Recent NCCIH Studies on Tai Chi

July 7, 2019 Joe Brady

Recent studies on Tai Chi funded by the National Center for Complementary and Integrative Health (NCCIH) have added to the growing knowledge of the potential benefits of some mind and body practices and provided insights into how these practices may work. One study involved a detailed examination of the effects of tai chi training on gait (the way a person walks). The study showed that as little as 6 months of tai chi might improve an important indicator called gait dynamics, which shows how well a person can walk. Tai chi may exert its effects by maintaining or improving flexibility to respond and adapt to unpredictable changes in terrain, stimuli, and stresses while walking.

Long known to reduce the risk of falling, this preliminary clinical trial on Tai Chi adds to the growing understanding of why that may be so. The trial, funded by NCCIH and conducted by a team led by researchers at Harvard Medical School and Beth Israel Deaconess Medical Center, found that as little as 6 months of tai chi training might improve an important indicator of how well a person can walk: gait dynamics, just one of many active ingredients in this mind and body approach that originated in China.

Improvements in Gait mechanics

Declines in walking ability with age have been linked to a wide range of health issues as well as increased risks of falls and death from all causes. Gait, or the way in which one walks, has thus become a research target. Gait enlists many systems throughout the body and has them work together in complex ways. One aspect that has not been much studied is “long-range gait dynamics”—how much people’s gaits fluctuate and change over time when they walk.

This study compared gait speed and gait dynamics in 27 tai chi experts (with at least 5 years of tai chi experience) and 60 people of similar ages who had never practiced tai chi. These 60 people were then randomly assigned to two groups: one group received 6 months of tai chi training, while the other group (the control group) was placed on a waitlist. Gait was assessed at 0, 3, and 6 months. During gait testing, participants walked for 10 minutes at their preferred pace, and wireless switches on their heels and toes captured data on multiple aspects of gait. All 87 participants were very healthy adults aged 50 to 79.

The team found that the tai chi experts had gait dynamics indicative of better gait health. Six months of tai chi training led to a slight trend in the same direction, but it didn’t reach statistical significance. Tai Chi was not associated with gait speed. More tai chi class attendance and home practice appeared to be of some benefit (though this did not reach statistical significance). The authors noted that tai chi may exert its effects by maintaining or improving our flexibility to respond and adapt to unpredictable changes in terrain, stimuli, and stresses when we walk.

The authors cited a need for larger and longer randomized trials to more definitely ascertain whether tai chi can beneficially affect age-related gait dynamics, especially in people with impaired gait, e.g., from Parkinson’s disease. The study’s limitations included its small sample size and the possibility that factors other than tai chi training caused differences between the experts and the other participants.

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Gow BJ, Hausdorff JM, Manor B, et al. Can tai chi training impact fractal stride time dynamics, an index of gait health, in older adults? Cross-sectional and randomized trial studies. PLoS One. 2017;12(10):e0186212. 

Tai Chi has a better impact on preventing falls 

Another randomized control trial sought to explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy). Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. 

Self-Efficacy or Self Mastery Seems to Be at the Root of it

In this last study self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001) compared to conventional physical therapy. This study concluded that the impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program.

Disabil Rehabil. 2012;34(3):196-201. doi: 10.3109/09638288.2011.591891.

The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial.

Tousignant M1, Corriveau H, Roy PM, Desrosiers J, Dubuc N, Hébert R, Tremblay-Boudreault V, Beaudoin AJ.

To the Chinese the whole point of practicing Tai Chi is the cultivation of mastery. Chinese culture is saturated in legends and stories of Tai Chi masters of the past and older adults in China who practice Tai Chi are renowned for their sense of self-efficacy which is at the root of self-care and healthy aging.