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Dynamic and static body postures are a defining characteristic of mind-body practices such as Tai Chi and Qigong (TCQ). A growing body of evidence supports the hypothesis that TCQ may be beneficial for psychological health, including management and prevention of depression and anxiety. Although a variety of causal factors have been identified as potential mediators of such health benefits, physical posture, despite its visible prominence, has been largely overlooked. We hypothesize that body posture while standing and/or moving may be a key therapeutic element mediating the influence of TCQ on psychological health. In the present paper, we summarize existing experimental and observational evidence that suggests a bi-directional relationship between body posture and mental states. Drawing from embodied cognitive science, we provide a theoretical framework for further investigation into this interrelationship. We discuss the challenges involved in such an investigation and propose suggestions for future studies. Despite theoretical and practical challenges, we propose that the role of posture in mind-body exercises such as TCQ should be considered in future research.
PurposeTo examine the effects of a 12-week tai chi program on quality of life and exercise capacity in patients with heart failure. Methods Thirty patients with chronic stable heart failure and left ventricular ejection fraction ≤40% (mean [± SD] age, 64 ± 13 years; mean baseline ejection fraction, 23% ± 7%; median New York Heart Association class, 2 [range, 1 to 4]) were randomly assigned to receive usual care (n = 15), which included pharmacologic therapy and dietary and exercise counseling, or 12 weeks of tai chi training (n = 15) in addition to usual care. Tai chi training consisted of a 1-hour class held twice weekly. Primary outcomes included quality of life and exercise capacity. Secondary outcomes included serum B-type natriuretic peptide and plasma catecholamine levels. For 3 control patients with missing data items at 12 weeks, previous values were carried forward. Results At 12 weeks, patients in the tai chi group showed improved quality-of-life scores (mean between-group difference in change, –25 points, P = 0.001), increased distance walked in 6 minutes (135 meters, P = 0.001), and decreased serum B-type natriuretic peptide levels (–138 pg/mL, P = 0.03) compared with patients in the control group. A trend towards improvement was seen in peak oxygen uptake. No differences were detected in catecholamine levels. Conclusion Tai chi may be a beneficial adjunctive treatment that enhances quality of life and functional capacity in patients with chronic heart failure who are already receiving standard medical therapy.
A systematic review of the literature on the effect of tai chi exercise on blood pressure (BP) was performed. The authors searched Medline, CAB, Alt HealthWatch, BIOSIS previews, Science Citation Index, and EMBASE systems (inception through January 2007); researched Chinese Medical, China Hospital Knowledge, China National Knowledge Infrastructure, and China Traditional Chinese Medicine databases (inception to June 2005); and performed hand searches at the medical libraries of Beijing and Nanjing Universities. Clinical studies of tai chi examining BP as an outcome published in English or Chinese were included. Studies reporting only acute exercise effects were excluded. Data were extracted in a standardized manner and 2 independent investigators assessed methodologic quality. Twenty-six studies examining patients with and without cardiovascular conditions met inclusion criteria: 9 randomized controlled trials, 13 nonrandomized studies, and 4 observational studies. Study heterogeneity precluded formal meta-analyses. Twenty-two studies (85%) reported reductions in BP with tai chi (3–32 mm Hg systolic and 2–18 mm Hg diastolic BP reductions). Five randomized controlled trials were of adequate quality (Jadad score ≥3). No adverse effects were reported. Tai chi exercise may reduce BP and serve as a practical, nonpharmacologic adjunct to conventional hypertension management.
ObjectiveTo assess the effects of a 12-week Tai Chi exercise program on sleep using the sleep spectrogram, a method based on a single channel electrocardiogram (ECG)-derived estimation of cardiopulmonary coupling, previously shown to identify stable and unstable sleep states. Methods We retrospectively analyzed 24-h continuous ECG data obtained in a clinical trial of Tai Chi exercise in patients with heart failure. Eighteen patients with chronic stable heart failure, left ventricular ejection fraction ⩽40% (mean [±standard deviation] age, 59±14 years, mean baseline ejection fraction 24%±8%, mean) were randomly assigned to receive usual care (N=10), which included pharmacological therapy and dietary and exercise counseling, or 12 weeks of Tai Chi training (N=8) in addition to usual care. Using the ECG-based sleep spectrogram, we compared intervention and control groups by evaluating baseline and 12-week high (stable) and low (unstable) frequency coupling (HFC & LFC, respectively) as a percentage of estimated total sleep time (ETST). Results At 12 weeks, those who participated in Tai Chi showed a significant increase in HFC (+0.05±0.10 vs. −0.06±0.09 % ETST, p=0.04) and significant reduction in LFC (−0.09±0.09 vs. +0.13±0.13 % ETST, p<0.01), compared to patients in the control group. Correlations were seen between improved sleep stability and better disease-specific quality of life. Conclusions Tai Chi exercise may enhance sleep stability in patients with chronic heart failure. This sleep effect may have a beneficial impact on blood pressure, arrhythmogenesis and quality of life.
Conventional medical science confirms what Tai Chi masters have known for centuries- regular practice leads to longer life, more vigor and flexibility, better balance and mobility, and a sense of well-being. Cutting-edge research from Harvard Medical School now also supports the long-standing claims that Tai Chi has a beneficial impact on the health of the heart, bones, nerves and muscles, immune system, and the mind. This research also provides insight into the underlying physiological mechanisms that explain how Tai Chi works. Dr. Peter Wayne, a longtime Tai Chi teacher and a researcher at Harvard Medical School, developed the simplified program in this book, similar to protocols that have been scientifically demonstrated to work in a number of clinical trials, and which is suited to people of all ages and can be done in just a few minutes a day. The Harvard Medical School Guide to Tai Chi includes- * The basic program, illustrated by 52 halftones of the author * Practical tips for integrating Tai Chi into everyday activities * A readable introduction to the traditional principles of Tai Chi as viewed through the lens of medical science * How Tai Chi can improve work productivity, enhance creativity, and boost sports performance
Objectives: Chronic low-back pain (CLBP) is burdensome and costly, and a common condition for which adults use integrative therapies. The effectiveness of multidisciplinary integrative approaches has not been well studied. The purpose of this observational study was to compare characteristics and outcomes of CLBP patients treated at the Osher Clinical Center (OCC) versus other clinics at Brigham and Women's Hospital. Design: Observational comparative effectiveness study. Setting: Tertiary care hospital. Subjects: Patients >= 21 years with 3+ months of CLBP or 6+ months of intermittent low-back pain. Intervention: All patients were observed for 12 months. OCC patients received care at the integrative clinic (7.3 visits on average over 13 weeks); non-OCC patients received usual care at other clinics of the same hospital. Outcome measures: Primary outcomes: change from baseline to 6 months in functional status (Roland Disability Questionnaire [RDQ]) and bothersomeness of pain (BOP). Secondary outcomes: change in RDQ and BOP at 3 and 12 months, percentages of patients with clinically meaningful (>= 30%) improvements. Results: One hundred fifty-six OCC and 153 non-OCC participants were enrolled; follow-up was 90.4 and 98.0%, respectively, at 12 months. There were substantial differences in baseline characteristics between groups. For RDQ, the adjusted mean group difference was nonsignificant at 6 months; for BOP, the differences were significant, but clinically small. At 12 months, the observed benefit on RDQ was significant and clinically meaningful; for BOP, there were significant, but clinically small differences. Percentages of patients with >= 30% improvements in RDQ were significantly greater in the OCC group only at 12 months, and both 6 and 12 months for BOP. Conclusions: Baseline characteristics can differ between those who select different sources of healthcare for CLBP. While benefits seen in the OCC versus non-OCC clinics were not large, further evaluation through randomized trials might be warranted to provide a more definitive evaluation.
PURPOSE: A growing number of cancer survivors suffer high levels of distress, depression and stress, as well as sleep disturbance, pain and fatigue. Two different mind-body interventions helpful for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared to usual care, they have never been evaluated in the same study or directly compared. This study will be the first to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. It will also allow for secondary analyses of which program best targets specific symptoms in particular groups of survivors, based on preferences and baseline characteristics.METHODS AND SIGNIFICANCE: The design is a preference-based multi-site randomized comparative effectiveness trial. Participants (N=600) with a preference for either MBCR or TCQ will receive their preferred intervention; while those without a preference will be randomized into either intervention. Further, within the preference and non-preference groups, participants will be randomized into immediate intervention or wait-list control. Total mood disturbance on the Profile of mood states (POMS) post-intervention is the primary outcome. Other measures taken pre- and post-intervention and at 6-month follow-up include quality of life, psychological functioning, cancer-related symptoms and physical functioning. Exploratory analyses investigate biomarkers (cortisol, cytokines, blood pressure/Heart Rate Variability, telomere length, gene expression), which may uncover potentially important effects on key biological regulatory and antineoplastic functions. Health economic measures will determine potential savings to the health system.
OBJECTIVE: To determine the feasibility of a randomized controlled trial of the effect of a tai chi program on quality of life and exercise capacity in patients with COPD.METHODS: We randomized 10 patients with moderate to severe COPD to 12 weeks of tai chi plus usual care (n = 5) or usual care alone (n = 5). The tai chi training consisted of a 1-hour class, twice weekly, that emphasized gentle movement, relaxation, meditation, and breathing techniques. Exploratory outcomes included disease-specific symptoms and quality-of-life, exercise capacity, pulmonary function tests, mood, and self-efficacy. We also conducted qualitative interviews to capture patient narratives regarding their experience with tai chi. RESULTS: The patients were willing to be randomized. Among 4 of the 5 patients in the intervention group, adherence to the study protocol was excellent. The cohort's baseline mean ± SD age, percent-of-predicted FEV1, and ratio of FEV1 to forced vital capacity were 66 ± 6 y, 50 ± 12%, and 0.63 ± 0.14, respectively. At 12 weeks there was significant improvement in Chronic Respiratory Questionnaire score among the tai chi participants (1.4 ± 1.1), compared to the usual-care group (−0.1 ± 0.4) (P = .03). There were nonsignificant trends toward improvement in 6-min walk distance (55 ± 47 vs –13 ± 64 m, P = .09), Center for Epidemiologic Studies Depression Scale (−9.0 ± 9.1 vs −2.8 ± 4.3, P = .20), and University of California, San Diego Shortness of Breath score (−7.8 ± 3.5 vs −1.2 ± 11, P = .40). There were no significant changes in either group's peak oxygen uptake. CONCLUSIONS: A randomized controlled trial of tai chi is feasible in patients with moderate to severe COPD. Tai chi exercise as an adjunct to standard care warrants further investigation. (ClinicalTrials.gov registration NCT01007903)