They Call It Meditation in Motion, but Does Tai Chi Heal Ills?
April 13, 2004
By MARK DERR
MIAMI BEACH, April 12 - On a languid March evening, Jeff Morris, a lean,
muscular man with a calm smile and shaved head, led a class of three men and
two women with slow, fluid, continuous movements through the formalized
postures of tai chi, the centuries-old Chinese Taoist martial art.
For 75 minutes, the participants focused their attention on controlling the
positions of their arms, legs, torsos and spines, guiding them in concert
repeatedly through their poses with varying degrees of gracefulness.
Told in 1986 that he had full-blown AIDS and just a year to live, Mr. Morris
turned to tai chi, its companion discipline qigong and later a cocktail of
antiviral drugs.
Now, H.I.V. is virtually undetectable in his blood, and he teaches tai chi
at various locations in Miami-Dade County.
Mr. Morris is not alone in attributing healing value to what is often called
meditation in motion. But as with acupuncture and other non-Western healing
arts, determining just how well this ancient discipline works challenges
researchers.
Tai chi first gained adherents in the United States in the late 1960's. The
practice is said to enhance balance, flexibility, gait, posture, digestion,
concentration, memory and overall physical and mental well-being. Its
proponents say it is especially beneficial for the elderly and for people
with chronic medical disorders.
Tai chi's methods and purpose stand in stark contrast to more active aerobic
activities, like running, cycling, swimming or even brisk walking. Eastern
exercises like tai chi emphasize internal strength and energy; Western
activities traditionally focus on building muscles, said Dr. Chenchen Wang,
who studies the medical use of tai chi at the Tufts-New England Medical
Center.
Over the past five decades, dozens of clinical studies have suggested that
tai chi may benefit people with high blood pressure, heart problems,
injuries, multiple sclerosis, arthritis, Parkinson's disease, Alzheimer's
disease, anxiety and depression, among other ailments.
But despite the generally favorable findings on the physiological and
psychological value of tai chi, Dr. Wang said, the studies were neither
conclusive nor definitive.
Dr. Wang based her conclusions on an analysis of 47 medical studies
conducted in China and the United States over the past five decades.
She and two collaborators, Dr. Joseph Lau of the Tufts-New England Medical
Center in Boston and Dr. Jean-Paul Collet of Jewish General Hospital at
McGill University in Montreal, published their findings in the March 8 issue
of the journal Archives of Internal Medicine.
"The promise of tai chi is great," Dr. Wang said, "but given the current
state of knowledge, I wouldn't recommend to my patients to do tai chi over
other exercise."
She added that more and better studies were needed to determine which of the
many forms of tai chi were best for which problems, how long a patient
needed to follow a program to show improvement and whether tai chi was more
effective than other forms of exercise.
Dr. Wang is now preparing to publish the findings of a comprehensive study
of the effectiveness of tai chi in helping people with rheumatoid arthritis
improve their balance and prevent falls.
It is axiomatic that exercise is essential to good health.
Although recommendations vary somewhat among organizations and for different
age groups, the National Center for Chronic Disease Prevention and Health
Promotion recommends for adults a minimum of 30 minutes of
moderate-intensity activity - brisk walking, for example - at least five
days a week, or a minimum of 20 minutes of vigorous exercise, like running,
three or more days a week.
Dr. Deborah Rohm Young, a kinesiologist at the University of Maryland, said
the question for the 80 to 85 percent of Americans who do not meet that
threshold, for reasons including chronic illness, is which exercise is best
- well-known aerobic activities like walking, jogging or cycling or Eastern
exercises like yoga, tai chi or even the physically passive qigong, which
focuses on meditation and breathing.
In a clinical trial in the late 1990's, Dr. Young and her colleagues found
that moderate-intensity aerobic exercise was slightly better than
low-intensity tai chi at lowering blood pressure and noticeably better at
improving fitness in a group of 62 sedentary elderly people over 12 weeks.
But the style of tai chi they taught, known as yang - popular because of its
slow, continuous movements - performed well enough to lead the researchers
to conclude that it might help sedentary older adults who could not engage
in more rigorous exercise, or did not want to.
Studies of tai chi are hard to conduct, because tai chi masters differ in
their instruction methods and often do not want to change what they do to
conform with other teachers, said Dr. Jorge Juncos, a neurologist at the
Emory University School of Medicine.
Dr. Juncos is conducting a study comparing the relative effectiveness of tai
chi, qigong and traditional huff-and-puff aerobics in helping patients with
Parkinson's disease improve their gait, balance, posture and conditioning.
Exercise may benefit Parkinson's patients primarily through caloric
expenditure; in that case, the form matters less than the intensity, Dr.
Juncos said. Alternatively, it may be the emphasis in tai chi on integrating
the mind and the body that is beneficial.
To find out, Dr. Juncos made sure that in his study, the tai chi
practitioners worked as hard physically as those doing aerobics. Because tai
chi emphasizes the meeting of mind and body, some experts believe it is
potentially more effective for people with neurological disorders than
aerobic activities like walking or pedaling a stationary bicycle.
While performing those activities, people often listen to music, read or
talk, Dr. Juncos noted.
Tai chi is thought to engage the brain through concentrated breathing. The
theory is that the breathing begins to shift primary neurological functions
to other brain regions, correcting to some degree the poor balance or gait
that are hallmarks of Parkinson's.
Tai chi may also help alleviate the thinking and memory problems that affect
some people with Parkinson's, Dr.
Juncos said.
Many studies do not continue long enough to measure the full effects of tai
chi, which takes time and practice to master, said Dr. Fuzhong Li, a
research scientist at the Oregon Research Institute.
In a study that has not yet been published, Dr. Li found that falls were
significantly reduced in a group of elderly people during six months of
training in tai chi.
A follow-up survey showed that six months after the end of the training,
there were still fewer falls among the people who were trained in tai chi
than among those who were not.
Seventy percent of the tai chi group had continued practicing after the
training period.
Because it can take months to learn proper tai chi movement, Dr. Li has
tried to make the exercise easier for people, so they do not quit
prematurely.
He developed a simplified version of yang-style tai chi that emphasizes
weight shifts, hand-eye coordination, trunk rotation and slow, continuous,
even flow through eight forms, or postures.
"We're not interested in the aerobic aspect of exercise,"
Dr. Li said. "We are interested in physical functioning and balance."
What makes tai chi valuable, he added, is that the physical movements are
combined with meditation, that it is low-impact and can be performed
anywhere, and that people, especially those who are older, enjoy the social
interactions of the classes.
At the Advanced Sports Medicine Wellness Institute in Miami Beach, without
breaking a sweat or driving his pulse rate far above normal, a physically
fit visitor with Parkinson's disease found Mr. Morris's 75-minute session to
be intense and hard.
But it seemed no better mentally, and was certainly less aerobic, than
swimming laps.