Tai Chi (T’ai Chi Ch’uan) is well-known and widely practiced for its health benefits. It’s particularly regarded for its ability to improve balance, range of motion, and lower limb strength, and has been highly researched to establish its effectiveness as a form of exercise for the elderly. In fact, there has been a great deal of research conducted on Tai Chi and Qigong exercises, and both the scientific evidence and the range of health conditions Tai Chi can prove beneficial for is constantly growing.
As a physiotherapist who practices and has been involved in teaching Tai Chi, I keep an eye on the evidence-based research coming out about Tai Chi and its benefits to people, so I can use this to advocate for Tai Chi as a form of therapeutic exercise. What has been interesting is seeing the breadth of research that is being undertaken, and the health conditions that Tai Chi is being shown to produce positive outcomes in beyond the classic falls prevention, various forms of arthritis, and age-related deconditioning. Conditions that I don’t believe most people would normally associate Tai Chi as being able to influence, much less produce positive outcomes. I’d like to illustrate this by bringing three such conditions to your attention, which you may not have been aware of.
Tai Chi and Breast Cancer
This has been of particular interest to me having had someone I care about recently undertake their own battle with breast cancer, as well as a number of past patients. Over the last several years researchers have been examining the effectiveness of Tai Chi as an intervention to prevent or improve secondary health conditions experienced by breast cancer survivors.
For example, a recent study by Galantino and colleagues (1.) has shown the feasibility of Tai Chi in improving the well-being of postmenopausal breast cancer survivors who have developed arthralgias (joint pain) as a side effect of being prescribed aromatase inhibitors (eg: Aromasin, Arimidex and Femara) to reduce estrogen production. Their study demonstrated statistically significant improvements amongst their test subjects for anxiety, depression, emotional well-being and fatigue, as well as the Sit-and-Reach test, and near statistical significance for pain severity, physical well-being, the Berg Balance Scale and Timed-Up-and-Go Test. This is important because, as the authors state, there are very few interventions that have been developed to counteract the side effects associated with this form of post-breast cancer therapy, and consequently many breast cancer survivors stop using their medication. If Tai Chi can limit the negative side effects of this type of therapy, not only can it improve peoples physical and emotional well-being, it can potentially increase adherence to medication regimes, and thereby reduce the risk of these survivors developing future complications.
The benefits Tai Chi can have on post-cancer symptoms experienced by many breast cancer survivors have also been demonstrated by other researchers. Huang and colleagues (2.) found that breast cancer survivors who engaged in physical activities like Tai Chi and Qigong demonstrated a proportional decrease in cancer-related fatigue compared to those who did not, while Sprod and colleagues (3.) demonstrated changes in biomarkers including insulin, glucose, and cortisol levels which correlated with improvements in health-related quality of life, physical functioning, social functioning and general mental health. Overall, the evidence is growing that breast cancer survivors – particularly those who are post-menopausal – would gain significant benefit from regular Tai Chi practice.
Tai Chi and Depression
Depression is an all-too-common, and in many ways still poorly managed, mental health condition in many societies, and one I encounter frequently amongst patients, particularly those suffering from chronic pain. While it is difficult to locate studies that have solely examined the relationship Tai Chi can have on depression, many studies exist where depression has been one of the variables measured as part of using Tai Chi as a form of therapeutic intervention.
One chronic pain condition that has been well-researched in terms of the effects of Tai Chi is fibromyalgia. An example of this is the research from Wang and colleagues (4.), who measured a number of physical, mental and emotional well-being indicators, including depression, amongst their participants who were engaged twelve weeks of Tai Chi training. Not only did they demonstrate improvements in measures of depression at the end of the twelve weeks of training, but these improvements persisted 12 weeks after the cessation of the training. Similar improvements in mental health measures, including depression, were reported the studies described for breast cancer suffers above.
Results such as these have led researchers and clinicians to call on health professionals to support patients wanting to explore Tai Chi as a form of complimentary therapy to treat issues such as depression. In their editorial in The New England Journal of Medicine, Yeh and colleagues (5.) called on physicians to ‘prescribe’ Tai Chi for patients with fibromyalgia, while psychotherapist Mary Ann La Torre (6.) advocates the use of body movement – in particular, Tai Chi, as a means of creating change and enhancing healing in psychotherapeutic treatment.
On a personal level, not only am I aware of the impact Tai Chi has on my own mental health, I have had patients with a variety of conditions where depression has been a component (for example, chronic pain, cancer, and HIV-positive status) who have all anecdotally reported improvements in their mental health and well-being having commenced Tai Chi training. It would be interesting to see future research specifically investigating the effects of Tai Chi on individual mental health conditions, such as depression, as these results would likely be transferable across a wide range of health conditions where depression is a factor.
Tai Chi and Diabetes
Another condition of close personal interest to me, not only because of its disproportionally high incidence amongst Aboriginal and Torres Strait peoples, but also because several people dear to me have either Type I or Type II diabetes. It is well-known that exercise is beneficial for the management of both types of diabetes, so it would be reasonable to expect that Tai Chi would produce similar benefits. However, what is interesting in the research being undertaken is that Tai Chi is not only beneficial for the secondary conditions associated with diabetes, for example, impaired mobility due to peripheral vascular complications (7.), it also has a direct effect on cellular physiology. For example, several studies have demonstrated that Tai Chi practice can increase insulin sensitivity and thereby reduce A1C levels (a better indicator of blood glucose levels over time, as opposed to the immediate result from a blood glucose monitor) (8.), and increase the levels and enhance the activity of regulatory T-cell levels (9.) which improves immune system functioning.
This is critical for those with diabetes, as being able to effect changes at the cellular level means better management of the primary complications associated with diabetes, which can then result in reduced risk of developing, or progression of, secondary complications, such as peripheral vascular disease and neuropathies.
These are only three examples of the wide range of health conditions that Tai Chi is proving itself to be able to make positive changes to. As quality of studies improve and researchers start to identify the specific ways in which Tai Chi can make changes to our health, it is my hope that we will see Tai Chi become a ‘treatment of choice’ in both managing and preventing ill-health.
Do you do Tai Chi? What ways has Tai Chi improved your health and well-being? Please feel free to share your answers in the comments section below.
1. Galantino, M. L., et al. (2013). Tai Chi for well-being of breast cancer survivors with aromatase inhibitor-associated arthralgias: a feasibility study. Alternative Therapies in Health and Medicine, 19(6): 38-44.
2. Huang, X., et al. (2010). Factors associated with cancer related fatigue in breast cancer patients undergoing endocrine therapy in an urban setting: a cross-sectional study. BMC Cancer, 10: 453-459
3. Sprod, L. K., et al. (2012). Health related quality of life and biomarkers in breast cancer survivors participating in tai chi chuan. Journal of Cancer Survivorship: Research and Practice, 6(2): 146-154.
4. Wang, C., et al. (2010). A randomized trial of tai chi for fibromyalgia. The New England Journal of Medicine, 363(8): 743-754.
5. Yeh, G. Y., et al. (2010). Prescribing tai chi for fibromyalgia – are we there yet? The New England Journal of Medicine, 363(8): 783-784.
6. La Torre, M. A. (2008). The role of body movement in psychotherapy. Perspectives in Psychiatric Care, 44(2): 127-130.
7. Orr, R., et al. (2006). Mobility impairment in Type 2 diabetes: association of muscle power and effect of tai chi intervention. Diabetes Care, 29(9): 2120-2122.
8. Bronas, U. G., et al. (2009). Alternative forms of exercise training as complementary therapy in the prevention and management of Type 2 diabetes. Diabetes Spectrum, 22(4): 220-225.
9. Yeh, S., et. al. (2007). Tai chi chuan exercise decreases A1C levels along with increase of regulatory T-cells and decrease in cytotoxic T-cell population in Type 2 diabetic patients. Diabetes Care, 30(3): 716-718.