Posts Tagged ‘mind-body’

Tai Chi Improves Breathing in COPD Patients

There is a growing body of research that suggests that the slow, rhythmic breathing during Tai Chi enhances the health of patients with chronic obstructive pulmonary disease (COPD).

Conventional pulmonary rehabilitation programs that focus on aerobic exercise and strength training can improve exercise capacity, quality of life, and symptoms in patients with COPD.

In addition to extending the breathing techniques taught in pulmonary rehabilitation, mind-body interventions such as Tai Chi integrate novel elements, such as progressive relaxation, imagery/visualization, mindfulness of breathing and overall body sensations, postural training, and coordinated patterns of breathing and movement.

“These therapeutic elements may allow Tai Chi to impact COPD symptoms and pathology via complex mechanisms not specifically targeted in conventional rehabilitation and therefore may be an effective adjunct to therapy,” says Peter Wayne, PhD, Director of Research, Osher Center for Integrative Medicine at Brigham and Women’s Hospital and Harvard Medical School.

Wayne is the author of the upcoming book The Harvard Medical School Guide to Tai Chi.

“Mind-body exercises may also allow patients with COPD to feel more confident about their ability to exercise and entice them to continue to exercise, which, of course, has the potential for lasting benefits.”

A new study published online today shows that Tai Chi can be used as an effective form of exercise therapy for people with COPD.

The Australian researchers found that short-form Sun-style Tai Chi done twice a week for 12 weeks could improve the exercise capacity and quality of life in people with COPD. The research published ahead of print in the European Respiratory Journal suggests that Tai Chi may be as beneficial as pulmonary rehabilitation.

“With increasing numbers of people being diagnosed with COPD, it is important to provide different options for exercise that can be tailored to suit each individual,” said lead author Regina Wai Man Leung from the Concord Repatriation General Hospital.

“The results from this small sample provide compelling evidence that Tai Chi is an effective training program for patients with COPD, and could be considered as an alternative to the usual exercise training program that are available in pulmonary rehabilitation.”

At Harvard Medical School, Wayne’s group has completed a small, pilot randomized controlled trial designed to determine the feasibility of administering a Tai Chi program to improve the quality of life and exercise capacity in COPD patients.

The Harvard Medical School researchers randomized 10 patients, average age 66, with moderate to severe COPD to 12 weeks of Tai Chi plus usual care or usual care alone.

The Tai Chi training consisted of a one-hour class, twice weekly, that emphasized gentle movement, relaxation, meditation, and breathing techniques.

“We looked at disease-specific symptoms and quality-of-life, exercise capacity, pulmonary function tests, mood, and self-efficacy,” says Wayne.

“Participants reported enjoying the Tai Chi program, and were able to participate without experience and adverse reactions to exercising.”

After 12 weeks, the Tai Chi participants said they felt significant improvement in chronic respiratory symptoms compared to the usual-care group.

The Tai Chi group also had slight improvements in their 6-minute walking distance, depression, and shortness of breath.

“Our conclusion: Tai Chi as an exercise appears to be a safe, positive adjunct to standard care and warrants further investigation,” says Wayne.

Led by Dr. Gloria Yeh, the Harvard Medical School group is now conducting a 10-fold larger trial sponsored by the National Institutes of Health comparing Tai Chi to both meditative breathing exercises (isolated out of the Tai Chi program) as well as to a non-exercise education program.

Tai Chi Helps Ease Depression in the Elderly

The ancient Chinese mind-body exercise of Tai Chi can help relieve the symptoms of depression in older people.

More than 18 million American adults suffer from depression, and 2 million of them are age 65 or older. A new study from the University of California at Los Angeles shows that 10 weeks of Tai Chi classes for 2 hours per week helped to relieve depressive symptoms, as well as improve quality of life, memory, and cognition, and provide more overall energy, among 112 adults age 60 or older with major depression who were also treated with an antidepressant drug.

The study in the current online edition of the American Journal of Geriatric Psychiatry is the first study to demonstrate the benefits of Tai Chi in the management of late-life depression, said lead author Dr. Helen Lavretsky, a UCLA professor-in-residence of psychiatry.

Any kind of exercise may seem the last thing you want to do if you are depressed, but exercise may help relieve your symptoms. The links between anxiety, depression, and exercise is quite robust. There’s good evidence to suggest that exercise can improve depression and anxiety, and exercise may be just as good as drugs in treating depression.

Exercise probably helps in a number of ways, including releasing feel-good brain chemicals (neurotransmitters and endorphins) and reducing immune system chemicals that can worsen depression. Exercise has many psychological and emotional benefits as well. These include gains in self-confidence, feeling better about your appearance, relaxation of the mind, and enhancement of social interactions.

A number of Tai Chi studies have reported improvement in mood, decreases in anxiety, and enhancement in vigor. A recent meta-analysis of 40 Tai Chi studies including more than 3,800 subjects conducted by Dr. Chenchen Wang from the Division of Rheumatology at Tufts University School of Medicine found that Tai Chi reduced stress, anxiety, depression, and mood disturbance, and increased self-esteem.

“Tai Chi provides a perfect combination of exercise, mood enhancement, stress reduction, and social support,” says Dr. Peter Wayne, Director of Tai Chi and Mind-Body Research Programs at Harvard Medical School’s Osher Research Center. “Being part of a group has therapeutic value for a variety of medical conditions, including depression and anxiety. In ongoing Tai Chi classes, students develop a strong sense of community, and with rich interactions and support from teachers and peers, often undergo a profound journey of self-discovery.”

Tai Chi may just be a natural way for our aging population to handle the psychological aspects of depression and improve their physical health at the same time.

8 Active Ingredients of Tai Chi

How does a mind-body therapy like Tai Chi work?

In modern medicine, drugs are prescribed because of their active ingredients. Well-defined, laboratory-synthesized chemical compounds, such as ibuprofen, the active ingredient in Advil or Motrin, are specifically designed to impact physiological pathways to elicit a predictable, desired effect—in the case of ibuprofen, blocking the sensation of pain and reducing inflammation and fever.

Tai Chi is obviously different than drug therapy. It has no well-defined, single chemical ingredient, and is more a mixture of exercise, meditative, and psychosocial components.

A writer-colleague, Dan Ferber, addresses this issue in a new article in Kung Fu magazine in his fascinating interview with Tai Chi Master Yang Yang, Director of the Center for Taiji Studies in Champaign, Illinois, who spoke last October at the First International Symposium on Exercise Therapy, which took place at the Mayo Clinic in Rochester, Minnesota.

Yang Yang notes that mind-body treatments are considerably more complex than treatment with pharmaceuticals: “The effectiveness of a new drug is typically tested in a trial that is double-blinded, which means that the subjects themselves do not know which treatment they received. In a trial of taiji and other mind-body modalities, the subjects will know which treatment they have received. Gold-standard pharmaceutical trials are also placebo-controlled, meaning that patients receive either drug or a sugar-pill that they can’t distinguish from the drug. Placebo controls are difficult to achieve for trials of mind-body interventions. Unlike a drug, which acts via a single cellular mechanism, mind-body interventions like taiji exert their effects in multiple ways simultaneously.”

He notes recent research by Drs. Peter Wayne and Ted Kaptchuk of Harvard Medical School into the effects of Tai Chi on musculoskeletal strength and flexibility training, deep breathing, mindfulness, visualization and intention, and massage or gentle touch, psychosocial interaction, ritual and spirituality.

“Which are the effective ingredients? Do they work together? Is it possible to create a placebo, or ‘sham’ taiji intervention to assess the efficacy of taiji versus a placebo? Is it necessary? All these questions remain to be answered,” says Yang Yang.

In a recent conversation, Wayne told me “for a variety of reasons, I have found it useful to think of and teach Tai Chi within a framework of active ingredients. My colleagues and I have come to call the ‘8 Active Ingredients’ of Tai Chi. They are: Awareness, Mindfulness, and Focused Attention; Intention, Belief and Expectation; Dynamic and Structural Integration, Form and Function; Moderate Effort and Relax Actively; Natural, Freer Breathing; Psychosocial Support; Alternative Health Paradigm; and Ritual and Repetition of Practice. We use this conceptual framework to evaluate the clinical benefits of Tai Chi, to explore its underlying mechanisms of action, and to shape the way we teach Tai Chi in our trials.”

In practice, each of these active ingredients is interdependent and interwoven with the others. For example, you can not substantially change your breathing without altering your posture, neuromuscular dynamics, inner awareness, intention, and mood. As Wayne says “just as white light shining through a prism leads to a rainbow of colors, the 8 Active Ingredients allow you to appreciate the multiple components that make up the whole of Tai Chi.”

Tai Chi — Medication in Motion

The article I wrote “Tai Chi: Medication in Motion” appears in the January 2011 issue of American Legion magazine.

The science of Tai Chi is just now catching up with (and justifying) what Tai Chi masters have known for centuries – this mind-body practice, which originated in China as a martial art, leads to longer life, more vigor and flexibility, better balance and mobility, and a sense of well being. Cutting-edge research now supports the long-standing claims that Tai Chi has a favorable impact on the health of the heart, bones, nerves and muscles, immune system, and the mind. In fact, Tai Chi might well be called “medication in motion.”

Tai chi combines meditation with slow, gentle, graceful movements, as well as deep breathing and relaxation to move vital energy (what the Chinese call qi) throughout the body. “Tai Chi can heighten bodily awareness and inner focus, make body movements more graceful and efficient, enhance natural breathing, and help you attain peace of mind,” says Dr. Peter Wayne, assistant professor of medicine at Harvard Medical School, who has practiced and studied Tai Chi for more than 35 years. “Our fast-paced, multi-tasking, over-stimulated, more-is-better, Type-A, Western lifestyle can be counteracted by the ‘meditation in motion’ of Tai Chi.”

New research provides insight into the underlying physiological mechanisms that explain how Tai Chi works. This knowledge has enabled Dr. Wayne and his colleagues to shape the essential elements of Tai Chi into a program to use in the rehabilitation — and prevention — of many health conditions. They have developed and successfully tested a simplified Tai Chi protocol in a number of clinical trials. A 12-week controlled study of Tai Chi in heart failure found that the Tai Chi participants were able to walk longer and faster and had improved quality of life. What’s more, they had reduced blood levels of B-type natriuretic protein, an indicator of heart failure.

A newly completed Harvard randomized controlled trial of post-menopausal women diagnosed with low bone density used bone density markers and computerized motion analysis to quantify how Tai Chi affects weight-bearing in the skeleton. The preliminary results show that Tai Chi arrested bone loss in the hip and spine compared to women who had usual care, says Dr. Wayne.

Many other studies have shown the health benefits of Tai Chi. A Harvard review of 26 studies in English or Chinese of Tai Chi and high blood pressure found that Tai Chi lowered blood pressure in 85% of the trials. Tai Chi has also been shown to improve balance, reduce falls in older women, and increase bone strength – all important ways to prevent fractures from low bone density.

And studies show Tai Chi may be effective for rehabilitation and prevention of chronic low back pain, can reduce the pain of knee osteoarthritis, can reduce stress, enhance mood and sleep, and may strengthen the immune system, which improves the body’s resistance to disease.

“The integration of Tai Chi as an adjunct into the medical world can help prevent the progression of many chronic diseases,” says Dr. Wayne.