Tai Chi for Stroke Rehab

A recent publication summarized several other studies on the use of tai chi for stroke rehabilitation. Five different clinical trials were reviewed. The authors concluded that studies were of only moderate quality, but there were indications that tai chi may be helpful in rehab.

Three of the studies reported that tai chi improves balance in participants who have had a stroke. Three studies examined quality of life and mental health and reported improvements in the tai chi groups. Three studies examined patient mobility and reported no benefit from tai chi.

Their conclusions: "This focused review suggests that Tai Chi exercise might be beneficial with respect to balance, quality-of-life, and mental health in survivors of stroke."

My conclusions: Tai chi improves mental outlook. This has been shown in other studies, too. This study points out that there are many poor quality studies out there that waste a lot of time and money. Medical researchers generally are pretty good at putting together good randomized trials. The difficulty seems to be that medical professionals don't understand tai chi. We can help with that.

There were no indications what the control groups were doing or what style of tai chi was used. The abstract is available online at American Journal of Physical Medicine & Rehabilitation.

© 2013 Eric Borreson

Marines Expand Use of Meditation Training

I often talk and write about the benefits of mindfulness meditation. No one that knows me would say that I am a wu-wu new ager. I am all about results. Researchers are using neuroscience to study what happens to people that meditate. The results are real. Meditation helps us be better people by nearly any measure you can imagine.

Doctors used to believe that our brains are fixed and never change after reaching adulthood. This is not true. In one way, our brains are like our muscles. Use it or lose it. Muscles that are not used shrink and become less effective. Muscles that are used grow and become more effective. It's the same with the brain. Meditation has been shown to

• increase the number of neural connections in the part of the brain responsible for concentration and empathy

• decrease the number of neural connections in the amygdala, the area of the brain that controls anxiety and fear

• enlarge the hippocampus, the area of the brain that controls memory

This is proof that we can use meditation to rewire our brains to become happier and more peaceful. We can remember better and make better decisions under stress.

The results have been so positive that the military has taken notice. In a small 2008 study called Mindfulness-based Mental Fitness Training (M-Fit), a small group of marines took part in their normal 8-week, 12-hour a day training as they usually did. In addition, they were taught breathing exercises, how to focus, and how to manage monkey mind. After their training was completed, they were found to have improved mood and attentiveness. The ones that meditated the most had the most benefit.

Tasks that require lots of mental effort, such as elite athletics and combat require lots of working memory capacity. So do emotional challenges, like leaving family behind and heading to a war zone. These types of tasks use up working memory. Over time, that working memory can be restored. Troops who meditated regularly increased their working memory capacity and they were more aware of their bodies response to stress. Before it is restored, depleted working memory leads to poor decision making, impulsive behavior, alcoholism, and domestic violence.

According to an article in Men's Journal, working memory is:

... a term that brain scientists use to define a cognitive resource that is much more than simple recall. Working memory capacity powers complex thoughts. It’s what we call upon to figure out restaurant tips, break down spreadsheets, or even settle ethical dilemmas like whether or not to pull a trigger. The level of this resource can be depleted throughout the day. A morning disagreement with a co-worker — or a roadside bomb for that matter — can make it harder to solve a problem that requires math skills a few hours later in the day. In the battlefield low levels of working memory capacity might mean the difference between life and death.

There is more in the newspaper article here (WashingtonTimes):

 

© 2013 Eric Borreson

Preparing for the Rest of Your Life

"If you wait for an emergency to happen before you decide what to do, you're already dead."* We need to be prepared for unexpected things to happen. However, it's even better to be prepared to prevent unexpected things from happening. Prevention is way better than cure.

We all expect to live forever. We all expect to be healthy and competent. Maybe hope is a better word than expect, but it doesn't change the message. Life is full of unexpected things: injury, illness, and loss. There is a certain amount of randomness to these things, but we can develop plans to minimize the probability of these things happening.

If you really, truly want to prepare for the rest of your life, you need to plan for ways to maintain health and prevent injury. If you really, truly want to plan ahead, you should be living a healthy life right now. Tai chi is proven to help with improving health, reducing depression, and preventing falls and other injuries. Don't wait for the time when stress has already caused damage to your body. Don't wait until your health deteriorates. Don't wait for the depression of old age and poor health.

Here is a brief list of benefits of Tai Chi for Health that have been proven through extensive studies:

Improved balance, reduced falls, and reduced fear of falling

Reduced blood pressure

Improved strength, range of motion, and endurance

Improved management of chronic pain

Improved strength in the deep stabilizer muscles

Strengthened immune system

Reduced bone loss in post-menopausal women

Improved outlook on life (symptoms of depression and stress)

Enhance mind-body connection through improved proprioception and kinesthetic awareness

You have a choice about how you live the rest of your life. You can be proactive and take charge right now. Or you can be reactive and wait until the damage is done. Prevention is much easier than cure.

Don't think you have time? I believe that TV should stand for "The Vacuum" because it sucks your brains out. I believe that investing 15 minutes a day in maintaining and improving your health is more important than having your brains sucked out by The Vacuum.

Sign up for a tai chi class now. They're everywhere.

Please share this article with anyone that you think would benefit from it.

*Quote from the movie, A Perfect Getaway (2009)

© 2012 Eric Borreson

Tai Chi for Heart Failure Patients

A recent study showed that tai chi is more beneficial to heart-failure patients than simple aerobic exercise. The study was conducted by the Harvard Medical School, Massachusetts General Hospital, and the VA Boston Healthcare system. It was a small sample size, but it was a good study because they compared tai chi to aerobic exercise. This study is one of the few studies that gave very complete details on the tai chi that was taught. They used adapted forms from Chen Man Cheng's Yang style tai chi.

This study looked at 16 patients with heart failure with preserved ejection fraction (HFPEF). Definitive therapy for this disease is unclear. Aerobic exercise has been shown to help this group. However, compliance with the exercise regimen is typically fairly low.

This study lasted 12 weeks. Compliance in the tai chi group was 89%. There were several measures where the tai chi group improved more than the group that did the aerobic exercise. These include 6 minute walk distance and Profile of Mood States-Depression scores. During exercise, the tai chi group showed reduced oxygen uptake, respiratory rate, and heart rate. This indicates that the tai chi group wasn't working as hard. This indicates a lower cardiovascular risk.

There were several other measures where there was no difference between groups. These include Minnesota Living with Heart Failure scores, self efficacy, and peak oxygen uptake.

The authors concluded that tai chi is feasible and safe in this study group. Therapeutic endpoints appear similar with tai chi relative to aerobic exercise despite a lower aerobic training workload.

My conclusions are that the improvement in Profile of Mood States-Depression is very important. It means that tai chi improves health, which we already knew, and it improves attitudes about life. In other words, this study shows that tai chi works with the mind and body to improve a patient's outlook on life.

The article was published online on Oct 12, 2012 ahead of publication in Congestive Heart Failure. The article is available online at http://onlinelibrary.wiley.com/doi/10.1111/chf.12005/full.

© 2012 Eric Borreson

Using Tai Chi to Deactivate the Fight-or-Flight Response

Our bodies have a physiological reaction to danger called the fight-or-flight response. When we are facing danger, our body reacts to help us survive. This is also called the sympathetic nervous system. Several involuntary responses follow, such as the release of stress hormones, increased heart rate and blood pressure, the activation of our immune system, etc.

Under normal circumstances, our bodies respond as needed and everything returns to normal after a time. However, a difficulty appears when we realize that our body responds the same way whenever we face emotional stress, like anxiety, anger, fear, or any other destructive emotion. We all face chronic stress because of the way we live our modern lives. Long-term chronic stress causes damage to our bodies because the stress hormones contribute to chronic illnesses like hypertension, autoimmune diseases, cardiovascular disease, diabetes, obesity, and many other illnesses.

Fortunately, our bodies have a complementary physiological response called the relaxation response. This is also known as the parasympathetic nervous system. The relaxation response calms down our bodies and minds to help us deactivate the fight-or-flight response and reverse the effects of stress.

Breathing is something that we do both voluntarily (conscious) and involuntarily (unconscious). We can use conscious breathing to affect the parasympathetic nervous system. Since the parasympathetic nervous system works to counteract the sympathetic nervous system, we can use conscious breathing to control, or even to reverse, the effects of stress on our body.

Tai chi is a nearly perfect way to practice conscious breathing. Tai chi can use abdominal breathing. Abdominal breathing is a breathing technique that helps you learn to calm the mind and body.

To practice abdominal breathing, start in a normal wu ji posture. Take several deep breaths with long exhales to allow your mind and body to relax. Place your right hand on your chest and your left hand on your abdomen just below your belly button. Pay attention to how your hands move while you are breathing. Inhale through your nose and consciously expand your abdomen. Exhale through your mouth and contract your abdomen. You should notice that your right hand (on your chest) barely moves. Your left hand (on your abdomen) should move much more. After you become comfortable with this technique, you no longer need to place your hands.

Breathing is also part of "Sinking the Qi". The slow, continuous movements of tai chi lead to relaxed breathing. The rhythmic yin-yang movements can be used to match the inhales and exhales of abdominal breathing. The mental focus required by tai chi helps us develop a mind-body connection and awareness. This all leads to teaching our mind and body to relax and calm down in order to counteract the fight-or-flight response.

© 2012 Eric Borreson

Qigong Shown to Help Symptoms of Fibromyalgia

Fibromyalgia is a chronic condition characterized by widespread pain and fatigue. The cause of fibromyalgia is not clear, but it appears that the condition amplifies pain signals by affecting how the brain processes signals. There are some western medicines and therapies that may help with the symptoms, but many people with the condition claim that they are receiving no benefit and have to live with the pain.

There was a recent study published that a particular type of qigong could help alleviate the symptoms of fibromyalgia. In the study, 100 participants were randomly assigned to either the study group or the control group. For the study group, qigong training was given over 3 days and was followed by weekly follow-up sessions for 8 weeks. The participants were asked to practice for 45 to 60 minutes per day during the study.

Participants reported improvement in all measured outcomes: pain, impact, sleep, physical function, and mental function. These outcomes continued to the end of the study at six months.

Qigong (pronounced chee gung) is two words from the Chinese language. The word qi is often translated as “internal energy”, but this doesn’t really seem to be a very good translation. According to Traditional Chinese Medicine, it primarily refers to connecting different parts of our body. It also refers to communication where our mind, or intention, moves our bodies. Gong can be translated as exercises or work done on a regular basis. So qi gong can be used to mean “exercises that enhance our vital energy and connectedness”.

There are thousands of qigong exercises for everything from curing illnesses to preventive medicine. This study used a type of qigong called Chaoyi Fanhuan Qigong (CFQ). According to the study,

Qigong training consisted of an initial workshop conducted over three consecutive half-days by a qualified CFQ instructor. Participants received training in level 1 CFQ; this consisted of instruction in seven key movements known as "the hexagram" and ancillary exercises. Hexagram movements consist of choreographed movements that emphasize softness, relaxation, downward releases and full body distribution of "qi".

The follow-up at 4 months and at 6 months indicated that the participants that maintained their CFQ practice for at least 45 minutes per day were able to maintain the improvements. Participants that practiced significantly less reported less benefit after the end of the practice training.

The complete study can be read here:

A Randomized Controlled Trial of Qigong for Fibromyalgia

Arthritis Research & Therapy. 2012 Aug 3;14(4): R178. By Lynch M, Sawynok J, Hiew C, Marcon D.

http://arthritis-research.com/content/14/4/R178

© 2012 Eric Borreson

Want a Bigger Brain? Tai Chi May Help

This is one of occasional articles I plan to write on the health benefits of tai chi. Tai chi has become popular as an exercise to promote good health. There have been quite a few studies done in the last few years that support this.

There was a recent study published in the Journal of Alzheimer's Disease that evaluated interventions designed to reduce dementia risk. A representative group of elderly men and women from Shanghai were randomly assigned to one of four groups for the 40 week intervention. The groups were tai chi, walking, social interaction, and a control group with no intervention. The type or style of tai chi were not described in the paper.

Previous studies have shown that physical exercise can reduce dementia risk. In addition, increased social interaction has been observed to reduce risk, this is the first study to use randomized trials to evaluate this. Brain MRIs were performed before and after the study. In addition, a battery of neuropsychological tests were included.

Increases in brain volume were found in both the tai chi group and the social interaction group. This means that the brain was increasing the number of neural connections. There were no overall average increases in brain volume for the walking group and the control group. However, when the walking group was stratified according to walking speed, it was found that the members of the group that walked fastest had the most increase in brain volume. This suggests that more vigorous exercise could give more favorable results. This may not be possible for the elderly.

In addition, there were improvements in many of the other tests for the tai chi group. The social interaction group also showed improvement in some of the other tests, but not as many as with the tai chi group. No differences were found between the walking group and the control group in other tests.

This study excluded people that had ever practiced tai chi. However, it did not exclude people that had never walked. One of the inclusion criteria was that participants must be able to walk 2 km. I suspect that this decision by the researchers may have reduced a possible effect of improvements for people that start walking for the study. They are already in fairly good shape. Nevertheless, it is a fairly good study that shows that activities that require complex mental activities, like learning tai chi or practicing social interactions, increase brain volume and improve cognitive functioning. It does not show that practicing tai chi has any effect on fitness over that of simple walking.

Complete article here:

Journal of Alzheimer’s Disease 30 (2012) 757–766

DOI 10.3233/JAD-2012-120079

IOS Press

© 2012 Eric Borreson

What is Meditation?

Meditation is a mental practice used to get beyond the unaware mind into a deeper state of awareness. According to Wikipedia,

“Different meditative disciplines encompass a wide range of spiritual and/or psychophysical practices which may emphasize different goals -- from achievement of a higher state of consciousness, to greater focus, creativity or self-awareness, or simply a more relaxed and peaceful frame of mind.”

A common form of meditation is mindfulness meditation. This is relatively easy for beginners to do. During meditation, we try to keep our mind on a single point of focus. The point of focus could be a short repetitive prayer, our breath, a breath count, qi energy flows, or anything else.

Meditation has a long history. It has been part of Buddhist culture for thousands of years. The two common types of Buddhist meditation are shamatha and vipassana. Shamatha consists of types of concentration meditations used to develop focus. Vipassana consists of practices to develop insight into the true nature of reality.

Step eight of the eight-fold path of Buddhism refers to “Right Concentration”, referring to meditation. In this context, concentration refers to a mental state where the entire mind is directed toward a single object. Through meditation, people develop the ability to remain calm and focused in everyday situations.

Christians have practiced meditation for almost as long, although they prefer the term "contemplation" nowadays. Some Catholics use the rosary to practice meditation. There are many biblical references to meditation among the prophets. Many scholars and religious officials of the Middle Ages wrote guides to meditation. In addition, there are many secular meditation practices.

Regardless of our motivation or background in meditation, our first efforts at meditation are difficult. Before we even notice it, our mind has wandered away. We find that our mind bounces around from one idea to another and it seems that there is nothing we can do to stop it. Some people describe it as your “monkey mind”, where your mind jumps around like a monkey jumping from one branch to another.

Mindfulness meditation is the process of recognizing when our minds have wandered away from our point of focus and bringing it back. Your mind may wander away during every single breath. That's OK. Just notice when it happens and bring it back. It is important to avoid judgment about how you are doing. There is no such thing as a "good" meditation or a "bad" meditation. It just is. Live in the moment during your meditation. It is not about forcing a result. It is about developing a skill. That's meditation.

The idea of meditation is to learn to become aware of our thoughts and emotions. It is not about stopping those thoughts. With practice, we can develop the ability to concentrate and focus so that we can control distractions and ignore all the stories we make up that cause us stress and discomfort.

Exercise develops your muscular strength or endurance. Meditation develops your “concentration muscles” and helps us learn how to maintain focus. When the mind wanders, all that is necessary is to bring the mind back to that point of focus. Do not allow recriminations or frustrations to develop. It is more important to meditate regularly than to meditate for a long time but only occasionally. If you are a beginner, start with 10 minutes a day. When that feels comfortable, go ahead and extend the time a little bit.

Let's finish with a quote from ZBOHY, the Zen Buddhist Order of Hsu Yun (http://www.hsuyun.org/chan/en/essays/bychuanzhi/204-healing-breath.html)

As the mind is quieted by the slow breathing exercise, the brain becomes better able to regulate serotonin (c.f. Bujatti, M. and Reiderer, P., Journal of Neural Transmission 39: 257-267, 1976) and other chemicals responsible for regulating our biochemistry: we sleep better, our overall mood improves, and we become calmer and less agitated. In addition, muscles relax, the cardiovascular and pulmonary systems become stronger and healthier, physical endurance and stamina increase, digestion improves, and mental capacity for concentration and memory are enhanced.

Here are some links to articles with some specific meditation guidelines:

You can read about breath counting meditation here 

You can read about meditation for relaxing and energizing here

You can read about walking meditation here

You can read about labyrinth walking meditation here

You can read about meditation in tai chi here

© 2012 Eric Borreson

Health Benefits of Tai Chi

This is one of occasional articles I plan to write on the health benefits of tai chi. 

I recently read an article titled, A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese. The objective of this study was to " evaluate the effects of Tai chi exercise on balance, sleep quality, and cognitive performance in community-dwelling elderly in Vinh city, Vietnam". It was published in the journal, Clinical Interventions in Aging.

For this study, 96 healthy participants were divided into two groups. The study group was assigned 6 months of tai chi training. The control group was asked to maintain their normal routine.

Now comes the tricky part: understanding the results.

The authors say that the results of the study indicate that the tai chi group improved scores on falls prevention, sleep quality, and the trail making test, a test of motor speed and visual attention, compared to the control group.

Let's look a little closer.

Every study has a control group that they compare with the test group. We need to understand what the control group did. In this case, the control group did nothing. That's a red flag. In other words, the study shows that learning tai chi is better than doing nothing. We know that the controls were already suffering the debilitating results of aging and inactivity. This paper does not show that tai chi is better than other forms of exercise.

Here's why I say that.

This study suffers from many of the problems that some other tai chi studies do. The authors do not give an adequate description of the method of teaching or how much the participants practiced when they were not in class. The study was not clear, but it appears that they learned the Yang 24 form tai chi. It does not show that tai chi is better than weight lifting or aerobic exercise. It does not show that tai chi is better than having the participants go for a morning walk and randomly wave their hands in the air. It shows that getting up and moving is better than sitting around.

One really good thing that this study did show was that the majority of the study group stayed with the program for the entire 6 months. Only 19% of the people dropped out. This indicates that exercise in a group setting was fairly effective at improving health.

My conclusion.

This study was a waste of time and money. There are many high-quality studies that show the health benefits of tai chi. This is not one of them. Always read claims like this with a critical eye.

The entire study can be read at

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396052/pdf/cia-7-185.pdf

© 2012 Eric Borreson

Truths About Tai Chi for Health

Many scientific studies of tai chi have been shown that there are significant medical benefits to practicing tai chi. These studies don't mention the two main obstacles to using tai chi to improve your health. It is our responsibility as teachers to make sure our students understand this early in their practice.

Truth #1 - It takes time

Many people have heard great things about tai chi. They expect wondrous benefits from showing up for class. They are accustomed to the ideas of Western medicine where a doctor gives you a pill and you are better in a few days or weeks at most. When the benefits of tai chi don't miraculously appear after their first class or two, they want to give up.

It is true that many people will start to feel better after a class or two and a couple of weeks of practice. Peacefulness and calmness are common feelings after a beginning tai chi class. However, studies have shown that measurable health benefits really don't show up until the student has practiced for about 10 or 12 weeks. Remember that tai chi doesn't cure anything. Tai chi promotes wellness and helps our bodies move toward their normal healthy status.

When learning tai chi, learning quickly is not necessarily better than learning slowly and deeply. Tai chi has many subtle details that take time to learn. You have to “digest” tai chi. It takes time for it to get into your body and your mind. With each lesson, it is important to practice regularly until that lesson becomes part of you.

Truth #2 - You are responsible

You can't pass the buck. Practice every day. The only way to get the health benefits of tai chi is to practice what you have learned. And guess what? You need to practice for the rest of your life. If you stop practicing, your health will gradually revert to what it was before you started tai chi.

You will have ups and downs to your practice. You will have times where you get bored with it. You have to persevere. Your teacher is a great resource and can help you get over the bumps and through the doldrums.

© 2012 Eric Borreson

Qigong - Strengthening Your Vital Energy

Qigong is part of Traditional Chinese Medicine. One way to translate "qigong" is "exercises to promote the flow of vital energy." There are thousands of exercises and routines that have been used for centuries to promote wellness. This Qigong for Health routine has been developed as a healthy and fun way to revitalize after a stressful day.

I. Warmup

The exercises start by working with your hands. Walk in a small circle, opening and closing your hands, and smile. This gets the blood flowing and your energy moving. Smiling promotes good energy and good feelings.

Feel Your Qi

Start by crossing your arms in front of you with the inside of the wrists near each other, almost touching. Move your arms in slow circles with your wrists moving past each other. Pay attention to any feeling between your wrists. After about 15 or 20 slow circles, turn your hands so that your palms are facing each other. Move your hands very slowly in circles with your concentration on your palms. Pay attention to any feeling between your hands. This exercise activates qi flow through the center of the palm. You will probably start to feel some warmth or tingling between palms. Spend some time "playing" with the energy. Learn to push one hand with the energy from the other.

II. First Set

The first set loosens your joints to get the energy flowing. All exercises start in wu ji posture with your feet about hip’s distance apart. Relax your shoulders and let all the tension go. Center your weight on both feet. Stand with active knees to allow for slow, smooth movements. Use abdominal breathing to encourage deep breathing. This is where you expand your abdomen when inhaling and compress your abdomen when exhaling. Above all, work within your comfort zone.

Loosen the Neck

Head Down. Start with your chin down toward your chest. Inhale and slowly raise your hands in front of you with your palms down. Visualize a balloon lifting each hand. As your hands move, follow the movement with your chin. When your hands reach shoulder height, you should be facing straight ahead. Turn your hands so that your palms are toward your face. Bring in your hands toward your chin and move your chin backward, as if your hands were pushing it back, keeping your head upright. This straightens your spine. Exhale, turn your hands so the palms are forward, and push your palms forward and then down. Allow your chin to follow the hand movements by extending your head forward and bending it down.

Side to Side. Raise one hand to shoulder height in front of your shoulder with your palm facing in. Move your hand out in an arc to the side. Keep your hips still and turn at the waist. Follow the movement by turning your head. Return to center and switch hands. Repeat to the other side.

Loosen the Shoulders

Shoulder Roll. Roll your shoulders forward three times. Stretch your shoulders outward and maintain a small space in your armpit to open up the joint to promote the flow of qi. Then do it again by rolling them backward three times.

Press the Qi. Inhale and bring your hands around from the sides toward your body in a big circle, bending your knees slightly and gathering qi as you move. Exhale and press your hands down in front of you. Imagine gathering qi into your hands from the universe around you. Reach out to expand all the joints in your arms as your move. As you exhale, sink your qi to your dan tien.

Stretch the Spine

Separating Heaven and Earth. Slightly tuck in your chin to straighten your upper spine. Hold your hands in front of you with one hand about chest height and palm down and the other at your lower abdomen with the palm up, as if holding a ball. Separate your hands and inhale, moving one hand palm up over your head and one palm down at your hip. As you inhale, visualize that your spine is a string and you are gently pulling the string from both ends to stretch your spine. Feel your qi flowing up your spine to the top of your head. Pause briefly without moving and feel your spine stretching and the space between the vertebrae opening up. Imagine yourself growing taller. As you exhale, bring your hands back to the center and visualize that your qi is flowing down the front of your body. Repeat to the other side.

Moving the Qi Ball. Hold your hands in front of you, right palm down and left palm up, as if holding a ball. Rotate at the waist in the direction of the top hand. When you reach your limit, reverse your hands and rotate in the other direction. Try to separate the movement of your hips and your waist and keep your hips still. There is no need to turn more than about 45° each way.

Loosen the Hips

Forward & Back. Shift your weight to your right leg and bend your knees slightly. Lift your left leg and extend it forward, touching your heel down. Keep most of your weight on your right foot. At the same time, push your hands back from your sides toward the back. Lift your left leg, bring it back to where you started, and extend it behind you, touching down on the ball of the foot. At the same time, raise your hands in front to about shoulder height. Repeat for a total of three stretches. Repeat on the other side.

Side Stretch. Shift your weight to your right leg and bend your knees slightly. Extend your left leg out to the left and gently touch down. Raise your hands with the palms facing to the right, right hand above the left. Press your hands to the right as if against a wall on your right side. Repeat to the left side.

Strengthen the Legs

Brush Knee. Place them at your waist, palm down. Shift your weight to your right leg and bend your knees slightly. Slowly lift your left foot slightly, place it forward, touch down on your heel, and touch the rest of your foot down. At the same time, shift your weight forward and slowly press your right hand forward while exhaling. Bring your left hand down past your left knee. Keep your back heel flat on the floor so you don’t become overbalanced. Keep your feet apart so you are not “walking a tightrope”. Shift your weight back, pick up your left foot, bring it back, and touch down where you started. At the same time, bring your hand back to your waist while inhaling. Maintain an upright posture to keep your qi flowing properly. Make sure your movements are slow and continuous. Stretch your hip joint from within by keeping your crotch in an arch. Repeat to the other side.

Kick & Punch Forward. Make your hands into loose fists and place them at your waist. Shift your weight to your right leg and bend your knees slightly. Slowly lift your left leg until your thigh is horizontal. Slowly kick out with your left foot. At the same time, slowly punch forward with your right fist while exhaling. Bring your foot back in and touch down where you started. Bring your fist back while inhaling. Focus on slowly, gradually shifting your weight. Repeat to the other side.

III. Second Set

The second set of exercises moves your mind and body into the calming phase.

Balancing Your Qi. Bring your hands to the Dantien, palms up and fingers facing each other. Lift up your hands out and up to chest height while inhaling. Turn palms down, bend your knees slightly, and let your hands move in toward your chest and sink down to the Dantien while exhaling.

Seven Jolts Prevent All the Ailments. This stimulates six of the main qi meridians and balances the flow of qi. Start in Wu Ji. inhale and raise up on your toes, lifting your heels as high as you can. Draw your shoulders back and expand your chest. Exhale suddenly, drop your heels to the floor and relax your entire body. Come back to the beginning position. Optionally, clasp your hands behind your back as you raise your heels.

Open and Close. Feel your qi as in the first set.

IV. Meditation

Meditation is a mental practice used to get beyond the thinking mind into a deeper state of awareness. It is voluntary sensory deprivation. Part of the idea of meditation is to develop concentration so that you can control distractions. Try to keep your mind on a single point of focus. The point of focus could be a short repetitive prayer, one’s breath, a breath count, qi energy flows, or anything else.

© 2011 Eric Borreson

Ten Signs Your Tai Chi for Health Practice is Working

Tai chi training is all about results. Here are some results that you may see because of your tai chi lessons and daily practice.

1. You feel better after your daily practice than you did before you started.

2. People start to notice that your personality has changed for the better.

3. People start to notice that you walk/move differently.

4. You don't get those minor, nagging illnesses that everyone around you shares.

5. You become stronger and more able to do things that you couldn't do before.

6. You start to feel calmer, with more thoughtfulness in your life. You are more able to manage your emotions.

7. You start to feel more creative and can find new solutions to old issues in your life.

8. You have more energy to do daily activities.

9. You look forward to your daily practice.

10. Your healthcare professional notices changes in you.

If you experience any or all of these, it indicates that your tai chi practice is working.

Let me give you an example from my own practice. Somehow, I had cut way back on my tai chi practice for a month or so. I was really busy with other things, I was traveling, I was trying to write, etc. I had lots of excuses.

I could see negative changes in my life because of my lack of practice. In short, I was turning into a couch potato. One thing that was really bothering me was a serious case of writer's block. I had a blog post that just wasn't getting done. I couldn't find the right words to finish it off.

I decided to start practicing again regardless of the excuses. Within three days, I could notice a significant increase in my energy level. My writer's block was gone. Over the weekend, I finished off the problematic article and the next three articles I had planned. I wrote an article for a newsletter. I got a significant start on a magazine article I had been planning to work on. The creative juices were flowing again.

Thanks to Marcus Santer, www.qigong15.com for the inspiration for this article.

© 2011 Eric Borreson

Tai Chi and Fibromyalgia

There was a study published recently in the New England Journal of Medicine showing that tai chi improves the symptoms of fibromyalgia. There is something that we need to keep in mind when reading medical studies. The word "significant" is used to mean that there is a measurable difference between the test group and the control group. However, this word does not mean that the difference is enough to make a difference in the patient's lives. The word "important" means that there is difference that matters to the patients.

For this study, a total of 66 patients with fibromyalgia were divided into two groups. Half the patients (33) were controls and were given wellness education and stretching for the treatment of fibromyalgia. The other half of the patients (33) were placed in a class where they learned classic yang-style tai chi. Both groups met for an hour twice a week.

The primary measured effect was a change in the Fibromyalgia Impact Questionnaire (FIQ) score. According to the authors, the tai chi group had "clinically important improvements in the FIQ total score and quality of life."

This is really important. Fibromyalgia is very difficult to treat and many patients do not feel that get any benefit from Western medicine. Tai chi can really change lives for people with fibromyalgia.

Below is the citation and abstract of the article. (I added some paragraph breaks to make it easier to read.)

Wang, C., C. H. Schmid, et al. "A randomized trial of tai chi for fibromyalgia." N Engl J Med 363(8): 743-54.

BACKGROUND: Previous research has suggested that tai chi offers a therapeutic benefit in patients with fibromyalgia. METHODS: We conducted a single-blind, randomized trial of classic Yang-style tai chi as compared with a control intervention consisting of wellness education and stretching for the treatment of fibromyalgia (defined by American College of Rheumatology 1990 criteria). Sessions lasted 60 minutes each and took place twice a week for 12 weeks for each of the study groups.

The primary end point was a change in the Fibromyalgia Impact Questionnaire (FIQ) score (ranging from 0 to 100, with higher scores indicating more severe symptoms) at the end of 12 weeks. Secondary end points included summary scores on the physical and mental components of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). All assessments were repeated at 24 weeks to test the durability of the response.

RESULTS: Of the 66 randomly assigned patients, the 33 in the tai chi group had clinically important improvements in the FIQ total score and quality of life. Mean (+/-SD) baseline and 12-week FIQ scores for the tai chi group were 62.9+/-15.5 and 35.1+/-18.8, respectively, versus 68.0+/-11 and 58.6+/-17.6, respectively, for the control group (change from baseline in the tai chi group vs. change from baseline in the control group, -18.4 points; P<0 .001=".001" p="p">
The corresponding SF-36 physical-component scores were 28.5+/-8.4 and 37.0+/-10.5 for the tai chi group versus 28.0+/-7.8 and 29.4+/-7.4 for the control group (between-group difference, 7.1 points; P=0.001), and the mental-component scores were 42.6+/-12.2 and 50.3+/-10.2 for the tai chi group versus 37.8+/-10.5 and 39.4+/-11.9 for the control group (between-group difference, 6.1 points; P=0.03). Improvements were maintained at 24 weeks (between-group difference in the FIQ score, -18.3 points; P<0 .001=".001" br="br"> 
CONCLUSIONS: Tai chi may be a useful treatment for fibromyalgia and merits long-term study in larger study populations. (Funded by the National Center for Complementary and Alternative Medicine and others; ClinicalTrials.gov number, NCT00515008.)

© 2011 Eric Borreson

Health Benefits of Tai Chi

There was a recent study published in the European Journal of Applied Physiology that discussed the health benefits of tai chi. The study authors claimed that tai chi significantly increases blood levels of adiponectin.

I had to look up the role of adiponectin. Adiponectin is a hormone that regulates glucose concentrations in the blood stream and the breakdown of fatty acids. It also plays a role in suppressing the metabolic malfunctions that lead to Type II diabetes, obesity, and atherosclerosis. Increased levels of adiponectin correlate with better health.

I'm not sure that this study proves what they claim. They showed that tai chi is better than sitting around. They did not show that tai chi is better than other exercise. Nevertheless, it is good news because it shows that tai chi improves health.

Here is the citation and abstract:

Chang, R. Y., M. Koo, et al. "Effects of Tai Chi on adiponectin and glucose homeostasis in individuals with cardiovascular risk factors." Eur J Appl Physiol 111(1): 57-66.

The aim of this study was to evaluate the acute effect of a single bout of Tai Chi (TC) exercise on adiponectin and glucose homeostasis in individuals with cardiovascular risk factors. Twenty-six individuals (mean age 60.2 years) with at least one cardiovascular risk factor who had been practicing Yang's style TC exercise for at least 3 months were recruited from a regional hospital in Taiwan. A one-group repeated measured quasi-experimental design was used. Participants completed a 60-min Yang's style TC exercise routine including warm up, stretching exercises, and TC followed by a 30-min resting period.

After a 1-week washout period, the same group of participants underwent a control condition in which they were instructed to remain seated for 90 min at the study location. Blood samples were collected both before and after the TC intervention or the sitting condition. The difference between pre-post measurements for adiponectin was 0.58 +/- 1.42 mug/ml in the TC trial and -0.46 +/- 0.99 mug/ml in the sitting trial. The differences between the two trials were statistically significant (P = 0.004). The changes from pretrial to posttrial were significantly greater for glycerol (P < 0.001), cholesterol (P = 0.046), and LDL-C (P = 0.038) in the TC trial compared with those in the sitting trial. Conversely, the changes were significantly lesser for HOMA-IR (P = 0.004), log (HOMA-IR) (P = 0.001), and glucose (P = 0.003) in TC trial compared with those in the sitting trial. In conclusion, a single bout of TC exercise had a significant positive effect on blood adiponectin concentrations in individuals with cardiovascular risk factors.

© 2011 Eric Borreson

Benefits of the Tai Chi for Arthritis (TCA) Program

This week, there are two studies I would like to review that used Dr. Paul Lam's Tai Chi for Arthritis (TCA). Dr. Lam developed his TCA program in the 1990s and it is now being taught all over the world.

First Study
The first study was the largest fall prevention study in the world. It involved 702 people from Australia, with a minimum age of 60 and an average of 69. The majority of the participants were taught TCA. Baseline tests were made and results were measured after a 16-week class that met once a week. Additional results were measured after 24 weeks.

RESULTS: Falls were less frequent in the tai chi group than in the control group. The hazard ratio of time to first fall was 0.67 (P=0.02) after 24 weeks. There were statistically significant differences in changes in balance favoring the tai chi group on five of six balance tests.

CONCLUSION: Participation in once per week tai chi classes for 16 weeks can prevent falls in relatively healthy community-dwelling older people.

For those that want to read the original, see A Randomized, Controlled Trial of tai chi for the Prevention of Falls: The Central Sydney tai chi Trial, Journal of American Geriatric Society: 55.1185-1191, August 2007. The abstract is available free.

Second Study
The second study was from Korea. This study looked at the effect of Tai Chi for Arthritis (TCA) on arthritis pain. Baseline tests were made and results were measured after 12 weeks.

RESULTS: The tai chi group had 35% less pain, 29% less stiffness, 29% more ability to perform daily tasks (like climbing stairs), as well as improved balance and abdominal muscle strength.

CONCLUSION: Older women with osteoarthritis were able to safely perform the base level of TCA and this was effective in improve their symptoms of arthritis, balance, and physical functioning.

For those that want to read the original, see Effects of tai chi exercise on pain, balance, muscle strength, and physical functioning in older women with osteoarthritis: A randomized clinical trial, J Rheumatol September 2003 30(9):2039-2044. The abstract is available free.

© 2011 Eric Borreson

Health Benefits of Tai Chi

This is one of occasional blogs that I plan to write on the health benefits of tai chi. I recently read an article by researchers at Tufts University about how tai chi has been shown to be effective in treating knee osteoarthritis.

One of the authors of this article was Ramel Rones. He is with Mind-Body Therapies, Boston, MA. He has many years of experience with tai chi, martial arts, and medical qigong. He taught a simplified Yang tai chi form used in this study.

The patients were placed in either a tai chi class that met for 1 hour twice a week or another class of wellness education and stretching for a comparable time. The tai chi class consisted of 10 minutes of self massage, 30 minutes of tai chi, 10 minutes of breathing exercises (presumably qigong), and 10 minutes of relaxation (presumably meditation).

After 12 weeks, the patients showed statistically significant improvements in measures of pain, physical movement, and quality of life. After the evaluation at 12 weeks, the patients were encouraged to continue practicing on their own at home.

Additional follow-ups were made at 24 and 48 weeks. After 48 weeks, less than half the patients were still practicing tai chi on their own. The group average pain score worsened after people stopped practicing tai chi. Improvements in self-efficacy and depression continued for the entire 48 weeks.

The authors conclusion about the improvement was that “… synergy between the physical and mental roles likely plays a role. First, tai chi may enhance cardiovascular benefits, muscular strength, balance, coordination, and physical function. All of these are thought to be able to reduce joint pain. Stronger muscles and better coordination improve the stability of the joints and reduce pain. Second, the mind-body component is thought to influence immune, endocrine, neurochemical, and autonomic functioning. Third, controlled breathing and movements promote a restful state and mental tranquility.”

My conclusions: Tai chi has proven health benefits, but the benefits continue only if you continue to practice. It is not a magic pill that can be taken one time to cure illness.

Tai Chi is effective in treating knee osteoarthritis: A randomized controlled trial
Arthritis & Rheumatism (Arthritis Care and Research)
Vol. 61, No. 11, November 15, 2009, pp 1545 – 1553
Chenchen Wang, Christopher H. Schmid, Patricia L. Hibberd, Robert Kalish, Ronenn Roubenoff, Ramel Rones, Timothy McAlindon

© 2011 Eric Borreson

Using Tai Chi to Strengthen Your Immune System (Part 2 of 2)

Stress is known to damage our bodies in many ways. It appears that one of those ways is a weakened immune system. According to WebMd, stress management could be the key that helps calm our bodies and strengthen our immune system. Tai chi is a well-known method of developing a mind-body connection that can invoke the relaxation response and activate the parasympathetic nervous system, which in turn reduces damage caused by stress.

Meditation has been shown to strengthen our immune systems. The mechanism is not entirely clear, but it seems like it is related to stress reduction. Dr. Herbert Benson studied the effect of meditation starting in the late 1960s and into the 1970s. He concluded that meditation relaxes our body and mind. He coined the term “relaxation response” to describe how our body responds to meditation and calms us after a stressful event.

Our nervous system has two parts. The sympathetic nervous system manages the stimulating activities related to the fight-or-flight response when we are under stress. The sympathetic nervous system keeps us alive when we are in danger. The parasympathetic nervous system is responsible for the relaxing activities that calm us down. It is sometimes called the rest-and-digest response because it is responsible for the activities that happen when we are at rest.

Many tai chi teachers (myself included) incorporate meditation as part of the class. This happens for a couple of reasons. Meditation is good for your health by itself. In addition to that, learning tai chi is stressful for beginners. It is difficult to teach our body to move in the slow, precise ways used in tai chi. No one ever pays attention when I tell them to relax and not worry about it. If I put stress into their lives, I want to help them manage it properly.

Tai chi can also be used to directly invoke the relaxation response. The basic principles of tai chi say to breathe deeply, move slowly and continuously, focus on the movement, and imagine moving against a gentle resistance. This is too much for a beginning student to be able to do at first. However, it can happen once a student develops a basic level of knowledge of the tai chi forms.

Regular practice of the forms in a simple set can be used to practice the basic principles of tai chi. This is very helpful in helping the student develop the relaxation response. To the students, it may seem like they are “in the flow”, or “really focused”, or some similar feeling. In tai chi terms, it means they are starting to develop some inner strength and intention. In medical terms, they are developing a mind-body connection and invoking the relaxation response, which activates the parasympathetic nervous system. Be aware that this does not happen immediately as people are learning tai chi. It takes time and practice to develop the feeling.

In part 1 of this article we developed the idea that the movements of tai chi activate the lymphatic system. In this article, we developed the idea that tai chi can be used to invoke the relaxation response. The overall effect of regular tai chi practice is that we are healthier, both physically and mentally, and we just feel better.

© 2011 Eric Borreson

Using Tai Chi to Strengthen Your Immune System (Part 1 of 2)

There is considerable evidence that tai chi and qigong can help strengthen your immune system. It is not always clear what is really happening to your body when you practice tai chi. Doctors don’t claim to fully understand what happens, but they do agree that it helps. One way that tai chi may work is by activating your lymphatic system.

The lymphatic system works by circulating lymph through the body. Lymph is a fluid that carries white blood cells (lymphocytes) from the lymph nodes, through a network of lymphatic vessels, to the interstitial areas around cells.

We normally think of white blood cells being associated with your circulatory system, but they are moved around by your lymphatic system, too. However, there is a big difference between the two systems. There is no heart to pump lymph. Lymph circulates only when the lymph nodes are massaged and compressed. The nodes can be manually massaged by medical professionals, but are normally massaged when you exercise. One of the best types of exercise for this is tai chi.

Lymph is stored in lymph nodes scattered throughout the body. There are concentrations of nodes in your upper chest near where your arms join to your torso, in the center of your chest, in your lower abdomen where your legs join to your torso, and the bottoms of your feet.

The nodes in your upper chest are massaged when you move your arms back and forth and up and down. This happens in many tai chi forms, such as brush knee, white crane spreads wings, repulse monkey, etc.

The nodes in the center of your chest are massaged by deep breathing. Really focus on deep breathing when you are practicing your tai chi.

The nodes in your lower abdomen are massaged when you step, shift your weight, or open your kuas (hips). Tai chi emphasises using the waist to lead the movement. Any tai chi form that involves stepping should have the effect of opening and closing the kuas.

The nodes on the bottom of your foot are massaged when you step forward onto your heel and shift your weight forward, bringing the rest of your foot down on the floor. In the medical field, the term “pedal pump” is used to refer to methods that massage the bottom of your feet to promote drainage of lymph from the lower extremities.

This is the end of part 1. Next week, I will finish this post by describing how the meditative aspects of tai chi also help strengthen your immune system.

© 2011 Eric Borreson

Qigong Benefits Heart Health

From the May, 2006 issue of Journal of Alternative and Complementary Medicine, reported in the Summer 2007 issue of Qi Journal.

Recent studies have concluded that qigong, an ancient technique, may benefit the human heart’s overall health. Practicing qigong lowers the pulse rate, blood pressure, metabolic rates and oxygen demand.

Doctors of a recent study of qigong said, “the qigong group demonstrated greater improvement in psychological measures in addition to reduction in systolic blood pressure.” Note: the article did not specify the qigong exercises used.

Qigong is a 4,000-year-old technique that involves preventative and therapeutic health care, physical training and philosophy. There are nearly 5,000 styles of qigong cataloged by the Chinese Government.

Medical qigong consists of breathing exercises and meditation, which controls energy within the body, which, in turn, replaces stress and anxiety with positive images, increased confidence and enhanced spirit.

Qigong is frequently practiced with Taiji [t’ai chi], a Chinese movement-based exercise. The practice of qigong and taiji is a low-cost means of improving functional status in older persons.

Elderly's Restless Nights Helped By Ancient Martial Art

I recently found an online article that described how tai chi chih has been shown to help with sleeping difficulties. Over half of older adults report occasional or frequent problems sleeping. See http://www.medicalnewstoday.com/articles/112302.php for the full article.

People with sleep difficulties often turn to medication, which leads to side effects or other health problems. A study, published in the journal Sleep, describes how tai chi chih has been tested and shown to help improve sleep. The lead study author was Dr. Michael Irwin, the Norman Cousins Professor of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA and director of the UCLA Cousins Center for Psychoneuroimmunology.

Exercise has been shown to improve sleep. However, older adults may not be able or willing to participate in active exercise programs. Therefore, tai chi chih was selected for a test study. In the study, two groups were compared. One group practiced 20 simple tai chi chih moves. The other group received classes on stress management, diet, and sleep habits.

The study found that the tai chi chih group showed improved sleep quality and a remission of clinical impairments, such as drowsiness during the day and inability to concentrate, compared with those receiving health education. The tai chi chih participants showed improvements in their own self-rating of sleep quality, sleep duration and sleep disturbance.

Dr. Irwin led a previous study that showed that tai chi chih strengthened the immune system of elderly people suffering from shingles. Other studies done at UCLA have shown improvement in control of headaches and that tai chi chih may help in reducing blood pressure.

© 2010 Eric Borreson