What is tai chi?

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.

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 is gaining 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 is not strong. 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 benefit even when there is one.

Although there is some evidence that Tai Chi can improve balance and reduce the risk of falling, researchers conducting a 2008 review of nine randomized-controlled trials were unable to conclude that Tai Chi or Tai Chi-inspired exercises can effectively prevent fall-related harm in the elderly. The trials were too inconsistent in their methods and quality.

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 provide inconsistent
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 a small, randomized-controlled trial of sixty-six persons, Tai Chi appeared to
improve symptoms, function, and quality of life for those with fibromyalgia.
In one randomized study, a certain form of Tai Chi was more effective than health
education after twenty-five weeks in persons with moderate insomnia. A review of
seven studies found insufficient evidence to conclude whether or not Tai Chi
improves quality of life or psychological or physical outcomes in persons with
breast cancer.

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.

Low, S., et al. “A Systematic Review of the Effectiveness of Tai Chi on Fall Reduction Among the Elderly.” Archives of Gerontology and Geriatrics 48 (2009): 325–31. Print.

Wang, C. “Tai Chi Improves Pain and Functional Status in Adults with Rheumatoid Arthritis.” Medicine and Sport Science 52 (2008): 218–29. Print.

Wang, C., et al. “A Randomized Trial of Tai Chi for Fibromyalgia.” New England Journal of Medicine 363 (2010): 743–54. Print.

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.

Yeh, G. Y., P. M. Wayne, and R. S. Phillips. “T’ai Chi Exercise in Patients with Chronic Heart Failure.” Medicine and Sport Science 52 (2008): 195–208. Print.

Yeh, G. Y., et al. “The Effect of Tai Chi Exercise on Blood Pressure.” Preventive Cardiology 11 (2008): 82–89. Print.