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KEY CLINICAL UPDATES IN TAI CHI

A 2020 review synthesized evidence from more than 200 meta-analyses of randomized controlled trials with over 100 unique health outcomes found evidence supporting tai chi in the improvement of physical and mental health among adults with cancer, neurological disorders such as Parkinson disease, metabolic diseases, cardiopulmonary diseases including heart failure and coronary artery disease, musculoskeletal diseases such as fibromyalgia, and psychological disorders.

DEFINITION

Tai chi chuan is a martial art that can be practiced as a gentle, meditative exercise that consists of flowing movements, balance and weight shifting, breathing, and body awareness.

HISTORY

The exact origin of tai chi is obscure, but it likely began between 300 and 800 years ago and developed in monastic settings in China.

TRAINING & CERTIFICATION

There is no widely recognized, standardized teacher training or certification in tai chi. Teachers are established through a lineage tradition of master-to-student transmission. When referring patients to tai chi programs, it is helpful to inquire about the characteristics of that lineage and how many years of experience the teacher has.

CLINICAL PRACTICE

There are four major styles of tai chi, but the majority of publicly available classes in the United States are in the Yang style. Yang style uses slow, flowing movements of medium excursion. Wu style uses smaller, more compact movements. The Chen style is the most physically demanding, especially on the knees and low back. Some of the movements in the Chen style are rapid and forceful. The Hao style emphasizes internal chi movement more than external visible movements.

ADVERSE EVENTS

Tai chi practice appears to be very safe. A systematic review of adverse events in the tai chi literature was conducted in 2014 and found 50 of 153 eligible randomized controlled trials reported any adverse events. Most of these trials found no adverse effects. Of the events that did occur, none were serious. The most common events were minor musculoskeletal pains (knees, ankles, low back). Nine falls were reported, but out of thousands of patients, many of whom are referred to tai chi for problems with balance, this is probably neither surprising nor alarming.

CLINICAL USES

A 2020 review synthesized evidence from more than 200 meta-analyses of randomized controlled trials with over 100 unique health outcomes. It found there is evidence supporting tai chi in the improvement of physical and mental health among adults with cancer, neurologic disorders such as Parkinson disease, metabolic diseases, cardiopulmonary diseases including heart failure and coronary artery disease, musculoskeletal diseases such as fibromyalgia, and psychological disorders.

A. Balance/Falls

Tai chi improves balance and reduces falls. A 2017 systematic review and meta-analysis of 10 studies and 3000 ...

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