Tai Chi For Seniors Exercise / Benefits Cited In Scientific Studies
Tai chi for seniors has alot of benefits as these two scientific research project reports and an editorial published in the Journal of the American Geriatrics Society confirm. The practice of Tai Chi Chuan produces measurable benefits in reducing frailty and falls in older persons and helps in maintaining balance and strength.
The two different research projects, one in Atlanta, GA and one based in Connecticut, both suggest there would be value in additional studies on the benefits of tai chi for seniors. The Atlanta group is already planning to seek two additional study grants.
The most significant and favorable test was designed and conducted in Atlanta, GA, where Tai Chi Chuan instructor Tingsen Xu, Ph.D., designed and taught selected Yang style movements intended to improve the mind and body connection and specific balancing skills.Tai chi was found to reduce the risk of multiple falls by 47.5%.
The Atlanta study concluded that, “A moderate Tai Chi intervention can impact favorably on defined biochemical and psychosocial indices of frailty. This intervention can also have favorable effects on the occurrence of falls. Tai Chi warrants further study as an exercise treatment to improve the health of older people.”
In addition to the favorable conditions of the report, the benefits of tai chi for seniors were endorsed in an editorial in the same May issue of the Journal of the American Geriatrics Society, written by Steven N. Blair, PED, and Melissa E. Garcia, MPH of the Cooper Institute of Aerobics Research, Dallas, TX.
The Editorial Said About Tai Chi For Seniors Exercise, In Part:
“ The principal advantage of Tai Chi Seniors exercise is that it is a low technology approach to conditioning that can be implemented at relatively low cost in widely distributed facilities throughout the community."
“Convenience can be maximized and costs for staff and equipment minimized." The results of the Atlanta and Connecticut studies add to the growing body of evidence regarding the efficacy of Tai Chi individual interventions in improving or maintaining function in older individuals.
The design and methods of these two studies address weakness of some earlier reports, thus increasing confidence in the benefits of Tai Chi intervention. The main findings are that Tai Chi can help maintain strength and balance gains achieved by more intensive laboratory training and reduce the risk of multiple falls.
“Thus, Tai Chi appears to influence favorably two important physical fitness training's” balance and strength. It is unfortunate that neither study had an adequate measure of aerobic power, but other reports suggest that Tai chi also affects this important fitness component.
The authors of the editorial suggest while most fitness studies focus on aerobic exercise, the accumulating research on older persons suggests more studies of the value of fitness exercises such as tai chi for seniors.
The Atlanta project included 200 persons aged 70 or older and studied three aspects: Tai Chi, computerized balance training and an education control group. The Tai Chi movements taught by Dr. Xu emphasized components of movement that typically become limited with aging.
The report conclusion said: “Our data suggests that Tai Chi can influence older individuals’ functioning and well-being significantly and provide some appreciation for why this exercise form has been practiced by older Chinese for more than three centuries.”
Among the results reported in Atlanta were findings that those who participated in Tai Chi had less loss in left hand grip strength, reduces ambulation speed, and lowered systolic blood pressure after a 12-minute walk.
“Fear of falling and intrusiveness improved in the Tai Chi group, compared with the ED (education control group). Finally, T’ai Chi participants had a substantial reduction in the rate of falls occurrences.”
The reduced loss of grip strength in the Tai Chi group was an “unexpected observation.” The subjects “did not engage in activities designed to strengthen the upper extremities during the intervention, and the clinical relevance of this change (0.7 vs 0.8) is not apparent.”
The report commented:
“Compared with the practice of Tai Chi in China, our intervention intensity was quite modest, and this may explain why we did not observe changes in strength and flexibility similar to changes reported with Tai Chi, which is practices routinely.”
During a 15-week period, the balance training and the control group met once a week. The Tai Chi group met twice a week. This procedure was deemed necessary so that the Tai Chi participants could receive some individual attention regarding proper movements. The total individualized weekly contact time between clinician and subject was comparable in the three groups.
“The dynamic nature of Tai Chi permitted chances for between-session practice. In fact, subjects were requested to try Tai Chi forms twice daily for 15 minutes".
The study also found that the change in systolic blood pressure after a 12-minute walk was larger for the Tai Chi participants than for the Balance Training or Education group.
In literature discussing cardiovascular changes in older Tai Chi practitioners, the study said ( it said) that only research by Qu Mianya reported that Chinese Tai Chi for seniors older than age 60 reduced their resting blood pressure to 134mm Hg, compared with a sedentary group (resting systolic blood pressure, 154mm Hg).
(This was part of a medical assessment of Simplified Tai Chi Chuan by Chinese Sports Editorial Board, Beijing, China, 1986.)
“These values are lower than seen in our treatment groups and may be the result of a different age rang and exercise intensity, which were not reported by Qu Mianya.”
The Tai chi subjects in the study were found to have slowed their walking speed in a walking test. “Whether changes in distance ambulated might have been caused by awareness of pain or movement limitations associated with Tai Chi practice or are attributable to enhanced awareness of the environment cannot be determined. "Further investigations are needed.”
Regular Tai Chi For Seniors Exercise Could Significantly Improve Participants Balance Control
The study referred to the report by Tse and Bailey that demonstrated that regular Tai Chi for seniors could significantly improve participants balance control in three of five clinical tests, compared to a matched group of nine non-participants.
It also cited a study by A. E. Kirsteins, F. Dietz and S.M. Hwang, which evaluated the safety and potential use of a weight-bearing exercise, Tai Chi, for rheumatoid arthritis patients. That study found no adverse effects on active range of motion or weight bearing joint integrity of Rheumatoid arthritics.
The report noted that, “Many Tai Chi participants gave anecdotal reports of aborted falls events, independently reporting awareness of both the environment and appropriate body maneuvers in the presence of unexpected perturbations.”
It also said that almost half of all the tai Chi participants chose to continue meeting as an informal group to practice after conclusion of the follow up assessment.
“Future studies should investigate outcomes associated with Tai Chi for seniors training, as a function of different instructional techniques, different Tai Chi leaders, a target diagnostic group, such as individuals with rheumatoid arthritis, and an increased intervention intensity."
The Atlanta study team consisted of Steven L. Wolfe, Ph.D., FAPTA, Huiman X. Barnhart, Ph.D., Nancy G. Kutner, Ph.D., Elzabeth McNeely, Carol Coogler, ScD, PT, Tingsen Xu, Ph.D., and the Atlanta Group of FICSIT ( Frailty and Injuries: Cooperative Studies of Intervention Techniques).
The Effect Of Tai Chi On Balance And Strength
The Connecticut study focused on the effect on balance and strength of three months of intensive balance and/or weight training followed by six months of low intensity Tai Chi training for maintenance of gains.
The report said that, “Significant gains (in balance and strength training) persisted after six months of Tai Chi."
The Connecticut study, which included 110 health community dwellers (mean age 80), had balance training, strength training, a combined balance and strength training, and a control group.
Following completion of these segments, subjects in all four groups participated in a 26 week maintenance phase of Tai Chi Chuan “because it is a safe and highly structured training technique that utilizes bio mechanically sound principles of movement and posture.”
The report went on to say that, “The goal of Tai Chi is to develop an enhanced sensibility of the pelvis and trunk as the frame of reference for movement. Instruction in body awareness, relaxation, imagery, and breathing are integral aspects of the training.”
The subjects of the study Tai chi for seniors attended weekly one-hour group training sessions, and were asked to practice twice a week at home for 5 to 15 minutes and to maintain a practice log. The methodology for the Tai Chi followed the descriptions in the book, “tai Chi,” by Cheng Man-ching and Robert W. Smith.
The teaching of tai chi for seniors emphasized “very slow weight shifts, steps, and turns while maintaining a lowered center of gravity, i.e., with the knees and hips kept mild to moderate flexion.”
“Movements were performed using a combination of specifics:
- body alignments (perpendicular torso, horizontal pelvis, axially extended neck);
- orientations (head, torso and pelvis direct at frames of reference in the room);
- weight shifts ( while center of gravity is maintained in a horizontal plane); and
- directional changes ( rotation about the hips rather than the neck or trunk)….”
Subjects received concurrent instruction on body awareness, relaxation, imagery and breathing.
The study reported that attendance at the one hour a week Tai Chi for seniors class, during the six months maintenance phase was moderately good, with subjects attending a mean of 72 percent of the sessions.
“Although some subjects practiced regularly at home (2-3 times a week), most home practice was infrequent and inconsistent and many subjects preferred performing Tai Chi in a group and under supervision.”
The report said that,"Finally the Tai Chi maintenance program sustained improvements in balance and strength for six months after the intervention.”
However, it did note that, ‘Following a Tai Chi for seniors maintenance program, a portion of the balance improvements noted in the balance at PM (Post maintenance, 9 months) was still significantly better than at BA (Baseline).
The strength-trained group maintained much of the strength improvement attained at PI ( Post intervention, 3 months). The small but significant decrease in GVU (Usual Gait Velocity) at PM in balance trained groups may have been influenced by the deliberate slowness of the Tai Chi movements.
“Preservation of balance and strength gains for 6 months was encouraging in view of the low intensity of the Tai Chi training.”
The Connecticut report on tai chi for seniors concluded: “The study demonstrated that relatively healthy older persons can realize meaningful short-term gains in balance and strength by means of a high intensity,laboratory-based, training program can maintain those gains to a lesser extent through a low-intensity maintenance program of Tai Chi practice."
The Connecticut study was conducted by Leslie Wolfson, MD, Robert Whipple, MA PT, Carol Derby, Ph.D., James Judge, MD Mary King, MD Paula Amerman, MS Julia Schmidt, and Donny Smyers, MS, PT.
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