Tai Chi as medicine

[taai gihk yahn]

Most of these studies at Harvard are run by Ramel Rones, using some basic qigong, or his 'Sunrise Tai Chi' form, which is basically the first 9 movements of the classical Yang form as taught by Dr. Yang, Jwing-Ming, plus a closing move and abdominal breathing.

do you know if Joe Audette, MD has anything to do w/any of that work? (he was a PM&R resident back when I was in PT school at Columbia)

The osteoarthritis study was designed by Ramel under Chenchen Wang, MD, MSc.

as you obviously know, doing good research is a biotch, and most done by "alternative" types in the not too distant past is crap (never mind the stuff coming out of PRC - it's like a running gag); that seems to be changing of late, thankfully...
what were the results of the study?

He presented their research on the benefits of tai chi for osteoarthritis of the knee at the International Tai Chi Symposium in Nashville, TN in July this year.

that looked like a nice event - it was suggested to me to attend, possibly even present something, but time was not available; do you know if this will be a yearly thing?

"Rami" has been involved with the NIH in Boston since the 1990's and they have been very serious about slowly building real mainstream credibility, by operating WITHIN the system and following all the procedures requires of this kind of research.
These studies are VERY controlled, with all the double-blind controls required, and they have been slowly progressing over the past 10 years or so, from small groups toward larger, longer-term studies.

I know Steve Wolfe, PT, PhD has been involved in taiji research for over a decade down in Atlanta, which resulted in the body of work demonstrating decreased falling incidence in geriatric pop as a result; nice thing about a standardized "mini-form" w/a specific protocol is that you can factor out operator influence to a viable greater degree and ty to get the modality interacting more "purely" in a sense; although some would argue that this robs taiji of something essential...

Many places here in Boston, Mass General Hospital, Tufts medical School, Dana Farber Cancer Institute, are involved in these studies, and offer weekly taiji/qigong classes

I keep thinking about going around to local hospitals and starting classes, but it's always an issue of time, time, time...

Its impossible to say if Taiji, or Qigong, or Daoyin, or whatever, is better for health and healing - it depends on the teacher, the student, the condition, etc.

this is often the confounding aspect of doing studies along these line: operator skill / subjectivity is a critical component in application of some of this stuff - similar to any integrated movement approach (Feldenkreis, Alexander, Pilates, etc.);

But it is becoming clear that unlike jogging or other 'external' exercises, 'internal' arts like taiji and qigong have a lot of benefit because not only do they exercise the body, and increase range of motion, and oxygen uptake, but they also trigger the 'relaxation response' which retrains the nervous system and can have health benefits even on the genetic level.

are there any studies demonstrating differences between something like joggin and practicing taiji? personally, I would suggest that "relaxation" can happen w/just about any sort of movement, including running (there is even practice of "qigong running"), so I would say it has more to do w/the intent and the presence of awareness that one brings to it - running on a treadmill can be "internal", but not if you are staring at ESPN and wishing you weren't there at the same time!

I would say taiji is about 15 years behind yoga as far as when it will hit the mainstream in a big way. Qigong is probably another 10 years behind that.

I think taiji in its "traditional" incarnation may be on a plateau - modified forms, such as taught by guys like Yang Yang, PhD or Stephen Wolfe, PhD are more "consumer friendly"; qigong, OTHO, I think is just ascending, but quickly - I mean, when the Boomers figure out that they can't do yoga anymore, what are they gonna do?

if you are interested in a large bibliography of taiji / qigong research, I can post the link

[YMAA_com]

Yes, post the link please, I collect that kind of data.

I think the Tai Chi Symposium will be annual.

In general these studies show benefits in varying degrees. Interestingly, data has show that the physical body can improve and range of motion can increase and immunity can be restored even at advanced age.

There are many, many of the studies being done now through the NIH and its really starting to happen now. Newsflash! Exercising and relaxing is good for you!

I haven't seen a study that weighs qigong against jogging or somesuch, but I agree with your point. ANY kind of activity can be a type of qigong, or moving meditation. That's kind of the point of practicing qigong: it becomes you. After a while of regular practice, you can't help but be mindful of your alignment when climbing stairs, or how you're breathing while you drive, or how you internalize negative stressors...until you are practicing all day every day.

I think its clear that Taijiquan in all its martial glory is alive and well and there is a revived, growing internal arts community. But a simplified, short taiji or qigong form serves an entirely different purpose, and there's no need for it to be tremendously accurate to a certain lineage. A short form is a useful tool for getting people to turn attention inward and take responsibility for their own health physically, energetically, etc.

In fact, a single exercise like 'Embrace the Tree' can serve that purpose. Its got everything inside: alignment, four/five gates breathing, abdominal breathing, interaction with the earth and heavens...

But of course, people need to move their bodies too...

(said the person sitting in a c0mput3r chair...)

[lance]

This in from Reuters recently.


It's an expanded study of earlier work done by Prof. Michael Irwin. Here's an older report:

GeneChing ,

ืHello , anyway , there are differebt forms of tai chi chuan Yang , chen , wu , and the sun style of tai chi chuan . The movements is ' nt just movements , they all have applications for each move just like TCMA . Tai Chi regardless of what style you practice , it helps keep you healthy because you ' re building your internal energy as well , I practice yang style tai chi the short version . It helps me develop my intuition more and developing internal energy . Internal energy is what makes you even stronger .

Intuition - Whereever I go for example store , office , school , companies of any type , you feel the aura and vibration and you can feel the people ' s energy force . And you can tell if the situation is good or bad , this all happens to me .

Other than that it helps me to get stronger when people accidently bump into me . Or when I do some kind of physical contact like when someone pushes me around in a playful , you feel the difference you notice that you can push the people , but they can ' t push you .

Tai chi of any style takes time and patient to get the benefits , but you need to relax and breath normally , and keep on practicing the movements until you feel the benefits .

Lance

[GeneChing]

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.

[GeneChing]

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

[GeneChing]

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.

[GeneChing]

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.

[GeneChing]

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.

[GeneChing]

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).

[GeneChing]

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
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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.

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heart.org and strokeassociation.org

[GeneChing]

Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial

Michael R. Irwin, Richard Olmstead, Carmen Carrillo, Nina Sadeghi, Perry Nicassio, Patricia A. Ganz, and

Abstract

Purpose
Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer.

Patients and Methods
This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response—that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index—at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression.

Results
Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months (P = .02) and at months 3 (P = .02) and 6 (P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups.

Conclusion
CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

Tai Chi Chih as Medicine

[GeneChing]

Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis.
December 12, 2017
This study aims to summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind-body exercises on symptoms and quality of life (QOL) in cancer survivors.

A systematic search in four electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and QOL in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges' g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed.

Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n = 7), prostate (n = 2), lymphoma (n = 1), lung (n = 1), or combined (n = 4) cancers. RCT comparison groups included active intervention (n = 7), usual care (n = 5), or both (n = 3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue (ES = - 0.53, p < 0.001), sleep difficulty (ES = - 0.49, p = 0.018), depression (ES = - 0.27, p = 0.001), and overall QOL (ES = 0.33, p = 0.004); a statistically non-significant trend was observed for pain (ES = - 0.38, p = 0.136). Random effects models were used for meta-analysis based on Q test and I 2 criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results.

Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made.

TCQ shows promise in addressing cancer-related symptoms and QOL in cancer survivors.

Journal of cancer survivorship : research and practice. 2017 Dec 08 [Epub ahead of print]

Peter M Wayne, M S Lee, J Novakowski, K Osypiuk, J Ligibel, L E Carlson, R Song

Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, 900 Commonwealth Avenue, 3rd floor, Boston, MA, 02215, USA. pwayne@partners.org., Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea., Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, 900 Commonwealth Avenue, 3rd floor, Boston, MA, 02215, USA., Zakim Center for Integrative Therapies and Healthy Living, Dana Farber Cancer Institute, Boston, MA, USA., Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., College of Nursing, Chungnam National University, Daejeon, Republic of Korea.

PubMed http://www.ncbi.nlm.nih.gov/pubmed/29222705

More medicinal Qigong & Tai Chi

[GeneChing]

Time to split off an indie thread dedicated to Tai Chi, Veterans & PTSD from our Tai Chi as medicine thread. This is important work.

Local VA Offers 1st Ever Tai Chi Program For Veterans
Alexandra Koehn
3:22 PM, Feb 8, 2018
9:03 PM, Feb 8, 2018


The VA in Murfreesboro has offered a class to veterans that’s the first of its kind at any VA in the country. Veterans have been learning the art of tai chi, and it’s been changing their lives.

MURFREESBORO, Tenn. - The Department of Veterans Affairs in Murfreesboro offers the only adaptive Tai Chi class in the country for veterans.

After recognizing success from the pilot program, the instructor has been training people across the country on how to incorporate Tai Chi into VA programs.

In the community room, socialization has helped some veterans find peace of mind.

"Research has demonstrated that Tai Chi is one of the most effective ways of maintaining mind body health," Dr. Zibin Guo said.

Guo helped launch the program two years ago. He said it was made possible by a grant.

Mindfulness is something that's imperative for veterans like Bruce Stophlet.

"Not the past, not tomorrow. Just now," Stophlet said.

Stophlet said the class has helped him physically and mentally. He suffers from post traumatic stress disorder, anxiety, depression, and a neurological condition.

"I have an issue with tremors and they tend to exacerbate when I'm in a stressful situation or around people," Stophlet said.

In Tai Chi class, he said he's able to achieve peace of mind.

"It's more than just the Tai Chi," Stophlet said. "It's just a comfort place. It's mindfulness. When we're working together."

Eventually the veterans in the class will be able to learn self defense through the martial arts practice.

"A lot of people find the practice and the idea of those movements and improve self confidence," Dr. Guo said.

So when these veterans go home, they have a new mission: to practice mindfulness, so they can heal.

"The mind is very powerful," Guo said. "It can make your body become anything you want to."

Aaron Grobengieser helps to manage the program.

“We don’t just have to be there for them when they’re having an acute problem, and we can really help them find ways to cope with some of the things they go through in a proactive way," Grobengieser said.

He said if you are a veteran, the class is free at the Murfreesboro location.

“We are a starting point. We are a flagship. We are an opportunity to see how it goes. We have a great opportunity here to really see what works," Grobengieser said.

Dr. Guo has recently visited the VA in Dallas and Salt Lake City to train instructors there in Tai Chi. He hopes to launch the programs soon.

[GeneChing]

The visual abstract is really helpful but I'd have to screen shot that to copy it here. Just follow the link below. This is the source of all the fibromyalgia news.

Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial
BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k851 (Published 21 March 2018)
Cite this as: BMJ 2018;360:k851

Chenchen Wang, director and professor of medicine1, Christopher H Schmid, professor of biostatistics and co-director2, Roger A Fielding, director and professor of medicine3, William F Harvey, assistant professor of medicine1, Kieran F Reid, scientist III3, Lori Lyn Price, statistician4, Jeffrey B Driban, assistant professor of medicine1, Robert Kalish, associate professor of medicine5, Ramel Rones, tai chi instructor6, Timothy McAlindon, division chief and professor of medicine1
Author affiliations
Correspondence to: C Wang cwang2@tuftsmedicalcenter.org
Accepted 13 February 2018
Abstract
Objectives To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration.

Design Prospective, randomized, 52 week, single blind comparative effectiveness trial.

Setting Urban tertiary care academic hospital in the United States between March 2012 and September 2016.

Participants 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group.

Interventions Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone.

Main outcome measures The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life.

Results FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group difference in FIQR scores=16.2 points, 8.7 to 23.6, P<0.001). The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007). There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly. Participants attended the tai chi training sessions more often than participants attended aerobic exercise. The effects of tai chi were consistent across all instructors. No serious adverse events related to the interventions were reported.

Conclusion Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. Longer duration of tai chi showed greater improvement. This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia.

[GeneChing]

Practicing Tai Chi helps improve respiratory function in patients with COPD
Tai Chi offers a low-cost, easily accessible alternative to pulmonary rehabilitation, according to a new study in the journal CHEST®
April 4, 2018

Glenview, IL – Finding ways to help patients with COPD improve their functional status is an area of interest for pulmonary healthcare providers. Currently, pulmonary rehabilitation (PR) is used where available to improve exercise capacity and quality of life, but the treatment requires access to trained staff and specialized facilities. A new study in the journal CHEST® looked at Tai Chi as a lower cost, more easily accessed treatment option. Investigators found that this slow, methodical form of exercise is equivalent to PR for improving respiratory function in patients with COPD.

Tai Chi, an ancient martial art that involves significant levels of physical exertion, is gaining popularity, especially among older people, across the globe. Originating in China, Tai Chi incorporates stretching, breathing, and coordinated movement and requires no special equipment. “Knowing the potential benefits of Tai Chi, we hypothesized that, in patients being treated with medication to manage their COPD symptoms, it could help improve the quality of life when compared to a course of classical western style PR,” noted Professor Nan-Shan Zhong, MD, State Key Laboratory of Respiratory Disease, Guangzhou, China.

The study tracked 120 patients with COPD in rural China who had never used a bronchodilator. After beginning daily treatment with indacaterol, subjects were randomly assigned to groups receiving traditional PR or Tai Chi. Both the Tai Chi and PR groups showed similar improvements in Saint Georges Respiratory Questionnaire (SGRQ) scores, a standard measure of health status in patients with diseases causing airway obstruction. However, after twelve weeks, a clinically significant difference in SGRQ scores emerged favoring Tai Chi. Similar trends were noted in performance of a six-minute walk test.

“Tai Chi is an appropriate substitute for PR,” explained lead investigator Professor Yuan-Ming Luo, PhD, also of the State Key Laboratory of Respiratory Disease. “While neither training approach differed from the other by more than the minimal clinically important difference of four SGRQ points at the end of this 12-week study, an additional twelve weeks after discontinuation of formal training, improvements emerged in favor of Tai Chi in SGRQ score, six-minute walk distance, modified Medical Research Council dyspnea score, and quadriceps strength. We conclude that Tai Chi is equivalent to PR and may confer more sustained benefit.”

Subjects in the Tai Chi group met for formal instruction five hours per week for 12 weeks and were taught the 24 form Yang style. The results of the Tai Chi group were compared to that of another group of subjects who received PR 3 times a week for 12 weeks.

Tai Chi
After the initial 12 weeks, participants were encouraged to continue their Tai Chi either alone or with a group in their community; however, no formal assistance was provided to patients during this period. Those in the PR group were participants received verbal encouragement to remain as physically active as possible. Final analysis of all data was conducted 12 weeks after the formal training had concluded.

Image: Study subjects participate in a daily Tai Chi session.

For many patients, reducing the symptoms of COPD can greatly improve their quality of life. While medication continues to play an important role in treating COPD, the cost of those medicines can be a barrier for some patients, especially for treating a chronic illness like COPD.

“This study demonstrates that a low-cost exercise intervention is equivalent to formal pulmonary rehabilitation and this may enable a greater number of patients to be treated,” concluded lead author of the study Michael I. Polkey, PhD, NIHR Respiratory Biomedical Research Unit, The Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, United Kingdom. “Physical activity is key to reducing symptoms in COPD. We do recommend pulmonary rehabilitation, but our study shows that Tai Chi is a viable alternative when there is no local PR service. We encourage pulmonary rehabilitation providers to consider offering Tai Chi as an alternative therapy that patients would then be able to continue unsupervised in their own home.”

About the journal CHEST®
The journal CHEST®, the official publication of the American College of Chest Physicians, features the best in peer-reviewed, cutting-edge original research in the multidisciplinary specialties of chest medicine: pulmonary, critical care and sleep medicine; thoracic surgery; cardiorespiratory interactions; and related disciplines. Published since 1935, it is home to the highly regarded clinical practice guidelines and consensus statements. Readers find the latest research posted in the Online First section each week and access series that provide insight into relevant clinical areas, such as Recent Advances in Chest Medicine; Topics in Practice Management; Pulmonary, Critical Care and Sleep Pearls; Ultrasound Corner; Chest Imaging and Pathology for Clinicians; and Contemporary Reviews. Point/Counterpoint Editorials and the CHEST Podcasts address controversial issues, fostering discussion among physicians. www.chestjournal.org

About American College of Chest Physicians (CHEST)®
CHEST is the global leader in advancing best patient outcomes through innovative chest medicine education, clinical research, and team-based care. Its mission is to champion the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. It serves as an essential connection to clinical knowledge and resources for its 19,000 members from around the world who provide patient care in pulmonary, critical care, and sleep medicine. For information about the American College of Chest Physicians and its flagship journal CHEST®, visit chestnet.org.

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare, open science and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support and professional education, including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray’s Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com

THREADS:
Simplified Yang 24 form?
Tai Chi as medicine