T'ai Chi Scientific Studies

My many thanks go to Mac Overmyer, a medical writer and Tai Chi practitioner, for writing the following intoductory text and sifting through the many abstracts of scientific studies on Tai Chi to select those presented on this website. Links to the abstracts of these studies are at the bottom of this page.

Introduction

Despite having origins in the 15th century, Tai Chi's benefits are but weakly studied by western medicine. At least some of this can be attributed to western prejudices and a pre-occupation with western exercise and western-designed physical rehabilitation routines. The National Library of Medicine (NLM) is the primary data base for medical studies published in all peer-reviewed journals in the world. It houses all articles published in all languages in all established clinical journals. Typing "exercise" into the NLM's search engine produces the titles of 142,782 medical articles; typing "aerobic exercise" reduces the list to 42,105 titles and typing "exercise - balance" cuts it to 3,109 articles. Typing "tai chi" produces 238 articles. These 238 have been winnowed to 34 representative abstracts (a condensed form of a study) in several categories: general or comparative studies, balance studies, bone density studies, cardiovascular studies, immune system studies, psychological effects, and therapeutic effects in disease and recovery.

Notes About Formal Medical Studies

Readers will observe that the authors of these studies often present cautious or ambiguous conclusions. There are reasons for this. When working with humans, a host of uncontrollable factors come into play making it difficult to state with certainty that one factor (Tai Chi) produced one effect (improved bone density). For instance, the men and women in the study were aware that their bone density was being evaluated. This worried them so on the way home from the exercise clinic, they stopped at the local deli to buy milk, yogurt and other calcium-containing foods to improve their bones. The result was that men and women attending the Tai Chi clinic showed improvements in bone density compared to those who did not attend the clinic (or stop by the deli). You may smile but factors much smaller than this have distorted the findings of some very large and expensive studies.

Many of the published Tai Chi studies are conducted in Asian settings or involve Asians. These studies may be affected by cultural bias. For example Chinese subjects may be expected to show greater benefits because they are familiar with the art and are culturally programmed to expect benefits whereas western subjects are not as familiar with the exercise and may even be skeptical of the art. A number of Asian abstracts were discarded from the following list, not because of flaws in the studies, but to reduce redundancy and to soften the criticism that benefits are to be expected in an Asian population because they are Asian.

Many study authors conclude that their findings are "significant." They are not bragging about the success of their study or telling the reader that the findings are important. The term is used differently in scientific literature. It means that the findings are not accidental and are likely caused by the intervention. An example would involve 10 people given tai chi lessons being compared to 10 are not. After a year, 4 of the10 Tai Chi students have fallen and broken a hip compared to 6 of the 10 people who did not take the lessons. It cannot be claimed that the study shows that Tai Chi reduces hip fracture. The numbers are too small. The extra two people in the non-lesson group who broke their hips may have just been unlucky. The findings of the study are not significant. However, if 100 persons take lessons and 100 do not, and 40 in the lesson group break hips compared to 60 in the non-lesson group, it is reasonable to claim that the difference is "significant" and that Tai Chi, not luck or chance, reduces fractures. It is hard to imagine 20 people having the same bad luck.

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Two Final Observations

There is no question that Tai Chi improves balance and this is no small finding. Falls in the middle-aged and elderly can severely restrict their lives and leave them with a feeling of dependence and helplessness. Some researchers have reported that up to a third of the elderly who suffer hip fractures from falls die within a year of the fracture. Improving balance is one of the greatest benefits tai chi can bring to this population.

The second observation concerns Tai Chi, aerobic and weight bearing exercise. Consider the following when reading the conclusions of such studies. One form of exercise does not obviate the other. An individual can study Tai Chi and pursue health through aerobic and weight lifting. In fact, he or she will probably be better off for it. Secondly, and importantly, Tai Chi is not a repetitious activity even though it may appear as such to the casual observer. Tai Chi can be said to be an extended balletic form of martial arts. The foundation of the varied postures and movements in tai chi may take up to a year or longer to learn and several years to perfect. Some would argue that a person can spend his or her life perfecting forms and enjoying the rewards of learning something at each session. Conversely, once you have picked up a 10 lb dumbbell 15 times, you know everything there is to know about picking up a dumbbell. The point to be made is that Tai Chi remains always a comfortable challenge that brings continual rewards. This enhances what doctors call "compliance," the propensity of participants to stick with a therapeutic exercise regimen rather than drop out. Tai Chi studies usually reflect a high rate of compliance.

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Conclusions

The following observations are reasonable and based on the science presented in the abstracts:

— Tai Chi exercise is associated with higher bone mineral density and better neuromuscular function. Because of this it should reduce the incidence of age-related (i.e. osteoporotic) fractures.

— Tai Chi reduces falls in the middle aged and elderly by significantly improving muscle tone and balance. It also has the psychological effect of reducing the fear of falling. This is no small point. Falls and the resultant morbidity have an extreme impact on the quality of life in the elderly and have been associated with increased mortality.

— Tai Chi improves cardiovascular performance and blood pressure.

— Tai Chi has positive effects on immune system cells.

— Tai Chi produces psychological benefits in both the young and old, particularly in terms of confidence and mood.

— Tai Chi may have beneficial effects in AIDS patients, rheumatoid arthritis patients and cancer patients.

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Links to Abstracts* of Tai Chi Scientific Studies by Category