Back to a serious note for a sec.....
Do you find that the success rate is so low because many patients have an emotional investment in their condition, as you have mentioned concerning Fibromyalgia, but in this case I refer to actual injuries?
Printable View
well, as far as actually gauging "success rate" overall, I really don't have any concrete numbers - first, you'd have to define success, then you'd have to keep track longitudinally, because theoretically what you fixed should stay fixed over time, barring any other untoward event - but that's really hard to determine if they have symptom return, what it was due to exactly (that's why when people post here that they have a 90% + success rate, I have serious doubts about that - it would imply a level of record keeping that would almost preclude having time to treat)
BUT ANYWAY...
in terms of FM specifically, I'd consider my "cure" rate non-existent, although my "success" from day-to-day in terms of flair-up control was pretty good - maybe ~70%? but that's a guesstimate at best; in regards to that specific pop, I'd say that to a not insignificant extent there is a large percentage of investment in their condition, and indeed the nature of the condition - chronic inflammatory state / hyper-stimulated immune response - is highly conducive to an emotional piece - nothing surprising there, of course; from personal experience, the few times I had someone w/FM walk out of my office essentially pain-free, the rebounds were always the worst; as I got more savvy, I mediated my treatments so that it was a gradual progression; of course, sooner or later something would "happen" and they'd ended up in crisis, largely because of poor self-management ability (despite my having worked on that with them); overall, I dislike treating FM, because it's really more about figuring out how not to enable someone's self-sabotage mechanism then it is about clinical management: you get a small window until they figure out how to "beat" you and add you to their list of failed therapists (my style towards the end of when I was working w/this pop was to ask them day one why they thought that I was going to be able to help them after they had been to so many other people w/out result - that at least got that reality out in the open and gave us some chance of defining realistic goals and create an exit strategy for me);...this population was typically suburban house-wives with crappy lives...
now in the case of chronic pain that was not FM, the people I can think of who did the best were the ones who self-managed well - these were people who had specific injuries that had not gotten better over time and were ever-present (often activity dependent) or that flared-up routinely; typically, these were people not invested in their pain, their lives didn't revolve around it, they wanted to be functional, maybe too much; for them, getting them pain-free was about clinical skill, finding the right thing and fixing it, then teaching them how to head re-injury off at the pass; this population was typically career-oriented Manhattan types: smart, driven, motivated to get better; many of these patients would get to the point where they were very good at telling the difference between the kind of pain that they could self-manage, and the kind that they need to come see me about, the frequency of the latter typically diminishing over time (yay)
the easiest were people coming in w/fresh / new injuries that hadn't had time to become entrenched in the system's compensatory mechanism: that was just a question of getting rid of the pain and normalizing the specific structure in question and making sure they didn't re-injure;
for me, the way around placebo effect is simple: I find something, anything really, that a patient can't actively do w/out having pain or stiffness: raise an arm, bend forward, turn their head one way, etc.; I make it very clear to them and make sure they know exactly what I am noting as dysfunctional - no illusions, it's right there; then I treat it; and then we re-test - and then they feel /see the difference; so it's about concretely establishing the change; and the less I talk the better (can you imagine that?!?), the faster I do it the better, almost so that they don't know what's happening - that is what, to me, helps avoid the placebo bit;
the opposite is someone who comes in and says, first thing, "I want you to do technique 'x' (usually cranial work, LOL) to me, because I know that's going to fix my problem"; well, I can go along w/the charade (I've done it, not recently though), or I can try to get them to agree to letting me do something else...ugh...
Thank you for the response.:)
20 years ago, I worked as the fitness trainer at a physical therapy/occupational health facility. I mostly set up training programs for the fitness club members and supervised weight training for the patients that were transitioning to a maintenance weight training program. I noticed a tendency for co-dependence to develop between the PT's and their patients!
Of course that happens a lot in my field too!
----------------
Now playing: Simon and Garfunkel - The Only Living Boy In New Yor
via FoxyTunes
----------------
Now playing: Simon and Garfunkel - The Only Living Boy In New Yor
via FoxyTunes
While I agree en toto, the lineage based system had too much abuse and was abused so the reformulation into the TCM of the past 50 years! with anatomical and physiological principles, is still valid up to a point. Even the lateral usage of Clasical Chinese Medicine is a stretch due to abuses on that side also but I do agree caution is the best strategy in acceptance.Quote:
Originally Posted by taai gihk yahn
As you know, acording to the historical record, acupuncture was banned at least 3 times? during the Qing due to secrecy, agendas, lack of professional acupuncturists, unsanitary practices of location and person and I believe that without this reformulation, TCM would have died a slow death.
You mention EBM and you must have seen studies with placebo points showing efficacy! Is it the voice or the person with compassion entering the sensory magnetic field of the sick person and healing, OR, is it the power of the eyes of the healer, OR, the touch that clears imbalances of the energy field! One of my teachers had some knowledge of Daoist Acupuncture (I am ignorant of the extent) but most of its objective tools would be laughed and ridiculed since its tools cannot be measured or even placed on an objective reality basis.
I had a small class with 6 people who had sarcodosis (they use to work in a coal mine-retired) and on a few occasion I put my hand on the shoulder of one fellow
who could not feel anything and his skin was usually hard to the touch. He shouted "God d*mm" your hands are on fire". At which point I was shocked that his awareness was such. Stuff like that cannot be quantified and if it was, it would be discounted as BS!
not quite sure about the overall point(s) you are trying to make, or if you are just sharing some anecdotes; as far as TCM being preferable to the older system, I'm not saying it is or isn't, but just that TCM itself is a recent construct, so it can hardly be used as a means by which to examine Chinese medicine as such over the last few millennia;
as for the whole "placebo" thing - I think that this "effect" is indicative of the organism's innate capacity, given just about any sort of impetus, to move towards homeostasis; meaning that, any kind of "healing" interaction, be it touch, acupuncture, verbal, etc. can be used by the system as an external fulcrum, of sorts, to leverage itself towards intrinsic balance (e.g. - regulation of ANS being a big piece of it); and that is fine, and I certainly try to capitalize on that effect when treating, but not as the prime mover of what I do;
that said, when researching a technique that necessarily is dependent upon operator skill, one faces the challenge of accounting for this generalized effect; with a bit of foresight, I think that this is possible, but one has to be rather skilled as a researcher to do so effectively and consistently; it also means you cannot be personally or professionally vested in the outcome, as it is too easy to bring this bias into play as a determining factor;
in retrospect, I find it borderline negligent that at no point during my schooling were we ever taught about transference and counter-transference, which, given the nature of the typical PT / client interaction, is a major issue to consider!
and yeah, many PT's need that co-dependency thing to feel good about themselves; some I know actually get romantically involved w/their clients, which I personally find unethical and just a little pathetic (although one guy I know used to get with any female relatives of patients that he could, which I find to be resourceful...)...
This entire sequence you've provided with Scott has more information - real information - on your field in a few pages than I have ever seen in total. In particular, you tie into taiji with:
"......because it's movement guys, get over it: intentioned, conscious, parasympathetic activating movement, often with 80 to 100% weightbearing on a single lower extremity, which, among other things, is going to have a big impact on lymphatic drainage of the lower quarter and balance capacity will improve dramatically as well, especially in the group most studied for that effect, namely geriatric population, which is going to stand to have the most dramatic statistical gains in balance because they are in general doing poorly in that area to begin with;
and it's social - show me it gets the same effects if people were made to practice alone instead of in a group, that would be surprising..."
I realize your real issue is with research and related findings; but the information is very detailed.
Thanks!
Haven't chased down the original source, but I don't think I'm going to in this case...
Quote:
Dorothy’s Story: Tai Chi gave me a purpose
August 10, 2009 by JBBC
I came across the story of Dorothy and her experience with Tai Chi on the Real Women, Real Advice blog. Dorothy says when she received her breast cancer diagnosis, it felt like a death sentence. At the age of 66, she had already retired and was looking forward to teaching and spending time with her grandchildren. Cancer has a way of divorcing the mind from the body. It is hard not to feel betrayed by something that has turned against you. Dorothy turned to her love of tai chi to get her through the fight of her life.
Tai chi is often described as “meditation in motion” because it promotes serenity through gentle movements–connecting the mind and body. Simply watching graceful movements of people gliding through dance-like poses as they practice tai chi is relaxing. Along with reconciling her mind and body, Tai chi enabled Dorothy to have a purpose in life, “It gave me positive movement.”
At close to eighty years of age, Dorothy continues to be an inspiration to other women with a diagnosis of cancer and says: “Being a 13-year breast cancer survivor, I feel very blessed. There’s so much hope now compared to when I went through the treatment. I feel that I’m still here for a reason – to help other victims of breast cancer.”
I met Douglas at the Zhang San Feng Festival earlier this year. He's really made his name on World Tai Chi day. There's a review of that ZSF in our current issue (Sep Oct 2009).
Quote:
KC tai chi master Bill Douglas is taking his case to D.C.
By JAMES A. FUSSELL
The Kansas City Star
Bill Douglas has two words for a country desperate to cut its skyrocketing health care costs.
Tai chi.
He’s not kidding.
“If you look at a Kaiser Permanente study that says that 70 percent of illnesses are caused by stress, you’re talking about a potential savings of trillions of dollars, year after year if we teach our citizens effective stress-management techniques on a massive scale.”
For decades Douglas has believed that the regular practice of the Chinese martial art, meant to unblock the flow of energy though the body, can be used to treat and even prevent a wide range of illnesses.
The medical world is beginning to agree with him.
In a few weeks, Douglas will give a presentation to the National Institutes of Health focusing on tai chi as a modern health solution, the first ever. And thanks to what he calls a “groundbreaking tectonic shift in health care,” he’s taking some persuasive ammunition with him: a stamp of approval from Harvard Medical School.
The May 2009 Harvard Health Publication said that tai chi, often described as moving meditation, should more aptly be called moving medication.
Douglas is the 52-year-old tai chi instructor who started World Tai Chi Day 11 years ago in Kansas City; the celebration is now observed in more than 65 countries.
Taiji is based on achieving a fullness of internal energy, breath, and spirit. Wudang Kung Fu contains profound Chinese philosophical theories, combining the traditional concept of Taiji, Yin and Yang, Wuxing and the Bagua.
Wudang Taiji Quan is based on achieving a fullness of internal energy, breath, and spirit. While practicing, the eight kinds of body awareness that Wudang Taiji Quan stresses are; lightness, easiness, roundness, evenness, flexibility, changeableness, steadiness and precision.
The motto for practice is: to be relaxed, complete, well-timed, and swift. Wudang Taiji requires one to be hard and strong inside, round and smooth outside and to strike out quickly, so fast that the opponent does not have the time to react. Move like the waves of the Yangzi River flowing to the ocean, one after another, never stopping.
Welcome Fabia!
This reminds me of slightly of our 2006 March/April cover Jonathon Miller. The hospital angle is nice.
Quote:
Hospital CEO takes tai chi as medicine
BY CARRIE MACMILLAN | REPUBLICAN-AMERICAN
How does a chief executive officer release stress? Waterbury Hospital's John Tobin trades his business suit for a silk jacket with an embroidered dragon. He picks up a shiny steel saber and practices the ancient Chinese martial art of tai chi.
Created centuries ago as a form of self-defense that channels one's "chi," or internal energy, for smooth and fluid movements, tai chi is now practiced by millions worldwide. In the West, it is usually a combination of yoga and meditation, a "soft" martial art that uses internal power, as opposed to "hard" forms like kung fu that use external power. It is believed to improve one's balance, flexibility and stability. Tai chi can be learned at any age, and is especially popular with seniors because the movements can be modified and even done from a wheelchair.
On Tuesday, Waterbury Hospital will offer members of Evergreen Club 50, a wellness organization for adults 50 and over, a preview of an upcoming 10-session tai chi class. Tobin, along with the class instructor, Pierce Reignier from Stillwater Meditation Center in Wolcott, will demonstrate moves and talk about the physical and mental health benefits of tai chi.
It's a side of Tobin, who has been CEO at Waterbury Hospital for 22 years, few know. At the many board meetings, banquets and concerts he attends, acquaintances are more likely to hear about how the city's largest employer is weathering the tough economy than about how a sense of introspection enables him to listen to what others are saying.
Good article. Glad progress is being made here.
I always wonder what kind of tai chi they are doing...
Quote:
UF study: Tai chi can help people with diabetes lower glucose levels
Filed under Health, Research on Wednesday, September 30, 2009.
GAINESVILLE, Fla. — A regular tai chi exercise program can help people better control their diabetes and lower glucose levels, according to a University of Florida study.
In a study of adults diagnosed with type 2 diabetes, those who participated in a supervised tai chi exercise program two days a week with three days of home practice for six months significantly lowered their fasting blood glucose levels, improved their management of the disease, and enhanced their overall quality of life, including mental health, vitality and energy.
“Tai chi really has similar effects as other aerobic exercises on diabetic control. The difference is tai chi is a low-impact exercise, which means that it’s less stressful on the bones, joints and muscles than more strenuous exercise,” said Beverly Roberts, the Annabel Davis Jenks endowed professor at the UF College of Nursing.
Roberts, with Rhayun Song, of Chungham National University, studied tai chi’s effect on older Korean residents. The research was featured in the June issue of The Journal of Alternative and Complementary Medicine.
About 23.6 million children and adults in the United States, or 7.8 percent of the population, have diabetes. It occurs when the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.
Risk factors include obesity, sedentary lifestyle, unhealthy eating habits, high blood pressure and cholesterol, a history of gestational diabetes and increased age, many of which can be reduced through exercise.
“People assume that for exercise to be beneficial you have to be huffing and puffing, sweating and red-faced afterward,” Roberts said. “This may turn people off, particularly older adults. However, we have found that activities like tai chi can be just as beneficial in improving health.”
Tai chi is an ancient Chinese martial art that combines deep breathing and relaxation with slow, gentle circular movements. This low impact exercise uses shifts in body position and stepping in coordination with arm movements.
Sixty-two participants, mostly Korean women, took part in the study. Half the group participated in at least 80 percent of two supervised sessions one hour per week, with three days of home practice for six months, and the other half served as a control group. Those who completed the sessions had significantly improved glucose control and reported higher levels of vitality and energy.
“Those who participated in the tai chi sessions actually had lower blood glucose at three and six months,” Roberts said. “Those individuals also had lower hemoglobin A1c, which means they had better diabetic control.”
In addition to improved blood glucose levels, participants also reported significantly improved mental health. This was very encouraging especially since people with less depression are typically more active and independent, Roberts said.
Tai chi has also been used for people with arthritis and disabilities to increase balance, muscle strength and mobility and to reduce the risk of falls. It is worth investigating its effects in other conditions, especially in older people, Roberts said.
“Tai chi provides a great alternative for people who may want the benefits of exercise on diabetic control but may be physically unable to complete strenuous activities due to age, condition or injury,” Roberts said. “Future studies could examine if tai chi could similarly benefit conditions such as osteoporosis or heart disease.”
Since tai chi is an exercise that involves so many parts of the body and also helps to relax the mind, it is more likely participants will adhere to the exercise, said Paul Lam, a lecturer with the University of South Wales School of Public Health and Community Medicine and a practicing family physician in Sydney, Australia.
“This study shows that tai chi can have a significant effect on the management and treatment of diabetes — a significant and growing health challenge for all Western countries,” Lam said.
I think if you have someone who does absolutely no exercise with diabetes, then have them do exercise, it will of course be better in all areas.
Obesity, Heart disease, high cholesterol, hypertension, metabolic syndrome, and diabetes is all helped by regular exercise. And it can be as simple as walking, not Tai Ji Quan.
My wife and I walk 2 miles every morning and 6 miles on Saturday. I have lost a little weight over the past few years and am willing to eat less meat in my diet now. Shortly, we will make one of the few trips a year we do for ourselves to get away; we will go walking in the woods for two days over the weekend now that it is cooling off somewhat. So our main entertainment for the entire year consists of doing something good for us both.
Unfortunately walking ( and other exercise efforts) are BORINGGGGGGG! We have been walking together off and on for over 40 years.
What has changed for me, the difficult one to get out the door, eat right, etc..... is that at about 3 years of taiji practice I found that being old, fat and slow was a considerable "hindrance" (sp?). That CMA wannabe in my mind was not keeping up with my desire to advance by just being in so-so shape.
Taijiquan is not boring! What taiji has to offer is something the old, fat, slow, guys can do that is good for them, and is not boring! Of course ladies - young, old, whatever - will do yoga, jazzersize, ride a stationary bike, taijiquan or the latest Oprah recommendations... they will put up with boring for health benefits.
But me? Already been there and done all the other stuff, lifted weights, tae kwon do, running - nothing stuck over the long term but taiji has.
Just my 2 cents worth....
Skip,
Its best to walk 5 miles a day - schedule 2 half hour walks for yourself twice a day, or wear a good pedometer and go for 10000 steps a day.
Eat a largely dark green leafy vegetable diet with 2 ounces of protein and some fats/oils, with fruits, nuts.
Avoid processed foods, hidden sugars, artificial stuff, preservatives.
Boring or not, walking is the king of all exercises. I say walk in a mall, in a new place, in a crowded outdoor area, you'll never find it boring.
Tai Ji is good, but does little for your cardiovascular system (except maybe for Chen style done in high reps) and hardly burns the calories. Its fun and varied, but diet and exercise are the pillars to good health. Look at Tai Ji as a way to vary your time with a healthy lifestyle.
Hey Robert;
Yep, I agree with all of that..... but I look at taiji as encouraging me to get out and walk to train for taiji..... or I would not be out walking at all... again....
It's not an either/or situation for me, it's both.... And also, while at 61 my mind has not quite vegetated yet, I notice the not-boring part engaging the minds of older students in their '70's and '80's to be a very good thing.....
Again, I'd like to know what form of tai chi exactly...
Quote:
Tai Chi May Be An Effective Treatment For Dizziness, Balance Issues
ScienceDaily (Oct. 5, 2009) — Tai Chi, a form of Chinese martial arts often practiced for its health benefits, may be an effective treatment option for patients who suffer from dizziness and balance disorders (also known as vestibular disorders).
In a paper presented at the 2009 American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO in San Diego, researchers evaluated the utility of Tai Chi in managing patients with vestibular symptoms who have failed conventional vestibular therapy. It could include individualized physical therapy or different sets of physical maneuvers that a doctor performs on a patient.
Researchers conducted a questionnaire study from April 2008 to March 2009 at an outpatient rehabilitation program, utilizing the activities-specific balance confidence scale and dynamic gait index survey, both prior to therapy and at the conclusion of an eight-week course. A total of 21 patients (18 females, 3 males) completed the study to date. Patients reported subjective improvements in their vestibular symptoms.
Researchers theorize that the technique may be effective because Tai Chi promotes coordination through relaxation, rather than muscular coordination.
I was a PhD candidate in psych. APA format still haunts me... :o
Quote:
Complementary and Alternative Therapies ResearchReview - Complementary and Alternative Therapies Research
by Tiffany Field
American Psychological Association, 2009
Review by Roy Sugarman, Ph.D.
Oct 13th 2009 (Volume 13, Issue 42)
So much for these therapies being 'flakey'. Dr Field is a serious and acknowledged researcher in the field, and holds appointment and has received awards in and from prestigious universities and societies, as well as publishing hundreds of journal articles, and many books, of which this is the latest.
She thus sets about demonstrating the evidence base for therapies that can be combined with psychotherapy, and the evidence for the success or lack of it in doing so.
In this way, she takes on Massage therapy, Acupressure, Reflexology, Acupuncture, Tai Chi, Chi Gong, Yoga, Pilates, Exercise as a whole, Music Therapy, Aromatherapy, Progressive muscle relaxation, Imagery, Hypnosis, Biofeedback, Meditation, and so on, including what works in children. Elsewhere in the book , she looks at resources for complementary medicine, training and credentialing of therapists, what works for what illnesses or conditions, and the origins of the therapies above as an alternative or complementary set of approaches.
Suffice it to say it's a thinnish book, despite being thorough. She notes she could only find two decent studies on combining complementary therapies with psychotherapy, specifically in depression. These two studies cover CBT and mindfulness, and interpersonal therapy combined with massage therapy. There are a myriad of lighter weight studies and concepts examined, such as light music or incense/oil burners in a therapy room, through to movement or massage being incorporated, or being practiced at a separate venue. Many of the subjects examined in the book, as listed above, are already part of many standard approaches to psychological intervention, such as relaxation, hypnosis and biofeedback to name a few.
She spends some time on the origins of complementary and alternative therapies, eg Ayurvedic medicine (not much research) and Chinese medicine ( a lot of evidence in many conditions) , Shamanism (weakest support of all approaches for efficacy), Homeopathy (highly individualized, with contradictory results), Native American Medicine (no standardized data, but high acceptance in 80% of patients), Naturopathy (individualized, but with seemingly good results in some conditions, studies not scientific though), Osteopathy (hard to evaluate as it is conventional medicine-friendly, but more expensive), Chiropractic (only modest evidence despite widespread acceptance in nonjoint problems) and so Field must conclude that although most of the evidence is from Zero impact journals, or in non-English speaking journals, there is good evidence to support many alternatives to the standard approaches, and many are highly effective in certain conditions.
Massage therapy in particular has been shown to enhance the activity of the Vagal system, leading to a decrease in the stress hormone cortisol, and perceived stress, changes in the EEG, higher dopamine and serotonin levels versus lower epinephrine and cortisol levels, and with applications in pre and post natal depression, borderline personality disorders, bulimia, smoking cessation, anorexia nervosa, pain syndromes with evidence of lowered substance P measures, lower adrenergic levels, and in headaches, a good response to migraine as well. MS and Parkinson's patients also declared benefits, as did those with objective measures of wellbeing in hypertension, CVD, the immune system in cancer patients, and in HIV patients. There are successful findings in sport and injury as well, as expected, and acupressure and reflexology are also examined here.
Acupuncture in particular longer duration manual acupuncture, has been demonstrated to have the most effect on different parts of the brain. The only problem is that sham procedures often produce significant brain effects as well. As the world overall accepts, placebo is a real effect, not psychological, but accompanied by brain changes. In this way, some forms of acupuncture are effect irrespective of where the needles are placed, eg in auricular acupuncture in smoking cessation, but in others, e.g., cocaine users, only in the 'correct' locations. Similarly, outcome expectations will also affect results. There is apparently a correlation between acupuncture and local nitrous oxide levels, and patients with fibromyalgia may benefit. Neck pain and back pain may benefit. Evidence in more severe musculoskeletal conditions and neurological disorders is scarce and contradictory. Some effects in ulcerative colitis may be noteworthy, but moxibustion may also help in such cases (little dirt cones piled on acupuncture sites).
Movement such as that in Tai Chi and Chi Gong is expected to work, given our sedentary lives, and it does. Blood pressure, cholesterol levels, heart rate, aerobic measures, EEG, pain, osteoporosis, immune conditions such as HIV and cancers all show changes along with the obvious physical benefits. Age is not immune, and so in one study at least, older Tai Chi practitioners (and Golfers!) were able to compare performances with young university students in reaction times and leaning flexibility. Chi Gong has less impressive characteristics, but there is some evidence.
Yoga appears to increase vagal activity and reduce cortisol, and can improve various medical conditions such as pain, migraine, insomnia, hypertension and so on. Anxiety, depression, sleep, all show improvements. A host of conditions respond to yoga and Pilates.
The benefits of exercise are well known, and accepted, and there is an emerging trend in books anyway from authors such as John Ratey that the benefits to both body and brain are extensive and way in excess of what has been traditionally accepted to be the case.
Music therapy has also received attention, increasing blood flow in reward and arousal areas of the brain, and with a role in anxiety, depression, and a large number of more serious mental conditions. The list of conditions here studied is really large, more so than exercise for instance. T cells and killer cells increase, cortisol decreases and so on, as for other interventions, but in some ways, for many more conditions across the board.
Field continues in this vein for the treatments noted above, demonstrating in each case the benefits of each intervention as studied in various conditions.
Interestingly, the human responses are not just in certain conditions, but in multiple, suggesting this less targeted approach is universally better for the body and brain complex. However, whilst medicine may target individual complaints or conditions, there appear to be benefits in some conditions and not others, but mostly, intervening for one thing may improve other things in a single person.
Many of the interventions are highly personalized, and with the entire field of personalized medicine, one size fits all randomized control studies may not be possible, as in homeopathy for instance.
Field has done extensive work with touch, and this is evidenced in the chapter on children, a small but compelling one. Evidence is presented for glucose levels and peak airflow in particular that is most impressive. The role of exercise in children, especially in a new generation of sedentary indoor kids, is well established, and her results as presented here are accepted widely. The most frequent intervention in children was in those with autism and attentional disorders, with nearly all being supplemented with some complementary or alternative intervention.
Field has produced a sound and comprehensive work, arguing impassively for consideration to be given to complementary and alternative approaches to most conditions, with few exceptions, but with some reservations mentioned in some treatments noted above. She has produced a very welcome and useful work, for things to do when what you do is not working entirely as you want it, and as a way of empowering patients to do more, and safely so. For overall, there is virtually not a word given to side effects and very few to contraindications, hence, the popularity of many of these interventions.
Sham acupuncture is a sham! If you put anything over an acupuncture point, it will get stimulated.
APA and AMA standards are the accepted, but human beings can get well in other means than just chemical or surgical means.
One of my favored sources of studying TCM:
http://www.osher.hms.harvard.edu/default.asp
http://www.osher.hms.harvard.edu/research.asp
http://www.osher.hms.harvard.edu/fil...blications.doc
Division Directors
David M. Eisenberg, MD
Director, Harvard Medical School Osher Research Center
Bernard Osher Associate Professor of Medicine
Beth Israel Deaconess Medical Center
Program Director, Integrative Medicine
Brigham and Women's Hospital
Sally M. Andrews, BA, MBA
Executive Director
Julie E. Buring, ScD
Director of Clinical Research
Professor of Medicine
Brigham and Women's Hospital
Donald Levy, MD
Medical Director, Osher Clinical Center
Assistant Clinical Professor of Medicine
Brigham and Women's Hospital
Russell S. Phillips, MD
Director, Fellowship Training
Professor of Medicine
Chief, Division of General Internal Medicine
Beth Israel Deaconess Medical Center
Peter Wayne, PhD
Director, Tai Chi and Mind-Body Research Programs
Assistant Professor of Medicine
Beth Israel Deaconess Medical Center
Roger Davis, ScD
Director, Biostatistics
Associate Professor of Medicine
Beth Israel Deaconess Medical Center
Ted J. Kaptchuk
Director, Complementary Specialties
Associate Professor of Medicine
Beth Israel Deaconess Medical Center
Jon Clardy, PhD
Co-Director, Marcus Natural Product Program
Hsien Wu and Daisy Yen Professor
Biological Chemistry and Molecular Pharmacology
Harvard Medical School
Bruce A. Littlefield, PhD
Scientific Director, Marcus Natural Product Program
Lecturer on Biological Chemistry and Molecular Pharmacology
Biological Chemistry and Molecular Pharmacology
Harvard Medical School
Associated Faculty
Andrew Ahn, MD, MPH
Instructor in Medicine
Beth Israel Deaconess Medical Center
Gurjeet Birdee, MD, MPH
Instructor in Medicine
Beth Israel Deaconess Medical Center
Shugeng Cao, PhD
Director, Marcus Natural Product Laboratory
Research Associate
Biological Chemistry and Molecular Pharmacology
Harvard Medical School
Lisa Ann Conboy, MA, MS, ScD
Instructor in Medicine
Beth Israel Deaconess Medical Center
Co-Director of Research
New England School of Acupuncture
Eric Jacobson, PhD
Lecturer on Medicine
Department of Global Health and Social Medicine
Harvard Medical School
Catherine Kerr, PhD
Instructor in Medicine
Beth Israel Deaconess Medical Center
Weidong Lu, MB, MPH
Instructor in Medicine
Beth Israel Deaconess Medical Center
Acupuncture Therapist
Dana Farber Cancer Institute
Diana E. Post, MD
Assistant Professor of Medicine
Brigham and Women's Hospital
Steven C. Schachter, MD
Professor of Neurology
Director of Research, Department of Neurology
Beth Israel Deaconess Medical Center
Gloria Yeh, MD, MPH
Assistant Professor of Medicine
Beth Israel Deaconess Medical Center
Program Fellows
Eric Harris, PhD
Botanist, Marcus Natural Product Program
Research Fellow
Biological Chemistry and Molecular Pharmacology
Harvard Medical School
Jacinda Nicklas Mawson, MD, MA
Research Fellow in Medicine
Beth Israel Deaconess Medical Center
Asghar Naqvi, MD
Research Fellow in Medicine
Beth Israel Deaconess Medical Center
Aditi Nerurkar, MD, MPH
Research Fellow in Medicine
Beth Israel Deaconess Medical Center
Long T. Nguyen, PhD
Research Fellow in Medicine
Beth Israel Deaconess Medical Center
Christopher Trojanovich, MD
Research Fellow in Medicine
Beth Israel Deaconess Medical Center
Rebecca Erwin Wells, MD
Research Fellow in Medicine
Beth Israel Deaconess Medical Center
Division Staff
Jackie Craigue, BS
Director of Operations
Ellen Connors, BS, MA
Project Coordinator
Jane Craycroft, BA, MPH
Administrative Director, Natural Product Program
Mark Cunningham, BA
Clinical Administrator
Osher Clinical Center
Mary Teresa Quilty, BA, BS
Project Coordinator
Kim Ravenscroft
Assistant to the Executive Director
Susan Rodliff
Executive Assistant to the Director
Mary Anne Ryan, BA, LMT
Grants Manager
Robert Scholten, MS
Information Architect
Patricia Wilkinson
Faculty Assistant
..it just makes for dry reading, not appropriate for a newsstand magazine. But for a psych journal, it's great.
Ok, here's another article.
Quote:
Research shows Tai Chi exercise reduces knee osteoarthritis pain in the elderly
October 29th, 2009
Researchers from Tufts University School of Medicine have determined that patients over 65 years of age with knee osteoarthritis (OA) who engage in regular Tai Chi exercise improve physical function and experience less pain. Tai Chi (Chuan) is a traditional style of Chinese martial arts that features slow, rhythmic movements to induce mental relaxation and enhance balance, strength, flexibility, and self-efficacy. Full findings of the study are published in the November issue of Arthritis Care & Research, a journal of the American College of Rheumatology.
The elderly population is at most risk for developing knee OA, which results in pain, functional limitations or disabilities and a reduced quality of life. According to the Centers for Disease Control and Prevention (CDC) there are 4.3 million U.S. adults over age 60 diagnosed with knee OA, a common form of arthritis that causes wearing of joint cartilage. A recent CDC report further explains that half of American adults may develop symptoms of OA in at least one knee by age 85.
For this study, Chenchen Wang, M.D., M.Sc., and colleagues recruited 40 patients from the greater Boston area with confirmed knee OA who were in otherwise good health. The mean age of participants was 65 years with a mean body mass index of 30.0 kg/m2. Patients were randomly selected and 20 were asked to participate in 60-minute Yang style Tai Chi sessions twice weekly for 12 weeks. Each session included: a 10-minute self-massage and a review of Tai Chi principles; 30 minutes of Tai Chi movement; 10 minutes of breathing technique; and 10 minutes of relaxation.
"Tai Chi is a mind-body approach that appears to be an applicable treatment for older adults with knee OA," said Dr. Wang. Physical components of Tai Chi are consistent with current exercise recommendations for OA, which include range of motion, flexibility, muscle conditioning, and aerobic work out. Researchers believe the mental feature of Tai Chi addresses negative effects of chronic pain by promoting psychological wellbeing, life satisfaction, and perceptions of health.
The remaining 20 participants assigned to the control group attended two 60-minute class sessions per week for 12 weeks. Each control session included 40 minutes of instruction covering OA as a disease, diet and nutrition, therapies to treat OA, or physical and mental health education. The final 20 minutes consisted of stretching exercises involving the upper body, trunk, and lower body, with each stretch being held for 10-15 seconds.
At the end of the 12-week period, patients practicing Tai Chi exhibited a significant decrease in knee pain compared with those in the control group. Using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale, researchers noted a -118.80 reduction in pain from baseline between the Tai Chi and control group. Researchers also observed improved physical function, self-efficacy, depression, and health status for knee OA in subjects in the Tai Chi group. "Our observations emphasize a need to further evaluate the biologic mechanisms and approaches of Tai Chi to extend its benefits to a broader population," concluded Dr. Wang.
More information: "Tai Chi Is Effective in Treating Knee Osteoarthritis: A Randomized Controlled Trial." Chenchen Wang, Christopher H. Schmid, Patricia L. Hibberd, Robert Kalish, Ronenn Roubenoff, Ramel Rones, and Timothy McAlindon. Arthritis Care & Research; Published Online: October 29, 2009 (DOI:10.1002/art.24832); Print Issue Date: November 2009.
Nice that they specified Yang. That wouldn't be my pick for something to ward off knee pain. Nice usage of 'ward off' in the article title.
Quote:
Tai Chi May Help Ward Off Knee Pain in Seniors
THURSDAY, Oct. 29 (HealthDay News) -- Want to improve that osteoarthritis in your knee? New research suggests that regular Tai Chi exercise can reduce pain and help your knee function better.
"Tai Chi is a mind-body approach that appears to be an applicable treatment for older adults with knee osteoarthritis," Dr. Chenchen Wang, co-author of a study published in the November issue of Arthritis Care & Research, said in a news release from the journal's publisher.
In the United States, an estimated 4.3 million adults over 60 suffer from this form of arthritis. As many as half of American adults may develop symptoms by age 85, the U.S. Centers for Disease Control and Prevention reported recently.
Wang and colleagues from Tufts University School of Medicine recruited 40 patients, with an average age of 65, who had been diagnosed with knee osteoarthritis.
Half of the group took part in Yang-style Tai Chi sessions for an hour at a time, twice weekly over a period of three months. The Tai Chi session consisted of 10-minutes of self-message and review, a half hour of movement, 10 minutes of breathing exercises and 10 minutes of relaxing.
The other participants took two 60-minute classes per week for three months and learned about issues such as diet and nutrition, and treatments for osteoarthritis. They also stretched for 20 minutes.
Those who practiced Tai Chi had significantly less knee pain than the other group and also reported less depression, more physical function and better overall health.
"Our observations emphasize a need to further evaluate the biologic mechanisms and approaches of Tai Chi to extend its benefits to a broader population," Wang said.
They said Yang but did the MEAN Yang or something else.
Many people call 24 Posture Simplified Yang style...even though it is based on concepts from Yang mixed with influences from Wu and Sun...and simplified to make it easier to learn and easier on the knees due to the use of the rock step in moving Gong Bu.
If they were taught Cheng Manching's 37 posture, the higher stances and easier movements make it easier on the knees and also not in the mainstream of Yang style.
So...not all Yang style is Yang style.
Newbies in their 60's and up, all with knee problems - would be starting out with the 24 Simplified I think.... Advanced movements will come later, years later - if any of them stick with it. That first year is really tough on the old folks... and they come in thinking that they want to do taiji because it looks soooo easy...
Level of instruction, if good enough then even Beijing (24) shi taijiquan is a great way towards health. It has shown excellent effects for well being and general welfare as evidenced by a Japanese study done about 5 years ago, if I recall rightly.
Absolutely right!
Those old folks that will stay with a beginners course all the way thru the 24 will improve their health in many ways.... including me...
And a few stay on after that.... I don't believe that there is a limit to their (our) health improvement other than dropping out...
I have had students with MS as well as Rheumatoid and Osteo Arthritis...knee surgeries, and so on.
All of them were able to start with 24 Posture Taijiquan. (I can also say that none of those would have ever been able to approximate traditional Yang style without a number of major modifications in stance work.)
The ones with knee or joint issues, should they continue after learning 24 Posture (and 32 sword), I will teach differently. I include things like 20 Postures for Longevity Qi Gong and even Sun Style Taijiquan since its stance requirements can be slackened off a bit...and it is quick enough to hold the interest as far as spirit and complexity.
The only real issue I have ever had with older students is when a couple comes in. The men end up quitting. I think it is that their wives seem to pick up on things easier....and the old male ego rears its head and they quit.
Almost always..... I have heard one say he felt like a dancing bear and quit after two weeks. Most men who stay with it for years come on their own because they wanted to. For me, this is the one activity I have separate from my wife. I have no interest in her coming to class, and she has no interest.... she does her yoga on occasion, and is so far ahead of me physically I'll never catch up, so I don't feel guilty about it. We have a new guy that just retired that has come to 4 classes with his wife. She has been coming over a year, so maybe he won't feel like he should be in competition with her. His attitude is good so far.
Funny thing is that in each instance where a couple came in and the husband quit, two things of note:
(1) of the two, the husband NEEDED to to Taijiquan more than the wife. He was always one of those guys who would have said "I need to get BACK into shape." but was NEVER in shape in the first place...unless you consider ROUND a shape.
(2) when the man quit, soon after, he began to pressure the woman to quit too...and eventually she did...and in each case she quit reluctantly.
I still give family and couple discounts...I just don't expect too much out of it until BOTH show an interest. I teach the same...I just don't externalize my expectations any longer.
Yes and yes to both..... unfortunately.... as you say, these guys start out round, and they want to stay round..... except we're talking about old folks here.
The young ones (in their '40's) - well, the wife wants the husband to come but that does not affect whether she comes or not. If anything, they are less distracted with the husband gone and progress faster...
...what style of tai chi?
This link is worth clicking just for the tai chi pic...;)Quote:
Study finds tai chi helps treat osteoarthritis symptoms in elderly
By Health News Team • Nov 9th, 2009 • Category: Joint Health, True Health News
Tai Chi can help alleviate osteoarthritis symptoms, according to study
Treating arthritis pain may be possible with a relaxing alternative therapy, according to researchers. They say the ancient Chinese martial art known as tai chi may be effective in reducing knee pain in older people with osteoarthritis (OA).
The study, published in the November issue of the journal Arthritis Care and Researchsuggests that practicing tai chi can help seniors suffering from OA reduce their pain and improve their physical function.
A research team in Boston studied the effects of twice- weekly 60-minute tai chi sessions over a period of 12 weeks on a group of seniors with confirmed cases of knee OA. The sessions included practicing tai chi movements as well as breathing and relaxation techniques.
At the end of the 12-week study period, patients practicing tai chi exhibited a significant decrease in knee pain compared with those in the control group. In addition, researchers say they observed improved physical function, self-efficacy, depression, and health status in the group that took part in the exercise.
Tai chi features slow, rhythmic movements to induce mental relaxation and enhance balance, strength, flexibility, and self-efficacy. Components of the martial art are consistent with current exercise recommendations for OA, which include range of motion, flexibility, muscle conditioning, and aerobic workout.
According to the Centers for Disease Control and Prevention there are 4.3 million U.S. adults over age 60 diagnosed with knee OA, a common form of arthritis that causes wearing of joint cartilage.
Nutritional supplements containing glucosamine and chondroitin are also believed to help reduce symptoms associated with joint pain.
I should really netsearch the details of SMILE, just to find out if there's anything notable there. Or maybe someone else here should... ;)
Quote:
Tai Chi therapy against depression encouraging: Australian scientist
English.news.cn 2010-01-20 15:29:38
CANBERRA, Jan. 20 (Xinhua) -- Australian scientist Liu Xin, who designed a Tai Chi exercise program to fight depression, diabetes and obesity said Wednesday that an initial trial of the program is encouraging.
Hailing the program as a breakthrough in the fight against depression, diabetes and obesity, the University of Queensland scientist said 50 volunteers took part in the three-month trial of the SMILE exercise regime.
The proportion of participants with clinical levels of depression dropped from 60 percent to 20 percent.
Participants also saw significant reductions in their body mass index and waist circumference.
"Without involvement of any dietary intervention and high intensity training, it was very encouraging to see such impressive results over a short period of time," Liu said.
In addition to the improvements in depression and obesity, participants also said they slept better, had more energy, higher self-esteem and improved confidence.
With one in five Australians experiencing depression at some stage of their lives, Liu said the program has great potential to ease suffering.
Editor: Fang Yang
More from University of Queensland researcher Liu Xin.
Quote:
Tai Chi Moves May Benefit Those With Type 2 Diabetes
Thursday, February 11, 2010
An ancient form of Chinese exercise may hold hope for staving off a modern illness - type 2 diabetes, according to a university researcher.
People with - or at risk of developing - diabetes who took part in preliminary studies of a tai chi-based program recorded falls in blood pressure, weight and blood sugar levels.
Many reported decreases in depressive symptoms after their involvement in the classes, designed by University of Queensland researcher Liu Xin.
Dr Liu said the program had been tailored to benefit people with, or at risk of, type 2 diabetes and included movements to specifically exercise the pancreas, which is involved in digestion and in the regulation of blood sugar levels.
"Like in designing or producing medication, we need to target the disease specifically," Dr Liu said.
"Different movements target different internal organs."
Shirley Fraser said she signed up to a trial of Dr Liu's program after watching her father struggle with the effects of type 2 diabetes towards the end of his life.
She attended the tai chi classes for up to 90 minutes a day, three days a week, for three months and also performed the exercises at home. Although the program did not involve a change of diet, she lost 10kg.
She said her blood pressure and blood sugar levels had also improved.
If Tai Ji were "medicine", you'd have to be licensed to practice it!
Any exercise would help Type II diabetes... and a better diet would, too.