1. Dr Lam’s YouTube Videos

Dr Lam offering the gift of tai chi for health

Dr Lam offering the gift of tai chi for health

From Dr Lam: I have published over 100 YouTube clips, from free tai chi lessons, answer enquiries and medical studies to tai chi and life style topics. I intended to post useful information to you without any pay advertisement. My clips have 7,683,531 hits so far. They are:

For more videos please go to YouTube or Google and search for Dr Paul Lam and your topic. Feel free to contact me at service@tchi.org. 


1. Published Studies of Dr Lam’s Tai Chi for Health Programs

For a pdf version of this list, please visit this link

1.     Lam P. New horizons…developing tai chi for health care. Journal of Australian Family Physician. 1998 Jan-Feb;27(1-2):100-1.

2.     Lam, P. (2004). “Tai Chi for ageing and its associated chronic conditions.” Journal of Aging and Physical Activity 12(3): 347-347.

3.     Song, Lee E, Lam P, Bae S. Effects of Tai Chi exercise on pain, balance, muscle strength, and physical functioning in older women with osteoarthritis: A randomized clinical trial. Journal of Rheumatology. Sept 2003. 30:9 page 2039-2044.

4.     Lam P and Stephenson A. Tai Chi for Back Pain: Rationale and Available Evidence Supporting Tai Chi as a Complementary Treatment. Journal Medical Paradigm. August 2004 page 5-12 (journal no longer in publication)

5.     CHOI J .H. , MOON J . S. & SONG R. Effects of Sun-style Tai Chi exercise on physical fitness and fall prevention in fall prone older adults. Journal of Advanced Nursing 2005, 51(2),150–157

6.     Orr R, Tsang T, Lam P, Comino E, Fiatarone M. Mobility Impairment in Type 2 Diabetes. Diabetes Care. Volume 29, Number 9, Sept 2006. page 2120-2122

7.     Fransen M, Nairn L, Winstanley J, Lam P,  Edmonds J.  A Randomized Control Trial Of 200 Subjects Comparing Tai Chi, Hydrotherapy And Control, To Measure Improvement In Pain, Physical Function, Muscular Strength And Walking Capacity. Arthritis Care and Research.. Vol.57, No.3, April 15, 2007, pp407-414.

8.     Alexander Voukelatos, MA (Psychol), Robert G. Cumming, PhD, Stephen R. Lord, DSc,and Chris Rissel, PhD. A Randomized, Controlled Trial of tai chi for the Prevention of Falls: The Central Sydney tai chi Trial. JAGS 55:1185–1191, 2007

9.     Tsang T, Orr R, Lam P, Comino E, Fiatarone M. Health benefits of Tai Chi for older patients with Type 2 diabetes: The “Move It for Diabetes Study” – A randomized controlled trial. Clinical Interventions in Aging 2007:2(3) 429-439

10.  Paul Lam, Sarah M Dennis, Terry H Diamond, Nicholas Zwar. Improving Glycaemic and BP control in type 2 diabetes The effectiveness of Tai Chi. Australian Family Physician Vol. 37, No. 10, October 2008 P884-887

11.  Lam P Tai Chi for fall prevention.  NZ Family Physician Journal.  June 2006 volume 33 number 3 page 202

12.  Song, R., Lee, E. O., Lam, P., & Bae. S. C. (2007). Effects of a Sun-style Tai Chi exercise on arthritic symptoms, motivation and the performance of health behaviors in women with osteoarthritis. Journal of Korean Academy of Nursing (English), 37(2), 249-256.

13.  Song, R. Lee, E. O., Bae, S. C., Ahn, Y. H., Paul Lam, Lee, I. O. (2007). Effects of Tai Chi Self-help program on glucose control, cardiovascular risks, and quality of life in type II diabetic patients. Journal of Muscle and Joint Health, 14(1), 13-25.

14.  E Lee, Aeyong Eom, Rhayun Song, Young Ran Chae. Factors Influencing Quality of Life in Patients with Gastrointestinal Neoplasms. Journal of Korean Academy of Nursing. 2008 ISSN 1598-2874 Vol(Ed.) 38(5)

15.  M Lee, Paul Lam, E Ernst. Effectiveness of tai chi for Parkinson’s disease: A critical review. Parkinsonism and Related Disorders, Pages 589-594, ISSN 1353-8020, Vol(Ed.) 14(8, 2008)

16.  Ching-Huey Chen, Miaofen Yen, Susan Fetzer, Li-Hua Lo, Paul Lam. The Effects of Tai Chi Exercise on Elders with Osteoarthritis: A Longitudinal Study, Asian Nursing Research December 2008 Vol 2 No 4

17.  Stephanie S. Y. Au-Yeung, PhD, Christina W. Y. Hui-Chan, PhD, and Jervis C. S. Tang, MSW. Short-form Tai Chi Improves Standing Balance of People With Chronic Stroke. Neurorehabil Neural Repair Online First, published on January 7, 2009

18.  Song, R., Lee, E. O., Lam, P., Bae, S. C. (2009). Effects of Tai Chi or Self-help Program on Balance, Flexibility, Oxygen Consumption, and Muscle Strength in Women with Osteoarthritis. Journal of Korean Academy of Fundamental Nursing, 16(1), 30-38.

19.  Song, R., Eom, A., Lee, E. O., Lam, P․ & Bae, S-C. (2009).  Effects of Tai Chi combined with Self-help Program on Arthritic Symptoms and Fear of Falling in Women with Osteoarthritis.  Journal of Muscle and Joint Health, 16(1), 46-54.

20.  Amanda M Hall, Chris G Maher, Jane Latimer, Manuela L Ferreira and Paul Lam. A randomized controlled trial of tai chi for long-term low back pain (TAI CHI): Study rationale, design, and methods. BMC Musculoskeletal Disorders 2009, 10:55 (28 May 2009).

21.  Rhayun Song, Sukhee Ahn, Beverly L Roberts, Eun Ok Lee, and You Hern Ahn. Adhering to a Tai Chi program to improve glucose control and quality of life for individuals with type 2 diabetes. Journal of Alternative and Complementary Medicine, 15(6), 2009, 627-632.

22.  Eun Ok Lee, Young Ran Chae, Rhayun Song, Aeyong Eom, Paul Lam, and Margaret Heitkemper. Feasibility and Effects of a Tai Chi Self-Help Education Program for Korean Gastric Cancer Survivors, Oncology Nursing Forum • Vol. 37, No. 1, January 2010

23.  Rhayun Song, Beverly L. Roberts, Eun-Ok Lee, Paul Lam, Sang-Cheol Bae. A Randomized Study of the Effects of T’ai Chi on Muscle Strength, Bone Mineral Density, and Fear of Falling in Women with Osteoarthritis. The Journal of Alternative and Complementary Medicine, Volume 16, Number 2, 2010, pp. 1–7

24.  Michelle DiGiacomo, Paul Lam, Beverly L. Roberts, Tang Ching Lau, Rhayun Song, Patricia M. Davidson. Exploring the Reasons for Adherence to T’ai Chi Practice. The Journal of Alternative and Complementary Medicine. December 2010, 16(12): 1245-1246.

25.  Amanda M. Hall, Chris G. Maher, Paul Lam, Manuela Ferreira, Jane Latimer. Tai Chi Exercise for Treatment of Pain and Disability in People With Persistent Low Back Pain: A Randomized Controlled Trial. Arthritis Care & Research. Vol. 63, No. 11, November 2011, pp 1576–1583

26.  Hyung Kyoung Oh, Sukhee Ahn, Rhayun Song. Comparing effects of Tai Chi exercise on pain, activities of daily living, and fear of falling in women with Osteoarthritis and Rheumatoid arthritis. Journal of Muscle and Joint Health, 18(2), 2011, 137-146.

27.  Hua Ren,Veronica Collins, Sandy J. Clarke, Jin-Song Han, Paul Lam, Fiona Clay, Lara M.Williamson, K. H. Andy Choo. Epigenetic Changes in Response to Tai Chi Practice: A Pilot Investigation of DNA Methylation Marks. Evidence-Based Complementary and Alternative Medicine, Volume March 2012, Article ID 841810, 9 pages.

28.  Sukhee Ahn, Rhayun Song. Effects of Tai Chi exercise on glucose control, neuropathy scores, balance, and quality of life in patients with Type 2 diabetes and Neuropathy. Journal of Alternative and Complementary Medicine, 18(12), 2012, 1172-1178.

29.  Rhayun Song, Moonkyoung Park, Jin Ok Chung, Jae Hyung Park, In Whan Sung. Effects of Tai chi exercises on Cardiovascular Risks, Recurrence Risk, and Quality of life in Patients with coronary artery disease. Korean Journal of Adult Nursing, 25(5), 2013, 516-527.

30.  Pao-Feng Tsai, RN, PhD, Jason Y. Chang, PhD, Cornelia Beck, RN, PhD, FAAN,Yong-Fang Kuo, PhD, and Francis J. Keefe, PhD. A Pilot Cluster-Randomized Trial of a 20-Week Tai Chi Program in Elders With Cognitive Impairment and osteoarthritic Knee: Effects on Pain and Other Health Outcomes. Journal of Pain and Symptom Management Vol. 45 No. 4 April 2013

31.  Moonkyoung Park, Rhayun Song. Effects of Tai Chi on fall risk factors: a Meta analysis. Journal of Korean Academic Nursing, 43(3), 2013, 341-351.

32.  Regina Wai Man Leung, Zoe J. McKeough, Matthew J. Peters and Jennifer A. Alison. Short-form Sun-style t’ai chi as an exercise training modality in people with COPD. Eur Respir J 2013; 41: 1051–1057

33.  Beverly Roberts, Rhayun Song, Sukhee Ahn, Paul Lam. Research Metholodogies for Tai Chi research. Edited by mark langweiler, Research methodology for Complementary and alternative therapy. 2015.

34.  Rhayun Song, Sukhee Ahn, Heeyoung So, Eun-hyun Lee, Younghae Chung, Moonkyoung Park. Effects of Tai Chi on balance: A population based meta analysis, The Journal of Alternative and Complementary Medicine 21(3) 2015, 141-151.

35.  Leigh F. Callahan, Rebecca J. Cleveland, Mary Altpeter, and Betsy Hackney. Evaluation of Tai Chi Program Effectiveness for People with Arthritis in the Community: A Randomized Controlled Trial. Journal of Aging and Physical Activity, 2016, 24, 101 -110


The First Tai Chi for Back Pain Study

The First Tai Chi for Back Pain Study conducted in Sydney 2008-2010, Using Dr Paul Lam’s Tai Chi for Back Pain Program

Summary of a Randomized Controlled Trail (RCT) Using “Tai Chi Exercise for the Treatment of Pain and Disability in People with Persistent Low Back Pain”
By: Anastasia Yianni & Wilfred Kwok

Authors of the study: A. M. Hall, C. G. Maher, P. Lam, M. Ferreira and J. Latimer

Published in the Arthritis Care & Research Journal November 2011 

The study consisted of 160 volunteers between ages 18 and 70 years deemed eligible if they had moderate pain and/or activity limitation, with a diagnosis of “persistent nonspecific low back pain”. Half the participants undertook tai chi exercise consisting of 18 group sessions, 40 minutes in duration over 10 weeks. The other 80 participants (control group) continued with their usual health care.

The results collected immediately after the 10 week course program indicated that there was a statistically significant treatment effect for 75% of the tai chi participants and that tai chi exercise is a safe and effective intervention for improving pain and disability outcomes for people with persistent low back pain.

This again adds to the evidence of tai chi’s health benefits when done on a regular basis and that more and more people are considering it to be worthwhile in their approach to positive health.
Please read an additional article on the Chartered Society of Physiotherapy Website regarding this study.

Tai Chi for Arthritis – Published 2016 Journal of Aging and Physical Activity

The largest study of Tai Chi for Arthritis, by Professor Leigh Callahan and colleages from the University of North Carolina, shows significant health benefits for people with all types of arthritis. This landmark study was publised at the Journal of Aging and Physical Activity, 2016
Title: A Randomized Controlled Trial. Journal of Aging and Physical Activity
In the study, 354 participants were randomly assigned to two groups. The Tai Chi group received 8 weeks of lessons, while the other group was a control group waiting for Tai Chi classes. It was found that there was significant pain relief, less stiffness and better ability to manage daily living.  The participants felt better about their overall wellness, as well as experiencing improved balance.

The Tai Chi intervention is based on Dr Paul Lam’s Tai Chi for Arthritis program, and instructors were trained and certified by his Master Trainers. Dr Lam’s Tai Chi for Health Institute has established a comprehensive curriculum that includes knowledge of tai chi and chronic conditions, effective teaching methods and how to stay safe. Click here for more information about the institute.

Leigh F. Callahan, Rebecca J. Cleveland, Mary Altpeter, and Betsy Hackney. Evaluation of Tai Chi Program Effectiveness for People with Arthritis in the Community: A Randomized Controlled Trial. Journal of Aging and Physical Activity, 2016, 24, 101 -110

This article can also be read in Arabic
Related Articles:

Tai Chi for Arthritis Helps CVA

Dr Paul Lam

Published in Neurorehabilitation and Neuro Repair, Volume 20, Number 10, January 7 2009
 
Authors Stephanie S. Y. Au-Yeung, PhD, Christina W. Y. Hui-Chan, PhD, and Jervis C. S. Tang, MSWtai chi for people with chronic conditions in New Zealand 2008
 
All subjects were six months or more post-stroke.  Over a twelve week period a control group of 62 subjects performed general exercise, and a further 74 subjects received training in Tai Chi for Arthritis.  The subjects were tested for improved balance and reaction after six weeks, twelve weeks (conclusion of training) and eighteen weeks (six weeks post study).
 
Results showed that the tai chi group improved their reaction times on the non-affected side, and this was still noticeable six weeks after the study concluded.
 
This result supports the idea that regular practice of short-form Tai Chi for 6 to 12 weeks improves standing balance in people with chronic stroke. With its lasting effect beyond the training period, such short-form Tai Chi might be applied in community rehabilitation programs for patients who have adequate sensorimotor function and learning ability to safely participate.
 
Related Articles
 
 

Reference of the study: Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J : Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai chi classes Arthritis & Rheumatism (Arthritis Care & Research) April 2007, 57:3 pp 407-414.


Tai Chi for Diabetes Study by Dr Paul Lam Et Al

A Tai Chi for Diabetes Study 2008
 
 “Improving Glycaemic and BP control in type 2 diabetes –  The effectiveness of Tai Chi”
Published in the Australian Family Physician, Vol 37, Number 10, October 2008 p884-887
Authors: Lam, P., Dennis, S., Diamond, T., & Zwar, N.

 

This community based, randomised control trial assessed the effects of a modified Tai Chi program for people with poorly controlled type II diabetes. It found improvements in HbA1c (an important indicator of blood glucose level); six-meter walk test and total cholesterol in both the control and Tai Chi group. Improvements in physical and social functioning were found in the Tai Chi group. 

Fifty-three people who fulfilled the study criteria were randomly divided into a Tai Chi (28) and control group (25). The Tai Chi group were taught the specially designed Tai Chi for Diabetes program twice per week for six months. The control group were given ten weeks of free lessons after the study. At six months, improvements in HbA1c, six-meter walk test and total cholesterol were not statistically significant between the groups. However, improvements were observed in physical and social functioning in the Tai Chi group from baseline to follow up. Many people joined Tai Chi classes after the study.

The researchers believe that Tai Chi with its relatively low cost, easy accessibility and high adherence rate may be a useful part of the treatment of type II diabetes in the community. Tai Chi for Diabetes may be a useful introduction to greater physical activity. However, longer duration or increased number of Tai Chi sessions per week may be required to demonstrate statistically significant reductions in metabolic or cardiovascular parameters.

The authors gratefully acknowledge the RACGP Cardiovascular Research Grant that supported this project.
 

Tai Chi for Fall Prevention study 2005

By: Dr Paul LamSummary of a published article:

"The Effects of Sun-Style Tai Chi Exercise on Physical Fitness and Fall Prevention in Fall-Prone Adults"
Published in the journal of Advanced Nursing 51(2), 150-157
by Dr Choi J.H., Moon J.S. and Song R. (2005)
TCD Template Paul 3

"As people get older they are more likely to experience falls and this can lead to some very serious health issues…Our study shows that low-intensity exercise such as Tai Chi has great potential for health promotion as it can help older people to avoid falls by developing their balance, muscle strength and confidence." says co-author Professor Rhayun Song (who is also a master trainer of the Tai Chi for Arthritis program) from the Chung Nam National University in South Korea.

A total of 68 older adults with a mean age of 77.8 year olds participated in the study. This group was divided into 29 people in the tai chi group and 30 as control. The tai chi program was the Tai Chi for Arthritis program based on Sun style. It was provided 3 times a week for 12 weeks and the subjects were tested before and after the three months for strength of the knee and ankle, flexibility and mobility, and the risk ratio of falls. The tai chi group reported significantly more confidence in falls avoidance than did the control group. It was concluded that this tai chi program can safely improve physical strength and reduce fall risk in fall-prone older adults in residential care facilities.

The study has attracted attention from the media worldwide including Fox News, Hindustan Times of India, Medical News Today of UK, and United Press. You can read more reports about it at:
http://www.seniorjournal.com/NEWS/Fitness/5-06-27TaiChi-Falls.htm
TCA Template Paul 1

The World’s Largest Fall Prevention Study 2007

Summary of "A Randomized, Controlled Trial of tai chi for the Prevention of Falls: The Central Sydney tai chi Trial"
By Dr Paul Lam
Authors of the study: Alexander Voukelatos, MA (Psychol) et al
Published on the Journal of American Geriatric Society, August 2007. 55:1185–1191, 2007
 
This largest fall prevention study in the world involved 702 people in the community. After 16 weeks of learning and practicing a Tai Chi program (80% of the participants did the Tai Chi for Arthritis program), the results showed that Tai Chi significantly reduced the number of falls. Tai Chi also significantly reduced the risk of multiple falls by approximately 70%.
 
The study concludes: "the findings from this study indicates that participation in weekly community-based tai chi classes can reduce falls in relatively healthy, community-dwelling older people. Given that the tai chi program used existing community facilities, the study suggests that tai chi is an effective and sustainable public health intervention for falls prevention for older people living in the community."
 

Congratulations to the Central Area Health Promotion Unit! This is one of the most effective works anyone can do for health promotion. And it adds to the mounting evidence of the many tai chi's health benefits.

Related articles:
 

Tai Chi for Arthritis study (same Tai Chi program) published in the Arthritis Care and Research Journal April 2007 

"The Effects of Sun-Style Tai Chi Exercise on Physical Fitness and Fall Prevention in Fall-Prone Adults"
Published in the journal of Advanced Nursing 51(2), 150-157
by Dr Choi J.H., Moon J.S. and Song R. (2005)

Effects of tai chi exercise on pain, balance, muscle strength, and physical functioning in older women with osteoarthritis: A randomized clinical trial"
Published by the Journal of Rheumatology Sept 2004

 


Tai Chi for Arthritis – Published April 2007 Arthritis Care and Research

A Recently Published Significant Tai Chi for Arthritis Study
By: Libby Spiers

Summary of the study ‘Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai chi classes’***, by Libby Spiers

Libby Spiers is a physiotherapist and warm water exercise coordinator at Arthritis Victoria.A Tai Chi for Arthritis class

A recent study published in Arthritis and Rheumatism found that both hydrotherapy and Tai Chi for Arthritis classes can provide large and sustained improvements in physical function for older, sedentary people with chronic osteoarthritis (OA) of the knee or hip.

The researchers carried out a randomised controlled trial among 152 older people with chronic OA of the hip or knee. Participants attended either Tai Chi for Arthritis classes or hydrotherapy twice per week for 12 weeks. At 12 weeks, compared with controls, the exercise group participants demonstrated significant improvements for pain and physical function scores. These improvements were maintained at 24 weeks.
 
“This study shows the health benefits of the Tai Chi for Arthritis program, these benefits don’t necesarily translate to other forms of tai chi” Dr Marlene Fransen, chief investigator of this study.”
 
*** Fransen M, Nairn L, Winstanley J, Lam P,  Edmonds J.  A Randomized Control Trial Of 200 Subjects Comparing Tai Chi, Hydrotherapy And Control, To Measure Improvement In Pain, Physical Function, Muscular Strength And Walking Capacity. Arthritis Care and Research.. Vol.57, No.3, April 15, 2007, pp407-414.
 
Related Articles
 
 

Reference of the study: Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J : Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai chi classes Arthritis & Rheumatism (Arthritis Care & Research) April 2007, 57:3 pp 407-414.


1. Tai Chi for Fall Prevention

By Dr Paul Lam, Dr Pamela Kircher and Maureen MillerDSC04312

© Copyright 2013 Dr Paul Lam. All rights reserved, except copy for non-profit making educational purpose. For example, you may forward to your friends or make copies for your fee-paying students as long as no fee is charged for this material.

Abstract

Treatment of injuries, due to falls, is one of the most expensive health conditions. Evidence has shown tai chi being one of the two effective exercises to prevent falls. Dr Paul Lam’s “Tai Chi for Arthritis” program is proven by the world largest study on older adults for fall prevention, and also to improve health and the quality of life.

Update – CDC Recommends Tai Chi for Arthritis for fall prevention.PC20131

NB: CDC recommends the Tai Chi for Arthritis program which is exactly the same as Tai Chi for Arthritis and Fall Prevention except the later has additional emphasis on fall prevention. Both programs are evidenced based to effective at preventing falls. 

Falls and Tai Chi
According to the US Centers for Disease Control and Prevention (CDC), one in three adults over the age of 65 fall each year. Treatment of injuries due to falls is the most expensive health cost, estimated 2015 by CDC to be 31 billion dollars per year in USA.
 
There are many studies on measures to prevent falls. A recent review of 111 randomised trials involving over 55,000 subjects singled out tai chi and individually prescribed exercise programs to be effective. There remain skeptics who see tai chi as too gentle an exercise to have such significant effects. True, tai chi movements appear to be gentle and graceful, but like the force beneath a seemingly calmly flowing river, tai chi movements contain much power and internal strength. What is fascinating is that the fear of falling often results in more falls; hence, confidence in “not falling” will help to reduce falls. With regular practice, tai chi improves balance by strengthening muscles and co-ordination; at the same time, it strengthens the mind, thereby improving calmness and confidence in not falling. Thus, both physically and mentally, tai chi is an extremely effective exercise for fall prevention. A great bonus, at the same time, tai chi also improves almost all aspects of health!DSC04414
 
An Evidence Based Approach
In addition to established manuals and consistent instructor training world-wide, the Tai Chi for Arthritis program is evidence based. The following are several examples.
 
Similar to other western countries, the New South Wales Health Department of Australia experiences high costs related to injuries due to falls—far higher than from injuries of any other source including road trauma.iv In 2001, the Department funded the world’s largest fall prevention study in a community setting. The majority of participants were taught the Tai Chi for Arthritis program. vi This study found that recurring falls were reduced by nearly 70%. It also found that building confidence—a fundamental component of the Tai Chi for Arthritis program—correlates closely to the reduced rate of falling. This study was one of the two listed on the CDC official site as evidence of tai chi preventing falls.

Since then, and based on the evidence of the study, the New South Wales Health Department has funded many tai chi for faDSC04240ll prevention programs using Tai Chi for Arthritis. One of these was conducted in the town of Ford. For two years, approximately 20% of the population participated in tai chi classes. An evaluation by the Health Department, taken of the 576 persons age 65 or over, sampled 31 participants. It was found that 99% of the participants had improved balance and flexibility and 100% improved strength.

In addition to the New South Wales Health Department, the Aged Care Department in Victoria, the South Australia Health Department, and Sport and Creation Department, among others around the world, have funded training for Tai Chi for Arthritis programs.
 
A Greater South Health Area Service (GSHAS) program was studied by the Australian National University. The GSHAS, which covers a total population of 452,643 distributed over an area of 166,000 square kilometers, has implemented and provides ongoing support for the Tai Chi for Arthritis program on a not-for-profit basis for eight years. A research team from the Australian National University studied the recent three years (Feb 2007 to June 2010) during which the Tai Chi for Arthritis program was followed by 1.7% of the target population. There were 119 classes in 49 locations at a cost estimated to be 76 AU$ per person per year. The outcome shows significant improvement in fall rate and general well being. Interestingly, falls and fear of falling are a relatively minor factor in participants’ motivation to join the tai chi classes. Instead, people keep coming to tai chi classes because they experience a range of physical, social and cognitive benefits which they find overwhelmingly positive. These benefits include improvements in physical function, psychological health and well-being, and social vigour—all relatively evenly distributed among the participant body. Such benefits address a range of issues which pose challenges for the elderly and ageing population in rural communities.DSC04357

In 2000, the Accident Compensation Corporation (ACC) in New Zealand, a national government body that has a no-fault policy and compensates all accidents and injuries in the country, realised that prevention is often much cheaper than treatment. Their medical experts recommended using tai chi, among other exercises, to prevent falls. Being new to tai chi, the ACC’s initial foray into contracting for tai chi instruction was met with several challenges. For example, instructors taught different styles of tai chi, making it difficult to assess outcome and enforce safety standards; one major provider, who franchised instructors nationally, based the teaching on Chen style, which was too complex and martial. Additionally the teaching methodologies were not geared to learning styles of older adults and did not focus on safety. However, once the ACC adapted the less complex and easier to learn Tai Chi for Arthritis program, more positive results were obtained.dsc00855

As the ACC discovered, tai chi encompasses a vast number of styles and forms; plus there are a myriad ways of teaching tai chi. In translating medical evidence to benefit a community, not only is content important, but equally so is the teaching method. The ACC worked with Dr Lam to install a training program that included safety and quality control. Within a year, instructors were trained and excellent quality was maintained with minimal cost. By 2009, approximately 80% of the ACC’s 700 trained instructors were using the Tai Chi for Arthritis program, delivering Tai Chi to over 35,000 people.

How Tai Chi Works
No matter what forms of tai chi, if specific tai chi principles are incorporated into tai chi practice, the result will be better balance and reduced falls. The principles are:TCworkshop_2015_100
 
1. Movement control
Tai chi movements are slow, smooth and continuous, helping to strengthen internal muscles, like the deep stabilisers that support and strengthen the spine. Additionally, tai chi practitioners move against a gentle resistance to build full
muscular strength. Slow and smooth movements calm the mind, helping to reduce falls resulting from sudden movements that lead to significant blood pressure drop, especially in elder people taking medication that can cause
change of blood pressure.
 
2. Weight transference
Tai chi practitioners are mindful of transferring weight with each step, helping to improve mobility, coordination and balance. This, in addition to emphasis on upright and supple posture, further strengthens muscles.
DTCA vermont2
 
3. Integration of mind and body
Tai chi is an internal art, which stresses the integration—and balance—of mind and body. Tai chi practitioners focus, calm their minds, and loosen and relax their joints and ligaments. A number of studies indicate that being confident results in less falls, since the fear of falls increases the risk of falling. Practicing a mindbody exercise, such as tai chi, builds confidence, thus alleviating the fear of falling. 
 
Why Tai Chi for Arthritis for Fall Prevention Workshome2
Factors that make the Tai Chi for Arthritis program so effective include a high standard and consistent training of instructors throughout the world—one of the reasons CDC has listed this program and is promoting it for fall prevention.
 
Tai Chi for Arthritis incorporates a progressive stepwise teaching method that simplifies and enhances the student’s ability to learn. The teaching method also encourages students through specific positive feedback and minimal corrections, thereby enhancing their enjoyment of learning and creating a sense of achievement. Instructor training also includes understanding the principles listed above and working with students to incorporate them into real life situations. Because of the allure of the Tai Chi for Arthritis form itself and the standardised teaching method, students tend to adhere to this tai chi program much more than in a regular exercise program.DTCA Ashville 2
 
Extra Benefit: Reduction of the Burden of Chronic Diseases.
Investing in tai chi programs can have cost savings in other areas. As the practice of tai chi improves many aspects of health, it can also be an ideal preventive intervention. The U.S. National Institute of Health’s National Center for Complementary and Alternative Medicine suggests that people practice tai chi for a variety of health-related purposes, such as
• for benefits associated with low-impact, weight-bearing, aerobic exercise;
• to improve physical condition, muscle strength, coordination, and flexibility;
• to improve balance and decrease the risk for falls, especially in elderly people;
• to ease pain and stiffness—for example, from osteoarthritis;
• to improve sleep;home3
• for overall wellness.
 
The largest study about the practice of tai chi by people with arthritis, published in the Arthritis Care and Research Journal, found that the Tai Chi for Arthritis program not only reduced pain, but also improved the quality of life. It has also been found to improve standing balance for people with strokes as well as six out of eight measurements of quality of life for older adults. A study, published in the Journal of Alternative and Complementary Medicine, followed 82 older women divided into tai chi and control groups. After six months, those practicing tai chi significantly increased knee extensor endurance and bone mineral density and had less fear of falling than the control group.
 
most exciting study has shown regular tai chi practice improves genetic components that are associated with health and wellness at the molecular level, e.g. tai chi practitioners have improved chromosomal markers relating to health and significant slowing (by 5–70%) of the age-related methylation losses.Dr Lam, Linda from MN and Linda from UK at Alaska Tai Chi for Diabetes workshop
 
The May 2009 issue of the Harvard Health Newsletter suggests that while tai chi is often described as “meditation in motion”, it could well be called “medication in motion”. For, in addition to preventing falls, tai chi programs have been shown to be helpful for a number of medical conditions including: arthritis, lower back pain, low bone density, breast cancer and its side effects, heart disease and heart failure, hypertension, Parkinson’s disease, sleep problems, and stroke.
 
“A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age,” says Peter M. Wayne, assistant professor of medicine at Harvard Medical School and director of the Tai Chi and Mind-Body Research Program at Harvard Medical School’s Osher Research Center.
 
Tai Chi Has an Important Role in the Future of Health Management.
Research has demonstrated that the practice of tai chi improves many components of health. Tai Chi for Arthritis, in particular, has been shown to help prevent falls and improve health and the quality of life. Additionally, it may prevent and/or improve the management of chronic diseases, particularly for our ageing population, and thus be an effective measure to save significant health care costs. The Milken Institute reports that the annual economic impact on the U.S. economy of the most common chronic diseases is calculated to be more than one trillion dollars. However, if the
impact of seven chronic diseases—diabetes, pulmonary conditions, hypertension, mental disorders, heart disease, cancers and stroke—could be prevented, by midcentury the annual GDP could be reduced by six trillion dollars a year. Tai chi has a important role to play in preventing these chronic conditions and improving health and wellness.

References:

Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.

ii Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. Journal of  Forensic Science 1996;41(5):733–46.

iii Gillespie L D, Robertson M C, Gillespie W J, Lamb S E, Gates S, Cumming R G, Rowe B H; Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2009, Apr 15;(2): CD007146. http://www.ncbi.nlm.nih.gov/pubmed/19370674

iv Policy Directive, Fall Injury Among Older People – Management Policy to Reduce in NSW  health, http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_353.pdf

v Alexander Voukelatos, MA (Psychol); Robert G. Cumming, PhD; Stephen R. Lord, DSc; Chris Rissel, PhD. A Randomised, Controlled Trial of Tai Chi for the Prevention of Falls: The Central Sydney Tai Chi Trial. Journal of American Geriatrics Society, August 2007, Vol. 55, No. 8

vi Quote from Dr Lam’s correspondence with the chief author, Dr Alex Voukelatos: ’”Of the 76 Tai Chi programs taught by 22 instructors, 58 (76%) were Tai Chi for Arthritis (TCA) based on Sun style tai chi. They were taught by instructors certified in TCA by Dr. Paul Lam’s Tai Chi for Health.”

vii  Hall SJ, Phillips CB, Dubois L, Follett N & Pancaningtyas N. Preventing Falls, Promoting Health, Engaging Community: Evaluation Report of the Greater Southern Area Health Service Physical Activity Leaders Network Tai Chi Program. Canberra: ANU Medical School. 2010.

viii  Presentation at the ACC annual conference 2010 by Rose Ann, Programme Manager, Accident Compensation Corporation, Wellington, New Zealand

ix  http://nccam.nih.gov/health/taichi/

 Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J. A Randomised Control Trial Of 200 Subjects Comparing Tai Chi, Hydrotherapy And Control, To Measure Improvement In Pain, Physical Function, Muscular Strength And Walking Capacity. Arthritis Care and Research. Vol. 57, No.3, April 15, 2007, pp
407-414.

xi  Stephanie S. Y. Au-Yeung, PhD, Christina W. Y. Hui-Chan, PhD, and Jervis C. S. Tang, MSW; Neurorehabilitation and Neuro Repair, Volume 20, Number 10, January 7 2009,

xii  Ching-Huey Chen, Miaofen Yen, Susan Fetzer, Li-Hua Lo, Paul Lam; The Effects of Tai Chi Exercise on Elders with Osteoarthritis: A Longitudinal Study. Asian Nursing Research. December 2008 Vol. 2 No4.

xiii  Rhayun Song, Beverly L. Roberts, Eun-Ok Lee, Paul Lam, Sang-Cheol Bae. A Randomized Study of the Effects of T’ai Chi on Muscle Strength, Bone Mineral Density, and Fear of Falling in Women with Osteoarthritis. The Journal of Alternative and Complementary Medicine, Volume 16, Number 2, 2010,
pp. 1–7

xiv  Hua Ren,Veronica Collins, Sandy J. Clarke, Jin-Song Han, Paul Lam, Fiona Clay, Lara M.Williamson,K. H. Andy Choo. Epigenetic Changes in Response to Tai Chi Practice: A Pilot Investigation of DNA Methylation Marks. Evidence-Based Complementary and Alternative Medicine, Volume March 2012,Article ID 841810, 9 pages.

xv  “The health benefits of tai chi”, Harvard Health Publications. May, 2009. https://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2009/May/The-health-benefitsof-tai-chi

xvi http://www.milkeninstitute.org/publications/publications.taf?function=detail&ID=38801154&cat=Arts