TAI CHI: IMPACT ON AGEING

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 a reading committee) ... - Most of the experiments were carried out by American teams, and even more by Chinese teams or other Asian countries (this was to be expected) - 32 articles (to me) seem particularly important and/or the best argued on the scientific level. They are summarised below - Of particular note is the experimental study carried out by the FICSIT cohort and the team of Wolf et al. This study was initiated in 1993. The results were presented in 1996 and were reprinted in full in the JAGS in 2003, given the importance attached to this work by the American Geriatrics Society. This landmark study has given rise to other studies that qualify the results, but above all tend to validate/adapt Tai Chi to the typology of the AP and its level of frailty in order to better define the most effective preventive action. - We should also note the excellent general review by Wu (2002) and the more nuanced review by Verhagen (2004)

LISTE DES ARTICLES LES PLUS IMPORTANTS AVEC LEURS CHAMPS D'INTÉRÊT

 

1 - Le Tai Chi en Australie : une approche acceptable et efficace pour améliorer l'équilibre et la mobilité des personnes âgées ? Hill K, Choi W, Smith R, Condron J Australasian Journal on Ageing ; 24(1) 9-14, 2005 = Tai Chi, et bénéfice global

 

2 - L'efficacité du Tai Chi Chuan chez les personnes âgées : une revue systématique. Verhagen AP, Immink M, van der Meulen A, Bierma-Zeinstra SM. Fam Pract., 21(1):107-13, 2004 = méta-analyse nuançant l'importance du bénéfice du Tai Chi

 

3 - L'intensité relative de l'exercice du Tai Chi Chuan est similaire dans différents âges et sexes. Lan C, Chen SY, Lai JS Am J Chin Med, 32(1):151-60, 2004 = ubiquité du Tai Chi

 

4 - La capacité aérobique et l'efficacité ventilatoire pendant l'exercice chez les pratiquants de Qigong et de Tai Chi Chuan. Lan C, Chou SW, Chen SY, Lai JS, Wong MK. Am J Chin Med, 32(1):141-50, 2004 = comparaison Tai Chi et Ci Kong

 

5 - Effet d'un entraînement intensif de 4 et 8 semaines de Tai Chi sur le contrôle de l'équilibre chez les personnes âgées. Tsang WW, Hui-Chan CW. Med Sci Sports Exerc, 36(4):648-57, 2004. = bénéfice rapide du Tai Chi ; effet prolongé

 

6 - Effet de l'exercice du tai chi sur la proprioception des articulations de la cheville et du genou chez les personnes âgées Xu D, Hong Y, Li J, Chan K, Br J Sports Med , 38:50-54, 2004 = Tai Chi et proprioception

 

7 - Le Tai Chi améliore le contrôle de l'équilibre debout dans des conditions sensorielles réduites ou conflictuelles. Tsang WW, Wong VS, Fu SN, Hui-Chan CW. Arch Phys Med Rehabil., 85(1),129-37, 2004 = Bénéfice très important du Tai Chi si troubles visuels ou vestibulaires

 

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 et qualité du sommeil

 

9 - Réseaux neuronaux artificiels et modélisation du centre de pression : une méthode pratique pour l'évaluation de la dégradation sensorimotrice. Shan G, Daniels D, Gu R.. J Aging Phys Act., 12(1), 75-89, 2004 = Tai Chi et plasticité neuronale

 

10 - Réduire la fragilité et les chutes chez les personnes âgées : 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. Réimprimé à partir de : Wolf S, Barnhart H, Kutner N, McNeely E, Xu T, et le groupe Atlanta FICSIT. Reducing frailty and falls in older persons : an investigation of Tai Chi and computerised balance training. 1996 ; 44 : 489-97. = Tai Chi et risque de chutes chez la PA peu fragile

 

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 et PA en situation de fragilisation

 

12 - Effets du tai chi sur la proprioception articulaire et les limites de stabilité chez les sujets âgés. Tsang WW, Hui-Chan CW. Med Sci Sports Exerc, 35(12), 1962-71, 2003 = Tai Chi et proprioception

 

13 - Interventions par l'exercice : désamorcer la bombe à retardement de l'ostéoporose Chan KM, Anderson M & Lau E Bulletin de l'Organisation mondiale de la santé, 81, 827-830, 2003 = Tai Chi et prévention de l'ostéoporose

 

14 - Évaluation de l'efficacité du Tai Chi pour améliorer l'équilibre et prévenir les chutes dans la population âgée - une revue. Wu G. J Am Geriatr Soc., 50(4):746-54, 2002 = Revue générale qui fait bien le point sur des travaux antérieurs

 

15 - L'entraînement au Tai Chi Chuan est associé à une meilleure dilatation dépendante de l'endothélium dans le système vasculaire cutané d'hommes âgés en bonne santé. Wang JS, Lan C, Chen SY, Wong MK J Am Geriatr Soc. 50(6):1159-60, 2002 = Impact du Tai Chi sur la circulation périphérique

 

16 - Effets de l'exercice du tai chi sur la douleur, l'équilibre, la force musculaire et les difficultés perçues dans le fonctionnement physique chez les femmes âgées atteintes d'arthrose : un essai clinique randomisé. Song R, Lee EO, Lam P, Bae SC. J Rheumatol. 30(9):2039-44, 2003 = Bénéfice du Tai Chi dans l'ostéoarthrite

 

17 - L'entraînement au Taiji améliore la force des extenseurs du genou et le contrôle de la force chez les adultes plus âgés. Christou EA, Yang Y, Rosengren KS. J Gerontol A Biol Sci Med Sci. 58(8):763-6, 2003 = Bénéfice du Tai Chi sur le quadriceps

 

18 - Effets des exercices de Tai Chi sur l'équilibre, la mobilité fonctionnelle et la peur de tomber chez les femmes âgées. Taggart HM Appl Nurs Res. ; 15(4), 235-42, 2002 = Tai Chi, équilibre et chutes

 

19 - Amélioration de la force isocinétique des extenseurs du genou et réduction de l'oscillation posturale chez les personnes âgées grâce à des exercices de Tai Chi à long terme. Wu G, Zhao F, Zhou X, Wei L. Arch Phys Med Rehabil. ; 83(10), 1364-9, 2002 = Tai Chi, puissance musculaire et instabilité posturale

 

20 - Une évaluation des effets de l'exercice du Tai Chi sur la fonction physique chez les personnes âgées : un essai randomisé contrôlé. Li F, Harmer P, McAuley E, Duncan TE, Duncan SC, Chaumeton N, Fisher KJ. Ann Behav Med. 23(2):139-46, 2001. = Tai Chi et motricité équilibre

21 - Le Tai Chi Chuan pour améliorer la force musculaire et l'endurance chez les personnes âgées : une étude pilote. Lan C, Lai JS, Chen SY, Wong MK. Arch Phys Med Rehabil. ; 81(5):604-7, 2000 = Tai Chi et puissance/endurance musculaire du membre inférieur

 

22 - Contrôle de l'équilibre, flexibilité et aptitude cardiorespiratoire chez les pratiquants de Tai Chi âgés. Hong Y, Li JX, Robinson PD. Br J Sports Med ; 34(1):29-34, 2000 = Tai Chi, motricité équilibre et adaptation cardio-respiratoire

 

23 - Les effets d'un programme d'exercices à court terme sur le mouvement, la douleur et l'humeur chez les personnes âgées. Résultats d'une étude pilote. Ross MC, Bohannon AS, Davis DC, Gurchiek L. J Holist Nurs.;17(2),139-47, 1999. = Tai Chi, et effet global sur bien-être et qualité de vie

 

24 - Un programme thérapeutique pour les personnes atteintes de démence. Gibb H, Morris CT, Gleisberg J. Int J Nurs Pract. ; 3(3):191-9, 1997 = Tai Chi : pratique bénéfique au cours des démences non sévères

 

25 - Fonction cardiorespiratoire, souplesse et composition corporelle chez les pratiquants gériatriques du Tai Chi Chuan. Lan C, Lai JS, Wong MK, Yu ML. Arch Phys Med Rehabil. ; 77(6), 612-6, 1996 = Tai Chi, souplesse, adaptation cardio-respiratoire et masse grasse

 

26 - Changements dans les paramètres hémodynamiques après le Tai Chi Chuan et l'exercice aérobique chez les patients se remettant d'un infarctus aigu du myocarde. Channer KS, Barrow D, Barrow R, Osborne M, Ives G. Postgrad Med J. ; 72(848), 349-51, 1996 = Tai Chi, et infarctus du myocarde

 

27 - Tendances à deux ans de la fonction cardiorespiratoire chez les pratiquants âgés du Tai Chi Chuan et les sujets sédentaires. Lai JS, Lan C, Wong MK, Teng SH. J Am Geriatr Soc. ; 43(11):1222-7, 1995 = Tai Chi : moindre déclin fonctionnel cardiorespiratoire

 

28 - Réponses cardiorespiratoires des pratiquants de Tai Chi Chuan et des sujets sédentaires pendant l'ergométrie du cycle. Lai JS, Wong MK, Lan C, Chong CK, Lien IN. J Formos Med Assoc. ; 92(10), 894-9, 1993 = Tai Chi et adaptation cardiorespiratoire (seniors jeunes)

 

29 - L'étude FICSIT d'Atlanta : deux interventions d'exercice pour réduire la fragilité chez les personnes âgées. Wolf SL, Kutner NG, Green RC, McNeely E. J Am Geriatr Soc. ; 41(3):329-32, 1993 = Tai Chi : article socle du programme FICSIT

 

30 -Evaluation de la sécurité et de l'utilisation potentielle d'un exercice avec mise en charge, le Tai-Chi Chuan, pour les patients atteints de polyarthrite rhumatoïde. Kirsteins AE, Dietz F, Hwang SM. Am J Phys Med Rehabil. ; 70(3):136-41, 1991 = Tai Chi : bénéfice dans la PR

 

31 - Changements dans la fréquence cardiaque, la noradrénaline, le cortisol et l'humeur pendant le Tai Chi. Jin P. J Psychosom Res. ; 33(2), 197-206, 1989 = Tai Chi et paramètres biologiques du stress 32 - Preventive geriatrics : an overview from traditional Chinese medicine. Zhou DH. Am J Chin Med ; 10(1-4),

 

32-39, 1982 = Premier article trouvé et prenant en compte le Tai Chi en prévention et Santé COMMENTAIRES D'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 70 year old average age APs this team confirms the benefit of Tai Chi (1h 3 times a week) having used an exhaustive battery of tests validated in the field of balance. It is balance that is significantly improved. In addition, the authors emphasise the more global benefit of Tai Chi, with a strong adherence of the participants, most of whom wish to continue the programme, with an improvement in life balance and an interest on the part of the test subjects in the cognitive stimulation action of Tai Chi linked to the memorisation 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 disturbances in the elderly often have serious and difficult to assess consequences, including increased morbidity and mortality from cardiovascular disease. In all cases, sleep disorders modify the quality of life and well-being of the patient. There are many causes of sleep disorders. While sleep impairment may be the obvious consequence of poor health, directly related to ongoing disease(s), this type of situation is far from explaining everything. Indeed, if we refer to the most documented study of 9000 IPs (survey of the national institute on aging: Foley DJ & al, Sleep, 1995), more than 50% of IPs over 65 express chronic sleep disorders when questioned. Sleep disturbances in APs are therefore almost always the result of situations other than acute or ongoing pathology. These causes are apparently more benign, and generally insufficiently investigated. The main causes are the progressive lack of physical activity and daily muscular effort, the reduction of the basic acts of daily life, anxiety and depressive states, environmental stress situations, etc. The Li F et al study (Jags, 2004) compared the effects (for 6 months, 3 times 1 hour per week) of a Tai-Chi programme (n=62) with those of a conventional low-intensity physical exercise programme (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/balance, and perceived quality of life (SF12). The two cohorts were perfectly matched, as shown in the table below:

 

The authors demonstrate a very significant improvement in sleep quality, both by a reduction in the time to sleep (-18min) and an increase in sleep time (+48min). Simultaneously, and confirming the literature, Tai-Chi shows a clear improvement in physical performance tests (unipodal standing, chair lifting, brisk walking). This improvement is much more significant than that obtained with conventional low intensity exercises.

 

The table below provides the main results: On the other hand, the perceived quality of life (measured by the SF12) was improved in both cases and the difference was not significant between the two groups. Tai chi thus appears to be an effective non-drug approach to the management of sleep disorders in BP. 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 (The Atlanta Frailty and Injuries Cooperative Studies and Intervention Techniques) programme, the study by Wolf et al compared the effects of 2 physical training methods on 200 elderly people over 70 years of age (mean age 76 years; 162 women, 38 men): - Tai Chi (TC), - a more conventional method of balance training through programmed exercises (BT). The 2 main arms (TC and BT) were compared with a 3rd arm, receiving a purely educational and counselling programme (ED). The intervention period was 15 weeks and was extended by a subsequent 4-month follow-up.

 

Several parameters were assessed in the FICSIT programme to monitor the level of frailty of the programme participants and to establish indicators. Biomedical: muscle 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 recurrence of falls. The cohorts were roughly comparable, as shown in the table below:

 

In all the groups tested, overall performance was improved, particularly in terms of muscle strength. But the results clearly show the best benefits of Tai-Chi, compared to the other 2 groups, with : - A very significant decrease in resting blood pressure, as well as systolic pressure measured after a 12-minute forced walk, - A very significant reduction in fear of falling. Statistical adjustment of the results then shows that the risk of recurrence of falls was reduced by 47% by Tai-Chi in this experiment. The main results are presented 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, showed the benefits of Tai Chi on patients with little or no frailty. This new study, while confirming the previous results, qualifies their scope. The experiment was carried out on a selected and targeted population: elderly people in the process of becoming frail. In terms of public health and prevention policy, it is obvious that this is the most interesting population: the one on which targeted health care can be designed. To define this population (in the process of becoming frail), the team retained 10 criteria of frailty in recognised areas: age, balance, walking ability, other physical activities, level of depression, use of sedatives, close-up vision, pathological status and co-morbidities, strength of upper and lower limbs Based on these criteria, a BP is considered "robust" if 4 out of 10 items are strictly normal and if less than 2 items are severely disturbed. Conversely, an AP is considered fragile if 4 out of 10 criteria are severely impaired and if only one criterion remains normal. The APs corresponding to the intermediate cases are then classified as being in a transitional situation of fragility. For inclusion in the protocol, the BPs also had to have fallen at least once in the preceding year. However, disabling cardiac or respiratory insufficiency, a Folstein MMS <24, and restricted mobility at bed-chair transfer were exclusion criteria.

Under these conditions, 145 IPs were included in an arm receiving Tai Chi (TC) versus an arm of 141 IPs receiving only a health and ageing advice programme (WE). The average age was 81 years (range: 70 - 97 years). The conditions for learning the Tai Chi figures were strictly defined as were the qualifications of the instructors. The intervention series were continued for 48 weeks. Numerous parameters were measured comparatively... In this targeted population, and for the entire 48-week intervention period, the study did not show a significantly different risk of falling between TC and WE.

 

On the other hand, a more detailed trend analysis, taking into account the intermediate evaluation times, shows significant variations obtained with Tai Chi. More specifically, during the first month of training, Tai Chi significantly increased the risk of falling.

 

Then, from the 4th to the 12th month, Tai Chi significantly reduces the risk of falling (47% in the TC group, versus 60% in the WE group). The following figure shows these results. 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 who are not very frail or simply vulnerable. However, this finding calls for some comments: - In these highly frail APs, the results are less clear-cut than those obtained by the same team in patients who are not very fragile or who are simply vulnerable.

 

In these highly frail patients, it is only at the very beginning of Tai Chi practice that the risk of falling increases. It is then necessary to question the vigilance to be put in place and the methods of initiation to this type of practice (chronology, progression of the exercises, quality of the trainer, 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 already had cognitive deficits.

 

However, other studies show that interventional practice to prevent falls is only marginally or not at all effective 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, flexibility and overall health.

 

Walking, aerobics and Tai Chi are particularly good for stimulating bone formation and strengthening supporting muscles. Encouraging physical exercise at all ages is therefore a top priority in preventing osteoporosis. 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 best performing exercise. To do this, the authors measured the kinesthetic threshold of the ankle and knee joints in 21 APs who regularly practised Tai Chi (TC), versus 20 APs who regularly jogged and swam (RS), and 27 sedentary APs (control group, CG).

 

They show that the kinesthetic threshold of the ankle joint is significantly different between the three groups. The TC group very significantly detected movements of much lesser amplitude than the other two (RS and CG not being significantly different from each other). For the knee joint, a more detailed analysis shows that it is the sensitivity to flexion that is significantly improved, the sensitivity to extension of the knee joint remaining similar for the 3 groups.

In conclusion, this study shows that regular practice of Tai Chi is an ideal method to preserve or restore good balance control. Tai Chi promotes better kinesthetic proprioception at the ankle or knee joints, with Tai Chi being even more effective than footing/swimming in preserving the kinesthetic threshold of the ankle joint.

 

This is important because we know that AP makes greater use of proprioceptive information from the hip joint to compensate for the weakening of kinesthetic information from the ankle or knee. Loss of ankle proprioception is largely responsible for the risk of falling. 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 25 to 80 years, separated into 3 age groups and divided according to gender. Heart rate, respiratory rate and blood pressure were measured. Tai Chi Chuan is an aerobic exercise of moderate intensity, practised with the same intensity regardless of age or sex and resulting in the same level of adaptive response in the subject practising regularly.

 

Tai Chi Chuan is therefore particularly suitable for maintaining functional capacities with age, regardless of 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 The study compared the benefits of Tai Chi and Qigong in a population of 36 subjects divided into 3 groups (n=12) compared to a control group.

 

In the elderly subjects, the benefit of the two types of exercise was identical on ventilatory capacity. However, the training provided by Tai Chi is more effective. However, Qigong also provides a benefit due to the 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 programme, and the benefits were still significant 4 weeks after the programme was stopped. 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 shows that Tai Chi is particularly effective in restoring balance in APs with visual and/or vestibular disorders. The benefit on proprioception is less clear (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 of the studies, the type of Tai Chi proposed is a Yang style comprising 10 to 20 figures, with a frequency varying from 1h/week for 10 weeks to 1h/day for 1 year.

 

Although most of the experiments demonstrate the benefits of Tai Chi, with benefits of up to 47% on the reduction of the number of falls, the authors qualify this beneficial result by criticising the methods of the protocols often used and the subsequent 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

The aim of this randomised trial was to demonstrate that a 6-month Tai Chi programme was able to improve the health status of inactive home-dwelling IPs (65-96 years; n=90). The experiment demonstrated significant improvement in six quality of life criteria in the IPs participating in Tai Chi, in particular in walking, stair climbing and running abilities. 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 conducted with a 6-month weekly Tai Chi Chuan programme 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 obtained are 13 to 22% and 18 to 24% respectively. In addition, knee extension endurance capacity is increased by 10 to 18% in men and 10 to 15% in women.

 

All the improvements were significant (the subjects were their own controls) and clearly show the value of Tai Chi training for increasing muscle power in the lower limbs. 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 IPs who have been practicing Tai Chi for more than 13 years with that of 30 IPs of comparable age who are sedentary. 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/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 level, mood, pain perception threshold.

 

The entire evaluation, 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 programme combining Tai Chi with narrative memory training in 9 patients with moderately advanced dementia.

 

The results indicate that Tai Chi is still feasible in this stage of dementia and may help to improve the quality of life and immediate behaviour of such patients 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 conducted 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 strictly matched; the mean age was 69 ± 4. These are APs in successful aging.

For the Tai Chi group (versus the sedentary BP group), respiratory capacity and VO2max are significantly higher (measured with a bicycle ergometer). The flexibility of the dorsolumbar spine (measured with an inclinometer) was significantly greater. The authors also note a significant decrease in body fat (measured with an adipometer). They conclude that Tai Chi is an activity to be prescribed preventively to facilitate successful ageing. 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 could be preferred. Indeed, Tai Chi is the exercise with the best compliance. Moreover, although 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 homebound APs who had been practicing Tai Chi for 7 years with a group of 39 sedentary APs. The IPs included in the protocol (64 ± 9 years old at inclusion) were then followed for 2 years.

 

The authors show that the functional cardio respiratory decline is significantly lower in Tai Chi practitioners, especially 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 was conducted by comparing the results of 41 Tai Chi practitioners versus 49 sedentary subjects.

 

The benefit of Tai Chi on cardio respiratory parameters is very 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 seminal publication reports on the initiation of the FICSIT programme. It is the first interventional programme to study with great scientific rigour 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 by experiments which tend to refine the health profile and the level of frailty of the targeted 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 The measurement of numerous parameters (joint flexibility and amplitude, forced walking time, grip strength, quality of life, pain) demonstrates a very significant beneficial action of Tai Chi practice (1 hour, twice a week for 10 weeks) in PA patients with rheumatoid arthritis. The study was conducted on 11 patients with RA versus a control group of 9 patients. The practice of Tai Chi was always well supported.

 

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 of 33 APs practicing Tai Chi and 33 APs not practicing Tai Chi, this Australian team shows that Tai Chi improves heart rate, increases urinary noradrenaline secretion and decreases salivary cortisol.

 

IPs practising Tai Chi report feeling better, less depressed, less anxious, less tired and feel 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 in Medline suggesting the value of practicing the traditions of Chinese medicine in gerontology.

 

The preventive aspects and the 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 agreement 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.