Tai chi

(ty chee) Is A form of Traditional Chinese Medicine practice with mind/body exercise and meditation that uses slow sets of body movements and controlled breathing done to improve balance, flexibility, muscle strength, and overall health.

Taoist Tai Chi demo

Background

Tai chi and qi gong are centuries-old, related mind and body practices. They involve certain postures and gentle movements with mental focus, breathing, and relaxation. The movements can be adapted or practiced while walking, standing, or sitting. In contrast to qi gong, tai chi movements, if practiced quickly, can be a form of combat or self-defense.

Science

Research findings suggest that practicing tai chi may improve balance and stability in older people and those with Parkinson’s, reduce pain from knee osteoarthritis, help people cope with fibromyalgia and back pain, and promote quality of life and mood in people with heart failure and cancer. There's been less research on the effects of qi gong, but some studies suggest it may reduce chronic neck pain (although results are mixed) and pain from fibromyalgia. Qi gong also may help to improve general quality of life.

Both also may offer psychological benefits, such as reducing anxiety. However, differences in how the research on anxiety was conducted make it difficult to draw firm conclusions about this.

Falling and Balance

Exercise programs, including tai chi, may reduce falling and the fear of falling in older people. Tai chi also may be more effective than other forms of exercise for improving balance and stability in people with Parkinson’s disease.

• A 2012 review determined that tai chi, as well as other group- and home-based activity programs (which often include balance and strength-training exercises) effectively reduced falling in older people, and tai chi significantly reduced the risk of falling. But the reviewers also found that tai chi was less effective in older people who were at higher risk of falling.
• Fear of falling can have a serious impact on an older person’s health and life. In a 2014 review, researchers suggested that various types of exercise, including tai chi, may reduce the fear of falling among older people.
• Findings from a 2012 clinical trial with 195 people showed that practicing tai chi improved balance and stability better than resistance training or stretching in people with mild-to-moderate Parkinson’s disease. A 2014 followup analysis showed that people who practiced tai chi were more likely to continue exercising during the 3 months following the study compared with those who participated in resistance training or stretching.

For Pain (knee osteoarthritis, fibromyalgia, chronic neck pain, back pain)

There’s some evidence that practicing tai chi may help people manage pain associated with knee osteoarthritis (a breakdown of cartilage in the knee that allows leg bones to rub together), fibromyalgia (a disorder that causes muscle pain and fatigue), and back pain. Qi gong may offer some benefit for chronic neck pain, but results are mixed.

Women practicing Tai Chi in New York City

Knee Osteoarthritis

• Results of a small NCCIH-funded clinical trial involving 40 participants with knee osteoarthritis suggested that practicing tai chi reduced pain and improved function better than an education and stretching program.
• An analysis of seven small and moderately-sized clinical studies concluded that a 12-week course of tai chi reduced pain and improved function in people with this condition.

Fibromyalgia

• Results from a small 2010 NCCIH-supported clinical trial suggested that practicing tai chi was more effective than wellness education and stretching in helping people with fibromyalgia sleep better and cope with pain, fatigue, and depression. After 12 weeks, those who practiced tai chi also had better scores on a survey designed to measure a person’s ability to carry out certain daily activities such as walking, housecleaning, shopping, and preparing a meal. The benefits of tai chi also appeared to last longer.
• A small 2012 NCCIH-supported trial suggested that combining tai chi movements with mindfulness allowed people with fibromyalgia to work through the discomfort they may feel during exercise, allowing them to take advantage of the benefits of physical activity.
• Results of a 2012 randomized clinical trial with 100 participants suggested that practicing qi gong reduced pain and improved sleep, the ability to do daily activities, and mental function. The researchers also observed that most improvements were still apparent after 6 months.

Chronic Neck Pain

Research results on the effectiveness of qi gong for chronic neck pain are mixed, but the people who were studied and the way the studies were done were quite different.

• A 2009 clinical study by German researchers showed no benefit of qi gong or exercise compared with no therapy in 117 elderly adults (mostly women) with, on average, a 20-year history of chronic neck pain. Study participants had 24 exercise or qi gong sessions over 3 months.
• In a 2011 study, some of the same researchers observed that qi gong was just as effective as exercise therapy (and both were more effective than no therapy) in relieving neck pain in the 123 middle-aged adults (mostly women) who had chronic neck pain for an average of 3 years. Exercise therapy included throwing and catching a ball, rowing and climbing movements, arm swinging, and stretching, among other activities. People in the study had 18 exercise or qi gong sessions over 6 months.

Back Pain

• In people who had low-back pain for at least 3 months, a program of tai chi exercises reduced their pain and improved their functioning.

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Tai Chi in Hong Kong

For Mental Health and Cognitive Function

While a range of research has suggested that exercise helps reduce depression and anxiety, the role of tai chi and qi gong for these and other mental health problems is less clear. However, there is evidence that tai chi may boost brain function and reasoning ability in older people.

• NCCIH-supported research suggested that practicing tai chi may help reduce stress, anxiety, and depression, and also improve mood and self-esteem. However, in their 2010 review, which included 40 studies with more than 3,800 participants, the researchers noted that they couldn't develop firm conclusions because of differences in study designs.
• In a 2010 NCCIH-supported review, researchers found that the results from 29 studies with more than 2,500 participants didn't offer clear evidence about the effectiveness of tai chi and qi gong on such psychological factors as anxiety, depression, stress, mood, and self-esteem. But the researchers noted that most of these studies weren't looking primarily at psychological distress and didn't intentionally recruit participants with mental health issues.
• Results from another NCCIH-supported review published in 2014 suggested that practicing tai chi may enhance the ability to reason, plan, remember, and solve problems in older people without evidence of significant cognitive impairment. The data also indicated that tai chi boosted cognitive ability in people who showed signs of mild cognitive impairment to dementia, but to a lesser degree than in those with no signs of cognitive impairment.

For Quality of Life

Much research suggests that physical activity enhances quality of life. Health providers who treat people with cancer often recommend exercise to reduce illness-related fatigue and improve quality of life. Some studies also suggest that physical activity helps people with heart disease and other chronic illnesses.

Cancer

Research results indicated that practicing qi gong may improve quality of life, mood, fatigue, and inflammation in adults with different types of cancer, compared with those receiving usual care. However, the researchers suggested that the attention received by the qi gong participants may have contributed to the positive study findings.

Heart Disease

• Regular practice of tai chi may improve quality of life and mood in people with chronic heart failure, according to a 2011 clinical trial funded by NCCIH.
• Results from a small study suggested that practicing tai chi improved the ability to exercise and may be an option as cardiac rehabilitation for people who have had a heart attack.

Other

A 2010 NCCIH-supported research review examined the effects of tai chi and qi gong on the quality of life of adults who were healthy, elderly, were breast cancer or stroke survivors, or had a chronic disease. The analysis suggested that practicing tai chi or qi gong may improve quality of life in healthy and chronically ill people.

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Seated Tai Chi

Science

Tai chi and qi gong appear to be safe practices. One NCCIH-supported review noted that tai chi is unlikely to result in serious injury but it may be associated with minor aches and pains. Women who are pregnant should talk with their health care providers before beginning tai chi, qi gong, or any other exercise program.

Training, Licensing, and Certification

Tai chi instructors don’t have to be licensed, and the practice isn't regulated by the Federal Government or individual states. There’s no national standard for qi gong certification. Various tai chi and qi gong organizations offer training and certification programs—with differing criteria and levels of certification for instructors.

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