Tai Chi

Tai Chi is a traditional Chinese exercise which has over 5000 years of history in China. It combines Chinese martial arts with breathing techniques. In China, a large group of people practice Tai Chi daily for their health and wellness. Tai Chi is also widely taught in Chinese medical schools especially Chinese medicine universities. Tai Chi is very good in relaxation of mind and body, stress relief, chronic pains, hypertension and improvement balance and flexibility.

Tai chi, which originated in China as a martial art, is a mind-body practice in complementary and alternative medicine (CAM). Tai chi is sometimes referred to as "moving meditation"—practitioners move their bodies slowly, gently, and with awareness, while breathing deeply. This Backgrounder provides a general overview of tai chi and suggests sources for additional information.

• Many people practice tai chi to improve their health and well-being.
• Scientific research is under way to learn more about how tai chi may work, its possible effects on health, and chronic diseases and conditions for which it may be helpful.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Tai chi developed in ancient China. It started as a martial art and a means of self-defense. Over time, people began to use it for health purposes as well.

Accounts of the history of tai chi vary. A popular legend credits its origins to Chang San-Feng, a Taoist monk, who developed a set of 13 exercises that imitate the movements of animals. He also emphasized meditation and the concept of internal force (in contrast to the external force emphasized in other martial arts, such as kung fu and tae kwon do).

The term "tai chi" (shortened from "tai chi chuan") has been translated in various ways, such as "internal martial art" and "supreme ultimate fist." It is sometimes called "taiji" or "taijiquan."

Tai chi incorporates the Chinese concepts of yin and yang (opposing forces within the body) and qi (a vital energy or life force). Practicing tai chi is said to support a healthy balance of yin and yang, thereby aiding the flow of qi.

People practice tai chi by themselves or in groups. In the Chinese community, people commonly practice tai chi in nearby parks—often in early morning before going to work. There are many different styles, but all involve slow, relaxed, graceful movements, each flowing into the next. The body is in constant motion, and posture is important. The names of some of the movements evoke nature (e.g., "Embrace Tiger, Return to Mountain"). Individuals practicing tai chi must also concentrate, putting aside distracting thoughts; and they must breathe in a deep and relaxed, but focused manner.

Arthritis Rheum. 2009 Nov 15;61(11):1545-53.

Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of Tai Chi in the treatment of knee osteoarthritis (OA) symptoms. METHODS: We conducted a prospective, single-blind, randomized controlled trial of 40 individuals with symptomatic tibiofemoral OA. Patients were randomly assigned to 60 minutes of Tai Chi (10 modified forms from classic Yang style) or attention control (wellness education and stretching) twice weekly for 12 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score at 12 weeks. Secondary outcomes included WOMAC function, patient and physician global assessments, timed chair stand, depression index, self-efficacy scale, and quality of life. We repeated these assessments at 24 and 48 weeks. Analyses were compared by intent-to-treat principles. RESULTS: The 40 patients had a mean age of 65 years and a mean body mass index of 30.0 kg/m(2). Compared with the controls, patients assigned to Tai Chi exhibited significantly greater improvement in WOMAC pain (mean difference at 12 weeks -118.80 mm [95% confidence interval (95% CI) -183.66, -53.94; P = 0.0005]), WOMAC physical function (-324.60 mm [95% CI -513.98, -135.22; P = 0.001]), patient global visual analog scale (VAS; -2.15 cm [95% CI -3.82, -0.49; P = 0.01]), physician global VAS (-1.71 cm [95% CI -2.75, -0.66; P = 0.002]), chair stand time (-10.88 seconds [95% CI -15.91, -5.84; P = 0.00005]), Center for Epidemiologic Studies Depression Scale (-6.70 [95% CI -11.63, -1.77; P = 0.009]), self-efficacy score (0.71 [95% CI 0.03, 1.39; P = 0.04]), and Short Form 36 physical component summary (7.43 [95% CI 2.50, 12.36; P = 0.004]). No severe adverse events were observed. CONCLUSION: Tai Chi reduces pain and improves physical function, self-efficacy, depression, and health-related quality of life for knee OA.

Med Sport Sci. 2008;52:195-208.

T'ai Chi exercise in patients with chronic heart failure.

OBJECTIVE: To review the physiological and psychosocial effects of a 12-week T'ai Chi program (TC) in patients with heart failure (HF) as previously reported in a clinical trial. METHODS: We randomized 30 patients with chronic HF (left ventricular ejection fraction < or =40%) to receive TC plus usual care (n = 15), or usual care alone (wait-list control, n = 15). Outcome measures included quality of life, exercise capacity, B-type natriuretic peptide, catecholamine levels, heart rate variability, and sleep stability. RESULTS: The mean age (+/-SD) of patients was 64 +/- 13 years, mean baseline ejection fraction (+/-SD) was 23 +/- 7%, and median New York Heart Association Class was 2 (range 1-4). At 12 weeks, patients who participated in TC showed improved quality of life (mean change -17 +/- 11 vs. 8 +/- 15, Minnesota Living with HF Questionnaire, p = 0.001), increased exercise capacity (mean change 85 +/- 46 vs. -51 +/-58 m, 6-min walk, p = 0.001), and decreased B-type natriuretic peptide (mean change -48 +/- 104 vs. 90 +/- 333 pg/ml, p = 0.03) compared to the control group. Those who participated in TC also showed improvement in sleep stability (increase in high-frequency coupling +0.05 +/- 0.10 vs. -0.06 +/- 0.09 proportion of estimated total sleep time, p = 0.04; reduction in low-frequency coupling -0.09 +/- 0.09 vs. +0.13 +/- 0.13 proportion of estimated total sleep time, p < 0.01), compared to the control group. CONCLUSION: TC may enhance quality of life, exercise capacity, and sleep stability in patients with chronic HF.

Clin Rheumatol. 2008 Feb;27(2):211-8. Epub 2007 Sep 14.

Tai chi for osteoarthritis: a systematic review.

The aim of this study was to evaluate data from controlled clinical trials testing the effectiveness of tai chi for treating osteoarthritis. Systematic searches were conducted on MEDLINE, AMED, British Nursing Index, CINAHL, EMBASE, PsycInfo, The Cochrane Library 2007, Issue 2, the UK National Research Register and ClinicalTrials.gov, Korean medical databases, the Qigong and Energy database and Chinese medical databases (until June 2007). Hand searches included conference proceedings and our own files. There were no restrictions regarding the language of publication. All controlled trials of tai chi for patients with osteoarthritis were considered for inclusion. Methodological quality was assessed using the Jadad score. Five randomised clinical trials (RCTs) and seven non-randomised controlled clinical trials (CCTs) met all inclusion criteria. Five RCTs assessed the effectiveness of tai chi on pain of osteoarthritis (OA). Two RCTs suggested significant pain reduction on visual analog scale or Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to routine treatment and an attention control program in knee OA. Three RCTs did not report significant pain reduction on multiple sites pain. Four RCTs tested tai chi for physical functions. Two of these RCTs suggested improvement of physical function on activity of daily living or WOMAC compared to routine treatment or wait-list control, whilst two other RCTs failed to do so. In conclusion, there is some encouraging evidence suggesting that tai chi may be effective for pain control in patients with knee OA. However, the evidence is not convincing for pain reduction or improvement of physical function. Future RCTs should assess larger patient samples for longer treatment periods and use appropriate controls.