & Schuster; 2000:78-79.

Rappaport J. Muscle and meditation: the ancient art of tai chi builds strength—and serenity—in a few minutes a day. Natural Health. 1997;27(2):104-110.

Sifton DW, ed. The PDR Family Guide to Natural Medicines and Healing Therapies. New York, NY: Three Rivers Press; 1999:151-153.

Taggart HM. Effects of Tai Chi exercise on balance, functional mobility, and fear of falling among older women. Appl Nurs Res. 2002;15(4):235-242.

Wang JS, Lan C, Wong MK. Tai Chi Chuan training to enhance microcirculatory function in healthy elderly men. Arch Phys Med Rehabil .2001;82(9):1176-1180.

Ward J. Tai chi for older people. Nurs Older People. 2001;13(1):10-13.

Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler CE, Xu T. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc. 1996;44(5):489-497.

Wolf SL, Sattin RW, O'Grady M, et al. A study design to investigate the effect of intense tai chi in reducing falls among older adults transitioning to frailty. Control Clin Trials. 2001;22(6):689-704.

Wong AM, Lin YC, Chou SW, Tang FR, Wong PY. Coordination exercise and postural stability in elderly people: Effect of tai chi chuan. Arch Phys Med Rehabil. 2001;82(5):608-612.

Wu G. Evaluation of the effectiveness of tai chi for improving balance and preventing falls in the older population – a review. J Am Geriatr Soc. 2002;50(4):746-754.

Yalden J, Chung L. Tai chi: towards an exercise program for the older person [review]. Aust J Holist Nurs. 2001;8(1):4-13.

Review Date: December 2002

Reviewed By: Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma and Senior Medical Editor A.D.A.M., Inc.; Lonnie Lee, MD, Internal Medicine, Silver Springs, MD.