Tai Chi and the Older Person

Original Editor - Lucinda hampton Top Contributors - Lucinda hampton, Kim Jackson, Vidya Acharya and Lauren Lopez

What is Tai Chi[edit | edit source]

Old people are making sports.jpg

Tai chi a ‘soft’ martial arts that was developed by the ancient Chinese. It is becoming a more common exercise in the West as a means of stress management and exercise. Tai chi consists of a series of slow, controlled movements or postures, in a seated or standing position.[1] As it can be performed in sitting it is ideal for those with lower limb problems or poor balance.

Tai chi is low impact and puts minimal stress on muscles and joints thus it is ideal for all ages and fitness levels. Tai chi is especially suitable for the older adult who otherwise may not exercise.[2]

Health Benefits of Tai Chi[edit | edit source]

The benefits of Tai Chi may include:

  • Decreased stress, anxiety and depression
  • Improved postural muscles
  • Improved mental health
  • Improved aerobic capacity
  • Increased energy and stamina
  • Improved flexibility, balance and co-ordination
  • Improved muscle strength and definition

Some evidence also suggests that Tai Chi may

  • Enhance quality of sleep
  • Decrease back pain
  • Enhance the immune system
  • Help lower blood pressure
  • Improve joint pain
  • Improve symptoms of congestive heart failure
  • Improve overall well-being
  • Reduce risk of falls in older adults[2]

Evidence of Health Benefits of Tai Chi[edit | edit source]

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Numerous published research articles have reported positive health benefits for Tai Chi. In 2015 alone, there were on average 15 new studies published each month, including Cochrane reviews.[3]

A Cochrane review published on 31 January 2019 examining the evidence for exercise regimes for preventing falls in older people living in the community, found that exercise involving balance and functional training, including Tai Chi, reduced falls compared with inactive control groups. It found that “Tai Chi" reduced the number of people experiencing falls (high‐certainty evidence) and may reduce the rate of falls (low‐certainty evidence).[4] As at least one-third of community-dwelling people over 65 years of age fall each year, with one in five requiring medical attention and around one in ten involving fractures, this is a significant outcome.[3]

Tai Chi for Back Pain

Research has shown that strong stabilizers will prevent back pain and hasten recovery[5].

  • Strengthening the back stabilizer muscles is very similar to tai chi training. The key is an upright posture, using abdominal breathing, and exercising the stabilizers through the pelvic floor and the transverse abdominus muscles. This is one of the major reasons why tai chi works so well for back pain.
  • Another bonus is that Tai chi trains the mind and body, making both stronger and integrated. It is one of the most effective tools to help with the mental aspects of back pain.[5]

The below video gives a brief insight into Tai chi for falls prevention.

[6] A 2016 Cochrane Review of Tai Chi for chronic obstructive pulmonary disease (COPD), comparing Tai Chi with usual care, reported that Tai Chi demonstrated better functional capacity (i.e. people able to walk farther) and improved pulmonary function compared with patients undergoing usual care.[7] Likewise a 2018 systematic review on Tai Chi as an exercise for coronary heart disease patients concluded that "significant effects of Tai Chi have been found in improving aerobic endurance and psychosocial well-being among coronary heart disease patients. Tai Chi could be a cost-effective and safe exercise option in cardiac rehabilitation".The below video gives an example of Tai Chi in use in a coronary heart rehabilitation program.

[8]

Parkinson's disease clients can also benefit from Tai Chi. A 2012 study found that Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson's, with additional benefits of improved functional capacity and reduced falls.[9] The video below shows such a class in action.

[10]

A systematic review published in 2016 on Tai Chi as a treatment for chronic pain "demonstrated positive evidence regarding the effects of Tai Chi on chronic OA pain, and some beneficial evidences of Tai Chi for LBP and osteoporosis. The minimal valid duration of Tai Chi for chronic OA pain may be 6 weeks, and a longer duration of Tai Chi exercise may achieve more gains. However, there was no valid evidence on the follow-up effects of Tai Chi for chronic pain conditions.[11]

A systematic review from 2018 found good news too when it comes to Tai Chi (TC) as option for stroke rehabilitation, stating "TC has an overall beneficial effect on ADL, balance, limb motor function, and walking ability among stroke survivors, based on very low-quality evidence, and may also improve sleep quality, mood, mental health, and other motor function".[12]

Studies on depression and Tai Chi also report benefits. Participants in Tai Chi therapy were more likely to have reductions in depression symptoms, experience depression remission and have greater improvement of physical functioning, and cognitive tests.[13]

The results of a meta-analysis show that there was a positive effect of Tai Chi in improving cognitive function in older adults, but no significant dose-response association between Tai Chi dose duration (i.e., Tai Chi session duration, Tai Chi practice duration per week, study duration, and Tai Chi practice duration for entire study) and cognition was seen. A longer time of Tai Chi was unrelated to more significant improvements in cognitive function. This study suggests that Tai Chi has beneficial effects on cognitive function even with a low dose (e.g., three 20-min sessions/week).[14]

Physiotherapy[edit | edit source]

Tai Chi is a great exercise to prescribe in many settings and for a myriad of health conditions.

The scientifically proven benefits of practicing Tai Chi on the physical (cardiovascular, muscle strength and flexibility) as well as mental (stress relief, relaxation) strength make it a great exercise. As shown above in only a few examples of chronic conditions Tai Chi can be utilised by physiotherapists in a variety of settings. It is a safe and effective exercise which is of particular importance when treating patients with chronic pain.

References[edit | edit source]

  1. Better health channel. Tai Chi. Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/tai-chi-health-benefits (last accessed 21.5.2019)
  2. 2.0 2.1 Mayo clinic Stress management. Available from: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/tai-chi/art-20045184 (last accessed 21.5.2019)
  3. 3.0 3.1 Your health Your choice Health benefits of Tai Chi: What is the evidence? Available from: https://www.yourhealthyourchoice.com.au/news-features/health-benefits-of-tai-chi-what-is-the-evidence/ (last accessed 21.5.2019)
  4. Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. Exercise for preventing falls in older people living in the community. Cochrane database of systematic reviews. 2019(1). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/full (last accessed 22.5.2019)
  5. 5.0 5.1 Harvard Health The benefits of Tai Chi Available from:https://www.health.harvard.edu/staying-healthy/the-health-benefits-of-tai-chi (last accessed 18.5.2020)
  6. Mayo Clinic. Mayo clinic minute- Tai Chi keeps seniors on their feet. Available from: https://www.youtube.com/watch?v=9vljJ0u-avg&app=desktop (last accessed 22.5.2019)
  7. Ngai SP, Jones AY, San Tam WW. Tai Chi for chronic obstructive pulmonary disease (COPD). Cochrane Database of Systematic Reviews. 2016(6). Available from: https://www.cochrane.org/CD009953/AIRWAYS_tai-chi-chronic-obstructive-pulmonary-disease-copd (last accessed 22.5.2019)
  8. Swansea bay NHS TV. Tai chi helps cardiac patients. Available from: https://www.youtube.com/watch?v=cKV1Eq2fOh4 (last accessed 22.5.2019)
  9. Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, Maddalozzo G, Batya SS. Tai chi and postural stability in patients with Parkinson's. New England Journal of Medicine. 2012 Feb 9;366(6):511-9. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa1107911 (last accessed 22.5.2019)
  10. Beth Israel Deaconess Tai Chi for Parkinson's Available from: https://www.youtube.com/watch?v=2yyg1eDy0r0&app=desktop (last accessed 22.5.2019)
  11. Kong LJ, Lauche R, Klose P, Bu JH, Yang XC, Guo CQ, Dobos G, Cheng YW. Tai chi for chronic pain conditions: a systematic review and meta-analysis of randomized controlled trials. Scientific reports. 2016 Apr 29;6:25325. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850460/ (last accessed 22.5.2019)
  12. Lyu D, Lyu X, Zhang Y, Ren Y, Yang F, Zhou L, Zou Y, Li Z. Tai Chi for stroke rehabilitation: a systematic review and meta-analysis of randomized controlled trials. Frontiers in physiology. 2018;9:983. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068268/ (last accessed 22.5.2019)
  13. Psychiatric times. Tai Chi Is a Biological Treatment for Depression Available from: https://www.psychiatrictimes.com/depression/tai-chi-biological-treatment-depression (last accessed 22.5.2019)
  14. Chen ML, Wotiz SB, Banks SM, Connors SA, Shi Y. Dose-Response Association of Tai Chi and Cognition among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2021 Jan;18(6):3179.