Objective To conduct a systematic review of reports on the physical and psychological effects of Tai Chi on various chronic medical conditions. Data Sources Search of 11 computerized English and Chinese databases. Study Selection Randomized controlled trials, nonrandomized controlled studies, and observational studies published in English or Chinese. Data Extraction Data were extracted for the study objective, population characteristics, study setting, type of Tai Chi intervention, study design, outcome assessment, duration of follow-up, and key results. Data Synthesis There were 9 randomized controlled trials, 23 nonrandomized controlled studies, and 15 observational studies in this review. Benefits were reported in balance and strength, cardiovascular and respiratory function, flexibility, immune system, symptoms of arthritis, muscular strength, and psychological effects. Conclusions Tai Chi appears to have physiological and psychosocial benefits and also appears to be safe and effective in promoting balance control, flexibility, and cardiovascular fitness in older patients with chronic conditions. However, limitations or biases exist in most studies, and it is difficult to draw firm conclusions about the benefits reported. Most indications in which Tai Chi was applied lack a theoretical foundation concerning the mechanism of benefit. Well-designed studies are needed.

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The effect of Tai Chi on health outcomes in patients with chronic conditions: a systematic review.

AIMS: To design simple tests of lateral stability for assessing balance in older people and to determine whether poor performances in these tests are associated with impaired vision, lower limb sensation, quadriceps strength, simple reaction time, and falling in this group.

DESIGN: A cross-sectional and retrospective study.

SETTING: Falls and Balance Laboratory, Prince of Wales Medical Research Institute.

PARTICIPANTS: One hundred fifty-six community-dwelling men and women aged 63–90 years (mean age 76.5, SD = 5.1).

OUTCOME MEASURES: The maximal lateral sway in a near-tandem stability test with eyes open and closed and the necessity of taking a protective step in the near-tandem stability test with eyes closed.

RESULTS: All 156 subjects could complete the near-tandem stability test with eyes open, but only 99 subjects (63.5%) could undertake the test with eyes closed without taking a protective step. Subjects with a history of falls had increased lateral sway both with eyes open and eyes closed as well as poorer visual acuity, proprioception, and quadriceps strength. Fallers were also significantly more likely to take a protective step when undertaking the near-tandem stability test with eyes closed. Multiple regression analysis revealed that impaired lower limb proprioception, quadriceps strength, and reaction time were the best predictors of increased maximal sway in the near-tandem stability test with eyes open. Reduced proprioception and quadriceps strength, in addition to age, were also found to be the best determinants of the necessity of taking a protective step in the near-tandem stability test with eyes closed.

CONCLUSIONS: The study findings identify simple new tests that are associated with falling in older people and elucidate the relative importance of specific physiological systems in the maintenance of lateral stability. J Am Geriatr Soc 47:1077–1081, 1999.

Lateral stability, sensorimotor function and falls in older people.

Background—Tai Chi Chuan (TTC) exercise has beneficial eVects on the components of physical condition and can produce a substantial reduction in the risk of multiple falls. Previous studies have shown that short term TCC exercise did not improve the scores in the single leg stance test with eyes closed and the sit and reach test. There has apparently been no research into the eVects of TCC on total body rotation flexibility and heart rate responses at rest and after a three minute step test. Methods—In this cross sectional study, 28 male TCC practitioners with an average age of 67.5 years old and 13.2 years of TCC exercise experience were recruited to form the TCC group. Another 30 sedentary men aged 66.2 were selected to serve as the control group. Measurements included resting heart rate, left and right single leg stance with eyes closed, modified sit and reach test, total body rotation test (left and right), and a three minute step test. Results—Compared with the sedentary group, the TCC group had significantly better scores in resting heart rate, three minute step test heart rate, modified sit and reach, total body rotation test on both right and left side (p<0.01), and both right and left leg standing with eyes closed (p<0.05). According to the American Fitness Standards, the TCC group attained the 90th percentile rank for sit and reach and total body rotation test, right and left. Conclusion—Long term regular TCC exercise has favourable eVects on the promotion of balance control, flexibility, and cardiovascular fitness in older adults. (Br J Sports Med 2000;34:29‐34)

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Balance control, flexibility, and cardiorespiratory fitness among older Tai Chi practitioners

Objectives: To determine the effectiveness of tai chi on self-rated sleep quality and daytime sleepiness in older adults reporting moderate sleep complaints.

Design: Randomized, controlled trial with allocation to tai chi or exercise control.

Setting: General community.

Participants: One hundred eighteen women and men aged 60 to 92.

Intervention: Participants were randomized into tai chi or low-impact exercise and participated in a 60-minute session, three times per week, for 24 consecutive weeks.

Measurements: Primary outcome measures were the seven subscales of the Pittsburgh Sleep Quality Index (PSQI), PSQI global score, and Epworth Sleepiness Scale (ESS). Secondary outcome measures were physical performance (single leg stand, timed chair rise, 50-foot speed walk) and 12-item short form (SF-12) physical and mental summary scores.

Results: Tai chi participants reported significant improvements in five of the PSQI subscale scores (sleep quality, sleep-onset latency, sleep duration, sleep efficiency, sleep disturbances) (P<.01), PSQI global score (P=.001), and ESS scores (P=.002) in comparison with the low-impact exercise participants. Tai chi participants reported sleep-onset latency of about 18 minutes less per night (95% confidence interval (CI)=–28.64 to –7.12) and sleep duration of about 48 minutes more per night (95% CI=14.71–82.41) than low-impact exercise participants. Tai chi participants also showed better scores in secondary outcome measures than low-impact exercise participants. Both groups reported improvements in SF-12 mental summary scores.

Conclusion: Older adults with moderate sleep complaints can improve self-rated sleep quality through a 6-month, low- to moderate-intensity tai chi program. Tai chi appears to be effective as a nonpharmacological approach to sleep enhancement for sleep-disturbed elderly individuals.

Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomized controlled trial.

Objectives—To assess the characteristic eVects of Tai Chi Chuan (TCC) exercise on metabolism and cardiorespiratory response,andtomeasureitseVectoncardiorespiratory function, mental control, immune capacity, and the prevention of falls in elderly people. Design—A review of controlled experimental studies and clinical trials designed with one of two aims: either to assess physiological responses during the performance of TCC or to assess the impact of this exercise on general health and fitness. Main outcome measures—Metabolic rate, heart rate, blood pressure, ventilation, maximal oxygen uptake (V ~O2MAX), immune capacity, falls, and fall related factors. Subjects—A total of 2216 men and women. Results—Under review were 31 original studies, published in Chinese or English journals, that met the criteria for inclusion. Most of the papers written in Chinese had not been introduced into the Western literature. Nine of these studies showed that TCC can be classified as moderate exercise, as its does not demand more than 55% of maximal oxygen intake. When this form of exercise and others conducted at equal intensity were compared, TCC showed a significantly lower ventilatory equivalent (V ~E/V ~O2MAX). Evidence provided by cross sectional and longitudinal studies suggests that TCC exercise has beneficial eVects on cardiorespiratory and musculoskeletal function, posture control capacity, and the reduction of falls experienced by the elderly. Conclusions—TCC is a moderate intensity exercise that is beneficial to cardiorespiratory function, immune capacity, mental control, flexibility, and balance control; it improves muscle strength and reduces the risk of falls in the elderly. (Br J Sports Med 2001;35:148‐156)

https://bjsm.bmj.com/content/bjsports/35/3/148.full.pdf

Tai chi: physiological characteristics and beneficial effects on health

The purpose of this study was to assess the effect of T'ai Chi Chuan training on lateral stability, kinesthetic sense, and strength of voluntary knee extension. Subjects consisted of 24 naive volunteers (12 men and 12 women) between the ages of 20 and 45 years. Pre- and 12-week posttests included lateral body stability, kinesthetic sense in the glenohumeral joint for 30°, 45°, and 60°, and strength of knee extension. After pretest data collection, 12 subjects performed T'ai Chi Chuan three times per week for 12 weeks, learning 108 forms of T'ai Chi Chuan. A 2 × 2 analysis of variance was used to estimate significance of group differences on all of the dependent variables. Significant group differences were found in lateral body stability, kinesthetic sense at 60°, and strength of the dominant knee extensor. No significant differences between the T'ai Chi and the control group were found for kinesthetic sense at 30° and 45° rotation of the glenohumeral joint. Film analysis indicated that the two lesser ang...

Larry Guerrero

Papers

The effect of T'ai Chi Chuan training on balance, kinesthetic sense, and strength