Newsletter #48 - August 2005

In this issue:
-- From Me to You by Dr Lam
-- Tai Chi for Arthritis and Diabetes; a health initiative evaluation by Susan Harch
-- Tai Chi Outside the Box by Dr Stephanie Taylor
-- Tai Chi Inside Out and Outside In by Dr Lam
-- Sarasota 2005 - "Moving Stillness" Tai Chi Fan by Trevor Reynaert
-- Hello Paul from Denny Robinson
-- Alcohol. Drugs to help you stop drinking by Your_Health

Click on the title to read the article, and here to read all previous newsletters

Hello Everyone!

The tai chi workshop in Florida has generated so much good energy and ideas; I won't be able to include everything in this newsletter. I'll tell you about them soon, though.

Professor Rhayun Song, a master trainer of Tai Chi for Arthritis, from South Korea's Chung Nam University and her colleagues have published a study in the latest issue of Journal of Advanced Nursing. The study has attracted attention from the media worldwide including Fox News, Hindustan Times of India, Medical News Today of UK, and United Press. It concludes that the Tai Chi for Arthritis program improved the learners' balance and physical strength and reduced the risks of falls. You can read more about it.

Last month I published Barbara Foster's study that shows both Tai Chi for Arthritis (a modified tai chi program designed by myself and our team) and strength training are effective at fall preventions and improving many aspects of health. I'm happy that so many of you have written to Barbara and me about it. Not all studies need to be published in a prestigious journal. If we all do our best to document, as scientifically as possible, the benefits of tai chi, it will help bring the message to many. For example, Susan Harch, a medical student from Monash University of Melbourne, Australia, did a marvelous study of the Central West Health unit. Medical students of her caliber give me great hope for the doctors of the next generation. Her study concluses: "…Tai Chi classes currently being conducted at Forbes District hospital are having multiple positive outcomes. These include improved health, balance, stress management, cognition and social supports..."

Coincidentally, Dr Stephanie Taylor's talk as part of the "Tai Chi Outside the Box series" and my talk at the workshop share a similar underlying theme. It's great to work from different angles and come to a similar conclusion.

Trevor and Dennis share their experiences at June's Sarasota workshop. And they're among the many others who walked on a cloud after workshop.

Your_Health, an Australian medical newsletter, gives a guide to different drugs that may help alcoholics.

Many of you have probably received an email from Bill Douglas, the creator of World Tai Chi Day, about the criticism of his book. I agree with Bill that it's undesirable to attack others. More people will benefit from tai chi if we work together to promote its health benefits. Criticism creates negative energy, whereas positive support within the tai chi communism will generate positive vibes throughout - it will bring more people into the tai chi world. Bill and his wife have made an invaluable contribution by making more people aware of tai chi. I know many of my friends have enjoyed the World Tai Chi Day and gained valuable publicity for their schools.

The photos of the Tai Chi for Arthritis and Tai Chi for Back Pain workshops in Sydney are now posted here. Check them out. I just finished the workshop in Philippine, the photos will be posted soon.

This month's feature products:
The complete package with all available teaching material to help you learn and progress with the Tai Chi for Arthritis program. This package will meet your learning requirements for years. Here is a free guide how to use these products effectively, read how useful they are and feel free to forward the guide to your friends:

1. Tai Chi for Arthritis DVD/video
2. Tai Chi for Arthritis Part II DVD/video
3. Tai Chi for Arthritis handbook
4. Overcoming Arthritis - the book
5. The Talk CD - Dr Lam Talks You Through the Tai Chi for Arthritis Program
6. Tai Chi Music CD
7. Sun style 73 DVD/video

The Cost: USD$90.00 (Normally $140.65. You save $50.65), Or AUD$120 (You save $60.65); GBP 50 (You save GBP30). Click this link to place your order.

This month's most useful letter is written by yulichi at this thread. She says: "… I told my husband I would order a video to learn Taichi. And he remembered seeing a Taichi video in our video/CD/DVD collection and it turned out to be Dr. Lam's Easy Six Forms. We don't even remember where it came from. We did not buy it. Is must be someone gave us at some point. Who knows! Using my mom's words, it dropped from the sky. It is a gift from the god in heaven…" I love it because she encourages us to keep up with our work. Click on the link to read her message. Yulichi we would like to send you a free Tai Chi Music CD, please email us at service@taichiproductions.com to claim your CD.

Next month Chaz Walter's "To Live Forever and Be Forever Young" and Jeff Morris's "Building Alliances, Many Paths, One Truth" would be worth waiting for.

Yours sincerely,
Paul Lam MD
http://www.taichiproductions.com

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Tai Chi for Arthritis and Diabetes; a health initiative evaluation.
By Susan Harch

Introduction;
In June 2005, I returned to Forbes, NSW for my second JFSS placement, where my mentor, Dr Claire Cupitt, is a valuable GP for the town and surrounding districts. This year during my placement, I placed greater emphasis on general practice, rather than allied health. This is because I now have a better grasp on clinical medicine as I commenced my hospital placements this year.

It is in the nature of general practice to see a high proportion of the patients to be elderly, with almost all presenting with some degree of arthralgia, arthritis or diabetes. With this in mind, I came across the initiative of the Central West Health service, 'Tai Chi for Arthritis' and 'Tai Chi for Diabetes'.

This project aims to evaluate the outcomes of the 'Tai Chi for Arthritis' and 'Tai Chi for Diabetes' and its success as a health initiative.

Description;
What is Tai Chi?
Tai Chi is a form of martial arts which originates from ancient China and involves gentle, slow 'circular movements' with coordinated, slow, deep breathing. It has numerous mental and physical health benefits which include;
" Mental health;
- Improved concentration and memory.
- Relaxation.
- Mind body integration.
" Physical health;
- Increased muscle strength which supports and protects joints.
- Improved flexibility.
- Greater stamina and fitness.
- Weight transference, which is valuable in falls prevention.

Tai Chi in Forbes;
Tai Chi has flourished in Forbes! Libby Godden, the rehabilitation co-ordinator, and Jill Cripps, a physiotherapist, run seven classes for approximately 80 students. Two forms of Tai Chi are taught, Tai Chi for arthritis and Tai Chi for diabetes. However, the lessons do not discriminate against those without these conditions, and several participants attend the classes for alternative reasons.

Objectives;
" Evaluate class participant demographics.
" Analyse the motives for attending Tai Chi.
" Review the efficacy of the different modes of publicity for the classes.
" Evaluate the subjective benefits experienced by participants from Tai Chi.

Results;
A survey was drafted which addressed the key objectives described above (see appendix 1). Due to my inability to attend the classes, Libby Godden kindly distributed the surveys to participants at the conclusion of the class. The return rate of the surveys was 28 (n=28).

Participant demographics;
1. Gender;
a. Male = 4
b. Female = 24
2. Age;
Age(years) Number of participants
41-50 1
51-60 5
61-70 10
71-80 7
81-90 5

Participant motives for attending Tai Chi;

Motive
Physical activity 10
Social activity 2
To maintain regular movement 4
Improved concentration and cognitive function 2
Improved health 9
To assist with balance 4
For improved breathing 1
To help arthritis 2
Instructed to by family member 2
For diabetes management 2
Stress management 1

The efficacy of the different methods of publicity for Tai Chi;
Mode of publicity; Participants who discovered Tai Chi via this mode;
Word of mouth, including family and friends 15
The Advocate (Local Newspaper) 8
Physiotherapy department 3
Hospital Noticeboard 1
Health services 1

Participant benefits from Tai Chi (Subjective);

Benefit; Number of participants who reported benefit;
Improved Balance 9
Improved coping skills and relaxation 6
Feel fitter and healthier 6
Improved concentration and cognitive function 4
Improved movement and coordination 4
Enjoyment and social interaction 4
Reduced stiffness 1

How participants' experiences differed from their expectations;

Different experience;
Number of participants who reported difference;
Level of enjoyment 9
Improvement in balance and joint strengths 6
Gentler movements 4
The amount of concentration and cognitive skills 3
Level of ability achieved 1
Friendlier 1

The success of participants incorporating Tai Chi into their 'every day life';

Number of participants who use Tai Chi in their daily living;
" Yes = 23
" No = 1
" No answer = 4
Methods participants have used to incorporate Tai Chi skills in daily living Number of participants
Practice Tai Chi as form of daily exercise 7
Improved breathing/use of techniques 6
Improved balance 5
To feel fitter and healthier 3
Meditation 1
Relaxation when tense 1
Improved cognitive function 1

Analysis and evaluation;
Most participants were female and the highest age sector was 61-70 years, followed by 71-80 years. This association may be due to the high prevalence of arthritis and diabetes in this age group. Since the classes are held during the day, they are likely to attract individuals who are retired or currently not working, thus those in the 61-80 year age bracket.

The most common reasons for participant attendance were to improve their physical activity, balance and health. These motives correspond with the age group of the participants, as these become greater concerns as people age as their compensatory mechanisms and physical abilities decrease.

Participants reported an improvement in balance, greater coping skills and relaxation and increased feelings of wellbeing and health. The reports on improved coping skills reflect the mental health benefits which correspond to Tai Chi, but were not predicted or expected by the participants prior to commencing their classes. The high proportion of participants who reported an improvement in their balance is particularly significant to this older aged sector, for whom falls represent greater mortality and morbity.

Interestingly, nine participants reported that they enjoyed the Tai Chi much more than they had expected. This may reflect the foreign nature of Tai Chi and the hesitancy of individuals to try something new. It may also be suggestive of the negative connotations people may hold with exercise or relaxation activities.

The high number of participants (n = 23) who have incorporated the skills gained from Tai Chi into daily activities, suggests that Tai Chi benefits can be adapted into a variety of environments. This also reinforces that the benefits have the potential to be long term, if the skills are practiced and maintained.

Outcomes and Recommendations;
Despite the small size of this study, it still displays that the Tai Chi classes currently being conducted at Forbes District hospital are having multiple positive outcomes. These include improved health, balance, stress management, cognition and social supports. These positive health outcomes are mainly occurring in the elderly population sector, who often have multiple co-morbities but also find it challenging to access appropriate services.

Considering the depth of positive outcomes received, further promotion and development of the Tai Chi classes is recommended. The study has displayed that advertising in the local newspaper and encouraging communication via word of mouth to be the most effective methods of promotion. It is suggested these be avenues for focus in the future.

Study results revealed many participants have experienced an improvement in stress management after learning Tai Chi. Taking this and the current popularity of Tai Chi into consideration, it is recommended additional classes could be commenced at the local gym, which could be accessed by the all sectors of the community, and structured to complement the common 'working day'.

For further study development, research could be conducted into long term benefits of Tai Chi experienced by the class participants. It would also be interesting provide follow up research into the retention rate of class participants, and how their experience of Tai Chi has expanded and developed.

This study could be improved by providing research into the possible improvements which could be carried out by the instructors for the Tai Chi classes. Additionally, the study only examined the subjective benefits received by Tai Chi. The validity of the study would be enhanced if objective measures were also discussed, eg pre- and post- maximum walking distance and muscle strength.

Conclusion;
Tai Chi is a gentle form of martial arts, with multiple mental, physical and social health benefits. Forbes Health service has successfully implemented a Tai Chi exercise program which targets the 60-80 year old population sector, for whom this form of activity is particularly beneficial. Thus, this study has demonstrated the Tai Chi classes are an effective health promotion initiative and further development should continue.

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Tai Chi Outside the Box
Dr Stephanie Taylor (As presented at the Sarasota workshop)

Hello. I'm Stephanie Taylor and I'm a small town country doctor. In the tradition of talking about our day jobs, I will briefly mention medicine. The way that medicine is practiced now, it's not only in the box, but it's in the corner of the box.

Last night we saw, "What the 'bleep' do we know?". This is the first time that we have shown a movie at a workshop. How many saw it last night or have seen it before? (Show of hands). Briefly, this is a movie about applying the discoveries of quantum physics to every day life. There are interviews with famous physicists and scientists, held together by a story line.

I would like to use the movie to discuss why we practice tai chi. We are aware daily of the problems in the world and it appears that as individuals we have no power to change the course of world events. However, Einstein said that the consciousness that created with problem cannot be used to solve the problem. By practicing tai chi, we are expanding our physical and psychological abilities.

So who benefits from our solitary practice of tai chi? One of the most famous experiments in quantum physics is the association of electrons. Two electrons that have been in a relationship, orbiting around the same nucleus, will continue to be associated even if they are artificially separated by great distances. They will retain the same relational spin and changing the spin on one will instantaneously change the spin on the other, even if they are separated by great distances. So, we deeply affect those we interact with in our daily lives with the kind word or smile. It affects yourself, your friends and family and also distant others. So, how many do we need to affect? It's also said that there are only six degrees of separation between the majorities of people in the world.

SO your tai chi practice benefits you and the world. "As it is within, so shall it be without."

May your practice be for a blessing for yourself and all the world.

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Tai Chi: From The Inside Out And Outside In
By Dr Paul Lam

Tai chi is an internal art? What is an internal art and what is internal?

If you look at yourself as a body, a person, the skin is external compared to the muscles. Among the muscles are deep muscles such as the deep stabiliser muscles of the back. They are very deep and right next to the bones. They are there to protect the bones. These muscles are internal to the other outside muscles such as the bicep and the rectus muscles. The bicep is the muscle at the arm, and the rectus is the obvious bulging muscle at the front of your stomach as you lift something. The bones are internal to the muscles and the organs are internal to the bones and muscles. The mind or the spirit is internal to the external body so practising an internal art can have a different meaning since it depends on how you define internal.

Generally speaking, tai chi focuses on using the mind to exercise the internal structure such as the organs, the bones, the deep muscles. When a tai chi practitioner delivers power, the focus is on internal strength in contrast to an external martial art such as karate where the focus is on stronger external muscles and faster speed.

If we look outside the person, humans interact with other humans. Tai chi is a martial art so it is designed to interact or to fight with other humans. The internal and the meditative property of tai chi is unlike an isolative type of meditation where one can shut himself away from the world. Tai chi trains the mind to be centred, to be clear, and to be serene in front of people and in front of adversity. The mindset is designed to be part of the world and maintaining your centre so you become more effective at fighting be it physically or mentally. Tai chi is not aimed at isolating oneself.

The art of tai chi fighting is different from many other martial art styles. Instead of blow for blow, block and hitting harder, tai chi works through contacting the opponent to feel the incoming force, then yielding and absorbing the incoming force and at the same time "listening" to understand the incoming force. Once you understand the nature and direction of this incoming force you can direct it to your advantage. And sometimes we utilise this force, adding our own force to gain control of the duel. Once you reach control, you can choose to disable your opponent or just stop him from harming you.

To follow the same thinking of extending outward if you are fighting with one group of people against another group, then your group is internal and the opponent group is external. Likewise one country against another. Using tai chi philosophy, with blow for blow, let's say somebody drops a bomb on your country. If you, in turn, drop a bomb back, you never reach a resolution. You never get to a win-win situation. As history has taught us. No war has ever been won by both sides. Both sides suffer loss of life, property, and privilege.

The tai chi way of fighting works better, if we work at what causes the war, then we have a better chance to resolve it to a win-win outcome.

Along the same lines, it's the human race against the environment. Human beings are the internal; the earth is the external. When the human race lives in harmony with other life forms, with nature, and with the environment, in the long run, we all benefit. When different nations live in harmony, in good balance, all countries prosper. The tai chi philosophy is also balance-Yin and Yang. When we reach balance within ourselves, we, as individuals, live a better quality of life. And when we reach a balanced situation among our groups, we are all happier. When we balance with mother earth, both the human and mother earth lives for ever.

I am going to refer to.Dr Stephanie Taylor's article because I think that there is a connection between what she says and the message in my article in that it seems to us that we cannot influence the events of the world. But wait! Maybe we could if we all practise the tai chi philosophy and extend this harmony to influence our own sphere of contacts. And perhaps slowly, our sphere of contacts would grow larger, and then maybe we would have contributed to the world being a better place.

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Sarasota 2005 - "Moving Stillness" Tai Chi Fan
by revor Reynaert, Gloucestershire, UK

Another year, another workshop passed. Once again I have been privileged to enjoy and experience the knowledge-sharing and comradeship of one of Dr Paul's week-long workshops.

In Monterey last year I studied the 73 Sun, however I was captivated by Dan Jones' demonstration Fan form. Fan form? Ladies only? There was nothing effeminate about 6ft 3in Dan performing this graceful weapon form. I resolved to learn it at the first opportunity.

This came at the 2005 US workshop in Sarasota. I completed the application to join the class and waited until June. Just before I left the UK I re-read the workshop information and discovered that it was classed as an intermediate to advanced form - and as the intermediate Sun 73 had been a challenge last year despite teaching TCA for several years, I began to doubt the wisdom of my choice.

On arrival Anna greeted me saying that I was the only man to take the class - oh well I decided - if Dan can do it then I can - after all I'm also 6ft 3in!

The time for the first lesson arrived and I met the female members of the class - a wonderful mixed group - enriched by teenager Zoe from Australia. Our teachers Dan and Sheila started to introduce us to handling the fan and the Yang style turns that structure the form. Slowly the beauty and power of "Moving Stillness" fan evolved. Although based on a martial weapon form, its split personality soon became apparent, with closed fan blocks, strikes and thrusts and its contrasting graceful (but equally martial) open fan movements and turns. The extension of the arm into the fan really does enhance the Chi and its power.

Would we ever successfully learn it? With 53 forms, all of them new, the learning curve was intense - no time to stop for a rest - it's tea break time again, where has the last hour gone? An average of 9 new forms a day. What comes next? Overhead block and closed fan thrust - double tap jumping turn - or was it sea bottom needle? Age dulls the memory and there were some difficult parts to master, however thanks to Dan's and Sheila's wonderful teaching and perseverance, and help from classmates, especially Betty I got to the end.

Demonstration day came - we did it - and we all appeared to arrive at the same points at the same time, and all finished together, so success must be claimed. Now that the movements have been learnt, all that is left is to practice and develop our style to enhance the Chi and add the grace and elegance that this form so richly deserves.

I must thank Dr Paul, all the friends that I met, and everyone who made the workshop possible. A special thank you to Dan for keeping alive a form passed personally to him and allowing me to share it. Thanks to him this form will now live on in the USA, UK and Australia and hopefully travel to the rest of the world.back to the top

A Letter from Denny Robinson

Hello Paul. I am just beginning to come down to earth! It was amazing! Even though I was totally exhausted from your weekend TCA workshop, Part One in Stockport U.K. When I worked in education, I attended many workshops /seminars but never one so compact, no time wasted. Very concise. Very professional.A big thank you to yourself, Lesley and all the staff .You asked me to write a brief account of what tai chi has done for me:

In June '04, I went for hydrotherapy for my fibromyalgia and OA in our main hospital's physiotherapy department in Derby. I have suffered for many years with pain and other physical health problems. My daily diary used to read like this: "My body is so painful today." Another day read: "Not too mobile - tried to walk into the village today, didn't make it." Another day: "Had to take extra pain relief, not coping."

This went on and on, week after week. I had to walk with a stick and lived on pain relief medication and regular acupuncture. I had to stop working due to my health, and I just felt old. (I'm only in my early 50s!). My balance wasn't very good. I had one particular fall that damaged my coccyx.

My physiotherapist at Derby hospital put me in touch with a fibromyalgia support group, which also practised Tai Chi for Arthritis. I was immediately impressed with what l saw. I got really enthusiastic and practised every day. I knew it was helping with my mobility and total well-being. My osteopath and herbalist both say the tai chi has put me in a stronger, healthier position. Since February of this year, I have walked without my stick and I'm now able to go out walking. I cope so much better with everyday life. And I'm free of the strong pain relief medication that the doctor prescribed for life! I still practice tai chi every day. I wouldn't be without it. Since qualifying as an instructor, I'm looking forward to starting my own Tai Chi for Arthritis group to help others in my area.

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ALCOHOL. DRUGS TO HELP YOU STOP DRINKING
by Your_Health an Australian medical newsletter

Is alcohol causing problems for you or your family? Two drugs are available to help reduce cravings and increase your chance of beating alcohol for good.
One in 6 Australians drinks above the recommended safe drinking limit, which is 4 'standard drinks' on average per day for men and 2 for women. One or 2 alcohol-free days per week are advised for all drinkers. Excessive alcohol can cause liver damage, high blood pressure, brain damage and memory loss, impotence and many cancers.
Drugs for alcohol dependence
Medication may be suitable for some heavier drinkers who are dependent on alcohol and who have cravings and difficulty controlling their drinking. Both work best if you are motivated to stop drinking and when combined with counselling and regular follow-up from your GP.
Both medications are usually taken for at least 3-6 months, and in some cases up to 12 months. They are subsidised under the PBS and are available at minimal cost.
Acamprosate. This medication changes chemical transmitters in the brain and this reduces cravings for alcohol. It has been tested in large numbers of patients and found to consistently increase success rates. It also appears to continue to have an effect for some time after being ceased.
Side effects, such as diarrhoea and rash are generally mild and short lasting. Acamprosate tablets are taken 3 times daily.
Naltrexone. This drug blocks the action of certain chemicals in the brain. Side effects e.g. nausea, headache and dizziness can occur, but are usually mild. Naltrexone can also cause depression and abnormal liver tests. One tablet is taken daily.
Speak to your GP for further advice.

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END OF NEWSLETTER
Warning: Dr. Lam does not necessarily endorse the opinion of other authors. Before practicing any program featured in this newsletter, please check with your physician or therapist. The authors and anyone involved in the production of this newsletter will not be held responsible in any way whatsoever for any injury which may arise as a result of following the instructions given in this newsletter.

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