Tai Chi May Work Best to Prevent Falls in Old Age

Dennis Thompson wrote . . . . . . . .

The ancient practice of tai chi may beat strength training and aerobics for preventing falls among seniors, a new trial shows.

A modified senior-centered tai chi program reduced falls nearly a third better in a head-to-head comparison with an exercise regimen that combined aerobics, strength training and balance drills, the researchers reported.

“This tai chi program better addressed the deficits that were contributing to fall risk,” said senior researcher Kerri Winters-Stone, a professor with the Oregon Health & Science University School of Nursing.

Tai chi is a centuries-old Chinese tradition that involves a graceful series of movements. People performing tai chi flow between different postures in a slow and focused manner, keeping their body in constant motion and frequently challenging their balance.

Researchers have long suspected that tai chi can help reduce risk of falling, said co-researcher Peter Harmer, a professor of exercise and health science with Willamette University in Salem, Ore.

Annually, about 28 percent of U.S. seniors report falling, and 2 out of 5 falls result in injuries leading to an ER visit, hospitalization or death, researchers said in background notes.

“Falling in adults age 65 and older is significantly associated with loss of independence, premature mortality and big health care costs,” Harmer said.

The movements of tai chi require people to move in all directions, while traditional exercise programs focus more on forward and backward motion, Winters-Stone and Harmer said.

“The reality of how falls happen tends to be quite varied and a bit unpredictable. In tai chi, the movements are in these multiple planes,” Winters-Stone said. “You’re moving your body outside of your center of gravity and then you’re pulling it back. There’s a lot of postural responses.

“If you accidentally started to fall, if you had been trained in tai chi you would probably be better at starting to counteract that movement and regain your balance,” Winters-Stone continued.

But classical tai chi can involve upwards of 100 different movements, which can be challenging for seniors to learn, Harmer said.

So, the research team for this clinical trial developed a pared-down form of tai chi that focuses on eight fundamental movements most related to fall prevention, Harmer said. The trademarked program is called Tai Ji Quan: Moving for Better Balance.

To see how well the program works, researchers tested it against both a traditional exercise program and a control group that only performed stretching exercises.

Researchers recruited 670 Oregonians with an average age of nearly 78 and assigned them to one of the three programs. “This was a more at-risk group than we’ve worked with before,” based on both their age and screening for fall risk, Harmer said.

After six months, the tai chi group was 58 percent less likely to have a fall than the stretching group, and the traditional exercise group was 40 percent less likely to fall than people who only stretched.

Compared against each other, the tai chi program outperformed traditional exercise. People taking tai chi suffered 31 percent fewer falls than those who took strength training and aerobics courses.

“Not falling is a pretty complex physiological behavior,” Harmer said, noting that you combine muscle strength with feedback from muscles and joints, eyesight and even hearing to regain your balance. “Tai chi directly challenges the integration of all those things.”

Although tai chi did work better, people following a traditional exercise program still gain a benefit, noted Nathan LeBrasseur, a physical medicine and rehabilitation researcher with the Mayo Clinic in Rochester, Minn.

“I would not discourage people who are actively participating in a strength and aerobic exercise program to throw in the towel and say, ‘Now I need to do tai chi,'” said LeBrasseur, who wasn’t involved in the study. “The real challenge is getting people to adopt and stick to an exercise program.”

Harmer said tai chi not only improves balance, but also improves confidence.

“We’ve found a major risk factor for people falling is fear of falling,” Harmer said. “People might have had a fall. They’re scared then of falling again, so they start doing fewer physical things so they don’t fall. It kind of becomes a self-fulfilling prophecy.”

The modified tai chi program requires people to push themselves out of their comfort zone, breaking the negative cycle, Harmer said.

LeBrasseur agreed that whatever the exercise, more should be asked of seniors if they want to protect their health.

“I do think we tend to hold back across multiple exercise interventions in terms of really challenging and pushing older adults with the notion it will lead to harm and injury, when in fact it probably will drive beneficial adaptations,” LeBrasseur said.

The new study was published in the journal JAMA Internal Medicine.

Source: HealthDay


Watch video at You Tube (8:32 minutes):

Tai Ji Quan: Moving for Better Balance . . . . .


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Tai Chi: A Gentler Way to Exercise for Ailing Hearts

People with heart disease who shy away from traditional cardiac rehabilitation may benefit from tai chi.

A small study found that the slow, gentle movements of this traditional Chinese practice may help increase physical activity among those who are reluctant to exercise.

More than 60 percent of heart attack survivors opt out of cardiac rehabilitation, often because of the perception that the exercise involved will be unpleasant or painful, according to the study authors.

“We thought that tai chi might be a good option for these people because you can start very slowly and simply and, as their confidence increases, the pace and movements can be modified to increase intensity,” said study author Dr. Elena Salmoirago-Blotcher. She is an assistant professor of medicine at the Warren Alpert School of Medicine at Brown University.

“Tai chi exercise can reach low-to-moderate intensity levels,” she explained in a news release from the American Heart Association. “The emphasis on breathing and relaxation can also help with stress reduction and psychological distress.”

Participants in the study included 29 people, age 68 on average, who’d had a heart attack or a procedure to open a blocked artery. All were sedentary, and most had risk factors for heart problems, such as being overweight, smoking or having diabetes or high cholesterol. All of them also had rejected participation in cardiac rehabilitation.

For the study, they took part in either a short program (24 classes over 12 weeks) or a longer one (52 classes over 24 weeks). All were given a DVD so they could practice tai chi at home.

Tai chi was found to be safe for the participants with heart disease, with minor muscle pain at the very start the only negative effect. Tai chi also was well-liked by the participants, who all reported they would recommend it to a friend. The researchers said the participants attended 66 percent of classes, suggesting it’s a manageable routine.

Tai chi didn’t boost the participants’ aerobic fitness levels after three months. But those who completed the longer program did get more moderate to vigorous physical activity on a weekly basis, the study reported.

The findings were published in the Journal of the American Heart Association.

“On its own, tai chi wouldn’t obviously replace other components of traditional cardiac rehabilitation, such as education on risk factors, diet and adherence to needed medications,” Salmoirago-Blotcher said.

“If proven effective in larger studies,” she said, “it might be possible to offer it as an exercise option within a rehab center as a bridge to more strenuous exercise, or in a community setting with the educational components of rehab delivered outside of a medical setting.”

Source: HealthDay

Why Yoga, Tai Chi and Meditation Are Good for You

Relax your mind and then consider this: The physical and mental health benefits of pursuits like yoga and meditation begin in your genes, a new review suggests.

The researchers reviewed 18 studies, involving a total of 846 people, to examine how the behavior of genes is affected by yoga, tai chi, meditation and other mind-body interventions.

The conclusion: Such activities reverse molecular reactions in DNA that cause poor health and depression.

“Millions of people around the world already enjoy the health benefits of mind-body interventions like yoga or meditation, but what they perhaps don’t realize is that these benefits begin at a molecular level and can change the way our genetic code goes about its business,” said lead researcher Ivana Buric.

Buric is a doctoral candidate with the Brain, Belief and Behavior Lab at Coventry University in Great Britain.

“These activities are leaving what we call a molecular signature in our cells, which reverses the effect that stress or anxiety would have on the body by changing how our genes are expressed. Put simply, [mind-body interventions] cause the brain to steer our DNA processes along a path which improves our well-being,” Buric said in a university news release.

More study is needed to understand these effects fully and how mind-body interventions compare to other healthy activities and dietary habits, she said.

“But this is an important foundation to build on to help future researchers explore the benefits of increasingly popular mind-body activities,” Buric added.

The findings were published in the journal Frontiers in Immunology.

Source: HealthDay


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Practicing Tai Chi Reduces Risk of Falling in Older Adults

Recently, researchers compared the effects of tai chi to leg strengthening exercises (a physical therapy called “lower extremity training,” or LET) in reducing falls. Falls are a leading cause of serious injuries in older adults and can lead to hospitalization, nursing home admission, and even death. Arthritis, heart disease, muscle weakness, vision and balance problems, dementia, and other age-related health problems can increase an older adult’s risk for experiencing a fall. The study is published in the Journal of the American Geriatrics Society.

In their study, researchers assigned 368 people 60-years-old and older who had received medical attention for a fall into one of two groups. The first group received hour-long individual tai chi classes conducted by tai chi instructors every week for 24 weeks. Tai chi is an exercise practice developed in China hundreds of years ago. It combines certain postures and gentle movements with mental focus, breathing, and relaxation. Tai chi can be practiced while you’re walking, standing, or even seated. Deep breathing, weight shifting, and leg stepping movements are part of the practice. The second group received individual, hour-long LET sessions for 24 weeks conducted by physical therapists. Sessions included stretching, muscle strengthening, and balance training.

The researchers asked participants in both groups to complete at least 80 percent of their sessions, and also to practice either tai chi or LET at home every day during the six- month program and the 12-month follow-up. During the course of the study, all participants kept diaries and recorded any falls they experienced, and they shared their diaries with researchers each month.

After six months of training, people in the tai chi group were significantly less likely to experience an injury-causing fall than were people in the LET group. Even a year after taking the training, people who took tai chi were about 50 percent less likely to experience an injury-causing fall compared to people in the LET group.

Though participants in the study took individualized tai chi classes at home, “I suggest that older adults learn tai chi exercises in a class, and practice at home at least once a day,” said Mau-Roung Lin, PhD, Professor and Director of the Institute of Injury Prevention and Control, Taipei Medical University in Taipei, Taiwan, a co-author of the study.

Source: EurekAlert!


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Chinese Exercises May Improve Cardiovascular Health

Traditional Chinese exercises such as Tai Chi may improve the health and well-being of those living with heart disease, high blood pressure or stroke, according to new research published in the Journal of the American Heart Association.

“Traditional Chinese exercises are a low-risk, promising intervention that could be helpful in improving quality of life in patients with cardiovascular diseases — the leading cause of disability and death in the world,” said Yu Liu, Ph.D., study co-author, and dean of the School of Kinesiology, at Shanghai University of Sport in China. “But the physical and psychological benefits to these patients of this increasingly popular form of exercise must be determined based on scientific evidence.”

Chen Pei-Jie, Ph.D., the study’s lead author and president of Shanghai University of Sport in China and his team reviewed 35 studies, including 2,249 participants from 10 countries.

They found, among participants with cardiovascular disease, Chinese exercises helped reduce systolic blood pressure (the top number) by more than 9.12 mm Hg and diastolic blood pressure (the bottom number) by more than 5 mm Hg on average.

They also found small, but statistically significant drops in the levels of bad cholesterol (low-density lipoprotein) and triglycerides. Chinese exercises also seemed to improve quality of life and reduce depression in patients with cardiovascular disease. However, traditional Chinese exercises did not significantly improve participant’s heart rate, aerobic fitness level or scores on a general health questionnaire.

The review only analyzed studies which randomly assigned participants to groups performing traditional Chinese exercises (most commonly Tai Chi, Qigong and Baduanjin), engaging in another form of exercise or making no change in activity level.

Although their review provided a good overview of the impact of traditional Chinese exercises on cardiovascular risk factors, several limitations: inclusion criteria varied across studies; participants were followed for a year or less; traditional Chinese exercises take many different forms and most results were evaluated by study leaders who knew which group participants had been assigned to, potentially biasing results.

Liu and his team have been studying the benefits of traditional Chinese exercises on a range of diseases for more than 5 years. They plan to conduct new randomized controlled trials to confirm the effect of different types of traditional Chinese exercises on chronic diseases.

Source: American Heart Association


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