TAI CHI: IMPACT ON AGING

In total: - 89 scientific articles (peer-reviewed journals) found in the international literature since 1980 - No scientific article referenced on Medline comes from French teams (validated by peer review) ... - Most of the experiments were carried out by American teams, and even more so by Chinese or other Asian teams (as was to be expected)

Most of the experiments were carried out by American teams, and even more so by Chinese or other Asian teams (not surprisingly) - 32 articles (to me) seem particularly important and/or the best scientifically argued. They are summarized below - Of particular note is the experimental study carried out as part of the FICSIT cohort and the team of Wolf et al.

This study was initiated in 1993. The results were presented in 1996 and reprinted in full in JAGS in 2003, given the importance attached to this work by the American Geriatrics Society.

This landmark study has given rise to other works that qualify the results, but above all tend to validate/adapt Tai Chi to the typology of the AP and its level of frailty to better define the place of the most effective preventive action. - We should also mention the excellent general review by Wu (2002) and the more nuanced review by Verhagen (2004)

LIST OF THE MOST IMPORTANT ARTICLES WITH THEIR FIELDS OF INTEREST
1 - Tai Chi in Australia: acceptable and effective approach to improve balance and mobility in older people? Hill K, Choi W, Smith R, Condron J Australasian Journal on Ageing ; 24(1) 9-14, 2005 = Tai Chi, and overall benefit
2 - The efficacy of Tai Chi Chuan in older adults: a systematic review. Verhagen AP, Immink M, van der Meulen A, Bierma-Zeinstra SM. Fam Pract, 21(1):107-13, 2004 = meta-analysis qualifying the importance of the benefit of Tai Chi
3 - Relative exercise intensity of Tai Chi Chuan is similar in different ages and gender. Lan C, Chen SY, Lai JS Am J Chin Med, 32(1):151-60, 2004 = ubiquity of Tai Chi
4 - The aerobic capacity and ventilatory efficiency during exercise in Qigong and Tai Chi Chuan practitioners. Lan C, Chou SW, Chen SY, Lai JS, Wong MK. Am J Chin Med, 32(1):141-50, 2004 = comparison Tai Chi and Ci Kong
5 - Effect of 4- and 8-wk intensive Tai Chi Training on balance control in the elderly. Tsang WW, Hui-Chan CW. Med Sci Sports Exerc, 36(4):648-57, 2004. = rapid benefit of Tai Chi; prolonged effect
6 - Effect of tai chi exercise on proprioception of ankle and knee joints in old people Xu D, Hong Y, Li J, Chan K, Br J Sports Med , 38:50-54, 2004 = Tai Chi and proprioception
7 - Tai Chi improves standing balance control under reduced or conflicting sensory conditions. Tsang WW, Wong VS, Fu SN, Hui-Chan CW. Arch Phys Med Rehabil, 85(1),129-37, 2004. = Very important benefit of Tai Chi if visual or vestibular disorders
8 - Tai Chi and Self-Rated Quality of Sleep and Daytime Sleepiness in Older Adults; a Randomized Controlled Trial Li F, PhD, K. Fisher KJ, PhD, Harmer P, PhD, Irbe D, Tearse RG, Weimer C J Am Geriatr Soc, 52, 892-900, 2004. = Tai Chi and sleep quality
9 - Artificial neural networks and center-of-pressure modeling: a practical method for sensorimotor degradation assessment. Shan G, Daniels D, Gu R.. J Aging Phys Act, 12(1), 75-89, 2004 = Tai Chi and neuronal plasticity
10 - Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training Wolf SL, Huimnan X. Barnhart XB, Kutner NG, McNeely E, Coogler C, Xu T, and the Atlanta FICSIT Group J Am Geriatr Soc 51, 1794-1803, 2003. Reprinted from: Wolf S, Barnhart H, Kutner N, McNeely E, Xu T, and the Atlanta FICSIT Group. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerised balance training. 1996; 44: 489-97. = Tai Chi and risk of falls in frail older people
11 - Intense Tai Chi Exercise Training and Fall Occurrences in Older,Transitionally Frail Adults: A Randomized, Controlled Trial. Wolf SL, Richard W. Sattin RW, Kutner M, O'Grady M, Greenspan AI, Gregor RJ J Am Geriatr Soc, 51, 1693-1701, 2003. = Tai Chi and frail IPs
12 - Effects of tai chi on joint proprioception and stability limits in elderly subjects. Tsang WW, Hui-Chan CW. Med Sci Sports Exerc, 35(12), 1962-71, 2003 = Tai Chi and proprioception
13 - Exercise interventions: defusing the world's osteoporosis time bomb Chan KM, Anderson M & Lau E Bulletin of the World Health Organization, 81, 827-830, 2003 = Tai Chi and osteoporosis prevention
14 - Evaluation of the effectiveness of Tai Chi for improving balance and preventing falls in the older population--a review. Wu G. J Am Geriatr Soc, 50(4):746-54, 2002 = A general review that takes stock of previous work
15 - Tai Chi Chuan training is associated with enhanced endothelium-dependent dilation in skin vasculature of healthy older men. Wang JS, Lan C, Chen SY, Wong MK J Am Geriatr Soc. 50(6):1159-60, 2002 = Impact of Tai Chi on peripheral circulation
16 - Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial. Song R, Lee EO, Lam P, Bae SC. J Rheumatol. 30(9):2039-44, 2003 = Benefits of Tai Chi in osteoarthritis
17 - Taiji training improves knee extensor strength and force control in older adults. Christou EA, Yang Y, Rosengren KS. J Gerontol A Biol Sci Med Sci. 58(8):763-6, 2003 = Tai Chi benefits the quadriceps
18 - Effects of Tai Chi exercise on balance, functional mobility, and fear of falling among older women. Taggart HM Appl Nurs Res ; 15(4), 235-42, 2002 = Tai Chi, balance and falls
19 - Improvement of isokinetic knee extensor strength and reduction of postural sway in the elderly from long-term Tai Chi exercise. Wu G, Zhao F, Zhou X, Wei L. Arch Phys Med Rehabil ; 83(10), 1364-9, 2002 = Tai Chi, muscle strength and postural instability
20 - An evaluation of the effects of Tai Chi exercise on physical function among older persons: a randomized contolled trial. Li F, Harmer P, McAuley E, Duncan TE, Duncan SC, Chaumeton N, Fisher KJ. Ann Behav Med. 23(2):139-46, 2001. = Tai Chi and motor balance
21 - Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study. Lan C, Lai JS, Chen SY, Wong MK. Arch Phys Med Rehabil ; 81(5):604-7, 2000 = Tai Chi and muscular strength/endurance of the lower limb
22 - Balance control, flexibility, and cardiorespiratory fitness among older Tai Chi practitioners. Hong Y, Li JX, Robinson PD. Br J Sports Med. ; 34(1):29-34, 2000 = Tai Chi, motor balance and cardiorespiratory fitness
23 - The effects of a short-term exercise program on movement, pain, and mood in the elderly. Results of a pilot study. Ross MC, Bohannon AS, Davis DC, Gurchiek L. J Holist Nurs;17(2),139-47, 1999 = Tai Chi, and overall effect on well-being and quality of life
24 - A therapeutic programme for people with dementia. Gibb H, Morris CT, Gleisberg J. Int J Nurs Pract; 3(3):191-9, 1997 = Tai Chi: beneficial practice in non-severe dementia
25 - Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners. Lan C, Lai JS, Wong MK, Yu ML. Arch Phys Med Rehabil ; 77(6), 612-6, 1996 = Tai Chi, flexibility, cardiorespiratory adaptation and body fat
26 - Changes in haemodynamic parameters following Tai Chi Chuan and aerobic exercise in patients recovering from acute myocardial infarction. Channer KS, Barrow D, Barrow R, Osborne M, Ives G. Postgrad Med J.; 72(848), 349-51, 1996 = Tai Chi, and myocardial infarction
27 - Two-year trends in cardiorespiratory function among older Tai Chi Chuan practitioners and sedentary subjects. Lai JS, Lan C, Wong MK, Teng SH. J Am Geriatr Soc ; 43(11):1222-7, 1995 = Tai Chi : less cardiorespiratory functional decline
28 - Cardiorespiratory responses of Tai Chi Chuan practitioners and sedentary subjects during cycle ergometry. Lai JS, Wong MK, Lan C, Chong CK, Lien IN. J Formos Med Assoc ; 92(10), 894-9, 1993 = Tai Chi and cardiorespiratory adaptation (young seniors)
29 - The Atlanta FICSIT study: two exercise interventions to reduce frailty in elders. Wolf SL, Kutner NG, Green RC, McNeely E. J Am Geriatr Soc ; 41(3):329-32, 1993 = Tai Chi: the cornerstone of the FICSIT program
30 -Evaluating the safety and potential use of a weight-bearing exercise, Tai-Chi Chuan, for rheumatoid arthritis patients. Kirsteins AE, Dietz F, Hwang SM. Am J Phys Med Rehabil ; 70(3):136-41, 1991 = Tai Chi: benefits in RA
31 - Changes in heart rate, noradrenaline, cortisol and mood during Tai Chi. Jin P. J Psychosom Res. ; 33(2), 197-206, 1989 = Tai Chi and biological parameters of stress 32 - Preventive geriatrics: an overview from traditional Chinese medicine. Zhou DH. Am J Chin Med; 10(1-4),
32-39, 1982 = First article found taking into account Tai Chi in Prevention and Health COMMENTARY ON ARTICLES Hill K, Choi W, Smith R, Condron J Tai Chi in Australia: acceptable and effective approach to improve balance and mobility in older people? Australasian Journal on Ageing ; 24(1) 9-14, 2005

On 90 average-age 70-year-old APs, this team confirms the benefits of Tai Chi (1 hour 3 times a week), using an exhaustive battery of tests validated in the field of balance. Balance was significantly improved. In addition, the authors underline the more global benefits of Tai Chi, with strong adherence from participants, most of whom wished to continue the program, with an improvement in life balance and an interest on the part of those tested in the cognitive stimulation action of Tai Chi linked to the memorization of figures. Li F, PhD, K. Fisher KJ, PhD, Harmer P, PhD, Irbe D, Tearse RG, Weimer C: Tai Chi and Self-Rated Quality of Sleep and Daytime Sleepiness in Older Adults; a Randomized Controlled Trial J Am Geriatr Soc, 52, 892-900, 2004.

Sleep disorders in the elderly often have serious and difficult-to-appreciate consequences, even leading to increased morbidity and mortality from cardiovascular disease. In all cases, sleep disorders affect quality of life and well-being. Sleep disorders have many causes. While impaired sleep may be the obvious consequence of poor health, in direct relation to one or more ongoing pathologies, this type of situation is far from explaining everything. In fact, according to the most well-documented study of 9,000 APs (National Institute on Aging survey: Foley DJ & al, Sleep, 1995), over 50% of APs over 65 expressed chronic sleep disorders when questioned. Sleep disorders in people with AD are therefore almost always the result of situations other than acute or ongoing pathology. These causes are apparently more benign, and generally under-researched. They include progressive lack of physical activity and daily muscular effort, reduction in basic daily activities, anxiety and depression, environmental stress, etc. The Li F et al study (Jags, 2004) compared the effects (over 6 months, 3 times 1 hour per week) of a Tai-Chi program (n=62) with those of a conventional low-intensity physical exercise program (n=56).

They used internationally validated scales and tests for sleep quality (PSQI-1989: Pittsburgh Sleep Quality Index; ESS-1991: Epworth Sleepiness Scale), motor activity and balance, and quality of life (SF12). The two cohorts were perfectly matched, as shown in the table below:
The authors demonstrate a highly significant improvement in sleep quality, both through a reduction in the time taken to fall asleep (-18min) and an increase in sleep time (48min). At the same time, and confirming the literature, Tai-Chi showed a clear improvement in physical performance tests (unipodal standing, chair raising, brisk walking). This improvement is far more significant than that obtained with conventional low-intensity exercise.
On the other hand, perceived quality of life (measured by the SF12) was improved in both cases, with no significant difference between the 2 groups. Tai chi thus appears to be an effective non-drug approach to the management of sleep disorders in AP. Wolf SL, Huimnan X. Barnhart XB, Kutner NG, McNeely E, Coogler C, Xu T, and the Atlanta FICSIT Group Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training J Am Geriatr Soc 51, 1794-1803, 2003. (Reprinted from JAGS 1996)

As part of the FICSIT program (The Atlanta Frailty and Injuries Cooperative Studies and Intervention Techniques), the study by Wolf et al compared the effects of 2 physical training methods in 200 APs over 70 (mean age 76; 162 women, 38 men): - tai Chi (TC), - a more conventional method of balance training using programmed exercises (BT). The 2 main arms (TC and BT) were compared with a 3rd arm, receiving a purely educational and counseling program (ED). The intervention period was 15 weeks, extended by 4 months of follow-up.
Several parameters were evaluated in the FICSIT program to monitor the evolution of the program participants' level of frailty and establish indicators. Biomedical: muscular strength, flexibility, cardiovascular endurance, body composition. - Psychosocial: depression scale, perception of present and future health, self-control and motivation, sleep quality, malaise.
A complementary analysis measured the fear of falling and the frequency of recurrent falls. The cohorts were broadly comparable, as shown in the table below:
In all the groups tested, overall performance was improved, particularly in terms of muscular strength. But the results clearly show the greater benefits of Tai-Chi, compared with the other 2 groups, with : - A highly significant reduction in resting blood pressure, as well as systolic pressure measured after a 12-minute forced walk, - a highly significant reduction in fear of falling. Statistical adjustment of the results then showed that the risk of recurrence of falls was reduced by 47% by Tai-Chi in this experiment. The main results are collated in the tables below: Wolf SL, Richard W. Sattin RW, Kutner M, O'Grady M, Greenspan AI, Gregor RJ Intense Tai Chi Exercise Training and Fall Occurrences in Older,Transitionally Frail Adults: A Randomized, Controlled Trial. J Am Geriatr Soc, 51, 1693-1701, 2003.

An earlier study by Wolf et al (Jags-1996, repeated in 2003, highlighted the benefits of Tai Chi on patients with little or no frailty. This new study, while confirming the earlier results, qualifies their scope. The experiment was carried out on a selected, targeted population: elderly people in the process of becoming frail. In terms of public health and prevention policy, it is clear that this is the most interesting population: one for which targeted health care can be designed. To define this population (in the process of becoming frail), the team selected 10 frailty criteria in recognized areas: age, balance, walking ability, other physical activities, level of depression, use of sedatives, near vision, pathological status and comorbidities, upper and lower limb strength. Based on these criteria, a BP is considered "robust" if 4 out of 10 items are strictly normal and fewer than 2 items are severely disturbed. Conversely, an AP is considered fragile if 4 out of 10 criteria are severely impaired and only one remains normal. APs corresponding to intermediate cases are then classified as being in a transitional situation of fragility. For inclusion in the protocol, APs also had to have fallen at least once in the preceding year. On the other hand, disabling cardiac or respiratory insufficiency, a Folstein MMS <24, and mobility restricted to bed-to-chair transfer were exclusion criteria.
Under these conditions, 145 APs were included in an arm receiving Tai-Chi (TC) versus an arm of 141 APs receiving only a health and "ageing well" advice program (WE). The mean age was 81 years (range: 70 - 97 years). The conditions for learning Tai Chi figures were strictly defined, as were the qualifications of the instructors. The intervention series continued for 48 weeks. Numerous parameters were comparatively measured... In this targeted population, and for the entire 48-week intervention period, the study did not show a significantly different risk of falls between TC and WE.
On the other hand, a more detailed trend analysis, taking into account intermediate evaluation times, showed significant variations obtained with Tai Chi. Specifically, during the first month of training, Tai Chi significantly increased the risk of falling.
Then, from months 4 to 12, Tai Chi significantly reduced the risk of falling (47% in the TC group, versus 60% in the WE group). These results, obtained on APs in the process of becoming frail, are therefore less clear-cut than those obtained by the same team on patients with little or no frailty. However, this finding calls for a number of comments
In these highly frail patients, the risk of falling increases only at the very beginning of Tai Chi practice. This raises the question of how much vigilance is required, and how to introduce this type of practice (chronology, progression of exercises, quality of instructor, etc.)
The population targeted in this experiment, even if the inclusion criteria were very rigorous, is not necessarily homogeneous, and reflects the whole of a population in the process of becoming more fragile. Above all, it should be noted that a significant number of APs were already cognitively impaired.
However, other studies show that interventional practice to prevent falls is of little or no benefit in patients with significant cognitive deficits, dementia or pre-dementia (see ref $$$, to be added). Chan KM, Anderson M & Lau E Exercise interventions: defusing the world's osteoporosis time bomb Bulletin of the World Health Organization, 81, 827-830, 2003 Exercise from an early age helps increase bone mineral density, and reduces bone loss in adulthood. Exercise not only improves the quality of the bone structure, but also strengthens muscles, coordination, balance and flexibility, resulting in better overall health.
Walking, aerobics and tai chi are particularly suitable for stimulating bone formation and strengthening supporting muscles. Encouraging physical exercise at all ages is therefore an absolute priority for osteoporosis prevention. Xu D, Hong Y, Li J, Chan K, Effect of tai chi exercise on proprioception of ankle and knee joints in old people, Br J Sports Med , 38:50-54, 2004 The aim of this study was to verify that traditional Tai Chi improves proprioception in AP, and that, in this context, Tai Chi is the most effective exercise. To this end, the authors comparatively measured the kinesthetic threshold of the ankle and knee joint in 21 APs who habitually practiced Tai Chi (TC), versus 20 APs who regularly jogged and swam (RS), and 27 sedentary APs (control group, CG).
They demonstrated that the kinesthetic threshold of the ankle joint was significantly different between the 3 groups. The TC group very significantly detected movements of much lower amplitude than the other 2 (RS and CG not being significantly different from each other). For the knee joint, a more detailed analysis shows that it is flexion sensitivity that is significantly improved, while knee joint extension sensitivity remains similar for the 3 groups.
In conclusion, this study demonstrates that regular practice of Tai Chi is an ideal method for preserving or restoring good balance control. Tai Chi promotes better kinesthetic proprioception of the ankle and knee joints, and is even more effective than footing/swimming in preserving the kinesthetic threshold of the ankle joint.
This finding is essential, since we know that AP makes greater use of proprioceptive information from the hip, to compensate for the weakening of kinaesthetic information from the ankle or knee. Loss of ankle proprioception is largely responsible for the risk of falls. Shan G, Daniels D, Gu R.. Artificial neural networks and center-of-pressure modeling: a practical method for sensorimotor degradation assessment. J Aging Phys Act, 12(1), 75-89, 2004
Tai chi would limit sensory-motor aging and the progressive decrease of functional units observed within neural networks. Lan C, Chen SY, Lai JS Relative exercise intensity of Tai Chi Chuan is similar in different ages and gender. Am J Chin Med, 32(1):151-60, 2004
The study involved 100 individuals aged between 25 and 80 years, separated into 3 age classes and divided according to gender. Heart rate, respiratory rate and blood pressure were measured. Tai Chi Chuan is a moderate-intensity aerobic exercise, practised with the same intensity regardless of age or sex, and resulting in the same level of adaptive response in subjects who practise it regularly.
Tai Chi Chuan is therefore particularly well-suited to maintaining functional capacity with age, whatever the age. Lan C, Chou SW, Chen SY, Lai JS, Wong MK. The aerobic capacity and ventilatory efficiency during exercise in Qigong and Tai Chi Chuan practitioners. Am J Chin Med, 32(1):141-50, 2004 In a population of 36 subjects divided into 3 groups (n=12), the study compared the benefits of Tai Chi and Qigong with a control group.
In elderly subjects, the benefits of the two types of exercise were identical in terms of ventilatory capacity. However, the training provided by Tai Chi is more effective. Qigong, however, also provides a benefit through specific training of diaphragmatic breathing. Tsang WW, Hui-Chan CW. Effect of 4- and 8-wk intensive Tai Chi Training on balance control in the elderly. Med Sci Sports Exerc, 36(4):648-57, 2004.
In 49 APs (70±5), the authors demonstrate that Tai Chi significantly improves balance and posture tests. The improvement was significant after a 4-week program, and the benefits obtained were still significant 4 weeks after interruption of the program. Tsang WW, Wong VS, Fu SN, Hui-Chan CW. Tai Chi improves standing balance control under reduced or conflicting sensory conditions. Arch Phys Med Rehabil, 85(1),129-37, 2004.
The study involved 20 APs practicing Tai Chi, versus 20 sedentary APs and 20 young subjects. The experiment demonstrated that Tai Chi was particularly effective in restoring balance in APs suffering from visual and/or vestibular disorders. The benefit on proprioception is less clear-cut (contrary to other publications) Verhagen AP, Immink M, van der Meulen A, Bierma-Zeinstra SM. The efficacy of Tai Chi Chuan in older adults: a systematic review. Fam Pract, 21(1):107-13, 2004 The authors conducted a meta-analysis to validate the benefits of Tai Chi on balance and cardio respiratory function. In most studies, the type of Tai Chi proposed is a Yang style comprising 10 to 20 figures, with 1 frequency varying from 1h/week for 10 weeks to 1h/day for 1 year.
While most studies demonstrate the benefits of Tai Chi, with up to 47% reduction in the number of falls, the authors qualify these beneficial results by criticizing the protocols often used and the resulting statistical analyses. Tsang WW, Hui-Chan CW. Effects of tai chi on joint proprioception and stability limits in elderly subjects. Med Sci Sports Exerc, 35(12), 1962-71, 2003
This study involved 21 subjects practising Tai Chi, versus a control group (mean age 70). Using a statokinetic platform, it confirms other results, showing a significant improvement in proprioceptive abilities at knee level, with an enlargement of the stability polygon in standing position (both in static and dynamic situations, combining weight shifting) Wu G. Evaluation of the effectiveness of Tai Chi for improving balance and preventing falls in the older population--a review. J Am Geriatr Soc, 50(4):746-54, 2002 General review of previous experiments. The tables below summarize the main results. The discussion is excellent. Wang JS, Lan C, Chen SY, Wong MK. Tai Chi Chuan training is associated with enhanced endothelium-dependent dilation in skin vasculature of healthy older men. J Am Geriatr Soc. 50(6):1159-60, 2002.
This study was carried out on 10 APs who had been practicing Tai Chi for 10 years, versus 10 APs and 12 sedentary young subjects. Several tests were performed, under basal conditions and after pharmacologically-induced vasodilation. Measurements were taken by Laser-Doppler recording. The main results are presented in the 3 figures below, taken from the article . The practice of Tai Chi is thus associated with a permanent and very significant increase in the deep cutaneous microcirculatory field, but above all with improved venous compliance and a better micro-arterial vasodilatory response, resulting in a better physiological adaptation capacity of the circulation in the lower limbs. Tai Chi tends to bring the vascular parameters of regular BP practitioners closer to those observed in sedentary young people. Tai Chi could therefore be an inexpensive method of preventing peripheral vascular accidents in BP. Song R, Lee EO, Lam P, Bae SC. Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial. J Rheumatol. 30(9):2039-44, 2003
Comparative study of a 12-week Tai Chi program in 62 women with severe osteoarthritis, versus a matched group not practicing Tai Chi. The authors noted a reduction in joint pain on mobilization, improved functional abilities by lifting disabling conditions, and significant improvements in abdominal muscle strength and postural balance. However, they did not observe any change in the strength developed by the knee joint. Christou EA, Yang Y, Rosengren KS. Taiji training improves knee extensor strength and force control in older adults. J Gerontol A Biol Sci Med Sci. 58(8):763-6, 2003
A 20-week Tai Chi program tested on 60 70-year-old PAs demonstrated its effectiveness in significantly increasing knee extensor muscle strength. Before significantly increasing individual muscle power, the Tai Chi program "normalizes" the population and reduces inter-individual differences. Taggart HM Effects of Tai Chi exercise on balance, functional mobility, and fear of falling among older women. Appl Nurs Res ; 15(4), 235-42, 2002 In a population of independent, home-dwelling women over 75, a 3-month, twice-weekly Tai Chi program improved balance, functional mobility and fear of falling. Wu G, Zhao F, Zhou X, Wei L. Improvement of isokinetic knee extensor strength and reduction of postural sway in the elderly from long-term Tai Chi exercise. Arch Phys Med Rehabil ; 83(10), 1364-9, 2002 In 20 PA over 65 years of age, Tai Chi regularly practised for more than 3 years was effective in increasing muscular strength in the thigh muscles (isometric contraction) and broadening the ability to maintain balance outside the sustentation polygon. Significance of the results was obtained using validated test batteries, versus a group consisting of 19 sedentary APs not practising Tai Chi. Li F, Harmer P, McAuley E, Duncan TE, Duncan SC, Chaumeton N, Fisher KJ. An evaluation of the effects of Tai Chi exercise on physical function among older persons: a randomized contolled trial. Ann Behav Med. 23(2):139-46, 2001.
The aim of this randomized trial was to demonstrate that a 6-month Tai Chi program was capable of improving the health status of inactive, home-dwelling PAs (aged 65-96; n = 90). The experiment demonstrated a significant improvement in 6 quality-of-life criteria in APs taking part in Tai Chi, in particular in their ability to walk, climb stairs and run. Lan C, Lai JS, Chen SY, Wong MK. Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study. Arch Phys Med Rehabil ;81(5):604-7, 2000 The study was carried out with a 6-month weekly Tai Chi Chuan program in 41 APs over 60 years of age. In men, leg flexion strength was increased by 15 to 20% and extension strength by 15 to 23%. In women, the gains were 13-22% and 18-24% respectively. In addition, knee extension endurance was increased by 10-18% in men, and 10-15% in women.
All improvements were significant (subjects being their own controls) and clearly demonstrate the value of Tai Chi training in increasing lower limb muscular power. Hong Y, Li JX, Robinson PD. Balance control, flexibility, and cardiorespiratory fitness among older Tai Chi practitioners. Br J Sports Med. ; 34(1):29-34, 2000 This study compares the physical performance of 28 68-year-old BPs who had been practicing Tai Chi for over 13 years, with that of 30 sedentary BPs of comparable age. The TC group showed significantly better functional parameters for resting heart rate, exercise heart rate, chair raising and unipodal standing with eyes closed. Ross MC, Bohannon AS, Davis DC, Gurchiek L. The effects of a short-term exercise program on movement, pain, and mood in the elderly. Results of a pilot study. J Holist Nurs;17(2),139-47, 1999.
The short-term effects of Tai Chi were evaluated in a pre-test/post-test program on 11 elderly women. Not only did the study show an improvement in motor/balance parameters, but also a significant improvement in anxiety levels, mood and pain perception threshold.
The entire assessment, which is well argued, is based on criteria using validated grids or scores (goniometry, dynamometry, timed unipodal station, tandem walking, depression and quality of life rating scale, analogue pain scale). Gibb H, Morris CT, Gleisberg J. A therapeutic programme for people with dementia. Int J Nurs Pract ; 3(3):191-9, 1997 Although insufficiently supported by a pragmatic scientific approach to measure the exact significance of the proposed procedure, the authors describe the benefits of a program combining Tai Chi with narrative memory training in 9 patients with moderately advanced dementia.
The results indicate that Tai Chi is still practicable at this stage of dementia and can help improve quality of life and immediate behavior in this type of patient Lan C, Lai JS, Wong MK, Yu ML. Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners. Arch Phys Med Rehabil ; 77(6), 612-6, 1996
The study was carried out by comparing the functional performance of a group of 22H 19F who had been practicing Tai Chi regularly for more than 10 years, with a group of 18H 17F. The arms were rigorously matched, with an average age of 69 ± 4 years, and were APs in the successful aging phase.
For the Tai Chi group (versus the sedentary AP group), respiratory capacity and VO2max were significantly higher (measured with a cycle ergometer). Flexibility of the dorsolumbar spine (measured with an inclinometer) was significantly greater. The authors also note a significant reduction in body fat (measured using an adipometer). They conclude that Tai Chi is an activity that should be prescribed preventively to facilitate successful aging. Channer KS, Barrow D, Barrow R, Osborne M, Ives G. Changes in haemodynamic parameters following Tai Chi Chuan and aerobic exercise in patients recovering from acute myocardial infarction. Postgrad Med J. ; 72(848), 349-51, 1996
The authors compared different types of exercise offered in post-care after myocardial infarction. In view of the results, Tai Chi may be the preferred choice. In fact, Tai Chi was the exercise with the best compliance. Moreover, while most of the (beneficial) variations in circulatory physiological parameters are identical whatever the exercise proposed, only Tai Chi significantly lowers diastolic blood pressure. Lai JS, Lan C, Wong MK, Teng SH. Two-year trends in cardiorespiratory function among older Tai Chi Chuan practitioners and sedentary subjects. J Am Geriatr Soc ; 43(11):1222-7, 1995 The authors compared 45 home-dwelling APs who had been practicing Tai Chi for 7 years with a group of 39 sedentary APs. The patients included in the protocol (aged 64 ± 9 at inclusion) were then followed for 2 years.
The authors demonstrate that cardiovascular functional decline is significantly lower in Tai Chi practitioners, particularly for VO2max. Lai JS, Wong MK, Lan C, Chong CK, Lien IN. Cardiorespiratory responses of Tai Chi Chuan practitioners and sedentary subjects during cycle ergometry. J Formos Med Assoc ; 92(10), 894-9, 1993 The study compared the results of 41 Tai Chi practitioners with 49 sedentary subjects.
The benefits of Tai Chi on cardio respiratory parameters are highly significant. Wolf SL, Kutner NG, Green RC, McNeely E. The Atlanta FICSIT study: two exercise interventions to reduce frailty in elders. J Am Geriatr Soc ; 41(3):329-32, 1993 This eminent publication reports on the initiation of the FICSIT program. This was the first interventional program to study the comparative effects of Tai Chi on the prevention of frailty in the elderly, with a cohort of 200 participants. The results were presented by the same team in 1996 and 2003.
The study has been continued with experiments aimed at refining the health and frailty profile of the target populations. Kirsteins AE, Dietz F, Hwang SM. Evaluating the safety and potential use of a weight-bearing exercise, Tai-Chi Chuan, for rheumatoid arthritis patients. Am J Phys Med Rehabil ; 70(3):136-41, 1991 Measurement of numerous parameters (joint flexibility and amplitude, forced walking time, grip strength, quality of life, pain) demonstrates a highly significant beneficial effect of Tai Chi practice (1h, 2 times/wk for 10 weeks) in PA patients with rheumatoid arthritis. The study was conducted on 11 patients versus a control group of 9. Tai Chi was always well tolerated.
The authors suggest combining Tai Chi with weight-bearing exercises, which are known to have a beneficial effect on bone synthesis and connective tissue strengthening. Jin P. Changes in heart rate, noradrenaline, cortisol and mood during Tai Chi. J Psychosom Res. ; 33(2), 197-206, 1989 In a comparison between 33 APs practicing Tai Chi and 33 APs not practicing it, this Australian team shows that Tai Chi improves heart rate, increases urinary noradrenaline secretion and decreases salivary cortisol.
APs who practiced Tai Chi reported feeling better, less depressed, less anxious, less tired and more vigorous. The team planned to compare Tai Chi with other forms of physical exercise. Zhou DH. Preventive geriatrics: an overview from traditional Chinese medicine. Am J Chin Med ; 10(1-4), 32-39, 1982 This is the first article found in the scientific literature collated in Medline, suggesting the value of practicing the traditions of Chinese medicine in gerontology.
The preventive aspects and management of the balance between the individual and his environment, between the body and the psyche, are philosophical and practical aspects of the Chinese tradition which are in full accord with the global and holistic approach of modern Western gerontology. The author suggests developing these practices, and in particular Tai Chi, to improve healthy aging and increase longevity.