Posts Tagged ‘Peter Wayne’

The Harvard Medical School Guide to Tai Chi Released

It’s official! The Harvard Medical School Guide to Tai Chi:12 Weeks to a Healthy Body, Strong Heart & Sharp Mind is now available in book stores and online book sellers, including Amazon.com and Barnes&Noble.com.

Conventional medical science on the Chinese art of Tai Chi now shows what Tai Chi masters have known for centuries: regular practice leads to more vigor and flexibility, better balance and mobility, and a sense of well-being.

Cutting-edge research from Harvard Medical School also supports the long-standing claims that Tai Chi also has a beneficial impact on the health of the heart, bones, nerves and muscles, immune system, and the mind.

This research provides fascinating insight into the underlying physiological mechanisms that explain how Tai Chi actually works.

Dr. Peter M. Wayne, a longtime Tai Chi teacher and a researcher at Harvard Medical School, developed and tested protocols similar to the simplified program he includes in this book, which is suited to people of all ages, and can be done in just a few minutes a day.

This book includes:

• The basic program, illustrated by more than 50 photographs

• Practical tips for integrating Tai Chi into everyday activities

• An introduction to the traditional principles of Tai Chi

• Up-to-date summaries of the research literature on the health benefits of Tai Chi

• How Tai Chi can enhance work productivity, creativity, and sports performance

Peter M. Wayne, PhD, is Assistant Professor of Medicine at Harvard Medical School and the Director of Research for the Osher Center for Integrative Medicine, jointly based at Harvard Medical School and Brigham and Women’s Hospital.

Prior to this appointment, Dr. Wayne served as the Director of Tai Chi and Mind-Body Research Programs at the Osher Research Center and Founding Research Director at the New England School of Acupuncture.

He has more than thirty-five years of training experience in Tai Chi and Qigong and is an internationally recognized teacher of these practices.

It was an honor to work with such a renowned Tai Chi teacher and researcher to put together this new book.

I can honestly say my life is richer, and my mind and body certainly more relaxed, from having practiced Tai Chi over the past 3 1/2 years as I worked with Dr. Wayne on the book.

Tai Chi Helps Stroke Survivors Reduce Falls

Tai Chi can enhance balance, lower blood pressure, and improve mood, which are all important for stroke survivors.

People who have had strokes often suffer damage to the parts of the brain that help in maintaining balance.

Many people who suffer these problems with balance are more prone to falling and injuring themselves.

A handful of studies have evaluated Tai Chi as a rehabilitation exercise for stroke survivors.

Now Arizona researchers have found that stroke survivors who learned Tai Chi had fewer falls compared with those who participated in an exercise program for older adults or those who received usual care to help them recover from a stroke.

“Learning how to find and maintain your balance after a stroke is a challenge,” said Ruth E. Taylor-Piliae, Ph.D., R.N., the study’s principal investigator and Assistant Professor at the University of Arizona College of Nursing in Tucson, AZ.

“Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls.”

Taylor-Piliae presented the results of the study at the recent American Stroke Association’s International Stroke Conference 2013 in Honolulu.

The study included 89 stroke survivors, average age 70, who had suffered a stroke an average of 3 years prior to enrolling in the study.

The researchers randomly assigned the stroke survivors to one of three groups.

One third received Tai Chi instruction for 12 weeks.

Another third took a 12-week SilverSneakers® exercise class that focused on improving muscle strength and range of movement.

A third group received weekly follow-up phone calls along with written information encouraging them to be physically active.

The Tai Chi and SilverSneakers® classes met three times a week for an hour-long workout.

During the 12-week study, the researchers found that the Tai Chi group had the fewest number of falls (5) compared to those in the usual care group (15) and in the SilverSneakers® group (14).

Only four people who fell required medical treatment.

“The main physical benefits of Tai Chi are better balance, improved strength, flexibility, and aerobic endurance,” Taylor-Piliae said.

“Psycho-social benefits include less depression, anxiety and stress, and better quality of life.”

Previous studies have shown that Tai Chi may help improve clinical measurements of balance, for example, the ability to maintain balance or to reach and lean both forward and backwards.

“What’s noteworthy about this small, but strong, study is the researchers measured actual falls, and showed that Tai Chi translated into a reduction in falls,” says Peter Wayne, PhD, Assistant Professor of Medicine, Harvard Medical School, and Director of Research, Osher Center for Integrative Medicine at Brigham and Women’s Hospital and Harvard Medical School, and author of the upcoming The Harvard Medical School Guide to Tai Chi.

Wayne and his colleagues, as well as other researchers, have shown that Tai Chi improves balance and the gait of people with various neurological conditions.

New studies are now underway to study Tai Chi in Parkinson’s disease.

“Tai Chi training has the potential to translate into practical improvement in daily activities,” says Wayne.

“It can help people get stronger and more flexible, and improve balance, including those with severe neurological injuries.

Tai Chi also reduces the fear of falling, which helps promote a more active lifestyle.”

So the bottom line is that Tai Chi not only helps you feel better and have better balance, but you are less likely to fall.

Tai Chi May Delay Onset of Alzheimer’s Disease

As an unprecedented number of Americans approach old age, there is a growing concern about the loss of cognitive function that is often attributed to aging.

By around age 70 1 in 6 people have mild cognitive decline.

Mild cognitive decline is considered an intermediate state between the cognitive changes of aging and the earliest clinical features of dementia, particularly Alzheimer’s disease.

The good news is that due to your brain’s plasticity you may be able to improve your cognitive function and offset age-related decline through exercise, stress reduction, learning new tasks, staying socially active, and learning how to focus better — all integral elements of Tai Chi training.

“A body of studies on Tai Chi and cognitive function lend support to the promise of Tai Chi for your brain and mind’s health,” says Peter Wayne, PhD, Assistant Professor of Medicine, Harvard Medical School Director of Research, Osher Center for Integrative Medicine Brigham and Women’s Hospital and Harvard Medical School, and author of The Harvard Medical School Guide to Tai Chi.

This ancient form of slow, meditative exercise helps to create mental activity, and scientists believe it may be possible to delay the onset of Alzheimer’s disease.

November is National Alzheimer’s Disease Awareness Month, and although there is no cure for the disease, a study published in the June issue of the Journal of Alzheimer’s Disease revealed that elderly people practicing Tai Chi just three times a week can boost brain volume and improve memory and thinking.

Scientists from the University of South Florida and Fudan University in Shanghai found increases in brain volume and improvements on tests of memory and thinking in Chinese seniors who practiced Tai Chi three times a week.

The 8-month randomized controlled trial compared those who practiced Tai Chi to a group who received no intervention.

The same trial showed increases in brain volume and more limited cognitive improvements in a group that participated in lively discussions three times per week over the same time period.

“The ability to reverse this trend with physical exercise and increased mental activity implies that it may be possible to delay the onset of dementia in older persons through interventions that have many physical and mental health benefits,” said lead author Dr. James Mortimer, professor of epidemiology at the University of South Florida College of Public Health.

Dr. Wayne notes that other randomized trials have evaluated Tai Chi in adults diagnosed with moderate levels of dementia.

In one large Chinese trial, a group assigned to Tai Chi showed greater improvements in cognitive performance after five months than a group assigned to a stretching and toning program, and fewer of those in the Tai Chi group progressed to dementia.

In a smaller study at the University of Illinois, a group of adults with dementia showed small increases in mental ability and self-esteem after 20 weeks of a combination of Tai Chi, cognitive behavioral therapies, and a support group as compared to an education group, who had slight losses of mental function.

“Interestingly, a follow-up companion study reported benefits of Tai Chi training to the caregivers of people with dementia,” says Dr. Wayne.

“Tai Chi may offer specific benefits to cognition, but more larger-scale trials that also include longer follow-up periods are needed to make stronger conclusions.”

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.

Isolating the 8 Active Ingredients of Tai Chi

Perhaps what makes Tai Chi so special is that it is a holistic, multi-component exercise that impacts us at physical, psychological, social, and philosophical levels.

Based on his research and 35 years of Tai Chi training, Peter Wayne, PhD, Research Director for the Osher Center for Integrative Medicine jointly based at the Harvard Medical School and Brigham and Women’s Hospital, has put into words what he describes as the 8 Active Ingredients of Tai Chi.


“Like the components of a multidrug combination to lower cholesterol and blood pressure, each ingredient has a unique impact on the physiology of the body,” says Wayne.

“However, in Tai Chi, there are many more components, and each of these factors is inseparable from, and synergistic with, each other.”

In a recent blog Dan Kleiman, a fellow Tai Chi instructor in the Boston area, discussed the concept of 8 Active Ingredients with Wayne.

Here are some excerpts from that interesting discussion between the two Tai Chi instructors:

The concept of isolating active ingredients is common in other medical research. But does it really make sense to think of Tai Chi within this framework?

Great question…..and I think absolutely so.

Part of why I chose this language is to bend the ear of my medical colleagues—to try to communicate in their language.

Even if we see positive clinical effects in Tai Chi trials, without plausible mechanisms–– that is, being able to attribute clinical health effects to specific ‘active ingredients’, research results often have little traction in the medical community.

Mechanisms are part of what we call the totality of evidence.

Additionally, by using this language, we’ve been able to emphasize Tai Chi’s richness—that it includes not just one active ingredient—but many—including those related to neuromuscular control, breathing, cognitive processes, etc.

This may explain why it’s helpful for so diverse a set of health issues.

Finally, as a teacher, thinking in terms of active ingredients has helped me shape a curriculum that tries to maximize the ‘dosage’ of essential Tai Chi principles in as short a period of time as is possible.

This is key for teaching in clinical trials which are often constrained in length due to funding limitations; but also relevant to community-based classes where we want people to get a real taste of deep Tai Chi as quickly and efficiently as possible.

Living in the research world and the Tai Chi world at the same time allows Peter to apply lessons from one to the other. Here he explains how his scientific education influences the way he understands teaching Tai Chi:

My formal academic training was in evolutionary biology and ecological modeling, and my research for the first 15 years was with plants.

So shifting to medical research 12 years ago was a big change for me.

Consequently, I bring a somewhat unique perspective to the teams of medical researchers I work with.

My training to think ecologically, in terms of systems, is more like Chinese Medicine in that it focuses on ecological interactions within the body—how systems interact to create a complex whole that is greater than the sum of its parts.

In contrast, Western medicine has traditionally emphasized reductionist thinking, focusing on smaller and smaller parts, often at the cost of not seeing the whole person.

Interestingly, systems biology is being increasingly appreciated in medicine, and Tai Chi research fits beautifully into this more ecological framework of health.

Can you give an example?

Sure…breathing is a really important element in our Tai Chi and qigong training.

But there’s no way you can substantially change your breathing without changing your posture and how you hold your structure.

And your breathing deeply affects you nervous and cardiovascular system, and many aspects of your mood; it can be a great tool for focusing the ‘monkey mind’ and becoming more sensitive to the inner landscape of our body.

And of course changes in all these processes feedback on how we move and socially respond and interact with others.

All these processes are ecologically intertwined with each other.

But I also still think it’s useful to unpack the interconnected components—for example to teach breathing exercises on their own and to study the physiological impacts of breathing exercises, in isolation of the larger package of Tai Chi.

As a teacher, focusing on individual components helps brings awareness to finer scale processes, and it helps make a clearer teaching intention.

Also talking about the physiology of breathing in classes helps some students appreciate the work, and for the students, there can be a lot of power in knowing.

Most of us like to be told why we are doing a given practice in a given way.

It really helps if students are informed.

It creates buy in.

I really love building bridges between traditional practices and modern science for this reason.

Tai Chi: One of the Best Exercises for Balance

Tai Chi may be one of the better exercises you can do to maintain balance and prevent falls, based on systematic reviews.

“The diverse, multiple active ingredients inherent in Tai Chi allow you to compensate for deficiencies in the physiological and cognitive components that underlie balance loss,” says Peter Wayne, PhD, Assistant Professor of Medicine at Harvard Medical School and Director of Research, Osher Center for Integrative Medicine Division of Preventive Medicine Brigham and Women’s Hospital and Harvard Medical School.

Keeping your balance is a complex task, involving the co-ordination between muscles and sensors that detect balance and are part of the nervous system.

In older people many factors, such as reduced muscle strength, stiff joints, delayed reaction times, and changes in the sensory system, all add up to a reduced ability to maintain balance.

A new Cochrane Review indicates that regular exercise helps older people improve their balance and reduces their risk of falling.

The new review included 94 studies that involved a total of nearly 10,000 participants.

The following types of exercise are the most effective, according to the review:

* exercise that targeted a person’s walking, balance, and co-ordination

* strengthening exercises

* 3-dimensional exercises, including Tai Chi, dance, and yoga

* general physical activity such as walking or cycling

* computerized balance training that uses visual feedback

* exercise involving vibrating platforms

In general, the effective programs ran 3 times a week for a duration of 3 months and involved exercises that challenged people’s balance while they were standing.

Dr. Wayne explains how Tai Chi helps balance:

* It’s a weight-bearing exercise.

* It sensitizes sensory systems.

* It helps coordinate neuromuscular patterns.

* It reduces the fear of falling, which is one of the biggest predictor of falls.

More Evidence Tai Chi Eases Low Back Pain

A growing body of evidence suggests that Tai Chi may be effective for easing pain and improving the quality of life of those with persistent low back pain.

Despite the widespread use of Tai Chi for back pain, surprisingly few Western studies have evaluated Tai Chi for back pain.

Now the results of the first larger-scale clinical trial studying the effect of Tai Chi for persistent low back pain have just been published in the November issue of the journal Arthritis Care & Research.

An Australian team led by Dr. Amanda Hall randomly assigned 160 adults between age 18 and 70 to either 10 weeks of Tai Chi training based on a simplified form, called “Tai Chi for Back Pain” developed by Dr. Paul Lam, or to a control group.

The results showed that Tai Chi significantly improved bothersome back pain symptoms (1.7 points on a 0-10 scale), which was the study’s primary outcome.

The participants also said they experienced less pain-related disability and felt their health-related quality of life had improved.

They also said they felt better in general for having done Tai Chi.

The researchers’ conclusion: Tai Chi is safe and effective for those experiencing long-term low back pain symptoms.

In a small, unpublished pilot study, Harvard researchers Peter Wayne, PhD, and Gloria Yeh, MD, anonymously surveyed 144 Tai Chi practitioners, average age 53, two-thirds of them women, at Boston area Tai Chi schools.

More than half said they have used Tai Chi for back or neck pain, and nearly all reported Tai Chi was “helpful” or “very helpful.”

“The gentle movements of Tai Chi might help begin to gently stretch and strengthen tissues and improve local circulation in the back,” says Wayne, who is Assistant Professor of Medicine at Harvard Medical School and Director of Research, Osher Center for Integrative Medicine Division of Preventive Medicine Brigham and Women’s Hospital and Harvard Medical School.

“Because Tai Chi is done slowly and mindfully, it is less likely to cause more trauma to injured regions of the back.

The reduction in what is often unconscious pain can lead to more efficient gait and posture, putting less biomechanical strain on tissues, including connective tissues.

Mindful breathing might help you sense and even massage regions of the lower back, and the meditative, stress-reducing aspects of Tai Chi might improve your anxiety, mood, and sleep pattern.”

The bottom line: If you have chronic low back pain, the many components of Tai Chi may just help relieve your pain.

Tai Chi Good for the Heart

If you have heart failure and practice Tai Chi, you’ll feel better about your life, your mood will lift, and you’ll be more likely to keep on exercising.

Those are the results of the largest study of the effects of Tai Chi on heart failure, reported this week in the Journal of the American Medical Association.

“The multi-component nature of Tai Chi – the combination of physical exercise, stress reduction, and social support – along with its integration of multiple body systems makes it an ideal way to prevent and rehabilitate heart disease,” says one of the co-authors of the study, Peter Wayne, PhD. Director of Tai Chi and Mind-Body Research Programs, Harvard Medical School’s Osher Research Center.

“Tai Chi can potentially prevent and aid the management of heart disease by providing a form of aerobic exercise, more efficient breathing, improved circulation, greater muscle strength, stress reduction, mood elevation, and encouragement of behavior changes.”

Heart failure is a particularly hard disease to live with due to the shortness of breath and low energy that results from the heart’s inability to pump enough blood. “Historically, patients with chronic systolic heart failure were considered too frail to exercise and, through the late 1980s, avoidance of physical activity was a standard recommendation,” writes the authors, led by Harvard’s Gloria Yeh, MD, MPH.

The Harvard researchers recruited 100 people with chronic heart failure and randomly assigned half of them to receive a 12-week Tai Chi program designed specifically for heart failure. The other half got a heart health education program.

The Tai Chi program involved some traditional warm-up exercises, including arm swinging, gentle stretches, breathing, and visualization techniques.

Then patients learned five simple movements adapted from Master Cheng Man-Ch’ing’s Yang-style Tai Chi, which the Harvard researchers have subsequently used in other clinical trials, all funded by the National Institutes of Health.

The patients also received an instructional videotape, and were encouraged to practice Tai Chi at home at least 3 times a week.

After 12 weeks, the patients in the Tai Chi group showed greater improvements in quality of life, in feelings of well-being, and in the confidence to perform exercise-related activities, compared with the education group.

Importantly, more than three-quarters of the participants came to the Tai Chi classes and many continued to practice Tai Chi at home when the researchers checked up on them 6 months later.

“This tells us that Tai Chi is enjoyable and can be safely incorporated into regular activities, even if you have chronic heart disease,” says Wayne.

Meditation vs Medication – One Letter Apart

There is a rich body of research showing that meditative exercises like Tai Chi can change the structure and function of the brain, and that focused concentration and non-judgmental moment-to-moment awareness in and of itself (without overt exercise) may modulate multiple aspects of health, including pain, immune function, and mood.

A new look at ongoing studies at Harvard in today’s Huffington Post suggests meditation may help to physically train the brain. Just as pumping iron trains muscles, meditation trains the brain by pumping neurons, writes Aditi Nerurkar, MD, Integrative Medicine Fellow at Harvard Medical School. She notes that studies show meditation can benefit patients with hypertension, chronic pain, rheumatoid arthritis, fibromyalgia, cancer, anxiety, depression, and substance abuse.

Tai Chi is commonly referred to as “meditation in motion.” One of the key features that distinguishes Tai Chi from simple movements using only your body weight for resistance is its rich, integrated set of meditative movements.

One of Tai Chi’s active ingredients relates to becoming more aware of, and at greater ease with, what is going on within your body and mind at any given moment. “Inner focus on moment-to-moment sensations allows you to train and hold your attention or mental focus, providing you with a tool to manage distracting thoughts and incessant mental chatter,” says Peter Wayne, PhD, Director, Tai Chi and Mind-Body Research Programs at Harvard Medical School. “As a result, you are more fully engaged and therefore more efficient with the physical tasks at hand and more in the moment.”

Unlike other Eastern practices, Tai Chi training does not teach meditation within the context of sitting on a pillow but through practical body-centered exercise. This may make what you learn more translatable to practical, everyday activities of daily living. One of the grand masters of Tai Chi, Wolfe Lowenthal, quoted Cheng Man Ch’ing in his book There Are No Secrets: Professor Cheng Man Ch’ing and His T’ai Chi Chuan: “The difference between yoga and Tai Chi is that even if you get it (meditative relaxation) studying yoga, there is nothing you can do if someone tries to knock you off your cushion.”

Other meditative traditions encourage the complete clearing or emptying of one’s mind of all thoughts. In contrast, Tai Chi is more of an active focused meditation. “During practice, when the mind wanders, you gently refocus it back to noticing practical and functional bodily sensations in the present moment,” says Wayne.

“One metaphor I commonly use during resting meditations is to think of the fabric of the body as a paper towel. Just as a paper towel naturally absorbs and holds water in its highly absorbent pores without effort, let the mind rest into and be held in or cradled by the body,” he says. “The spirit of this active ingredient is nicely captured in a clever phrase I saw on a bumper sticker and that I commonly cite in Tai Chi class: ‘Meditation—it’s not what you think.’”