Tai Chi Intervention Research Articles

The effectiveness of Tai Chi as a fall prevention intervention for older adults: a systematic review

Aim: To critically appraise the evidence for the effectiveness of the use of Tai Chi as a falls prevention intervention in the older age group. Background: Falls in the older population and their resulting injuries are a major public health issue. Tai Chi is an intervention that some nurses in the UK promote, but the research into its effectiveness is of varying quality with conflicting findings. It is crucial to review the evidence base for this intervention in order to inform best practice. Methods: A systematic literature review was conducted using the following major inclusion criteria: Tai Chi intervention, randomized controlled trials, participants aged 60 or more, falls occurrences as outcome measure. Eight electronic databases were searched. Two reviewers independently assessed methodological quality using the Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklist. Results: 66 potentially relevant articles were identified. A total of 6 randomized controlled trials were included with a total of 1857 participants, the majority being female. Intervention period duration ranged from 15 weeks to 2 years. No completed trials in the UK were identified. The level of evidence ranged from 1- to 1 + +. Conclusions: The evidence presented suggests that Tai Chi practice by older adults may be beneficial in reducing fall occurrences. However, the trials examined suggest that it may only be effective in a more robust older population and may not benefit frail participants. The implementation of Tai Chi schemes in the UK needs further investigation. Also, more research is needed with male participants.

Tai Chi workplace program for improving musculoskeletal fitness among female computer users

Workplace computer use has increased dramatically in recent years and has been linked to musculoskeletal disorders, a leading cause of work disability and productivity losses in industrialized nations. Tai Chi is a simple, convenient workplace intervention that may promote musculoskeletal health without special equipment or showering, yet no study has investigated Tai Chi as a workplace physical exercise for health promotion. To examine the effects of a workplace Tai Chi (TC) intervention on musculoskeletal fitness and psychological well-being among female university employees who are computer users. The exercise program consisted of two 50 minute TC classes per week for 12 consecutive weeks during the months of May-August 2007. Fifty-two participants were enrolled in a class conducted on campus by a professional TC practitioner during the lunch hour. Socio-demographic characteristics, including information on age, marital status, ethnicity, job category and perceived overall health were collected from all participants. Fitness testing conducted by qualified personnel was assessed pre- and post-program. The tests included resting heart rate, resting blood pressure, anthropometric measures, musculoskeletal fitness and back fitness. Psychological well-being was assessed by the Perceived Stress Scale pre- and post-program. There were significant positive results in several areas including resting heart rate, waist circumference and hand grip strength. Results showed that the TC program was effective in improving musculoskeletal fitness and psychological well-being. Significant improvements in physiological and psychological measures were observed, even at the large class sizes tested here, suggesting that TC has considerable potential as an economic, effective and convenient workplace intervention.

Pilot Study of a 10-Week Multidisciplinary Tai Chi Intervention in Sedentary Obese Women

Alternative approaches to weight control and physical activity are increasingly needed. Numerous factors influence weight management, including the choice of physical exercise. No study has previously examined the therapeutic effect of a multidisciplinary weight management program incorporating Tai Chi (TC) exercises among sedentary obese women. Randomized intervention trial with blinded medical provider. In day hospital consultations. Twenty-one obese women. All subjects participated in a 10-week weight management program that was part of usual care and included a hypocaloric balanced diet, a weekly physician/psychologist/dietician group session, and an exercise program. For the exercise component, subjects were randomized to either a 2-hour weekly session of TC or a conventional structured exercise program. Changes in weight, body composition, heart rate, blood pressure, mobility scores, mood, Three Factor Eating Questionnaire scores, and General Self-Efficacy. The TC arm improved in resting systolic blood pressure, chair rise test, mood, and reduced percent of fat at week 10 and at 6 months follow-up. General self-efficacy was enhanced in both groups and maintained at 30 weeks. The observed benefits over a 30-week period of a multidisciplinary weight management program incorporating TC exercises on physical functioning mood and dietary restraint need further understanding of how sedentary obese women adhere to physical activity like TC or other alternative exercises.

The Effect of Tai Chi on Knee Osteoarthritis Pain in Cognitively Impaired Elders: Pilot Study

This article reports a pilot study of the effect of tai chi (TC), a pharmacological adjunct and mild aerobic exercise, on osteoarthritic knee pain in elders with cognitive impairment (CI). The TC program included a warm-up, 12-form Sun-style TC, and a cool-down period, for a total of 20-40 minutes per session, twice a week for 15 weeks. The results showed no significant differences in knee pain after the TC intervention in 7 elders with CI. However, more minutes of TC attendance were related to improved pain scores (Spearman's rho=.78, P < .05). Greater accuracy in TC performance was also correlated with improvements in pain scores (Spearman's rho = .70, P=.08). Of 4 elders who participated in TC practice regularly (more than 20 sessions), 3 showed clinically important improvements, but 3 elders who participated in no sessions or only a few sessions showed no improvement.

A systematic review to determine the effectiveness of Tai Chi in reducing falls and fear of falling in older adults

Approximately 30% of elderly community dwellers fall each year. A large number of exercise-based interventions have been designed to reduce fall incidence, the movement therapy of Tai Chi being used increasingly. The aim of this systematic review was to examine the current literature surrounding the effectiveness of Tai Chi in reducing the incidence of and fear of falling in older people. A computerised literature search of Medline, AMED, CINAHL, the Cochrane Central Register of Controlled Trials, PubMed, PEDro and Scirus was performed. Only randomised controlled trials, with a study population aged over 60 years, investigating Tai Chi as an intervention to reduce incidence of falls and/or fear of falling were included. The methodological quality of the included trials was rated using the Delphi List. Owing to clinical heterogeneity, the data were qualitatively analysed using a 'best-evidence synthesis'. Seven randomised controlled trials involving a total of 1146 people met the inclusion criteria. The duration, frequency and intensity of the Tai Chi interventions showed great variation. The trials included were of high methodological quality. There is strong evidence to support the effectiveness of Tai Chi in reducing fear of falling, and weak evidence supporting its effectiveness in reducing the incidence of falls in older adults. Future research should focus on targeting defined clinical subpopulations with high-quality, well-designed randomised controlled trials of sufficient size and with long-term follow-up, to provide further evidence supporting the use of Tai Chi to reduce the incidence and fear of falling in older people.

Effects of 16-week Tai Chi intervention on postural stability and proprioception of knee and ankle in older people

Effects of 16-week Tai Chi intervention on postural stability and proprioception of knee and ankle in older people

Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program

Tai chi--moving for better balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the re-aim framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings.

The California Qi Gong and Tai Chi Project: A case study for developing and implementing community-based physical activity programs for older adults

Most previous research on Qi Gong/Tai Chi has emerged from highly controlled research trials and little is known about how to translate the outcomes from these studies into effective community-based programs. In 2005, a panel of physical activity and aging experts met to develop a strategic plan to increase the dissemination of Qi Gong/Tai Chi throughout the older adult population. One of the recommendations that emerged from the expert panel was the need to test the extent to which the use of Asian terminology and philosophical concepts serves as a barrier to the adoption of Qi Gong/Tai Chi programs nationwide. PURPOSE: Test the acceptance of two Qi Gong/Tai Chi programs that used identical physical movements but different terminology. METHODS: Two retirement communities in Southern California were chosen as the program sites. At location one, a traditional Tai Chi program was offered to 13 older adult participants. At location two, 18 individuals participated in a program that was advertised as "Empowered Longevity" and no reference was made to either Qi Gong or Tai Chi. Both programs were taught by the same instructor and used identical movements, however, the instructor used only "culturally-neutral" language in location two. Surveys and focus groups assessed issues related to health, the importance of physical activity, and prior knowledge and exposure to Qi Gong and Tai Chi. RESULTS: The survey and focus group data revealed that both the traditional and "culturally-neutral" versions of the Qi Gong/Tai Chi programs were well received and enjoyed by the participants with few differences between the two sites. In the focus group interviews, some participants suggested that it was important that the instructor use terminology and language that was easy to understand and remember. CONCLUSIONS: The California Qi Gong and Tai Chi project examined strategies to develop effective community-based Qi Gong and Tai Chi interventions. Our study suggests that, in the Southern California locations studied, Qi Gong/Tai Chi movements can be delivered equally well using traditional Asian teaching styles, or using a modified "culturally-neutral" curriculum. Our data suggest that alternative teaching styles may be an acceptable method to increase participation levels in Qi Gong/Tai Chi among older adults in America.

Tai Chi and Low Impact Exercise: Effects on the Physical Functioning and Psychological Well-Being of Older People

The effects of tai chi (TC) and low impact exercise (LIE) interventions on physical functioning and psychological well-being of sedentary older people were contrasted. Participants were randomized to TC, LIE, or non-exercise control groups with interventions running for 12 weeks. Post-intervention assessments with 72 participants who completed the study revealed that participants in both exercise groups improved with respect to upper body strength, balance, cardiovascular endurance, lower body strength, sleep disturbances, and anxiety. Participants in the LIE group reported better functional ability while those in the TC group reported better subjective health. Findings suggest that tai chi and low impact exercise are safe, cost-effective ways to improve both physical and psychological functioning of older people.

Does Tai Chi Improve Plantar Sensory Ability? A Pilot Study

Aging adversely affects balance and increases the propensity to slip and fall. Loss of plantar sensation due to diabetic peripheral neuropathy and other diseases has been shown to further increase this propensity to fall. The ancient Chinese art of Tai Chi has been previously shown as a method to improve balance in healthy elderly adults. The aim of this study was to determine if Tai Chi intervention improved both balance and plantar sensory perception in healthy elderly adults and elderly adults with diabetes and plantar sensory loss. Elderly subjects (mean +/- SD age = 73.1 +/- 5.9 years, n = 18) were tested for plantar sensory ability and several balance metrics before Tai Chi training and again after 6 months of weekly sessions. Participants were grouped by initial sensory perception scores (as measured by a vibrometer) in order to make inferences on the effects of Tai Chi on sensory perception. Plantar sensation results show all participants showed significant improvement in sensory ability with the 6 months of Tai Chi training. All groups also had a general improvement in all balance measures, with the greatest improvement seen in those subjects with large sensory losses. Hemoglobin A1C measurements also decreased as a result of the intervention. This study demonstrates the effectiveness of Tai Chi training as a method of improving plantar sensation and balance in elderly adults and elderly adults with diabetes with a large plantar sensation loss.

Well‐being of institutionalized elders after Yang‐style Tai Chi practice

Aims and objectives. The purpose of this study was to examine the effects of Tai Chi on the physical and psychological well‐being of elders who resided in long‐term care facilities.Background. The beneficial effects of Tai Chi on elders’ well‐being have been well‐documented; however, most of the studies focused on community‐dwelling or healthier elders.Design and methods. In this longitudinal, time‐series, quasi‐experimental study, a convenience sample of 28 institutionalized elders was recruited. A six‐month Yang‐style Tai Chi intervention was administered twice a week for 60 minutes per practice. The well‐being outcome variables, including physical and mental health status, blood pressure, quality of sleep, occurrence of falls and fear of falling, were measured before the intervention and then at one‐month, two‐month, three‐month and six‐month intervals.Results. Results indicated that the physical health status and social functioning of frail elders were significantly improved after Tai Chi practice [F(4,24) = 3·42, p = 0·038; F(4,24) = 9·66, p = 0·001 respectively].Conclusions. Tai Chi practice is beneficial for frail older people.Relevance to clinical practice. The findings provide a basis for using Yang‐style Tai Chi as a floor activity in long‐term care facilities to promote the well‐being of the older residents.

Tai Chi and Perceived Health Status in Older Adults Who Are Transitionally Frail: A Randomized Controlled Trial

Tai chi, a Chinese exercise derived from martial arts, while gaining popularity as an intervention for reducing falls in older adults, also may improve health status. The purpose of this study was to determine whether intense tai chi (TC) exercise could improve perceived health status and self-rated health (SRH) more than wellness education (WE) for older adults who are transitionally frail. Study subjects were 269 women who were >or=70 years of age and who were recruited from 20 congregate independent senior living facilities. Participants took part in a 48-week, single-blind, randomized controlled trial. They were randomly assigned to receive either TC or WE interventions. Participants were interviewed before randomization and at 1 year regarding their perceived health status and SRH. Perceived health status was measured with the Sickness Impact Profile (SIP). Compared with WE participants, TC participants reported significant improvements in the physical dimension and ambulation categories and borderline significant improvements in the body care and movement category of the SIP. Self-rated health did not change for either group. These findings suggest that older women who are transitionally frail and participate in intensive TC exercise demonstrate perceived health status benefits, most notably in ambulation.

Interventions to Reduce Fear of Falling in Community‐Living Older People: A Systematic Review

The objective was to assess which interventions effectively reduce fear of falling in community-living older people. An extensive search for relevant literature comprised a database search of PubMed, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials; expert consultation; and manually searching reference lists from potentially relevant papers. Randomized, controlled trials that assessed fear of falling in community-living older people were included. Two independent reviewers extracted data from full papers on study characteristics, methodological quality, outcomes, and process characteristics of the intervention. The search identified 599 abstracts, and 19 papers met the inclusion criteria. Seven of those papers were identified using expert consultation. Fifty-five percent of all validity items and 39% of process characteristic items were fulfilled across the 19 trials. Twelve of the 19 papers were of higher methodological quality. In 11 of these trials, fear of falling was lower in the intervention group than in the control group. Interventions that showed effectiveness were fall-related multifactorial programs (n=5), tai chi interventions (n=3), exercise interventions (n=2), and a hip protector intervention (n=1). Three of these interventions explicitly aimed to reduce fear of falling. Several interventions, including interventions not explicitly aimed at fear of falling, resulted in a reduction of fear of falling in community-living older people. Limited but fairly consistent findings in trials of higher methodological quality showed that home-based exercise and fall-related multifactorial programs and community-based tai chi delivered in group format have been effective in reducing fear of falling in community-living older people.

Group and home-based tai chi in elderly subjects with knee osteoarthritis: a randomized controlled trial

Objective: To evaluate the effects of tai chi consisting of group and home-based sessions in elderly subjects with knee osteoarthritis. Design: A randomized, controlled, single-blinded 12-week trial with stratification by age and sex, and six weeks of follow-up. Setting: General community. Participants: Forty-one adults (709 / 9.2 years) with knee osteoarthritis. Interventions: The tai chi programme featured six weeks of group tai chi sessions, 40 min/session, three times a week, followed by another six weeks (weeks 7 -12) of home-based tai chi training. Subjects were requested to discontinue tai chi training during a six-week follow-up detraining period (weeks 13-18). Subjects in the attention control group attended six weeks of health lectures following the same schedule as the group-based tai chi intervention (weeks 0 -6), followed by 12 weeks of no activity (weeks 7-18). Main outcome measures: Knee pain measured by visual analogue scale, knee range of motion and physical function measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were recorded at baseline and every three weeks throughout the 18-week study period. Data were analysed using a mixed model ANOVA. Results: The six weeks of group tai chi followed by another six weeks of home tai chi training showed significant improvements in mean overall knee pain (P = 0.0078), maximum knee pain (P = 0.0035) and the WOMAC subscales of physical function (P = 0.0075) and stiffness (P = 0.0206) compared to the baseline. No significant change of any outcome measure was noted in the attention control group throughout the study. The tai chi group reported lower overall pain and better WOMAC physical function than the attention control group at weeks 9 and 12. All improvements disappeared after detraining.

Effects of Extended Tai Chi Intervention on Balance and Selected Motor Functions of the Elderly

Balance ability decreases with age, which results in an increased risk of falls for people over age 65. Tai Chi exercise appears to offer potential benefits in the reduction of falls for the elderly. The purpose of the present study was to examine the effects of extended (6- and 12-month) Tai Chi exercise interventions on balance and selected motor functions for senior citizens. Forty-seven subjects were recruited from two local senior centers. Twenty of them (M = 71.8 years, SD = 7.1), 11 in the Tai Chi exercise group and 9 in the control group, completed the pre-, mid- and post-tests over 12 months on five selected functional performance tests: static balance, dynamic balance, choice reaction time, heel-rise strength, and ankle flexibility. The Tai Chi group was provided with a one-hour Tai Chi exercise session per week for 12 months; the control group did not participate in any exercise program. Results showed that static balance improved significantly after a 6-month Tai Chi intervention. Moreover, the Tai Chi group maintained a higher level in the test performance compared with the control group at the end of the 12-month intervention, but there was no significant difference between the two groups. Data suggested that Tai Chi exercise intervention could produce a positive influence on balance control for the elderly over a prolonged period, but not on muscle strength and ankle flexibility.

Research on psychoneuroimmunology: tai chi as a stress management approach for individuals with HIV disease

Psychoneuroimmunology is a framework for mind–body practice and research that combines cutting-edge scientific exploration with holistic philosophy to appreciate and understand stress responses. The rapidly growing research literature provides a foundation for building an integrative stress management model with the potential to positively influence the stress–disease relationship and, ultimately, health outcomes. This article introduces a novel tai chi intervention and provides quantitative and qualitative data from a randomized clinical trial indicating its effects on psychosocial variables in individuals living with various stages of HIV disease.

Challenges of Doing Intervention Research With the Elderly Taiwanese Population: Example of a Tai Chi/Movement Therapy

The purpose of this article is to address the challenges of conducting intervention research with an elderly population by using the example of a tai chi intervention study. Various difficulties can arise while conducting interventions with the elderly; these can involve factors related to long-term care facilities, health care providers, and the research team, as well as the institutionalized elders themselves. Any difficulty may influence research results. As a consequence, challenges must be dealt with in a positive manner to conduct a valid geriatric study. Modifications and strategies that the research team engaged to manage the challenges in this study are discussed.

Effect Of Tai Chi On Pain Self-efficacy Related To Knee Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis in the United States and causes functional limitations and pain that worsen an individual's quality of life. While reducing the pain associated with OA is an important consideration in managing OA, understanding the effect of the treatment on an individual's self-efficacy to deal with the pain is also a consideration. PURPOSE To examine the effectiveness of a 6-week Tai Chi intervention on improving self-efficacy for dealing with the pain associated with OA. METHODS Female participants (n = 34, 63.4±7.8 yr) were recruited through community announcements and screened based on clinical criteria. All participants were enrolled in a 6-week Tai Chi intervention program (1 hr/session, 2×/wk). Self-efficacy measurements were assessed at the beginning (a), 3-weeks (b), and the end (c) of the intervention using the Chronic Pain Self-Efficacy Scale (CPSS). The CPSS has three categories; self-efficacy for pain management (pse), self-efficacy for physical function (fse), and self-efficacy for coping with symptoms (cse). Time effects were assessed with repeated measures ANOVA. RESULTS Means±SD for the three measures at the three time points were as follows; pse: a= 72.4±21.7, b = 71.7±21.9, c = 76.9±23.5, fse: a = 78.1±21.5, b = 82.8±21.5, c = 84.5±23.1, cse: a = 73.9±18.9, b = 76.5± 19.5, c = 78.5±20.9. The analysis revealed no significant time effects on any of the self-efficacy measures: pse(2, 74) F = .83, p = .44, η =.03; fse(2, 74) F = 1.21, p = .30, η = .04; cse(2, 74) F = .73, p = .48, η =.02. CONCLUSION Self-efficacy scores tended to increase during the intervention; however, the magnitude of these changes was not statistically significant. It is possible that a short-term 6-week Tai Chi training program is not sufficient to improve self-efficacy. Additionally, the participants were functioning at a high level and possessed a high level of pain self-efficacy at the beginning of the intervention which may have led to a ceiling effect in improvement. Future investigations should examine participants with moderate or severe OA symptoms having more functional deficits and lower self-efficacy in a long-term intervention.

Effects Of Tai Chi On The Status Of Elderly Subjects With Knee Osteoarthritis

BACKGROUND Osteoarthritis (OA) is a major cause of disability in the aging population and its management is costly. Tai Chi (TC), an ancient form of Chinese martial art that encompasses low impact, low intensity controlled movements, has been proposed as an inexpensive alternative to benefit people with knee OA. PURPOSE The purpose of this study was to compare the effects of a TC intervention program including both group and home video sessions followed by detraining session to the effects of an attention control (AC) program on knee pain, knee range of motion (ROM) and function of subjects with knee OA. METHODS Subjects >50 yrs with knee pain were recruited. Diagnosis of knee OA was based on the Classification Criteria of the American Rheumatism Association for Osteoarthritis of the Knee. Subjects were assigned to a TC or AC group using a match-paired random block design. TC group received 40 minutes of TC 3x/week for 6 weeks, followed by 6 weeks of TC home program 3x/week and 6 weeks of no TC. AC group received 6 weeks of 40-minute lectures 3x/week, followed by no activities for the following 12 weeks. Knee ROM, knee pain using Visual Analogue Scales (VAS) and the McMaster Universities Osteoarthritis Index (WOMAC) were recorded at 0, 3, 6, 9, 12, 15 and 18 weeks. Data analyses were performed using 2 (treatments) × 6 (times) mixed repeated measures analysis of covariance model, with baseline value and Body Mass Index covariates. RESULTS Forty one subjects (7M/34F, 70 ± 9.2 yrs) participated in the study, 19 in the AC group and 22 in the TC group. For the AC group, knee pain, WOMAC and knee ROM scores did not change significantly during the study. For the TC group, mean knee pain significantly decreased at weeks 3, 6 (p <0.05) and 9, 12, 15 (p <0.01) from a high of 4.67 ± 2.59 at week 0 to a low of 2.30 ± 1.43 at week 9 and then increased to 3.46 ± 2.45 at the end of the study. TC group recorded significantly less knee pain than AC group at weeks 9, 12 and 15 (p = 0.008, 0.035, 0.043, respectively). WOMAC score also significantly decreased in the TC group at weeks 9, 12 and 15 (p <0.05), from 65 at week 0 to 51 at week 9, and was significantly better for the TC group than the AC group at week 9 (p = 0.005). No significant differences were found for knee ROM between the TC and AC groups. CONCLUSION Group exercise plus home video program of TC can provide significant knee pain reduction and improvement of function in the elderly with knee OA, and it may offer a cost effective alternative to the management of knee OA. However, such effect of TC was not sustained after detraining.

Tai Chi and Fall Reductions in Older Adults: A Randomized Controlled Trial

The authors' objective was to evaluate the efficacy of a 6-month Tai Chi intervention for decreasing the number of falls and the risk for falling in older persons. This randomized controlled trial involved a sample of 256 physically inactive, community-dwelling adults aged 70 to 92 (mean age, 77.48 years; standard deviation, 4.95 years) who were recruited through a patient database in Portland, Oregon. Participants were randomized to participate in a three-times-per-week Tai Chi group or to a stretching control group for 6 months. The primary outcome measure was the number of falls; the secondary outcome measures included functional balance (Berg Balance Scale, Dynamic Gait Index, Functional Reach, and single-leg standing), physical performance (50-foot speed walk, Up&Go), and fear of falling, assessed at baseline, 3 months, 6 months (intervention termination), and at a 6-month postintervention follow-up. At the end of the 6-month intervention, significantly fewer falls (n=38 vs 73; p=.007), lower proportions of fallers (28% vs 46%; p=.01), and fewer injurious falls (7% vs 18%; p=.03) were observed in the Tai Chi group compared with the stretching control group. After adjusting for baseline covariates, the risk for multiple falls in the Tai Chi group was 55% lower than that of the stretching control group (risk ratio,.45; 95% confidence interval, 0.30 to 0.70). Compared with the stretching control participants, the Tai Chi participants showed significant improvements (p<.001) in all measures of functional balance, physical performance, and reduced fear of falling. Intervention gains in these measures were maintained at a 6-month postintervention follow-up in the Tai Chi group. A three-times-per-week, 6-month Tai Chi program is effective in decreasing the number of falls, the risk for falling, and the fear of falling, and it improves functional balance and physical performance in physically inactive persons aged 70 years or older.