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Thread: Tai Chi as medicine

  1. #241
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    Tai Chi Versus Physical Therapy for Knee Osteoarthritis

    As always, I wonder what style of Tai Chi. I'd argue that Chen Tai Chi isn't necessarily knee friendly.

    Original Research | 17 May 2016
    Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial ONLINE FIRST
    Chenchen Wang, MD, MSc; Christopher H. Schmid, PhD; Maura D. Iversen, SD, DPT, MPH; William F. Harvey, MD, MSc; Roger A. Fielding, PhD; Jeffrey B. Driban, PhD; Lori Lyn Price, MAS; John B. Wong, MD; Kieran F. Reid, PhD, MPH; Ramel Rones; and Timothy McAlindon, MD, MPH

    Ann Intern Med. Published online 17 May 2016 doi:10.7326/M15-2143

    Background: Few remedies effectively treat long-term pain and disability from knee osteoarthritis. Studies suggest that Tai Chi alleviates symptoms, but no trials have directly compared Tai Chi with standard therapies for osteoarthritis.

    Objective: To compare Tai Chi with standard physical therapy for patients with knee osteoarthritis.

    Design: Randomized, 52-week, single-blind comparative effectiveness trial. (ClinicalTrials.gov: NCT01258985)

    Setting: An urban tertiary care academic hospital.

    Patients: 204 participants with symptomatic knee osteoarthritis (mean age, 60 years; 70% women; 53% white).

    Intervention: Tai Chi (2 times per week for 12 weeks) or standard physical therapy (2 times per week for 6 weeks, followed by 6 weeks of monitored home exercise).

    Measurements: The primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 12 weeks. Secondary outcomes included physical function, depression, medication use, and quality of life.

    Results: At 12 weeks, the WOMAC score was substantially reduced in both groups (Tai Chi, 167 points [95% CI, 145 to 190 points]; physical therapy, 143 points [CI, 119 to 167 points]). The between-group difference was not significant (24 points [CI, −10 to 58 points]). Both groups also showed similar clinically significant improvement in most secondary outcomes, and the benefits were maintained up to 52 weeks. Of note, the Tai Chi group had significantly greater improvements in depression and the physical component of quality of life. The benefit of Tai Chi was consistent across instructors. No serious adverse events occurred.

    Limitation: Patients were aware of their treatment group assignment, and the generalizability of the findings to other settings remains undetermined.

    Conclusion: Tai Chi produced beneficial effects similar to those of a standard course of physical therapy in the treatment of knee osteoarthritis.

    Primary Funding Source: National Center for Complementary and Integrative Health of the National Institutes of Health.
    Gene Ching
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  2. #242
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    Tai chi helps reinvigorate stem cells

    Tai Chi intervention increases progenitor CD34(+) cells in young adults.
    Ho TJ1, Ho LI, Hsueh KW, Chan TM, Huang SL, Lin JG, Liang WM, Hsu WH, Harn HJ, Lin SZ.

    Author information
    1 School of Chinese Medicine, China Medical University, Taichung, Taiwan.

    Abstract
    Tai Chi has been shown to have many great health benefits. However, few research attempts have been made to explore the effects of practicing TCC on life span. This study provides direct evidence of Tai Chi's antiaging effects. We conducted a retrospective cross-sectional study to compare the rejuvenating and antiaging effects among Tai Chi group (TCC) and brisk walking group (BW) and no exercise habit group (NEH). Thirty-two participants were selected out of a possible 60 based on a survey, and they were separated into three groups: the TCC group (practicing for more than 1 year), the BW group (practicing for more than 1 year), and the NEH group. The CD34(+) cell counts in peripheral blood of the participants was determined, and the Kruskal-Wallis test was used to evaluate and compare the antiaging effects of the three groups. Of the 32 participants in this study, the participants in the TCC group (N = 10) outperformed the NEH group (N = 12) with respect to the number of CD34(+) progenitor cells. No significant difference was found between the TCC group and the BW group. TCC practice sustained for more than 1 year may be an intervention against aging as effective as BW in terms of its benefits on the improvement of CD34(+) number.
    PMID: 24816453 [PubMed - indexed for MEDLINE]
    That's intriguing.
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  3. #243
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    NIH review on pain

    We have two masters coming in today, so I don't have time to search out the source articles for this right now. Perhaps someone else here will. Or perhaps we'll just go with this NIH report.

    Thursday, September 1, 2016
    NIH review finds nondrug approaches effective for treatment of common pain conditions

    U.S. study reviews trial results on complementary health approaches for pain relief; aims to assist with pain management.

    “Our goal for this study was to provide relevant, high-quality information for primary care providers and for patients who suffer from chronic pain.”

    —Richard L. Nahin, Ph.D., Lead Epidemiologist

    Data from a review of U.S.-based clinical trials published today in Mayo Clinic Proceedings suggest that some of the most popular complementary health approaches — such as yoga, tai chi, and acupuncture — appear to be effective tools for helping to manage common pain conditions. The review was conducted by a group of scientists from the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health.

    Millions of Americans suffer from persistent pain that may not be fully relieved by medications. They often turn to complementary health approaches to help, yet primary care providers have lacked a robust evidence base to guide recommendations on complementary approaches as practiced and available in the United States. The new review gives primary care providers — who frequently see patients with chronic pain — tools to inform decision-making on how to help manage that pain.

    “For many Americans who suffer from chronic pain, medications may not completely relieve pain and can produce unwanted side effects. As a result, many people may turn to nondrug approaches to help manage their pain,” said Richard L. Nahin, Ph.D., NCCIH’s lead epidemiologist and lead author of the analysis. “Our goal for this study was to provide relevant, high-quality information for primary care providers and for patients who suffer from chronic pain.”

    The researchers reviewed 105 U.S.-based randomized controlled trials, from the past 50 years, that were relevant to pain patients in the United States and met inclusion criteria. Although the reporting of safety information was low overall, none of the clinical trials reported significant side effects due to the interventions.

    The review focused on U.S.-based trial results on seven approaches used for one or more of five painful conditions — back pain, osteoarthritis, neck pain, fibromyalgia, and severe headaches and migraine — and found promise in the following for safety and effectiveness in treating pain:

    Acupuncture and yoga for back pain
    Acupuncture and tai chi for osteoarthritis of the knee
    Massage therapy for neck pain with adequate doses and for short-term benefit
    Relaxation techniques for severe headaches and migraine.

    Though the evidence was weaker, the researchers also found that massage therapy, spinal manipulation, and osteopathic manipulation may provide some help for back pain, and relaxation approaches and tai chi might help people with fibromyalgia.

    “These data can equip providers and patients with the information they need to have informed conversations regarding non-drug approaches for treatment of specific pain conditions,” said David Shurtleff, Ph.D., deputy director of NCCIH. “It’s important that continued research explore how these approaches actually work and whether these findings apply broadly in diverse clinical settings and patient populations.”

    Read more about this report and find graphics at nccih.nih.gov/pain_review.

    About the National Center for Complementary and Integrative Health (NCCIH): NCCIH’s mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health approaches and their roles in improving health and health care. For additional information, call NCCIH’s Clearinghouse toll free at 1-888-644-6226, or visit the NCCIH Web site at nccih.nih.gov. Follow us on Twitter (link is external), Facebook (link is external), and YouTube.

    About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

    NIH…Turning Discovery Into Health®

    Reference

    Nahin RL, Boineau R, Khalsa PS, Stussman BJ, Weber WJ. Evidence-based evaluation of complementary health approaches for pain management in the United States. Mayo Clinic Proceedings. 2016;91(9):1292-1306.
    ###
    Gene Ching
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  4. #244
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    Tai chi can help relieve chronic neck pain

    The link goes to the complete article.

    The Effects of Tai Chi and Neck Exercises in the Treatment of Chronic Nonspecific Neck Pain: A Randomized Controlled Trial

    Romy Lauche, Christoph Stumpe, Johannes Fehr, Holger Cramer, Ying Wu Cheng, Peter M. Wayne, Thomas Rampp, Jost Langhorst, Gustav Dobos

    Highlights

    •Tai Chi provides moderate benefit for patients with chronic nonspecific neck pain.
    •Tai Chi exercises appear to be as effective as conventional exercises for neck pain.
    •After 12 weeks a pain reduction of ≥50% was observed by 36.8% in the Tai Chi group.
    •A pain reduction of ≥50% was observed by 45.9% after conventional neck exercises.
    •Tai Chi and conventional neck exercises appear to be safe and well tolerated.

    Abstract

    This study aimed to test the efficacy of Tai Chi for treating chronic neck pain. Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises with weekly sessions of 75 to 90 minutes, or a wait-list control. The primary outcome measure was pain intensity (visual analogue scale). Secondary outcomes included pain on movement, functional disability, quality of life, well-being and perceived stress, postural and interoceptive awareness, satisfaction, and safety. Altogether, 114 participants were included (91 women, 49.4 ± 11.7 years of age). After 12 weeks Tai Chi participants reported significantly less pain compared with the wait list group (average difference in mm on the visual analogue scale: −10.5; 95% confidence interval, −20.3 to −.9; P = .033). Group differences were also found for pain on movement, functional disability, and quality of life compared with the wait list group. No differences were found for Tai Chi compared with neck exercises. Patients’ satisfaction with both exercise interventions was high, and only minor side effects were observed. Tai Chi was more effective than no treatment in improving pain in subjects with chronic nonspecific neck pain. Because Tai Chi is probably as effective as neck exercises it may be considered a suitable alternative to conventional exercises for those with a preference toward Tai Chi.
    Gene Ching
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  5. #245
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    A review

    I usually post the original source for this kind of news, like with the Journal of Pain study cited above, but I really liked the Tai Chi with Bach video.

    Study Confirms Tai Chi Benefits Include Reduced Neck Pain and Improved Blood Pressure


    Group practicing Tai Chi in front of Shanhai skyline (leniners/Flickr)

    A new study has found that the traditional Chinese exercise tai chi could be just as effective as conventional exercises in relieving long-term neck pain. Carried out by an international team of researchers, the study looked at 114 participants who had all been suffering from chronic neck pain for three consecutive months.
    Published online in the official journal of the American Pain society, The Journal of Pain, results showed that after 12 weeks, the tai chi group reported significantly less pain when compared to the control group, as well as improvements with disabilities, quality of life, and postural control.
    Participants were randomly assigned to 12 weeks of either group tai chi classes or conventional exercises (demonstrated in the artistic motion capture video below) with weekly sessions of 75 to 90 minutes. A third group acted as a control. Conventional neck exercises were equally beneficial, with co-author Peter M. Wayne adding that 12 weeks of tai chi was neither superior nor inferior to 12 weeks of the other exercises.



    The low-impact mind-body exercise tai chi originated in China and includes a combination of slow physical movements (see above) with breathing, relaxation, and meditation. Although no studies had previously looked at relieving chronic neck pain, research had found that it can have other health benefits. Findings published earlier this year in the Journal of the American Heart Association suggested that tai chi could improve cardiovascular health in those who had suffered from heart disease, high blood pressure, or a stroke. The study showed that tai chi could help to reduce blood pressure and therefore lower the risk of stroke by up to 41% and coronary heart disease by up to 22%. The team also found that tai chi could lower the levels of bad cholesterol, increase the overall quality of life, and reduce depression.


    Tai chi can have many health benefits, including relieving long-term neck pain according to a new study. (Spanic/iStock)

    In another study published this year, Taiwanese researchers found tai chi to be effective in reducing the risk of falling in seniors. One of the main causes of injury in older adults, preventing falls is important for seniors, since stopping them can prevent further complications caused by hospitalization or admission to a nursing home.
    After comparing tai chi to a physical therapy called “lower extremity training,” or LET, which involves leg-strengthening exercises, researchers from Taipei Medical University found that after six months of sessions, the tai chi group was significantly less likely to experience an injury-causing fall than those in the LET group, with participants also benefiting from an increase in cognitive function.
    -Relaxnews
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  6. #246
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    Tai Chi and PTSD

    Tai Chi may benefit veterans with PTSD
    Written by Honor Whiteman
    Published: Monday 5 December 2016

    Around 7 to 8 percent of Americans will experience post-traumatic stress disorder in their lifetime, and the condition is even more common among veterans, affecting around 23 percent of those involved in recent conflicts. According to a new study, the ancient Chinese exercise Tai Chi could help veterans manage symptoms of post-traumatic stress.


    Researchers say Tai Chi may be beneficial for veterans who have PTSD.

    Study co-author Barbara Niles, Ph.D., assistant professor of psychiatry at Boston University School of Medicine in Massachusetts, and colleagues recently reported their findings in BMJ Open.

    Post-traumatic stress disorder (PTSD) is a mental health condition that can arise after experiencing or witnessing a shocking or frightening event.

    Because veterans have been exposed to highly traumatic events more often than the general population, their rates of PTSD are much higher. According to the U.S. Department of Veterans Affairs, around 30 percent of veterans who served in the Vietnam War have experienced PTSD at some point in their lives.

    Symptoms of PTSD include flashbacks of the traumatic event, nightmares, negative emotions, and avoidance of situations that trigger memories of the event. Some individuals may also experience anxiety, depression, physical symptoms - such as chronic pain - and alcohol or drug abuse.

    Treatment for PTSD often includes a combination of medication and behavioral therapy. However, these treatments are not always effective.

    Now, Niles and colleagues say Tai Chi has the potential to offer significant benefits for veterans with PTSD.

    Veterans enrolled to four weekly Tai Chi sessions

    Originating from China, Tai Chi is a gentle form of exercise that incorporates slow movements, breathing, and meditation.

    Previous studies have documented the numerous health benefits of Tai Chi, which include improved muscle strength, increased energy, reduced inflammation, and better heart health.

    Research has also associated Tai Chi with better mental health, such as reduced anxiety and depression.

    According to Niles and team, few studies have investigated whether Tai Chi might help individuals with PTSD, although research has demonstrated the benefits of other mind-body practices - such as yoga - for the disorder.

    With this in mind, the researchers enrolled 17 veterans - 11 males and 6 females - with symptoms of PTSD to take part in an introductory Tai Chi program, which involved four once-weekly sessions over 4 weeks.

    Each session involved a warm-up - including a self-massage and a review of Tai Chi principles - Tai Chi movement, and breathing and relaxation. During the 4-week period, subjects were also encouraged to practice Tai Chi at home for at least 30 minutes daily.

    After the final Tai Chi session, each veteran completed a questionnaire that asked them how satisfied they were with the Tai Chi program, whether they would like to take part in future Tai Chi programs, and whether they felt it helped manage their issues.

    Positive findings should spur additional research

    The vast majority of veterans - 93.8 percent - said they were mostly or very satisfied with the introductory Tai Chi program and would rate the program as "excellent" or "good."

    Importantly, 68.8 percent of the veterans said that the Tai Chi program "helped them deal more effectively with their problems," and all subjects said they would take part in Tai Chi again if offered.

    The researchers note that the study sample size was small, and some of the participants only reported mild symptoms of PTSD, meaning their results may not apply to larger populations of veterans with the disorder.

    Still, the team says the results provide "evidence for the feasibility of enrolling and engaging veterans with symptoms of PTSD in a Tai Chi exercise program," adding:

    "Veterans were very satisfied with their Tai Chi experience and they indicated both willingness and a preference for additional sessions. Given these positive findings, additional research is needed to empirically evaluate Tai Chi as a treatment for symptoms of PTSD."

    Read how Tai Chi may boost health and well-being for people with cardiovascular disease.
    Here's the abstract on the BMJ site:
    BMJ Open 2016;6:e012464 doi:10.1136/bmjopen-2016-012464
    Complementary medicine
    Feasibility, qualitative findings and satisfaction of a brief Tai Chi mind–body programme for veterans with post-traumatic stress symptoms
    Barbara L Niles 1, DeAnna L Mori 2, Craig P Polizzi 3, Anica Pless Kaiser 1, Annie M Ledoux 3, Chenchen Wang 4

    + Author Affiliations
    1 National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts, USA
    2 VA Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts, USA
    3 National Center for PTSD and VA Boston Healthcare System, Boston, Massachusetts, USA
    4 Division of Rheumatology, Center for Integrative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA

    Correspondence to
    Dr Barbara L Niles; Barbara.Niles@va.gov
    Received 29 April 2016
    Revised 10 August 2016
    Accepted 4 October 2016
    Published 29 November 2016

    Abstract
    Objective To examine feasibility, qualitative feedback and satisfaction associated with a 4-session introduction to Tai Chi for veterans with post-traumatic stress symptoms.

    Design We observed and reported recruitment and retention rates, participant characteristics, adherence, and satisfaction across 2 cohorts. We also examined qualitative feedback provided by questionnaires, focus groups and individual interviews.

    Main outcome measures Rates of recruitment and retention, focus group and individual feedback interviews, self-reported satisfaction.

    Participants 17 veterans with post-traumatic stress symptoms.

    Results Almost 90% (17/19) of those eligible following the telephone screen enrolled in the programme. Three-quarters (76.4%) of the participants attended at least 3 of the 4 Tai Chi sessions. Qualitative data analysis revealed themes indicating favourable impressions of the Tai Chi sessions. In addition, participants reported feeling very engaged during the sessions, and found Tai Chi to be helpful for managing distressing symptoms (ie, intrusive thoughts, concentration difficulties, physiological arousal). Participants also reported high satisfaction: 93.8% endorsed being very or mostly satisfied with the programme. All participants (100%) indicated that they would like to participate in future Tai Chi programmes and would recommend it to a friend.

    Conclusions Tai Chi appears to be feasible and safe for veterans with symptoms of post-traumatic stress disorder (PTSD), is perceived to be beneficial and is associated with high rates of satisfaction. This study highlights the need for future investigation of Tai Chi as a novel intervention to address symptoms of PTSD.
    Gene Ching
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  7. #247
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    Psychosocial well-being among hidden elderly

    This is a significant beneficial aspect of Tai Chi & Qigong now with the ever expanding elderly community.

    This is just the abstract. Follow the link for the full article.

    Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial

    Authors Chan AW, Yu DS, Choi KC

    Received 13 October 2016

    Accepted for publication 29 November 2016

    Published 5 January 2017 Volume 2017:12 Pages 85—96

    DOI https://doi.org/10.2147/CIA.S124604

    Checked for plagiarism Yes

    Review by Single-blind

    Peer reviewers approved by Dr Lucy Goodman

    Peer reviewer comments 3

    Editor who approved publication: Professor Zhi-Ying Wu

    Aileen WK Chan, Doris SF Yu, KC Choi

    The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR

    Purpose: To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly.
    Patients and methods: “Hidden elderly” is a term used to describe older adults who are socially isolated and refuse social participation. This pilot randomized controlled trial recruited 48 older adults aged 60 or above who did not engage in any social activity. They were randomized into tai chi qigong (n=24) and standard care control (n=24) groups. The former group underwent a three-month program of two 60-minute sessions each week, with the socially active volunteers paired up with them during practice. Standard care included regular home visits by social workers. Primary outcomes were assessed by means of the Lubben social network and De Jong Gieveld loneliness scales, and by a revised social support questionnaire. Secondary outcomes were covered by a mental health inventory and the Rosenberg self-esteem scale, and quality of life by using the 12-Item Short Form Health Survey. Data was collected at baseline, and at three and six months thereafter.
    Results: The generalized estimating equations model revealed general improvement in outcomes among participants on the tai chi qigong program. In particular, participants reported a significantly greater improvement on the loneliness scale (B=-1.32, 95% confidence interval [CI] -2.54 to -0.11, P=0.033) and the satisfaction component of the social support questionnaire (B=3.43, 95% CI 0.10–6.76, P=0.044) than the control group.

    Conclusion: The pilot study confirmed that tai chi qigong with elderly neighborhood volunteers is a safe and feasible social intervention for hidden elderly. Its potential benefits in improving social and psychological health suggest the need for a full-scale randomized controlled trial to reveal its empirical effects.
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  8. #248
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    Tai Chi effects on Cognition and Fall Risk

    There's now 185 publications on Tai Chi in the JOURNAL OF THE AMERICAN GERIATRICS SOCIETY. I'm almost tempted to split this 'Tai Chi as medicine' thread into a separate 'Tai Chi as medicine for the elderly' thread.

    Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial

    Authors
    Somporn Sungkarat PhD,
    Sirinun Boripuntakul PhD,
    Nipon Chattipakorn MD, PhD,
    Kanokwan Watcharasaksilp MD,
    Stephen R Lord PhD
    First published: 22 November 2016
    DOI: 10.1111/jgs.14594View/save citation
    Article has an altmetric score of 13

    Abstract

    Objectives

    To examine whether combined center- and home-based Tai Chi training can improve cognitive ability and reduce physiological fall risk in older adults with amnestic mild cognitive impairment (a-MCI).

    Design

    Randomized controlled trial.

    Setting

    Chiang Mai, Thailand.

    Participants

    Adults aged 60 and older who met Petersen's criteria for multiple-domain a-MCI (N = 66).

    Intervention

    Three weeks center-based and 12 weeks home-based Tai Chi (50 minutes per session, 3 times per week).

    Measurements

    Cognitive tests, including Logical Memory (LM) delayed recall, Block Design, Digit Span forward and backward, and Trail-Making Test Part B–A (TMT B–A), and fall risk index using the Physiological Profile Assessment (PPA).

    Results

    At the end of the trial, performance on LM, Block Design, and TMT B–A were significantly better for the Tai Chi group than the control group after adjusting for baseline test performance. The Tai Chi group also had significantly better composite PPA score and PPA parameter scores: knee extension strength, reaction time, postural sway, and lower limb proprioception.

    Conclusion

    Combined center- and home-based Tai Chi training three times per week for 15 weeks significantly improved cognitive function and moderately reduced physiological fall
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    American College of Physicians guideline for back pain

    Relevant here: acupuncture and tai chi.

    American College of Physicians issues guideline for treating nonradicular low back pain

    Treatment recommendations include massage, acupuncture, spinal manipulation, tai chi, and yoga

    Philadelphia, February 14, 2017 -- The American College of Physicians (ACP) recommends in an evidence-based clinical practice guideline published today in Annals of Internal Medicine that physicians and patients should treat acute or subacute low back pain with non-drug therapies such as superficial heat, massage, acupuncture, or spinal manipulation. If drug therapy is desired, physicians and patients should select nonsteroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxants.

    Low back pain is one of the most common reasons for all physician visits in the U.S. Most Americans have experienced low back pain. Approximately one quarter of U.S. adults reported having low back pain lasting at least one day in the past three months. Pain is categorized as acute (lasting less than four weeks), subacute (lasting four to 12 weeks, and chronic (lasting more than 12 weeks).

    “Physicians should reassure their patients that acute and subacute low back pain usually improves over time regardless of treatment,” said Nitin S. Damle, MD, MS, MACP, president, ACP. “Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients.”

    The evidence showed that acetaminophen was not effective at improving pain outcomes versus placebo. Low-quality evidence showed that systemic steroids were not effective in treating acute or subacute low back pain.

    For patients with chronic low back pain, ACP recommends that physicians and patients initially select non-drug therapy with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise (MCE), progressive relaxation, electromyography biofeedback, low level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation.

    “For the treatment of chronic low back pain, physicians should select therapies that have the fewest harms and costs, since there were no clear comparative advantages for most treatments compared to one another,” Dr. Damle said. “Physicians should remind their patients that any of the recommended physical therapies should be administered by providers with appropriate training.”

    For patients with chronic low back pain who have had an inadequate response to non-drug therapy, ACP recommends that physicians and patients consider treatment with NSAIDs as first line therapy; or tramadol or duloxetine as second line therapy. Physicians should only consider opioids as an option in patients who have failed the aforementioned treatments and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients.

    “Physicians should consider opioids as a last option for treatment and only in patients who have failed other therapies, as they are associated with substantial harms, including the risk of addiction or accidental overdose,” said Dr. Damle.

    “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain” is based on a systematic review of randomized controlled trials and systematic reviews published on noninvasive pharmacological and non-pharmacological treatments of nonradicular low back pain. Clinical outcomes evaluated included reduction or elimination of low back pain, improvement in back-specific and overall function, improvement in health-related quality of life, reduction in work disability/return to work, global improvement, number of back pain episodes or time between episodes, patient satisfaction, and adverse effects.

    The evidence was insufficient or lacking to determine treatments for radicular low back pain. The evidence also was insufficient for most physical modalities and for which patients are likely to benefit from which specific therapy. The guideline does not address topical therapies or epidural injection therapies.

    ACP’s clinical practice guidelines are developed through a rigorous process based on an extensive review of the highest quality evidence available, including randomized control trials and data from observational studies. ACP also identifies gaps in evidence and direction for future research through its guidelines development process.

    ACP’s previous recommendations for treating low back pain were published in “Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society” in 2007. Some evidence has changed since the 2007 guideline and supporting evidence reviews. The 2007 guideline did not assess mindfulness-based stress reduction, MCE, taping, or tai chi.

    About the American College of Physicians

    The American College of Physicians is the largest medical specialty organization in the United States. ACP members include 148,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.
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    Tai chi may ease insomnia in breast cancer survivors

    Usually I track down the source article for these posts, but I'm too busy this week.

    Tai chi may ease insomnia in breast cancer survivors
    By HealthDay News | May 12, 2017 at 7:47 PM



    FRIDAY, May 12, 2017 -- For breast cancer survivors who struggle with sleep, a new study suggests that tai chi might calm their restless nights.

    Researchers found this slow-moving form of meditation was as good as talk therapy and more effective than medication in treating insomnia and reducing the risk for sleep loss-related health issues, including depression, fatigue and a weakened immune system.

    "Breast cancer survivors often don't just come to physicians with insomnia. They have insomnia, fatigue and depression," said study leader Dr. Michael Irwin. He directs UCLA's Cousins Center for Psychoneuroimmunology at the Semel Institute for Neuroscience and Human Behavior, in Los Angeles.

    "And this intervention, tai chi, impacted all those outcomes in a similar way, with benefits that were as robust as the gold standard treatment for insomnia [talk therapy]," Irwin added in a UCLA news release.

    Previous studies have shown that tai chi can help relax the body and the mind. This practice can also slow breathing and reduce inflammation, the study authors said.

    To investigate the effects of tai chi on sleep, the researchers asked 90 breast cancer survivors with insomnia and symptoms of depression and daytime sleepiness to take weekly cognitive behavioral therapy sessions ("talk therapy"), or weekly classes in a Westernized form of tai chi for a period of three months.


    The participants, who ranged in age from 42 to 83, reported on their insomnia and other symptoms at regular intervals over the course of 12 months.

    The findings showed that nearly half of the participants in both groups had significant improvement in their symptoms 15 months later.

    Currently, cognitive behavioral therapy is considered the best form of treatment for insomnia, according to the American Academy of Sleep Medicine. During treatment, people learn to identify and change the harmful thoughts and behaviors that are preventing them from getting enough sleep, the researchers explained.

    But this type of talk therapy may be too expensive for some people. Others with insomnia may have trouble finding a trained professional who can help, the study authors added.

    "Because of those limitations, we need community-based interventions like tai chi," said Irwin, who is also a member of the UCLA Jonsson Comprehensive Cancer Center.

    The findings were published May 10 in the Journal of Clinical Oncology.

    More information
    Breastcancer.org has more about insomnia and breast cancer.
    Gene Ching
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  11. #251
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    Tai chi reduces depression symptoms in Chinese-Americans

    Interesting. I wonder how much the statistics shift with non-Chinese-Americans and with Chinese immigrants in other nations.

    Tai chi significantly reduces depression symptoms in Chinese-Americans
    Date: May 25, 2017
    Source: Massachusetts General Hospital
    Summary: A new study finds that a 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese-Americans not receiving any other treatments.

    FULL STORY
    A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments. The pilot study conducted by investigators at Massachusetts General Hospital (MGH) and published in the Journal of Clinical Psychiatry enrolled members of Boston's Chinese community who had mild to moderate depression.

    "While some previous studies have suggested that tai chi may be useful in treating anxiety and depression, most have used it as a supplement to treatment for others medical conditions, rather than patients with depression," explains Albert Yeung, MD, ScD, of the Depression Clinical and Research Program in the MGH Department of Psychiatry, lead and corresponding author of the report. "Finding that tai chi can be effective is particularly significant because it is culturally accepted by this group of patients who tend to avoid conventional psychiatric treatment."

    Participants were recruited through advertisements offering tai chi for stress reduction, and their eligibility for the study was determined based on in-person interviews and assessments of overall health and depression symptoms. Eligible participants were Chinese-American adults fluent in either Cantonese or Mandarin, with a diagnosis of major depressive disorder in the mild to moderate range, no history of other psychiatric disorders, no recent practice of tai chi or other mind-body interventions, and no current use of other psychiatric treatments.

    Participants were randomized into three groups -- one that received the tai chi intervention; an active control group that participated in educational sessions that included discussions on stress, mental health and depression; and a passive control, "waitlist" group that returned for repeat assessments during and after the study period. The tai chi intervention involved twice weekly sessions for 12 weeks, in which participants were taught and practiced basic traditional tai chi movements. They were asked to practice at home three times a week and to document their practice. The education group also met twice weekly for 12 weeks, and sessions for both groups were offered in Cantonese or Mandarin. Members of both the education and waitlist groups were able to join free tai chi classes after the initial study period, something they were informed of at the study's outset.

    Of the 50 participants who completed the 12-week intervention period, 17 were in the tai chi group, 14 in the education group and 19 in the waitlist group. The 12-week assessments showed that the tai chi group had significantly greater improvement in depression symptoms than did members of either control group. Follow-up assessment at 24 weeks showed sustained improvement among the tai chi group, with statistically significant differences remaining compared with the waitlist group.

    "If these findings are confirmed in larger studies at other sites, that would indicate that tai chi could be a primary depression treatment for Chinese and Chinese American patients, who rarely take advantage of mental health services, and may also help address the shortage of mental health practitioners," says Yeung, who is an associate professor of Psychiatry at Harvard Medical School. "We also should investigate whether tai chi can have similar results for individuals from other racial and ethnic groups and determine which of the many components of tai chi might be responsible for these beneficial effects."

    Story Source:

    Materials provided by Massachusetts General Hospital. Note: Content may be edited for style and length.
    Gene Ching
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  12. #252
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    Gene Expression Changes Induced by Meditation and Related Practices

    My expression changes not when I meditate.

    But seriously, this is a big paper as it is a lit review. I'm only posting the intro. You can read the rest by following the link.

    Front. Immunol., 16 June 2017
    What Is the Molecular Signature of Mind–Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices

    imageIvana Buric1,2*, imageMiguel Farias1, imageJonathan Jong1, imageChristopher Mee3 and imageInti A. Brazil1,2,4,5
    1Brain, Belief, and Behaviour Lab, Centre for Psychology, Behaviour, and Achievement, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
    2Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
    3Centre for Applied Biological and Exercise Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
    4Forensic Psychiatric Centre Pompestichting, Nijmegen, Netherlands
    5Collaborative Antwerp Psychiatric Research Institute, Antwerp University, Antwerp, Belgium

    There is considerable evidence for the effectiveness of mind–body interventions (MBIs) in improving mental and physical health, but the molecular mechanisms of these benefits remain poorly understood. One hypothesis is that MBIs reverse expression of genes involved in inflammatory reactions that are induced by stress. This systematic review was conducted to examine changes in gene expression that occur after MBIs and to explore how these molecular changes are related to health. We searched PubMed throughout September 2016 to look for studies that have used gene expression analysis in MBIs (i.e., mindfulness, yoga, Tai Chi, Qigong, relaxation response, and breath regulation). Due to the limited quantity of studies, we included both clinical and non-clinical samples with any type of research design. Eighteen relevant studies were retrieved and analyzed. Overall, the studies indicate that these practices are associated with a downregulation of nuclear factor kappa B pathway; this is the opposite of the effects of chronic stress on gene expression and suggests that MBI practices may lead to a reduced risk of inflammation-related diseases. However, it is unclear how the effects of MBIs compare to other healthy interventions such as exercise or nutrition due to the small number of available studies. More research is required to be able to understand the effects of MBIs at the molecular level.
    Gene Ching
    Publisher www.KungFuMagazine.com
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  13. #253
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    Our latest sweepstakes. Enter to WIN!

    Enter to win KungFuMagazine.com's contest for Tai Chi for Depression Autographed by Dr. Aihan Kuhn! Contest ends 5:30 p.m. PST on 8/17/2017.

    Depression comes up 26 times on our Tai Chi as medicine thread. Dr Aihan Kuhn is on to something here.
    Gene Ching
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  14. #254
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    Ptsd

    Military Researchers Collaborate With University on Opioid Crisis
    By Sarah Marshall Uniformed Services University of the Health Sciences

    BETHESDA, Md., Aug. 25, 2017 — Opioids are the main driver of drug overdose deaths across the United States, and West Virginia has been among the hardest hit by the crisis, experiencing the highest overdose death rates in the country.


    With the military, West Virginia and the nation experiencing over-reliance on opioids for pain management, the Uniformed Services University of the Health Sciences and West Virginia University have established an official collaboration to pool their resources to help in solving the problem. Graphic courtesy of the Uniformed Services University of the Health Sciences

    With a shared vision of combating this growing epidemic, health care providers and researchers from the Uniformed Services University of the Health Sciences here and West Virginia University have established an official collaboration to pool their resources.

    In 2015, the overdose death rate in West Virginia was an estimated 41.5 per 100,000 people, an increase of about 17 percent from the year prior, according to the Centers for Disease Control and Prevention. Cabell County in southern West Virginia has a population of 96,000, and an estimated 10,000 of those residents are addicted to opioids.

    Additionally, the state's indigent burial fund, which helps families pay for a funeral when they can't afford one, reportedly ran out of money this year for the sixth consecutive year, largely due to the high number of overdose deaths.

    As the opioid epidemic continues to have a substantial impact on the state, leaders from WVU reached out to USU's Defense and Veterans Center for Integrative Pain Management, aware of their efforts to successfully combat opioid misuse in the military over the last several years with the idea that lessons learned in the military would be applicable to their state's current crisis. Earlier this year, leaders from both universities developed a cooperative research and development agreement allowing them to formally share pain management resources developed by DVCIPM.

    Adding Value to Civilian, Military Medicine

    The agreement also allows the DVCIPM an opportunity to measure the efficacy of the tools they've developed in a new environment – a collaboration that these leaders believe already is adding value to both civilian and military medicine.

    Nearly a decade ago, at the height of the wars in Iraq and Afghanistan, physicians were seeking to help troops get their chronic pain levels to zero as they survived combat injuries in record numbers. This was often achieved by using opioids – and using opioids as a single modality – which the military quickly realized was not effective, because this approach was affecting many service members and their relationships with loved ones, work, and daily living.

    In 2009, then-Army Surgeon General Lt. Gen. (Dr.) Eric Schoomaker chartered the Army Pain Management Task Force, which sought to make recommendations for a comprehensive pain management strategy, ensuring an optimal quality of life for service members and other patients dealing with pain. It became clear to the military that pain should be viewed as more than just a number, and over the last several years, the military has been dedicated to researching and developing more effective tools for pain management, ultimately reducing the number of those potentially exposed to opioid addiction.

    The task force's efforts led to the development of DVCIPM, which was designated as a Defense Department Center of Excellence last year.

    Schoomaker, now retired, continues to lead these efforts, serving as vice chair for leadership, centers and programs for USU's department of military and emergency medicine, which oversees DVCIPM.

    "We now have good evidence for the use of non-pharmacologic, non-opioid treatments, such as yoga, guided imagery, medical massage, chiropractic, acupuncture, Tai Chi, as well as a closely related movement therapy called Qigong, and music therapy," he said. "We have pretty good research to endorse their use."

    Because these practices might not work the same for each person, he added, it's important to use a variety of these modalities as part of a comprehensive program, tailored to the needs of an individual with chronic pain. Now, thanks to the official collaboration between USU and WVU, DVCIPM will have the opportunity to continue researching the efficacy of various integrative modalities and the pain management tools and resources they've developed.

    "We owe it to our patients, and we owe it to practitioners, to only use tools that have good evidence for their use," Schoomaker said.

    Gathering, Measuring Data

    DVCIPM Director Dr. Chester "Trip" Buckenmaier said the center's tools and resources have mainly been used in a fairly selective population within the military. Studying their efficacy in a smaller system within a state's civilian infrastructure will allow them to gather and measure data on how successful they can be in a broader population, which will continue to help illustrate the potential these tools have.


    Battlefield acupuncture is a unique auricular (ear) acupuncture procedure providing an integrative modality to help treat chronic pain. It’s being taught to qualified providers in the military. Now, thanks to a new collaboration between Uniformed Services University of the Health Sciences and West Virginia University, it’s also being employed in a new pain management center in West Virginia to help combat the opioid crisis. Uniformed Services University of the Health Sciences photo by Sarah Marshall

    "It's important to have relationships like we have with West Virginia. … They pay off in so many different ways that you can never anticipate," Schoomaker said.

    Dr. Mike Brumage, WVU's assistant dean for Public Health Practice and Service, initiated the collaborative effort by reaching out to USU about two years ago, wanting to do something about the issue affecting his native West Virginia. At the time, he had just retired after a 25-year career in the U.S. Army Medical Corps, and was able to connect with former military health colleagues, including Schoomaker and then-Army Maj. Gen. (Dr.) Richard Thomas, who was serving as the Defense Health Agency's chief medical officer. Thomas is an alumnus of WVU's undergraduate, dental and medical programs, and is now USU's president.

    This quickly led to several more meetings and discussions, led by Dr. Clay Marsh, vice president and executive dean of WVU's Health Sciences Center, and Dr. Bill Ramsey, assistant vice president of coordination and logistics for the center. Ultimately, they arrived at a CRADA, signed off by Thomas and Marsh, and have since continued looking for ways to make the most out of their collaboration.

    The hope is that this joint effort will galvanize further interest from other entities, Schoomaker said, leading to other similar collaborations, ultimately continuing the fight against a crisis that's impacting the entire nation.
    Medicinal Qigong & Tai Chi may ultimately be their greatest gifts (Acupuncture is intrinsically medicinal).
    Gene Ching
    Publisher www.KungFuMagazine.com
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  15. #255
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    Cardiac rehab

    As I often say - Tai Chi for rehab may be the greatest treasure martial arts have to offer the modern world.

    Tai Chi holds promise as cardiac rehab exercise
    Journal of the American Heart Association Report
    October 11, 2017

    Study Highlights:

    The slow and gentle movements of Tai Chi – which can increase in pace – hold promise as an alternative exercise option for patients who decline traditional cardiac rehabilitation.
    The study is the first to suggest that Tai Chi may improve exercise behaviors in this high-risk group.
    Embargoed until 4 a.m. CT / 5 a.m. ET Wednesday, Oct. 11, 2017

    DALLAS, Oct. 11, 2017 — The slow and gentle movements of Tai Chi hold promise as an alternative exercise option for patients who decline traditional cardiac rehabilitation, according to preliminary research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

    After a heart attack, more than 60 percent of patients decline participation in cardiac rehabilitation. Although the reasons include financial concerns and distance to a rehab center, many patients stay away because they perceive physical exercise as unpleasant, painful or impossible given their current physical condition.

    This is the first study suggesting that Tai Chi may improve exercise behaviors in this high-risk population.

    “We thought that Tai Chi might be a good option for these people because you can start very slowly and simply and, as their confidence increases, the pace and movements can be modified to increase intensity,” said Elena Salmoirago-Blotcher, M.D., Ph.D., lead author of the study and assistant professor of medicine at the Warren Alpert School of Medicine at Brown University. “Tai Chi exercise can reach low-to-moderate intensity levels. The emphasis on breathing and relaxation can also help with stress reduction and psychological distress.”

    Researchers adapted a Tai Chi routine for use in heart disease patients from a protocol previously used in patients with lung disease and heart failure. They compared the safety and compliance of two regimes: LITE, a shorter program with 24 classes over 12 weeks and PLUS, a longer program with 52 classes over 24 weeks. All participants received a DVD to use for home practice during and after receiving the classes.

    The study was conducted at The Miriam Hospital in Providence, Rhode Island and included 29 physically inactive heart disease patients (8 women and 21 men, average age 67.9 years) who expressed an interest in a Tai Chi program. Although the majority had experienced a previous heart attack (58.6 percent) or procedure to open a blocked artery (PCI - 82.8 percent; CABG - 31 percent), all had declined cardiac rehabilitation and continued to have many high-risk characteristics, including current smoker (27.6 percent), diabetes (48.3 percent), high cholesterol (75.9 percent), and overweight (35 percent) or obese (45 percent). All had received physician clearance to undergo Tai Chi training and none had orthopedic problems (such as recent joint replacement surgery) that would preclude doing Tai Chi.

    Researchers found Tai Chi:

    was safe, with no adverse events related to the exercise program except for minor muscular pain at the beginning of training;
    was well liked by participants (100 percent would recommend it to a friend);
    was feasible, with patients attending about 66 percent of scheduled classes;
    did not raise aerobic fitness on standard tests after 3 months of either the programs; and
    did raise the weekly amount of moderate to vigorous physical activity (as measured by a wearable device) after three and six months in the group participating in the longer program, but not in those who took part in the shorter program.
    “On its own, Tai Chi wouldn’t obviously replace other components of traditional cardiac rehabilitation, such as education on risk factors, diet and adherence to needed medications,” said Salmoirago-Blotcher. “If proven effective in larger studies, it might be possible to offer it as an exercise option within a rehab center as a bridge to more strenuous exercise, or in a community setting with the educational components of rehab delivered outside of a medical setting.”

    Co-authors are Peter M. Wayne, Ph.D.; Shira Dunsiger, Ph.D.; Julie Krol, M.S.; Christopher Breault, B.S.; Beth C. Bock, Ph.D.; Wen-Chih Wu, M.D., M.P.H.; and Gloria Y. Yeh, M.D., M.P.H. Author disclosures are on the manuscript.

    The National Center for Complementary and Integrative Health funded the study.

    Additional Resources:

    Multimedia available on the right column of the release link: https://newsroom.heart.org/news/tai-...b09d64abc73f58
    AHA Heart Attack Website
    AHA Cardiac Rehab Site
    American Heart Association Recommendations for Physical Activity in Adults
    After Oct. 11, view the manuscript online
    After Oct. 11, view the editorial olnline
    Follow AHA/ASA news on Twitter @HeartNews
    For updates and new science from JAHA, follow @JAHA_AHA
    ###

    Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

    About the American Heart Association

    The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

    For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

    Karen Astle: 214-706-1392; karen.astle@heart.org

    For Public Inquiries: 1-800-AHA-USA1 (242-8721)

    heart.org and strokeassociation.org
    Gene Ching
    Publisher www.KungFuMagazine.com
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