“You don’t have to be a world-class athlete to do tai chi — and the health benefits can be tremendous” – a quote from the 10/3/07 issue of the Johns Hopkins Medicine’s Health Alerts.[1]
Western medical and scientific research during the last 10-15 years has found evidence that practicing Taiji (also spelled Tai Chi) can result in various kinds of health benefits. Although most of the research was performed on only dozens of people, instead of thousands of people, and the results are still preliminary, it seems to indicate that practicing Taiji can lead to a variety of health improvements, including:
- General improvement in overall health
- Lowering of blood pressure
- Increase in immunity to shingles
- Relief to osteoarthritis
- Improvement in the control of Type 2 diabetes
- Lowering stress and pain reduction
- Reducing probability of Alzheimer’s disease
In this article, we report on some of these health benefits, and provide some possible explanations why Taiji could provide such health benefits.
What is Taiji? Taiji is a set of soft and slow organized movements (called forms) of various parts of the body in which breathing and meditation are integrated with doing the forms. Of course, there are many levels of Taiji practice, with the simplest involving only the bodily movements. Then some simple breathing method (beyond natural breathing) is integrated in the sense of perhaps when to breathe in and when to breathe out while doing the forms, and some simple involvement of the mind or meditation is incorporated in the sense of visualizing the form being performed. Since most of the reported research showing the health benefits of Taiji involves new or fairly new Taiji practitioners, apparently the benefits are already noticeable for people who are doing Taiji at the simplest levels, i.e., doing the forms with only a small involvement of breathing method and meditation.
General improvement in overall health: Quite a few studies have shown that practicing Taiji on a regular basis, usually three times a week for an hour each, can result in general improvement in the overall health of the practitioners. Overall health improvements include increased flexibility, increased balance, stronger lungs, increased leg strength. All these qualities are important to people of all ages, but especially important for senior citizens, e.g., in avoiding falls and breaking of the hips. What is special about Taiji is that it is a low-impact (actually almost zero-impact) exercise that can be practiced by almost anyone at all ages with essentially zero adverse effects. Furthermore, one can practice Taiji even if one is not necessarily in the best state of health.
Lowering of blood pressure: For a long time it is believed that Taiji can reduce blood pressure. This perhaps is not surprising since Taiji can help reduce at least two contributing factors to high blood pressure, excessive weight and stress. More than 10 years ago in 1998, a group of researchers at Johns Hopkins University’s School of Medicine performed a study of 62 sedentary adults 60 years old and over, with half the group doing moderate aerobic exercise consisting of brisk walking and low-impact aerobics, and the other half doing Taiji. The participants were recruited from the Baltimore community, with 45% of the participants being African-Americans and 79% being women. The study concluded that after 12 weeks of practice, the systolic blood pressure of the aerobic exercise group had fallen significantly, an average of 8.4 millimeters (mm) of mercury (Hg). To their surprise, they also found that the systolic blood pressure of the Taiji group had also fallen significantly, an average of 7 mm of Hg.[2]
A 2004 study in Britain recruited 17 sedentary but healthy middle-age women aged 33-55 years who were involved in a 12-week Taiji program three times per week for one hour each. The study found that at the end of the 12-week Taiji program, the group’s mean systolic blood pressure decreased by 9.71 mm Hg, and their mean diastolic blood pressure decreased by 7.53 mm Hg.[3]
A more recent study but involving only 11 participants was published in 2009 in the British Journal of Sports Medicine. The conclusion is that after 12 weeks of practicing Taiji, the systolic blood pressure of the participants had fallen by an average of 11.64 mm of Hg, and the diastolic blood pressure had fallen by an average of 9.73 mm of Hg.[4]
Increase in immunity to shingles: A recent study showed that Taiji can boost immunity to shingles, which is caused by reactivation of the chickenpox virus (varicella-zoster virus, or VZV). This study was headed by Dr. Michael R. Irvin of the University of California at Los Angeles, and funded by the National Institute on Aging and the National Center for Complementary and Alternative Medicine; both are components of the National Institute of Health. This research was first completed in 2003 involving 36 adults age 60 or older who were randomly assigned to either a 15-week program of Taiji or a health education (control) group. Then a similar expanded study was completed in 2007 that confirmed the results of the 2003 study. The 2007 study involved 112 healthy adults age 59 to 86 (average age of 70) over a 16-week program of either Taiji or a health education program that provided 120 minutes of instruction weekly (probably two 60-minute sessions per week). The health education (control) group participated in classes learning about a variety of health-related topics.
Testing for the VZV immunity took place throughout the study to determine their immunity level to VZV without the VARIVAX vaccine. Then after the 16-week programs, each person received the VARIVAX vaccine, and nine weeks after that all were tested to assess their immunity level to VZV after getting the VARIVAX vaccine.
Compared with the control group, the study found that when no VARIVAX vaccine was involved, the Taiji group increased the participants’ immunity to VZV by as much as the vaccine typically produces in 30 to 40 year-old adults. Furthermore, even with the addition of the VARIVAX vaccine, the Taiji group still produced a significantly higher level of immunity than the control group, about 40% higher than by the vaccine alone. The Taiji group’s rate of increase in immunity over the course of the 25-week study was double that of the health education (control) group. Both groups had similar VZV immunity when the study began.[5] Therefore, practicing Taiji increased the immunity to VZV with or without the VARIVAX vaccine.
Relief to osteoarthritis: A very recent study (published in the November 2009 issue of Arthritis Care & Research) headed by Dr. Chenchen Wang of the Tufts University School of Medicine showed that Taiji may help reduce the pain of knee osteoarthritis (OA) in older patients. Symptoms of knee OA include pain (can be severe), stiffness, limited range of motion in the knee, and localized swelling. In the U.S., an estimated 4.3 million adults over 60 suffer from this form of arthritis, and the Centers for Disease Control and Prevention recently reported that as many as half of American adults may develop symptoms by age 85.
The study involved 40 patients with mean age of 65 years from the greater Boston area who had confirmed symptomatic knee OA but in good health otherwise. The 40 patients were mostly female and Caucasian, and were randomly assigned to a Taiji group or an attention control group, with both groups having two 60-minute sessions per week. For each session, the Taiji group participated in a 10-minute self-massage and a review of Taiji principles; 30 minutes of Yang-Style Taiji movement; 10 minutes of breathing technique; and 10 minutes of relaxation. The control group participated in 40 minutes of instruction covering OA as a disease, diet and nutrition, therapies to treat OA, or physical and mental health education, and 20 minutes of stretching exercises involving the upper body, trunk, and lower body, with each stretch being held for 10-15 seconds.
They met for 12 weeks, and assessments were performed at 12, 24, and 48 weeks. At the end of the study period, those in the Taiji group had a 75 percent reduction in knee pain, on average, and a 72 percent improvement in their ability to perform everyday tasks, such as using stairs. The Taiji group also reported less depression and better overall health status. The control group also reported improvements, but they were much lower than in the Taiji group. Dr. Wang concluded that “Taiji is a mind-body approach that appears to be an applicable treatment for older adults with knee osteoarthritis.”[6]
Improvement in the control of Type 2 diabetes: According to two small studies published in the British Journal of Sports Medicine in April 2008, Taiji can improve blood glucose levels and improve the control of type 2 diabetes and immune system response. Type 2 diabetes is a form of diabetes that usually sets in later in life. It is associated with chronic inflammation caused by increased glucose levels in the blood, known as hyperglycemia. When there is excess blood sugar, it can combine with hemoglobin, the oxygen transporter in the red blood cell, to become glycated hemoglobin. This can be used to indicate the levels of excess sugars.
One study was done in Taiwan and involved 30 patients with type 2 diabetes participating in a 12-week Taiji program, and 30 non-diabetic patients of similar age as the control group. After 12 weeks of Taiji exercises, the levels of glycated hemoglobin fell significantly, from 7.59% to 7.16%, which is a significant difference, and the control group’s levels were essentially unchanged.[7]
A second study done in Australia involving only 11 participants also indicated that Taiji can help to control type 2 diabetes.[8]
Why Taiji can lead to these health benefits? We now make an attempt to understand why Taiji could result in such a large variety of health benefits. The explanation will also allow us to understand why Taiji can alleviate or reduce the magnitude of other health problems such as stress, back and other bodily pains, and Alzheimer’s disease.
There are five basic principles to guide Taiji exercises. One is correct posture: Keeping the upper body straight, having lateral separation between the feet so the body’s center of gravity is well within the two straight lines formed by the two feet, keeping a low posture by having one or both knees bent and motion is facilitated by constant bending and straightening of the knees and rotation of the waist. Another is relaxation of the total body, including the skeletal parts and joints, the muscles/tendons/ ligaments, and the mind. Another is integration with breathing, resulting in deep and slow breaths, synchronizing with the bodily movements, and involving lower abdominal breathing once beyond the beginning level. Another is involvement of the mind, in the sense of the mind leading the form. Another one is that the movements are mostly soft and slow.[9]
The relaxation of the total body in doing Taiji helps to reduce stress, which, according to a 2007 article by the American Psychiatric Association, can lead to 43% of adults to suffer adverse health effects. Therefore, reducing stress can eliminate or at least reduce the magnitude of many other ailments. Keeping the upper body straight can lengthen the spine, frequent rotation of the waist flexes the spine right and left while building strength and flexibility, keeping a low posture by bending the knees strengthens the legs. This can help to increase flexibility and strengthen the leg and back muscles, thus reducing back problems and falling problems as well as leading to general improvement in overall health.
Integration with breathing is the beginning of integration with Qigong, which is intimately tied to traditional Chinese medicine (TCM). The basis of TCM is that there is a vital force called Qi that circulates within our body. When there is sufficient Qi and Qi can circulate smoothly, it leads to good health. When there is insufficient Qi or Qi cannot circulate smoothly due to blockage, it leads to illness. Integrating breathing helps to generate more Qi and help to circulate Qi within our body or overcome blockages. The more advanced method of lower abdominal breathing via moving the diaphragm up and down massages those internal organs below the diaphragm. When we exercise our arms and legs, we strengthen them. Similarly, when we massage or exercise our internal organs, we strengthen them also. A very important, but not necessarily well known to non-Taiji practitioners, is the involvement of the mind in doing Taiji. The mind is not empty, but it is also not cluttered with many things and creating more stress. Instead, the mind is very focused on the Taiji exercise at hand. The mind visualizes the form while performing it, and the mind leads the circulation of Qi. On the one hand, this focused involvement of the mind, instead of the mind being cluttered, helps to relax the mind, and on the other hand it keeps the mind working, thus reducing the probability or at least delaying the onset of Alzheimer’s disease.
Because the Taiji movements are mostly soft and slow, it has low impacts on the body, and people of all ages in various states of health can practice Taiji. Although the Taiji movements are mostly soft and slow, Taiji does get the good results of more vigorous aerobic exercises. It has been estimated that Taiji burns about 280 calories per hour of practice. By comparison, brisk walking burns about 270 calories per hour and swing dancing about 240 calories per hour. Furthermore, Taiji will use up to 95% of the body’s natural motion range, with the closest second being swimming which uses up to 65%.
Summary: It seems that modern medical and scientific research is confirming the long-held belief that Taiji is an excellent exercise that can lead to a variety of health benefits. It is an exercise that can be performed by people of all ages, and it is an exercise that one can start young and continue into the 80s or 90s. Furthermore, one can start reaping the health benefits even as a beginner. One doesn’t have to be a world-class athlete to do Taiji; as a matter of fact, it can be done by people in various states of health.
A number of medical/scientific studies have been completed in the last 10-15 years indicating the various health benefits of Taiji. Although most of these studies have involved only dozens of people, instead of thousands of people, and the results are mostly preliminary, taking them together does allow one to conclude that most likely there are many health benefits to practicing Taiji. The current general medical attitude towards Taiji is summed up nicely in an extensive review of over 200 studies published in 2004 in The American Journal of Physical Medicine & Rehabilitation, titled “Comprehensive Therapeutic Benefits of Taiji: A Critical Review.” The review stated that “Controlled research evidence was found to confirm therapeutic benefits of Taiji practice with regard to improving quality of life, physical function including activity tolerance and cardiovascular function, pain management, balance and risk of falls reduction, enhancing immune response, and improving flexibility, strength, and kinesthetic sense.”[10]
[1] http://www.johnshopkinshealthalerts.com/reports/healthy_living/376-1.html?type=pf.
[2] http://www.sciencedaily.com/releases/1998/03/980320075947.htm
[3] http://heapro.oxfordjournals.org/cgi/content/abstract/19/1/33.
[4] http://bjsm.bmj.com/content/43/11/840.abstract.
[5] http://www.nih.gov/news/pr/apr2007/nia-06.htm.
[6] http://www.sciencedaily.com/releases/2009/10/091029102417.htm.
[7] http://www.medicalnewstoday.com/articles/102256.php.
[8] http://bjsm.bmj.com/content/43/11/840.abstract.
[9] Although in all Taiji styles, the movements are basically soft and slow, depending on the particular style there could be a mixture of hard and fast movements.
[10]http://journals.lww.com/ajpmr/pages/articleviewer.aspx?year=2004&issue=09000&article=00011&type=abstract.
