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CHI HAS THE POWER TO HEAL YOU! 
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Read the latest research and on tai chi:
Cardiovascular Health
Heart disease is the leading cause of death and disability in the United States. Approximately 700,000 people die of heart disease each year. Regular physical exercise helps lower the risk of heart disease by increasing the circulation of blood throughout the body.
Tai chi, which emphasizes relaxation, breathing and slow, fluid and continuous movements that are not overly strenuous, is an excellent exercise for individuals with heart disease. A recent clinical study found that tai chi was as effective as moderate aerobic exercise in improving aerobic capacity and better in terms of several other measures of cardiovascular fitness.
Studies show that tai chi lowers high blood pressure. Studies demonstrate that tai chi is a safe and beneficial exercise for people who have had heart failure, and other conditions such as arthritis and diabetes, which often limit physical activity.
In recent years the medical community has taken increased notice of the benefits of tai chi for people with cardiovascular diseases. Tai chi increases and balances the circulation of blood, helps practitioners to relax and improves balance and flexibility-benefits typically associated with moderate aerobic exercise.
A 2006 clinical study at Harvard medical school found that elderly women participating in a tai chi program were able to increase aerobic capacity as well as specific other measures of fitness such as balance, flexibility and lower leg strength significantly more than those doing brisk walking.
Improved Heart Rate Variability
The Harvard study mentioned above is one of many that show that people who practice tai chi improve their patterns of heart rate variability (HRV), which is increasingly recognized as an important measure of cardio health.
Heart rate variability decreases with age and tends to be lower for people who are inactive. Decreased HRV has been found to be associated with an increased risk of cardiac events. Decreased HRV is also associated with several medical conditions including rheumatoid arthritis, depression, diabetic neuropathy and high blood pressure. Stress reduces HRV by affecting the nerves that control the heart.
http://www.springerlink.com/content/b459e348cafe0155/
Heart rate variability provides a measure of sympathetic-parasympathetic balance in the autonomic nervous system. The sympathetic nervous system becomes more active during times of stress comprising the flight-or-fight response, lowering HRV. The counter actions of the parasympathetic nervous system, summarized by the phrase "rest and repose," are a major reason that tai chi and other chi programs are effective in improving HRV.
Risk Factors for Heart Disease
According to the Center for Disease Control (CDC), a large percent of the U.S. adult population have one or more risk factors associated with heart disease. Among these risk factors are (with % of US adult population affected in parentheses):
Hypertension-aka high blood pressure (30.2%)
Diabetes (6.5%)
Obesity (30.5)
Smoking (21.6%)
No leisure time physical activity (37.6%)
Tai Chi Lowers Blood Pressure
Several studies have documented that the practice of tai chi can lower blood pressure.
A study at Johns Hopkins found that individuals randomly assigned to a tai chi group and those randomly assigned to an aerobic group had similar decreases in blood pressure.
http://www.sciencedaily.com/releases/1998/03/980320075947.htm
Researchers in Taiwan found participants in a tai chi program decreased their blood pressure, showed favorable lipid profile changes and decreased anxiety. The observed decrease in systolic BP was 15.6 mm Hg and the decrease in diastolic BP was 4.7 mm Hg. In addition serum total cholesterol level was decreased by 15.2 mg/dL and high-density lipoprotein cholesterol (good cholesterol) was increased by 4.7 mg/dL.
http://www.ncbi.nlm.nih.gov/pubmed/14629852
Another study found statistically significant improvements in decreasing blood pressure and improving hypertension in participants with cardiovascular risk. After 12 weeks of tai chi, the average blood pressure measurements at rest went from 150/86 to 131/77 and the average blood pressure after a step-test went from 178/99 to 164/82, indicating improvements in aerobic endurance. Anxiety was also reduced.
Tai Chi: Help for Diabetics
Regular exercise is considered an important factor for lowering the risk of diabetes. Tai chi not only provides an enjoyable exercise experience, but also helps improve neuropathy of the feet. This is a major problem for diabetics, which results in impaired gait and balance, and jeopardizes safe mobility. The problem is caused by loss of plantar sensation.
A study conducted in 2006 helped confirm that tai chi is more effective than regular walking in improving plantar sensation and increasing muscle strength.
http://www.cuhk.edu.hk/spe/publication/Mao06APMR.pdf
A clinical study conducted in Taiwan and published in Diabetes Care in 2007 shows that tai chi may also be effective in decreasing blood sugar levels (AIC) and increasing regulatory T-cells. http://care.diabetesjournals.org/cgi/content/full/30/3/716?ck=nck
Another study correlated a non-statistically significant decrease in A1C to decreased body fat, which made the results somewhat inconclusive.
http://ageing.oxfordjournals.org/cgi/content/abstract/afm127v1
Tai Chi: Safe and Beneficial for People with Heart Failure
Several recent studies have shown that tai chi is safe and beneficial for people who have had heart failure. Tai chi classes were enjoyed by all, and led to significant improvements in quality of life, oxygen uptake and functional capacity.
Tai Chi: Get Better Sleep
Tai chi has also been shown to improve the quality of sleep, the lack of which has been linked to both heart disease and diabetes. One study demonstrated that elderly people practicing tai chi significantly reduced the time it took them to get to sleep while increasing duration of and quality of sleep. Participants in the same study that only did a low-intensity seated exercise program that included breathing, stretching and relaxation did not improve in these areas.
http://www.bastyrcenter.org/content/view/322/
A clinical study by researchers from Harvard retrospectively analyzed electrocardiogram (ECG) data of patients with chronic stable heart failure that practiced tai chi. They concluded that tai chi may enhance sleep stability in patients with heart failure and that this may have a cascading impact on helping to lower blood pressure, prevent the development of arrhythmia and improve overall quality of life.
http://www.ncbi.nlm.nih.gov/pubmed/17689142
How Tai Chi Works to Improve Circulation
Although tai chi and aerobics improve blood circulation and cardiovascular fitness, the methods used are different. In aerobics, raising the heartbeat increases the volume of blood entering the blood vessels until they become flooded and pumped up. The heart muscle has to work hard, often inadvisable for the elderly or those with severe medical conditions.
Tai chi's movements increase the power of the blood vessels to expand and contract by inducing an internal pumping within them, similar to how a water pump increases water pressure in the pipes of a closed system. The gentle expansion/contraction of the blood vessels brings them into sympathetic resonance with other fluids pumps in the body including the synovial fluid in the joints. Eventually, the vascular beds are flooded without significantly raising the heart rate.
Heart Disease: The Leading Cause of Death in the U.S.
Heart disease is the leading cause of death in the U.S. and is a major cause of disability. Almost 700,000 people die of heart disease each year. In 2006 the cost of heart disease was more than $258 billion.
http://www.cdc.gov/heartdisease/facts.htm
Chi Practices Help Your Heart Stay Healthy
You can do a lot to keep our heart healthy before or after your doctor warns you that you may be at risk for cardiac problems. Low-impact chi-based exercise programs give you many of the same benefits as aerobic exercise-and a lot more, like helping your relax and not become fearful, or keeping your balance and flexibility. Programs that include tai chi and qigong are low-cost alternatives that people of any age and/or fitness level can do to keep heart healthy.
TAI CHI IMPROVES BALANCE; HELPS PREVENT FALLS
Balance and Exercise
According to the Center for Disease Control (CDC), falls are a leading cause of death and disability for 1/3 of adults over 65. (1) Organizations such as the Center for Disease Control (CDC), the American Academy of Orthopaedic Surgeons and the AARP agree that balance training and exercise help senior citizens prevent falls. The keys are muscle strengthening, coordination and balance training. Exercises range from such simple ones as walking heel to toe or balancing on one leg to those involving balance and weight training machines to group classes in tai chi. A summary of the most effective exercises was the focus of a May 2008 article in the Los Angeles Times. (2)
Older Adults: Higher Risk for Falling
As people age, several factors contribute to an increased risk of falls. Their sense of balance and muscle strength tends to decline with age and reactions are slower. Cataracts and other eye problems add visual problems.
In addition many illnesses such as diabetes, arthritis, osteoporosis and Parkinson's contribute to the risk of falling. For example, diabetes can lead to a loss of nerve sensation in the feet, which impacts gait and balance; arthritis results in a loss of joint mobility. Many older people who fall develop a fear of falling, even when they are not injured, adding tension and stress to their lives.
Clinical Studies Provide Scientific Evidence for Tai Chi's Effectiveness in Improving Balance and Reducing Falls
Since 1996, many clinical studies that have been published in Western medical journals demonstrate that tai chi, an exercise system based on the principles of Chinese medicine, helps improve balance, reduce falls and restore confidence in older adults. Clinical studies provide credibility to the recommendations of Western health organizations and professionals that older adults learn tai chi. For example, a booklet available from The National Center for Injury Prevention and Control recommends tai chi for preventing falls, "Exercises that improve balance and coordination (like Tai Chi) are the most helpful."(3) An accompanying photograph shows people doing tai chi.
Here are summaries of some of the major clinical studies regarding tai chi and balance. They are among the most highly regarded studies because of the large number of participants in the studies and their divisions into groups that did tai chi, worked with balance exercises other than tai chi or participated in educational workshops, which made it possible to compare their effectiveness.
Emery University School of Medicine: 1996
Steven L. Wolf, Ph.D., and colleagues at Emory University, under the sponsorship of the National Institute of Aging (NIA), conducted a 15-week study on the effect of tai chi on fall reduction. Two hundred participants over age 70 were divided into three groups: those doing tai chi; those working out on a computerized balance platform; and those receiving educational meetings with a nurse gerontologist. The study concluded that tai chi participants had a 47.5 percent decrease in injuries from falls and a dramatic reduction in the fear of falling; while those in the other groups did not achieve significantly lower rates of falling. (4)
University of Connecticut Health Center: 1996
Leslie Wolfson, M.D., and colleagues at the University of Connecticut Health Center, also under the sponsorship of the NIA, conducted a 3-month study. In this 3-month program, 110 students, averaging age 80, were divided into four groups: one group received balance training in 45-minute sessions three times per week, including a computerized balance platform (different from the one used in the Wolf study summarized above) as well as low-tech balance exercises; another group took part in resistance training and weight lifting three times a week to improve strength; a third group did both balance and strength training; the fourth group participated in educational sessions on fall prevention and stress management.
After three months, all participants switched to weekly tai chi classes for 6 months. At the end of 9 months, those that had participated in intensive balance (followed by tai chi) showed a 25-50% improvement in three different measures of balance, while those participating in strength training (followed by tai chi) had a 17% improvement in strength. The researchers noted, however, that without a comparable group that did not receive tai chi training, it was difficult to evaluate how much tai chi contributed to gains in strength and balance. (5)
Emory University School of Medicine: 2004
In 2004, Dr. Steven L. Wolf, Ph.D., and colleagues at Emory University, under the sponsorship of the National Institute of Aging (NIA), conducted a 48-week study comparing the effects on balance to people doing tai chi to those taking wellness education classes that did not include exercise. More than 300 participants living in assisted-living facilities and ranging in age from 70-97 years of age were enrolled in the study. All had fallen one to three times in the year before they were enrolled. Participants were randomized by the facilities in which they lived to learn either tai chi or to take wellness education classes that did not include exercise.
At the end of the study, 46% of all participants in the study did not fall. Of the percentage of participants who fell at least once during that period, 47.6% were in the tai chi group and 60.3% in the wellness education group. In the tai chi group, risks of falling were reduced by 40% and participants became less dependent on walkers and wheelchairs. Commenting on the results, Wolf said, "Health promotion can be an effective intervention in preventing disease or injury. The wellness education activities may have motivated some participants to become more physically active, adopt healthier and safer lifestyles, and thus reduce their risk factors for falling." (6)
2005: Oregon Research Institute
A group of researchers at the Oregon Research Institute completed a six-month study that compared the effects of tai chi and light stretching on 256 physically inactive adults ranging in age from 70 to 92. Half the adults participated in tai chi; half did light stretching. At the end of the study, researchers concluded that tai chi reduced the risk for multiple falls by 55% over the group that did light stretching. They concluded that tai chi is effective in decreasing the number of falls, the risk and fear of falling, as well as improving functional balance and physical performance. (7)
University of Sydney, Australia: 2007
In 2007, a research group based at the University of Sydney's Center for Education and Research on Aging, studied the effect of tai chi on 702 healthy adults with an average age of 69. Some did tai chi for 16 weeks; others were placed on a waiting list. The study concluded that the group that practiced tai chi showed significant improvements in five of six balance tests compared to those in the control group and that falls were less frequent in the tai chi group than in the control group. (8)
Bucknell University, 2007: Help for Diabetics
A 6-month study conducted by the Biomedical Engineering Program at Bucknell University and the Milwaukee School of Engineering, tested (how many) elderly adults for plantar sensory abilities and several types of balance metrics before and after weekly tai chi session. The group was divided into healthy elderly adults and adults with diabetes and plantar sensory loss. Study results showed that all participants had significant improvement in plantar sensory ability and balance, "with the greatest improvement seen in those subjects with large sensory losses." An important secondary outcome was the drop in blood sugar, as measured by tests of Hemoglobin A1C. (9)
Why Tai Chi is Effective for Improving Balance
Although most tai chi masters will agree that tai chi is beneficial for improving balance, only a few clinical studies have begun to study why.
The following are summaries of two studies conducted at the Chinese University of Hong Kong that investigated the biomechanics of tai chi.
The Biomechanics of Normal Walking are Compared to Tai Chi Movements
This study measured the differences between normal walking and five fundamental tai chi movements (backwards, forwards, sideways, up and down, and stationery). Researchers recruited sixteen yang-style tai chi masters (eight men; eight women). Using special machines, researchers described and quantified the differences in where and how participants first made contact with the ground with the feet, distribution of pressure (plantar pressure) as the feet first made contact and then shifted to the whole foot, impacts exerted on the ground when the feet made contact, impacts on pressure as they shifted from one foot to the other or shifted weight.
Researchers were able to conclude that the movements of tai chi resulted in a more complex and varied gait, because of the variety of foot support patterns used and the wider distribution of plantar pressure on the feet, resulting in increased strength and better balance control than during normal walking. (10)
Normal Walking and One-Leg Tai Chi Stances are evaluated for Their Effect on Balance
This study, conducted by the same research team as the one just cited and the same 16 tai chi masters, measured the duration and plantar distribution during one-leg stances of tai chi and normal walking, to see whether one or the other resulted in greater balance and leg strength. Researchers concluded, "Tai Chi exercise may be associated with an improved ability to balance on one leg. The findings may provide useful information toward the development of strengthening programs, strategies for the prevention of falls, and the promotion of a physically active lifestyle." (11)
Tai Chi and Traditional Chinese Medicine
Traditional Chinese medicine sees health as more than just the absence of obvious disease. Rather, health exists when all aspects of a person's chi, or life force energy, are in balance-physically, emotionally, psychologically and spiritually. In Western cosmologies, the body and mind are separate. In Chinese medicine they are not. The health of the body and mind are determined by chi flow.
According to Frantzis in his book The Chi Revolution: Harness the Healing Power of Your Life Force, "Chi flows like river following the path of least resistance. When the flow of chi is free, open and unbound, if flows towards positive, life nurturing forces. However, the life force can become blocked. When energy is blocked or trapped, it acts much like a river where water backs up and stops, accumulating sludge and gunk. If the trapped chi is not dislodged and allowed to freely flow its location in the body becomes susceptible to stress and illness and disease" (12)
All Taoist chi practices such as acupuncture, tai chi, chi gung and meditation are based on principles of unblocking and increasing chi flow.
Although tai chi was first developed as a martial art, the majority of practitioners practice it to gain to help them release and balance the stagnant chi that builds up in their bodies and minds and become healthier and less stressed.
Tai chi is particularly venerated in China as a highly effective longevity regimen that improves health while systematically reducing stress. Tens of millions of people of all pages and fitness levels practice tai chi.
Which Style of Tai Chi is Best for Achieving Balance?
Tai chi has give major styles-Yang, Wu, Chen, Hao, and such combination styles as Sun-style. Although each style has a different approach toward the movements of their forms, all styles embody the common principle of increasing awareness and balancing the flow of chi in the body, mind and spirit.
In the opinion of Bruce Frantzis, Taoist master and lineage holder, people that have never taken lessons in tai chi might best start with a tai chi short form that has 24 moves or less because they are easier to learn than forms which have many more moves. A complete discussion about how to choose a style and teacher is found in Bruce Frantzis' book, Tai Chi: Health for Life. (13)
QUICK STATS
Falls: Escalating Problem as Baby Boomers Age
Falls are a leading cause of disability and injury deaths in adults over 65 years. Each year 1/3 of adults (approximately 12 million) over the age of 65 experience a fall. Well over a million falls result in injuries that are treated in hospital emergency rooms. The most serious injuries include hip and other fractures and traumatic brain injury. The medical expense related to falls is more than $20 billion annually in the US, and is projected to climb in to $32 billion annually by 2020. (14, 15)
References
1. The Center for Disease Prevention:
http://www.cdc.gov/ncipc/duip/preventadultfalls.htmSee also: "Don't Let a Fall Be Your Last Trip: Who is at Risk," American Academy of Orthopaedic Surgeons, http://orthoinfo.aaos.org/topic.cfm?topic=A00118&return_link=0
2. Erin Cline Davis, "Falls are Leading Cause of Death and Injury in Senior Citizens, Los Angeles times, May 26, 2008. http://www.latimes.com/features/health/la-he-balance26-2008may26,0,2131724.story
3. National Center for Injury Prevention and Control Falls Tool Kit
http://www.cdc.gov/ncipc/pub-res/toolkit/Falls_ToolKit/DesktopPDF/English/brochure_Eng_desktop.pdf4. Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T. "Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques," J Am Geriatr Soc. 1996 May;44(5):489-97.
Abstract available at: http://www.ncbi.nlm.nih.gov/pubmed/8617895
For an NIH press release summarizing this study: http://www.nia.nih.gov/NewsAndEvents/PressReleases/PR19960502TaiChi.htm
5. Wolfson L,Whipple R, Derby C. et al. "Balance and Strength Training in Older Adults: Intervention gains and Tai Chi maintenance." J Am Geriatr Soc. 1996;44:498-506.
Abstract available at: http://www.ncbi.nlm.nih.gov/pubmed/8617896?ordinalpos=
1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum6. Wolf SL, O'Grady M, Easley KA, Guo Y, Kressig RW and Kutner M. "The Influence of Intense Tai Chi Training on Physical Performance and Hemodynamic Outcomes in Transitionally Frail, Older Adults." J Gerontol A Biol Sci Med Sci. 2006 Feb;61(2):184-9. PMID: 16510864
Abstract available at: http://www.ncbi.nlm.nih.gov/pubmed/16510864?dopt=Abstract
Article summarizing the study available at: http://www.obgyn.net/newsheadlines/headline_medical_news-Emory_University-20040329-1.asp
7. Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E and Wilson NL. "Tai Chi and Fall Reductions in Older Adults: a Randomized Controlled Trial." J Gerontol A Biol Sci Med Sci. 2005 Feb;60(2):187-94.
8. Voukelatos A, Cumming RG, Lord SR, Rissel C. "A Randomized, Controlled Trial of Tai Chi for the Prevention of Falls: The Central Sydney Tai Chi trial." J Am Geriatr Soc. 2007 Aug; 55(8):1185-91.
Abstract available at: http://www.ncbi.nlm.nih.gov/sites/entrez?db=PubMed&cmd=retrieve&dopt=AbstractPlus&list_uids=17661956
9. Richerson S and Rosendale K. "Does Tai Chi Improve Plantar Sensory Ability? A Pilot Study." Diabetes Technol Ther. 2007 Jun 9(3):276-86.
Abstracts available at: http://www.ncbi.nlm.nih.gov/pubmed/17561798?ordinalpos=1&itool
=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSumOr http://www.liebertonline.com/doi/abs/10.1089/dia.2006.0033
10. D.W. Mao, J.X. Li. and Y. Hong. "Plantar Pressure Distribution during Tai Chi Exercise. Arch Phys Med Rehabil 2006;87:814-20.
Full text available at: http://www.cuhk.edu.hk/spe/publication/Mao06APMR.pdf
11. D.W. Mao, J.X. Li and Y. Hong. "The Duration and Plantar Pressure Distribution During One-leg Stance in Tai Chi Exercise." Clinical Biomechanics 21 (2006) 640-645
Full text available at: http://www.cuhk.edu.hk/spe/publication/Mao06CB.pdf
12. Frantzis, Bruce, The Chi Revolution: Harness the Healing Power of Your Life Force (Blue Snake Books, 2008), page 16.
13. Frantzis, Bruce, Tai Chi: Health for Life; Why it Works for Health, Stress Relief and Longevity (Blue Snake Books, 2006).
14. The Center for Disease Prevention: http://www.cdc.gov/ncipc/duip/preventadultfalls.htm
15. American Academy of Orthopaedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=A00118&return_link=0
ARTHRITIS
Arthritis and Exercise
"Oh, my aching joints," is the mantra of approximately 46.5 million people-one in 5-that are suffering from arthritis in the United States. (1)
According to the Arthritis Foundation, moderate exercise helps alleviate debilitating symptoms. "Exercise reduces joint pain and stiffness, builds strong muscle around the joints, and increases flexibility and endurance. But it also helps promote overall health and fitness by giving you more energy, helping you sleep better, controlling your weight, decreasing depression, and giving you more self-esteem. (2)
Statistics also show that 44% of people with arthritis do not exercise and have no leisure activity. (3) Some may give up on exercise because they are afraid of causing further injury and pain. Others are limited in the type of exercise they can do.
Arthritics that adopt sedentary lifestyles increase the risk of obesity, cardiovascular disease, diabetes and functional limitations (such as stooping, walking up stairs; grasping small objects).
The State of Clinical Studies on Tai Chi and Arthritis
Both the Arthritis Foundation in the U.S. and Arthritis Australia recommend tai chi as a safe, low-impact exercise that may help mitigate the effects of arthritis. Both organizations cite clinical studies that back up their recommendations. Arthritis Australia actively promotes a Sun-style tai chi program adapted from Dr. Paul Lam's program "Tai Chi for Arthritis."
However, systematic reviews of all clinical studies in all languages about tai chi and arthritis that were conducted by a trio of researchers in England revealed that they did not convincingly establish that tai chi led to pain reduction or improvement in physical functioning. (4, 5)
One review stated that the studies did not show that tai chi improved "people's ability to do chores, joint tenderness, grip strength or their number of swollen joints."
Both reviews asked for studies with larger numbers of participants and longer trials. "It is also not clear how much, how intense and for how long Tai Chi should be done to see benefits."
Neither review mentioned that clinical studies are also based on different forms of tai chi.
According to Bruce Frantzis, tai chi master and Lineage holder, future clinical studies should also evaluate and compare the effectiveness of different types of tai chi styles.
Tai Chi Masters Consider that Tai Chi Is Beneficial for Arthritis
"Despite the lack of scientific confirmation about the benefits of tai chi for arthritis, virtually all tai chi masters and many of their students agree that tai chi is beneficial for arthritics," says Frantzis. According to him, tai chi's gentle movements increase people's range of motion and flexibility while systematically reducing pain. Tai chi training emphasizes proper joint alignments, which helps to prevent further joint damage while strengthening the ligaments, tendons and muscles around the joints. Tai chi increases the flow of synovial fluid in the joints, keeping them lubricated.
Although tai chi cannot repair bone and cartilage damage caused by arthritis, much less cure it, tai chi can lessen the swelling and tenderness inside the joints, thus helping alleviate pain.
According to Frantzis, tai chi may also help alleviate secondary problems that often accompany arthritis. These include:
- Improving balance, thereby reducing falls
- Regulating and lowering blood pressure
- Improving circulation
- Getting a good night's sleep
Tai Chi and Traditional Chinese Medicine
Traditional Chinese medicine sees health as more than just the absence of obvious disease. Rather, health exists when all aspects of a person's chi, or life force energy, are in balance-physically, emotionally, psychologically and spiritually. In Western cosmologies, the body and mind are separate. In Chinese medicine they are not. The health of the body and mind are determined by chi flow.
According to Frantzis in his book The Chi Revolution: Harness the Healing Power of Your Life Force, "Chi flows like river following the path of least resistance. When the flow of chi is free, open and unbound, if flows towards positive, life nurturing forces. However, the life force can become blocked. When energy is blocked or trapped, it acts much like a river where water backs up and stops, accumulating sludge and gunk. If the trapped chi is not dislodged and allowed to freely flow its location in the body becomes susceptible to stress and illness and disease" (6)
All Taoist chi practices such as acupuncture, tai chi, chi gung and meditation are based on principles of unblocking and increasing chi flow.
Although tai chi was first developed as a martial art, the majority of practitioners practice it to help them release and balance the stagnant chi that builds up in their bodies and minds and become healthier and less stressed.
Tai chi is particularly venerated in China as a highly effective longevity regimen that improves health while systematically reducing stress. Tens of millions of people of all pages and fitness levels practice tai chi.
Which Style of Tai Chi is best for Arthritics?
Tai chi has give major styles-Yang, Wu, Chen, Hao, and such combination styles as Sun-style. Although each style has a different approach toward the movements of their forms, all styles embody the common principle of increasing awareness and increasing and balancing the flow of chi in the body, mind and spirit.
In the opinion of Bruce Frantzis, Taoist master and lineage holder, people that have never taken lessons in tai chi might best start with a tai chi short form that has 24 moves or less because they are easier to learn than forms which have many more moves. Senior citizens may find that Wu style short form is easier on the knee joints than other styles. A complete discussion about how to choose a style and teacher is found in Bruce Frantzis' book, Tai Chi: Health for Life. (7)
QUICK STATS
Arthritis: Growing Problem; Escalating Costs
According to a 2003 survey conducted by the National Health Interview Survey (NHIS), 46.4 million (1 in 5) adults have doctor-diagnosed arthritis. Approximately 21 million adults suffer from osteoarthritis and approximately two million suffer from rheumatoid arthritis.
The statistics do not show how many people with arthritis also have other diseases, such as diabetes and heart disease. The statistics do show that 34.8 million arthritics are already obese; and another 34% are overweight, putting them at risk for these and other diseases.
The total costs attributable to arthritis and other rheumatic conditions in the United States in 2003 was approximately $128 billion-$80.8 billon in medical expenditures and 47 billion in lost earnings. This equaled 1.2% of the 2003 U.S. gross domestic product. (8, 9)
By 2030, NHIS estimates that 67 million people will have arthritis. Of those, 25 million will have activity limitations.
http://www.cdc.gov/arthritis/data_statistics/index.htm
http://www.arthritis.org/exercise-intro.php
Myeong Soo Lee, Max H. Pittler and Edzard Ernst, "Tai Chi for Rheumatoid Arthritis: Systematic Review, Oxford
http://rheumatology.oxfordjournals.org/cgi/content/abstract/46/11/1648Myeong Soo Lee, Max H. Pittler and Edzard Ernst, "Tai Chi for Osteoarthritis: Systematic Review, Journal of Clinical Rheumatology, February 2007, pages 211-218.
http://www.springerlink.com/content/003m05563k411143Frantzis, Bruce, The Chi Revolution: Harness the Healing Power of Your Life Force (Blue Snake Books, 2008), page 16.
Frantzis, Bruce, Tai Chi: Health for Life; Why it Works for Health, Stress Relief and Longevity (Blue Snake Books, 2006).
TAI CHI AND THE IMMUNE SYSTEM
A healthy immune system is essential for health because it helps ward off a wide variety of diseases ranging from infectious diseases to cancer. A depressed immune system can leave the body vulnerable to infections while a hyperactive immune system can lead to autoimmune diseases such as rheumatoid arthritis, Type 1 Diabetes and multiple sclerosis.
Normally the immune system's army of white blood cells helps protect the body from harmful substances, called antigens. Examples of antigens include bacteria, viruses, toxins, cancer cells, and foreign blood or tissues from another person or species.
Recent scientific research has demonstrated that moderate exercise can have a powerful beneficial effect on the neuroimmune system by enhancing the body's ability to fight off disease and infection (imminocompetence). (1) Conversely, intense exercise such marathon running or biking, may be detrimental to the immune system. "Intense exercise can suppress the concentration of lymphocytes, suppress natural killer cell activity, and leave the host open to microbial agents, especially viruses that can invade during this open window of opportunity and may lead to infections." (2)
Although tai chi is considered by many health practitioners to be a moderate intensity exercise, two clinical studies set out to measure and compare differences in the intensity effects of Yang style tai chi. In the first study, 15 men, ranging in age from 26-15 years, performed 108 moves of the long-form style and cycling. (3) Before and after each exercise, blood pressure and blood samples were taken. During exercise, appropriate equipment was hooked up to measure heart rate, oxygen consumption and blood lactate. At the end of this study, researchers were able to demonstrate that classical Yang TCC is an exercise with moderate intensity.
A second study with 100 yang style practitioners segmented into three age groups demonstrated that moderate exercise intensity remains remarkably the same across different age groups and for each gender. (4)
Tai Chi and the Immune System
In China, tai chi is practiced for its health and longevity benefits. Tai chi is based on a mind-body approach, which promotes body awareness, relaxation and balance.
Tai chi's potent health benefits are increasingly being confirmed by Western medical clinical studies. According to these studies, tai chi helps improve balance, lower blood pressure, improve circulation, lower blood sugar, less stress and mitigate arthritis. (5)
Tai chi has been specifically studied to see whether its practice has beneficial effects on the immune system-both in its ability to increase the immune system's ability to fight infections and in modulating hyperactive immune systems. The main studies focused on whether tai chi reinforced the immune response to two different vaccines: the Varivax vaccine which helps protect older adults against shingles and influenza vaccine. Another study looked at the effects of tai chi on people with Type 2 Diabetes.
Tai Chi Boosts the Immune Benefits of the Shingles Virus
A 2003 study conducted by researchers at U.C. Irvine was the first to show that a behavioral intervention, tai chi, can influence a virus-specific cell-mediated immune response that is important in protection against symptomatic reinfection of the herpes zoster (varicella) virus, which causes shingles. (6) The researchers measured virus specific immunity by measuring the responsiveness of immune system cells (T Cells, etc) to existing virus antigens before and after the study. 36 older adults were either randomly assigned a tai chi chih group (a simple form of tai consisting of 19 movements and one standing posture) or to a health education group. None had received the Varivax vaccine. After 15 weeks, tai chi group had a nearly 50% increase of immunity levels over baseline, which is quite impressive considering that the Varivax vaccine by itself is said to result in a 75% increase over baseline. The control group showed no change in immunity levels.
In another study U.C. study, involving both tai chi and the shingles vaccine, 112 healthy older adults were randomly assigned a tai chi group or to a health education group. (7) After 16 weeks all participants were vaccinated with Varivax. The study found that the tai chi group had a large, statistically significant, increase in the varicella zoster virus cell-mediated immunity (VZV-CMI) compared to the health education group, with the increase comparable in magnitude to the increase produced by the varicella vaccine. Furthermore, the benefits of tai chi and the vaccine were additive, with the tai chi group having a substantially higher level of VZV-CMI after the vaccination than the health education group.
In theorizing about the implications of the study, researchers said, "For infectious diseases for which no vaccine is yet available (e.g., human immunodeficiency virus, avian influenza), the capacity of a behavioral intervention such as TCC to increase resting levels of memory T-cells may offer unique benefits."
A clinical study that was conducted in China found that tai chi practice improved the antibody response to influenza vaccine in older adults. (8) Fifty older adults were given the 2003-2004 flue vaccine, but only half practiced tai chi. The study compared antibody responses in both groups after 3, 6 and 20 weeks. The study found a large and statistically significant increase in the magnitude and duration of the antibody response (hemagglutination inhibition or HI titer) to the vaccine in the tai chi participants. Researchers found a 173, 130, and 109% increase in HI titer at 3, 6, and 20 weeks for the tai chi group as compared to 58, 54, and 10% in the other group.
Researchers said further studies were needed to determine whether the enhanced response is sufficient to provide definitive protection from influenza infection.
Tai Chi and Type 2 Diabetes
The effects of tai chi on Type 2 diabetics was he subject of a small clinical study conducted in Taiwan 2008. (9) There, researchers compared the effects of tai chi on 30 people with type 2 diabetes to 30 healthy people. Those doing tai chi participated in three hour-long sessions a week for 12 weeks and learned some 37 movements. The majority of them practiced tai chi at home. The study found that tai chi boosted the immune system or participants. Levels of interleukin-12 doubled and significantly increased T-cell counts (T-lymphocytes). The increases correlated to decreases in blood sugar levels (A1C) levels. The authors suggest that a combination of tai chi with diabetic medications may improve both glucose metabolism and immunity in type 2 diabetic patients. The study cited clinical studies indicating the beneficial effects of tai chi on the immune system and the potentially damaging effects of strenuous or high intensity exercise.
Tai Chi and the Autoimmune System
No clinical studies have measured the immune benefits of tai chi on the autoimmune system. Autoimmune disorders are caused by an overactive immune system that causes it to turn on itself turning on itself and attack the cells, tissues or internal organs. Common autoimmune disorders are rheumatoid arthritis, lupus and Type 1 Diabetes.
Stress and the Immune and Autoimmune System
A great deal of research has been conducted on the effects of stress on the immune system. All conclude that chronic stress can interfere with its normal function. (10) Chronic stress is the modern disease-affecting every corner of the society from war veterans, workplace employees from executives to laborers, teens, moms and boomers.
According to tai chi master and lineage holder Bruce Frantzis, "Stress is killing us. Chronic, unmitigated stress causes the body to overload, weaken and become prone to disease, a ling firmly established in conventional and alternative medical communities." (11)
The interactions between the immune and nervous systems were the subject of a 2002 clinical study that showed how they played an important role in controlling the functions of both the immune and autoimmune systems. (12) "Interactions between the immune system and nervous system have shed additional light on how mood, emotions, and immunocompetence are uniquely intertwined." Researcher findings help explain how emotional state and response to stress can modify a person's capacity to cope with such immune disease from colds to cancers as well as influence the course of autoimmune diseases.
The interactions between the central nervous system and the immune system have spurred the growth of a branch of biomedical science called neuroimmunology. Psychoneuroimmunology specifically studies the relationship between psychological processes and the nervous and immune systems of the human body.
Tai Chi and Stress
Only a few clinical studies have directly examined the effects of tai chi on stress. A small pilot study conducted in 2007 at Germany's Coburg University found that the practice of tai chi improved health and decreased stress. Researchers asked that further studies be conducted "with rigorous methodology and by further combining physical and psychological measurements with basic research, thereby also gaining knowledge of auto regulation and molecular physiology that possibly underlies mind/body medicine." (13)
A study conducted in 2004 found that tai chi can improve sleep quality. (14) Lack of adequate rest contributes to stress.
According to Bruce Frantzis, stress reduction is well known among teachers and practitioners for reducing stress. According to him, tai chi does this by systematically relaxing the nervous system, thereby mitigating chronic ‘fight or flight' responses to stressors. Tai chi's low impact, non-jarring motions are ideal for people of all ages and will allow people whose medical conditions prevent most other exercise to gain the benefits of moderate exercise. (15) "Because stress is so endemic in our modern culture, the benefits of tai chi in this area should be a primary focus of new clinical studies," he said.
References
1. Catherine C. Goodman and Z.F. Kapasi, "The Effect of Exercise on the Immune System," Rehabilitation Oncology, January 2002.
Full article:
http://findarticles.com/p/articles/mi_qa3946/is_200201/ai_n90722162. Goodman, op. cit.
3. Ssu -Yan Chen, L. Ching, J.S. Lai and M.K. Wong, Heart Rate Responses and Oxygen Consumption during Tai Chi Chuan Practice, American Journal of Chinese Medicine, Summer-Fall, 2001.
Whole article: http://findarticles.com/p/articles/mi_m0HKP/is_2001_Summer-Fall/ai_81596691/pg_3?tag=artBody;col1
4. Lan C, Chen SY, Lai JS, "Relative Exercise Intensity of Tai Chi Chuan is Similar in Different Ages and Gender," American Journal of Chinese Medicine 2004;32(1):151-60.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/15154294
Note: the results of both studies were summarized in a paper titled "The Exercise Intensity of Tai Chi Chuan" published in Medical Sport Science. Lan C, Chen S, Lai J, "The Exercise Intensity of Tai Chi Chuan"
Abstract only:
Hong Y (ed): Tai Chi Chuan. State of the Art in International Research. Med Sport Sci. Basel, Karger, 2008, vol 52, pp 12-19
For more information, www.energyarts.com/Research/index.html
Michael R. Irwin, Pike J., Cole, J.C. and Oxman, M.N., "Effects of a Behavioral Intervention, Tai Chi Chih, on Varicella-zoster Virus Specific Immunity and Health Functioning in Older Adults; Psychosomatic Medicine 65:824-830 (2003)
Abstract: http://www.psychosomaticmedicine.org/cgi/content/abstract/65/5/824\
7. Michael R. Irwin, Olmstead, R. and Oxman, M.N. et al, "Augmenting Immune Responses to Varicella Zoster Virus in Older Adults: A Randomized, Controlled Trial of Tai Chi. Journal of the American Geriatrics Society (2007), 55(4):511-517.
Article summarizing the study: http://nccam.nih.gov/research/results/spotlight/040607.htm
8. Y. Yang, Verkuilen J., Rosengren K.L., Mariani R.A., Reed M., Grubisich S.A. and Woods, J.A. "Effects of a Taiji and Qigong Intervention on the Antibody Response to Influenza Vaccine in Older Adults," Am J Chin Med. 2007;35(4):597-607
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/17708626
9. Yeh SH et al; "Tai Chi Chuan Exercise Decreases A1C Levels Along With Increase of Regulatory T-Cells and Decrease of Cytotoxic T-Cell Population in Type 2 Diabetic Patients," Diabetes Care 2007 Mar;30(3):716-8
Abstract: http://care.diabetesjournals.org/cgi/content/short/30/3/716
Full text: http://mail.turkiye-klinikleri.com/cgi/reprint/30/3/716
11. Two clinical studies that summarize the effects of stress:
a. Gregory E. Miller, Cohen, S. and Ritchey, A.K., "Chronic Psychological Stress and the Regulation of Pro-Inflammatory Cytokines: A Glucocorticoid-Resistance Model," Health Psychology, Vol 21, No. 6.
Full text: http://www.apa.org/journals/releases/hea216531.pdfSummary of article written by the American Psychological Association: http://www.apa.org/releases/chronicstress.html
b. Segerstrom & Miller, "Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry," Psychological Bulletin 130, 4 (2004).
Article summarizing the paper: http://mentalhealth.about.com/od/stress/a/stressimmune604.htm
Frantzis, Bruce. The Chi Revolution: Harness the Healing Power of Your Life Force (Blue Snake Books, 2008, distributed by North Atlantic Books and Random House,) page 30.
Goodman, op. cit.
T. Esch T., Duckstei J., Welke J., and Braun V, "Mind/body Techniques for Physiological and Psychological Stress Reduction: Stress Management via Tai Chi Training - A Pilot Study; Med Sci Monit. 2007 Nov;13(11):CR488-497.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/17968296
15. Li F et. Al, "Tai chi and Self-Rated Quality of Sleep and Daytime Sleepiness in Older Adults: A Randomized Controlled trial, J Am Geriatr Soc, 2004 Jun;52(6):892-900.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/15161452
16. Frantzis, Bruce, Tai Chi: Health for Life; Why it Works for Health, Stress Relief and Longevity (Blue Snake Books, 2006).
TAI CHI HELPS MANAGE TYPE 2 DIABETES
According to the American Diabetes Association (ADA), 20.8 million children and adults in the United States, or 7% of the population, have diabetes. Of these, 90-95% have type 2 diabetes. The problem is expected to rise because of increasing rates of obesity. (1)
In Type 2 diabetes, either the body is not producing enough insulin to help control blood sugar levels or the cells ignore insulin, thereby preventing the body from converting glucose into energy.
The causes are strongly linked to sedentary life styles, obesity, high blood pressure and high cholesterol.
Type 2 Diabetes and Exercise
According to the ADA, aerobic exercise is beneficial, because it helps mitigate high blood pressure and high cholesterol and controls obesity. There is also strong evidence that exercise causes the cells of the body to use sugar (glucose) as fuel, helping to lower blood sugar levels.
The ADA recommends regular aerobic exercise, such as walking, swimming playing tennis or dancing; strength training, such as weight lifting or working with elastic bands; and flexibility (stretching) exercises.
Tai Chi May Lower Blood Glucose Levels and Boost Immunity
Moderate exercise in generally recognized as being beneficial for maintaining a healthy immune system as one ages. Tai Chi's non-jarring motions are ideal for people of all ages and will allow people whose medical conditions prevent most other exercise to gain these benefits of moderate exercise.
To date few clinical studies have been performed that evaluate the effects of tai chi on blood sugar levels. Two small studies conducted in 2008 in Australia and Taiwan point to promising benefits. Both show that just 12 weeks of tai chi can boost immune levels and lower blood sugar in people with type 2 Diabetes. (2)
In Taiwan, researchers compared the effects of tai chi on 30 people with type 2 diabetes to 30 healthy people. Those doing tai chi participated in three hour-long sessions a week for 12 weeks and learned some 37 movements. The majority of them practiced tai chi at home.
In Queensland, Australia, eleven participants learned either tai chi or its close cousin qigong (chi gung).
At the end of the study period, both research studies showed significant drops in blood sugar levels as well as decreases in insulin resistance.
The Taiwanese study demonstrated that tai chi boosted the immune system of participants. It found that the levels of interleukin-12 doubled and significantly increased T cell counts (T-lymphocytes).
These findings were similar to those of a study conducted at UCLA in 2003 which showed that tai chi had a potent effect at increasing T-cell counts (t-lymphocytes) in patients with shingles. The UCLA study was significant as it was the first to demonstrate that a behavioral intervention, namely tai chi, can positively influence a virus-specific cell-mediated immunity response. (3)
Additionally, the Queensland study noted that participants had lower blood pressure, slept better and had fewer food cravings.
When asked why tai chi might provide lower levels of blood sugar, tai chi master and lineage holder, Bruce Frantzis commented that tai chi is renowned for balancing the circulation of fluids in the body, relaxing the nerves and retraining the body to relax. "This helps prevent the emotional spikes which release adrenalin in the body-a cause of higher blood sugar levels, insulin resistance and depressed immune function. However, while the results of these studies are promising, they had too small a number of participants to provide the type of credibility shown regarding the beneficial effects of tai chi for regulating and lowering blood pressure or improving circulation. More studies are needed to make it possible for the ADA and diabetic doctors to recommend tai chi as an effective exercise for managing Type 2 Diabetes."
Frantzis added, "Equally important is that tai chi is very helpful for people that cannot participate in strength training or aerobics. Tai chi is a low-impact exercise that can be done by any age and body type, including the obese, and is easy on the joints. (4)
Tai Chi: Mitigates Neuropathy
A few clinical studies help demonstrate tai chi helps improve neuropathy of the feet, a major problem for diabetics, because it results in impaired gait and balance and jeopardizes safe mobility. The problem is caused by loss of plantar sensation. As a result, many diabetics adopt sedentary life styles.
Summaries of two studies performed in 2006 and 2008:
Bucknell University, 2006
A study conducted by the Biomedical Engineering Program at Bucknell University and the Milwaukee School of Engineering, demonstrated that tai chi is more effective than regular walking in improving plantar sensation and increasing muscle strength. (5)
A 6-month study conducted tested elderly adults for plantar sensory abilities and several types of balance metrics before and after weekly tai chi session. The group was divided into healthy elderly adults and adults with diabetes and plantar sensory loss. Study results showed that all participants had significant improvement in plantar sensory ability and balance, "with the greatest improvement seen in those subjects with large sensory losses." An important secondary outcome was the drop in blood sugar, as measured by tests of Hemoglobin A1C. An abstract of the study did not indicate how may people participated in the study.
2006: Clinical Studies Compare the Biomechanics of Normal Walking and Tai Chi Movements
Two studies conducted at the Chinese University of Hong Kong investigated the biomechanics of tai chi.
The first study measured the differences between normal walking and five fundamental tai chi movements (backwards, forwards, sideways, up and down, and stationery). (6)Researchers recruited sixteen yang-style tai chi masters (eight men; eight women). Using special machines, researchers described and quantified the differences in where and how participants first made contact with the ground with the feet, distribution of pressure (plantar pressure) as the feet first made contact and then shifted to the whole foot, impacts exerted on the ground when the feet made contact, impacts on pressure as they shifted from one foot to the other or shifted weight and so on.
Researchers were able to conclude that the movements of tai chi resulted in a more complex and varied gait, because of the variety of foot support patterns used and the wider distribution of plantar pressure on the feet, resulting in increased strength and better balance control than during normal walking.
Normal Walking and One-Leg Tai Chi Stances are Evaluated for Their Effect on Balance
This study, conducted by the same research team and the same 16 tai chi masters measured the duration and plantar distribution during one-leg stances of tai chi and normal walking, to see whether one or the other resulted in greater balance and leg strength. Researchers concluded, "Tai Chi exercise may be associated with an improved ability to balance on one leg. The findings may provide useful information toward the development of strengthening programs, strategies for the prevention of falls, and the promotion of a physically active lifestyle." (7)
Tai Chi and Traditional Chinese Medicine
Traditional Chinese medicine sees health as more than just the absence of obvious disease. Rather, health exists when all aspects of a person's chi, or life force energy, are in balance-physically, emotionally, psychologically and spiritually. In Western cosmologies, the body and mind are separate. In Chinese medicine they are not. The health of the body and mind are determined by chi flow.
According to Frantzis in his book The Chi Revolution: Harness the Healing Power of Your Life Force, "Chi flows like river following the path of least resistance. When the flow of chi is free, open and unbound, if flows towards positive, life nurturing forces. However, the life force can become blocked. When energy is blocked or trapped, it acts much like a river where water backs up and stops, accumulating sludge and gunk. If the trapped chi is not dislodged and allowed to freely flow its location in the body becomes susceptible to stress and illness and disease" (8)
All Taoist chi practices such as acupuncture, tai chi, chi gung and meditation are based on principles of unblocking and increasing chi flow.
All Taoist chi practices such as acupuncture, tai chi, chi gung and meditation are based on principles of chi flow.
Although tai chi was first developed as a martial art, the majority of practitioners practice it to gain to help them release and balance the stagnant chi that builds up in their bodies and minds and become healthier and less stressed.
Tai chi's potent health benefits are increasingly being confirmed by Western medical clinical studies. According to these studies, tai chi helps improved balance, lower blood pressure, improve circulation, lower blood sugar, boost immunity and mitigate arthritis. (9)
QUICK STATS
The Dangerous Toll of Diabetes in the United States
According to the American Diabetes Association, 20.8 million children and adults in the United States, or 7% of the population, have diabetes. Of these, 90-95% has Type 2 diabetes. The problem is expected to rise because of growing rates of obesity.
Based on death certificate data, diabetes contributed to 224,092 deaths in 2002. Studies indicate that diabetes in generally under-reported on death certificates, particularly in the cases of older persons with multiples chronic conditions such as heart disease and hypertension. Because of this, the toll of diabetes is believed to be much higher than officially reported.
The total annual economic cost of diabetes in 2007 was estimated to be $174 billion. Medical expenditures totaled $116 billion and were comprised of $27 billion for diabetes care, $58 billion for chronic diabetes-related complications, and $31 billion for excess general medical costs. (6)
References
1. http://www.diabetes.org/diabetes-statistics.jsp
2. The British Journal of Sports Medicine, April 2008, referencing two primary sources:
a. Liu X, et al. "Preliminary Study of the Effects of Tai Chi and Qigong Medical Exercise on Indicators of Metabolic Syndrome and Glycemic Control in Adults with Raised Blood Glucose Levels" Br J Sports Med 2008; DOI: 10.116/bjsm.2007.045476.
b. Yeh SH, et al. "Regular Tai Chi Chuan Exercise Improves T Cell Helper Function of Patients with Type 2 Diabetes Mellitus with an Increase in T-beta Transcription Factor and IL-12 Pproduction" Br J Sports Med 2008; DOI: 10.1136/bjsm.2007.043562.
3. http://www.psychosomaticmedicine.org/cgi/content/abstract/65/5/824
Irwin, Michael, Jennifer Pike and Michael Oxman, "Effects of a Behavioral Intervention, Tai Chi Chih, on Varicella-Zoster Virus Specific Immunity and Health Functioning in Older Adults, Psychosomatic Medicine 65:824-830 (2003).
4. Frantzis, Bruce, Tai Chi: Health for Life; Why it Works for Health, Stress Relief and Longevity (Blue Snake Books, 2006).
6. D.W. Mao, J.X. Li. and Y. Hong. "Plantar Pressure
Distribution during Tai Chi Exercise. Arch Phys Med Rehabil
2006;87:814-20.
Full text available at: http://www.cuhk.edu.hk/spe/publication/Mao06APMR.pdf
7. D.W. Mao, J.X. Li and Y. Hong. "The Duration and Plantar Pressure Distribution During One-leg Stance in Tai Chi Exercise." Clinical Biomechanics 21 (2006) 640-645
Full text available at: http://www.cuhk.edu.hk/spe/publication/Mao06CB.pdf
8. Frantzis, Bruce, The Chi Revolution: Harness the Healing Power of Your Life Force (Blue Snake Books, 2008), page 16.
9. For more information, www.energyarts.com/Research/index.html
10. http://www.diabetes.org/diabetes-statistics.jsp