Tai Chi as medicine

[GLW]

The medical advice for Type II Diabetics and pre-Diabetics has consistently been to maintain a good weight, eat the correct diet - low fat, lo carb, high protein and fiber, and do aerobic exercise.

So, unless this advice is totally off base, what i REALLY want to know from a study is if Taijiquan, Qi Gong, or a combination of both is any better than any other form of exercise program at helping to control a person's Diabetes.

To this end, you really would not have to include the non-exercise group unless you wanted to lay a baseline of "See, exercise in and of itself does a lot of good..." This would then get you out of the ethical problem os "withholding treatment" even though a large number of people with Type II Diabetes or pre-Diabetes are already couch potatoes.

Now, maybe I am just sensitized...living in Houston with a couple of very large medical schools and a large well known medical center... Quoting a study like this in justifying why to take up Taijiquan over some other program will basically get your lunch eaten.

[cjurakpt]

One thing I wonder too is how can you do a controlled, randomized, DOUBLE-BLINDED study for exercise. Is it even possible?

The researchers could be blinded but there's no way to blind the person doing the exercise. There is no "placebo" exercise that you could do.

How might this bias the results of exercise studies?

EO

well, of course, you can't placebo movement per se - either people are engaged in kinetic activity, or they are not; I think what would differentiate qigong from aerobic exercise is the specifics of the movements and also how they are coordinated by with the breath; for example, some of the qigong I do utilizes end range breathing a great deal, meaning that one maintains an inhale or exhale to the point where the impetus to reverse it becomes physiological as opposed to voluntary (ok, not to be done by just anyone, I agree, especially not someone at risk for aortic aneurism, LOL); that is something that could not be replicated via placebo, if people in a "walking" group just walk without specific instruction regarding breathing in time with their stepping, for example; the idea is that, coordinated breathing practice could have some impact on ANS, the lymphatics, etc., so you could conjecture a differential there...

The medical advice for Type II Diabetics and pre-Diabetics has consistently been to maintain a good weight, eat the correct diet - low fat, lo carb, high protein and fiber, and do aerobic exercise.

So, unless this advice is totally off base, what i REALLY want to know from a study is if Taijiquan, Qi Gong, or a combination of both is any better than any other form of exercise program at helping to control a person's Diabetes.

To this end, you really would not have to include the non-exercise group unless you wanted to lay a baseline of "See, exercise in and of itself does a lot of good..." This would then get you out of the ethical problem os "withholding treatment" even though a large number of people with Type II Diabetes or pre-Diabetes are already couch potatoes.

Now, maybe I am just sensitized...living in Houston with a couple of very large medical schools and a large well known medical center... Quoting a study like this in justifying why to take up Taijiquan over some other program will basically get your lunch eaten.

again, same idea - it's not so much what you do, but how you do it: if I teach taiji movements and don't talk about details like coordination of breathing with movement, coordination of eye movements with body movements, specific kinesthetic awareness of weight transfer etc., then I am not teaching taiji, i'm just having people move around slowly - what a good research study would do would be to articulate these specific parameters in terms of physiologically / biomechanically what is going on, and project their possible impact based on analysis of how they might reasonably interact with autonomics, lymphatics, etc.; this of course means that you have to leave behind all the mumbo about "qi" and whatnot, and simply analyze the parameters of what is going on in as relatively objective a manner as possible - so for instance we can talk about coordinating eye and body movement in terms of the occulo gyro cephallic reflex, which is the phenomenon of muscles priming to activate to move the body in the direction that the eyes are looking, ostensibly leading to more appropriate agonist / antagonist relationships in the muscular system, and possibly leading to more appropriate postural tone overall in a group that practiced this way as opposed to one who didn't bother to coordinate where they were going with where they were looking (a not uncommon phenomenon, LOL);
so again, we need to identify specific parameters of an activity in order to differentiate
it from something that resembles it in another capacity; only then can you determine if the intrinsic properties of something like qigong or taiji are inherently more "health producing" than something else that does not contain those things; of course, if that is the case, then one might suggest that these parameters could conceivably be practiced in and of themselves in an alternative superstructure of movement, meaning that they do not require the architecture per se of taiji in order to be effective, LOL...

[taai gihk yahn]

some of the more reliable studies on taiji, to my knowledge, have been conducted by:

1) Steven Wolfe, PT, PhD - he was the one who got most of those studies going in the '90's on the benefits of taiji for balance in older adults, and things kinda took off from there

e.g.: http://ptjournal.org/cgi/content/abstract/86/9/1189

2) Yang Yang, PhD - he's a Chen guy w/a PhD in Kinese from Urbana - has been promoting his Evidence Based Taiji for a few years now

http://www.chentaiji.com/research/

here's a link to a rather exhaustive list of taiji related research compiled by a colleague of mine, Bill Gallagher, PT; some of it is probably better than others, but it shows you the range:
http://www.EastWestRehab.com/reference.htm

here's the gig w/research: it's hard to do good research, especially on a topic like taiji (or chiro, ostoepathic, acupuncture, etc.), which requires analysis and control of a large number of at times unknown variables and also is to a large degree contingent upon the personal skill of the operator - meaning that there is much more of a chance that subjectivity will creep in; now, I personally have no issue w/subjective reporting - anecdotal studies are a great tool - but they are just not generalizable, that's all; so when you are trying to do something about the effects of taiji w/a large cohort study, it can get tricky if you don't nail down your operational definitions / parameters, etc. really hard; so when people do shoddy research and present it as valid and reliable, (and this is often the case w/people who are trying to "prove" the efficacy of so-called "alternative" medicine) it's cause they are usually not trained as researchers; and as such, they should get shot down; problem is, they are often so cluless about their own shortcommings, that they accuse the people shooting them down of inherent bias against "alternative" stuff, labling them as close-minded; in fact, it's often the opposite: true skeptics are very open-minded, provided that one can demonstrate compelling objective (relatively) evidence as to why they ought to accept something into their belief system as being universally true...

[taai gihk yahn]

Altho nothing will satisfy those that feel their income threatened by us

who would think their income was threatened?

[Sifu]

Quite a few doctors in Texas taking private Tai Chi lessons. The don't really want their peers to find out, but the seed of change is being planted.

I got to present and teach Tai Chi to 75 medical students that where about to go into their internship. They were really great classes, and the students were wonderful. Medical school is pretty stressful, and the staff of many medical schools are looking for ways to reduce stress or help students deal with stress.

It would not surprise me if the majority of these students some day take up tai chi. Medical students don't have a whole lot of down time, but there was a lot of deep interest.

Reduction of stress is the doorway to introducing Tai Chi to the medical profession. After a few of them get back issues relived we will have a fairly exuberant set of mature doctors understanding the value of Tai Chi. Promoting qigong to them first thing is probably not the right path to enlightenment.

Bob

[GeneChing]

There's a vid if you click the link.

Tai Chi Martial Art can Tackle Pain: Study
2009-07-27 20:29:36 APTN Web Editor: Qin Mei
A new study by Australian researchers has found that the Chinese martial art of Tai Chi could have positive health benefits for arthritis sufferers.

It's the first comprehensive analysis of the role of Tai Chi in treating musculoskeletal pain, drawing on the experiences of patients who say the exercise improves their physical abilities.

Tai Chi is a gentle form of martial arts which has been popular in China for centuries.

But claims that it can relieve arthritis means it now has growing following in America and Australia as this class in Sydney shows.

Everyone here has some form of muscular or skeletal problem and they, like the scientists from Sydney's George Institute, are convinced regular classes like this can reduce their pain and increase their mobility.

Lead researcher Amanda Hall reached the conclusion after analysing data from seven separate randomised controlled trials which assessed the impact of Tai Chi on the physical condition of arthritis patients.

Although there is no specific medical evidence to support the idea that Tai Chi helps arthritis, Hall says most patients surveyed in her review reported an improvement in their pain and mobility levels thanks to the exercise.

Tai Chi has many forms, and the movements practised in classes like this one, have been specifically developed to benefit arthritis sufferers.

[GeneChing]

Personally, I've found qigong to be more powerful than tai chi for arthritis, but perhaps it's not as in the vernacular yet.

Tai Chi 'helps arthritis pain'
22nd June 2009

Researchers in Australia say they have found that the Chinese martial arts exercise Tai Chi has benefits for people suffering from arthritis.

A clinical trial carried out by researchers at The George Institute for International Health said the results showed a positive effect on musculoskeletal pain among participants who practised Tai Chi.

The study forms part of the first comprehensive analysis of Tai Chi and shows an improvement in pain and disability among arthritis sufferers who do the exercises, which evolved in China from martial arts and incorporate concepts of bodily energy, or qi.

The team said it would now go on to study whether similar benefits were seen in people suffering from chronic pain in their lower back.

Author Chris Maher said the study provided the first robust evidence in support of Tai Chi as a beneficial exercise for people with arthritis.

Tai Chi also showed a positive trend among practitioners in the direction of good general health, for which it is still practised by millions in China today.

Musculoskeletal pain such as that which comes with arthritis represented a severe burden on the sufferer, and on the community of which they were a part, the team said in a statement.

In Australia alone, 3.85 million people are affected by such chronic pain and disability. Low back pain is thought to cost the economy billions every year, the researchers said.

George Institute spokeswoman Amanda Hall said the research should encourage people with musculoskeletal conditions such as arthritis to seek exercise to relieve the pain.

Hall said Tai Chi was cheap, convenient and fun, bringing a host of benefits like social interactions and improved mental health.

Tai Chi is now being practised by growing numbers of people outside China and East Asia, and there is now a significant body of research investigating its health benefits.

Practised both alone and in groups or classes, it consists of set forms of slow martial arts movements like punching, kicking and blocking, encouraging stillness of mind and smoothness of motion.

[Sifu]

Personally, I've found qigong to be more powerful than tai chi for arthritis, but perhaps it's not as in the vernacular yet.

I agree that qigong can be quite a bit more powerful that way. To me that is almost the point. Tai Chi will help get people ready to handle what qigong can give them. Folk who grow up in an ultra conservative environment are often so blocked in their flows that qigong can be pretty distressing and even scary.

If you are doing the breathing correctly and the focus, tai chi is qigong and is much safer to learn if you don't have the right teacher.

Bob

[mawali]

..... tai chi is qigong and is much safer to learn if you don't have the right teacher.
Bob

I personally prefer the word daoyin, though it may be archaic!

[Sifu]

I do too, except I might be then asked to explain what Tao is.

Have you ever tried to explain Tao to a typical Texan? I have a hard enough time trying to explain it to myself.

Bob

[mawali]

Yep.....
High-powered medical experts in Houston require print and media reporters to report them saying that Tai Chi does not work.

If you read the fine print - it says exactly what GLW is saying about studies - altho most potential beginners don't read the fine print. These same folks say the same thing on TV - no fine print explanation - about supplements, Chinese traditional medicine, chiropractors, etc... in fact they have at least a century of practice of doing this to the chiro's..... and they're very good at it. When the study mentioned above from England came out, there was all the screaming and hair-pulling about studies from foreign countries being not reliable; and also they have managed medicine and can't be trusted to say anything about medical topics.

So, since they're trying to keep the beginners away - are they successful with doing that in Houston? I don't know.. but in Sugar Land we have a waiting list to get in and will start a new full-up beginner class in August.

So yea, having a for-real study to refute them would be very nice!!!! I just don't have a clue who would pay for it tho....

If you have seniors and others with chronic diseases in Asia and elsewhere doing taijiquan between 45-90 yrs and finding benefit and some say this is not real then let them eat diapers! US health requires continuous payment so if you can take care of your own wellbeing and fool the naysayers then so be it!
I am not saying doctors do not count but if the individual has more say in his health then better to smile and thank them for the craft they weave!