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

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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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Tai Chi May Help People Cope Better with Diseases of Ageing

It is thought tai chi dates back to the 12th century.

Tai chi is said to improve balance and flexibility.

“Tai chi can help older patients with disabling conditions,” The Guardian reports after an analysis of old data found the martial art may help relieve some symptoms of four age-related diseases: cancer, heart failure, osteoarthritis and chronic obstructive pulmonary disease (COPD).

Notable significant effects were seen, with improvements in walking for those who had heart failure, improved strength of the big quadriceps muscles for those with heart failure and COPD, and pain and stiffness for people with osteoarthritis. There were also trends for effects on depression and quality of life for those with heart failure and COPD.

However, this review can’t prove tai chi will definitely have a positive effect for people who have these conditions. The trials were highly variable in their study population, the type of tai chi practised, the type of comparison intervention, and the outcomes examined. Despite the large collective number of studies, most of the individual results were based on only one or a few studies.

Nevertheless, remaining active and exercising within your limits is positive in all stages of life, even for those who have a chronic disease. If you find tai chi enjoyable and it boosts your physical or mental wellbeing, that can only be a good thing.

If tai chi is not your cup of oolong, you could always try the Strength and Flex exercise plan.

Where did the story come from?

The study was carried out by researchers from the University of British Columbia and the University of Toronto, and was funded by the University of British Columbia and the British Columbia Lung Association.

It was published in the peer-reviewed British Journal of Sports Medicine.

The UK media provide a generally accurate picture of the evidence. However, it would have been helpful to note that this study was limited by the highly variable studies the researchers looked at, which makes it difficult to form any definite conclusions.

What kind of research was this?

This systematic review aimed to identify trials looking at the effectiveness of tai chi for four common chronic conditions: cancer, heart failure, COPD and osteoarthritis. The results of the identified trials were then pooled in a meta-analysis to give an overall effect.

Tai chi involves gentle flowing movements to improve strength, posture and balance, and has become an increasingly popular form of exercise, particularly among the middle-aged and elderly.

It has also been tried as a complementary healthcare approach for many different conditions, with some studies suggesting it has both physical and psychosocial benefits.

This review aimed to gather the evidence surrounding the martial art to get an overall conclusive summary of its effects. However, the results of a systematic review are only ever as good as the studies included, so there may be inherent limitations in the quality of the various studies and the methods used.

What did the research involve?

The researchers searched four literature databases up to the end of December 2014 for randomised controlled trials published in English that compared tai chi with any other control group in people with four chronic conditions: cancer, heart failure, COPD and osteoarthritis. The studies were assessed for quality, and the outcomes were pooled for different disease-specific symptoms and outcomes.

33 studies met the inclusion criteria, but several reported data in two or more publications, giving a total of 24 individual trials. There were five studies available each for cancer, heart failure and COPD, and nine for osteoarthritis. The results of all the osteoarthritis studies, and four of the studies for each of the other conditions, were pooled in the meta-analysis.

The trials were of average quality, with most having a score of five out of 10 on the quality scale used (the PEDro scale). The sample size of the trials included ranged from 11 to 206. The average age of the participants varied, but they tended to be in their 60s and 70s.

What were the basic results?

The studies examined different physical and psychological outcomes. The main effects were as follows.

Physical symptoms

Walking – tai chi gave significant improvements on the six-minute walk test in people with heart failure and COPD. One study each for cancer and osteoarthritis found no effects on walking.

Muscle strength – one COPD and one heart failure study found significant improvement in knee extensor strength, but there was no effect in the osteoarthritis studies.

Getting up and moving – the osteoarthritis studies found tai chi improved the timed get up and go test result, as well as sit to stand times. One heart failure study found no effect.

Chronic disease symptoms – tai chi significantly improved pain, stiffness and physical function in osteoarthritis. In COPD, there was a trend towards tai chi improving shortness of breath compared with control, but this was non-significant. No two cancer studies reported the same outcome. There was a trend for reduced fatigue in one study, but this had an extremely small sample size.

Other physiological effects – heart failure studies found no effect on blood pressure or respiratory function.

Psychological outcomes

Quality of life – tai chi had significant effects on osteoarthritis, but there were no significant effects in COPD, cancer or heart failure studies.

Depression – tai chi was associated with significant improvements in depression symptoms in heart failure studies, but there were non-significant trends in osteoarthritis and COPD studies. In cancer, it was the control intervention (stress management) that improved symptoms rather than tai chi.

How did the researchers interpret the results?

The researchers concluded that, “The results demonstrated a favourable effect or tendency of tai chi to improve physical performance, and showed that this type of exercise could be performed by individuals with different chronic conditions, including COPD, heart failure and osteoarthritis.”

Conclusion

This review searched the literature to summarise the effects of tai chi on four common chronic conditions. It identified a large number of trials collectively examining many different physical and psychological outcomes in a predominantly middle-aged to elderly population.

The notable significant effects seemed to be for improvements in walking for those with heart failure, knee extensor strength for those with heart failure and COPD, and pain and stiffness for those with osteoarthritis. There were also trends for effects on depression and quality of life for people with heart failure and COPD.

The researchers concluded that tai chi could be performed by individuals for many different chronic conditions. However, this review can’t demonstrate that tai chi will definitely have a positive effect if it’s tried out by someone who has one of these chronic conditions.

Overall, the systematic review is a high-quality study design. However, the evidence is only as good as the studies included. The 24 individual studies in this review were widely different, and most results are based on one to a few studies.

Variations across the studies included:

  • The type of tai chi, the overall duration of the intervention, and the frequency and duration of individual sessions.
  • The type of disease and severity, even within the same chronic disease category – for example, most cancer studies were in breast cancer, but even these varied in their stages, while another was just in “unknown cancer survivors”.
  • Osteoarthritis varied between spine, hip and knee, and the severity of pain and disability.
  • The comparison groups varied – for example, some were just usual care or waiting list, others self-help education, some spiritual or psychological-related, and others varied physical activities such as walking, aerobics or stretching programmes.
  • As demonstrated by the results, the outcomes examined varied widely, and individual outcomes were only examined by one to four studies per condition.
  • Sample sizes varied, and some were extremely small – for example, only 11 people in one study. Sometimes within these small studies, the dropout rate from the trial was also high – for instance, 10 people dropping out from a starting size of just 31 participants.

This makes it very difficult to say whether a certain type of tai chi will help individuals with chronic conditions.

Nevertheless, the benefits of exercising within our limits are well known – even when a person has a chronic disease. If you find tai chi enjoyable, this can only be a good thing.

Source: NHS Choices