Tai Chi Instruction
T'ai chi, also known as t'ai chi ch'uan, was developed in China hundreds of years ago and is a component of traditional Chinese medicine. On the surface, t'ai chi appears to be simply slow body movements. In practice, it may provide some of the physical benefits of exercise and the relaxation effects of meditation. T'ai chi has been widely practiced in China for centuries and has recently become popular in the United States.
Treatment Method
T'ai chi may be done individually or in groups. A high level of strength and flexibility are not required because it is based largely on technique. T'ai chi consists of slow, rhythmic body movements. The arms are moved slowly and smoothly in circular movements while weight is shifted from one leg to the other and specific breathing techniques are used. A specified series of movements is known as a form. T'ai chi movements are claimed to balance the two opposite forces, yin and yang. Performing t'ai chi movements is believed to strengthen and balance the life force, known as "chi" or "qi."
Studies in MS and Other Conditions
A small 1999 study found that t'ai chi may be beneficial for people with MS. This study, conducted at the American College of Traditional Chinese Medicine in San Francisco, examined the effects of an eight-week t'ai chi group program on 19 people with MS. People were accepted into the study regardless of the severity of their disability. T'ai chi improved emotional and social function and produced physical benefits, with a 21 percent improvement in walking speed and a 28 percent decrease in muscle stiffness. Comments obtained from participants indicated that the group experience itself was an important component of the program. The results of this study are promising, but there are limitations. Specifically, there was no placebo-treated group, and assessment was done by the participants themselves rather than by unbiased observers. Further studies are needed to investigate t'ai chi in MS.
The effects of t'ai chi on some MS-related symptoms have been investigated in other conditions. Most of the t'ai chi clinical trials have flaws and make it difficult to determine exactly how effective t'ai chi is relative to other forms of exercise. Most notably, t'ai chi has been found to be beneficial for improving walking steadiness in several studies in the elderly. In one study of 200 people, the risk of falls decreased by nearly 50 percent. Some of the effects of t'ai chi on walking may be due to increased confidence and decreased fear of falling. Research studies have found that t'ai chi also increases strength and flexibility. It may improve heart and lung function and decrease heart rate and blood pressure; it also may have a positive effect on mental function. There is limited evidence that t'ai chi improves depression, anxiety, fatigue, and confusion.
T'ai chi is an interesting example of a therapy that may be clinically effective in spite of the fact that its proposed mechanism of action-balancing and strengthening life energy-is unproven.
Side Effects
T'ai chi does not generally pose any known significant health risk. It could potentially worsen fatigue in people with MS. Also, walking unsteadiness and sensitivity to overheating may require modifications in technique. There is one report of a person with MS in whom t'ai chi provoked electrical sensations in the arms and back (known as Lhermitte's sign).
Practical Information
It is easiest to learn t'ai chi through classes. For people with significant disabilities, t'ai chi may be practiced, but the pace may need to be slowed. T'ai chi may be practiced individually after the basic techniques have been learned.
T'ai chi classes are often provided through community centers and health clubs and cost approximately $50 per month. Many books on this subject are available.
Conclusion
T'ai chi is a low-risk, low-moderate cost therapy. It may increase walking ability, decrease stiffness, and improve social and emotional functioning. Studies on other conditions indicate that t'ai chi increases strength and may improve fatigue, depression, and anxiety. For people with MS who have disabilities that prevent using strenuous exercise programs, t'ai chi may be a gentle way to obtain some of the general health benefits of a vigorous workout.
Additional Readings:
Books
Cassileth BR. The Alternative Medicine Handbook. New York: W.W. Norton, 1998:243-247.
Fugh-Berman A. Alternative Medicine: What Works. Baltimore: Williams & Wilkins, 1997:197-199.
Journal Articles
Husted C, Pham L, Hekking A, et al. Improving quality of life for people with chronic conditions: The example of t'ai chi and multiple sclerosis. Alt Ther 1999; 5:70-74.
Wolf Steven L, Barnhart Huiman X, Kutner Nancy G, et al. Reducing frailty and falls in older persons: An investigation of t'ai chi and computerized balance training. JAGS 1996; 44:489-497.
Wolf SL, Barnhart HX, Ellison GL, et al. The effect of t'ai chi quan and computerized balance training on postural stability in older subjects. Phys Ther 1997; 77:371-384.
Wolf SL, Coagula C, XU T. Exploring the basis of t'ai chi chuan as a therapeutic exercise approach. Arch Phys Med Rehabil 1997; 78:886-892.
The above information is from the copyrighted Demos publication, Alternative Medicine and Multiple Sclerosis. This resource may be purchased from www.demosmedpub.com.
MSIR: Multiple Sclerosis Information Resource
© 2002 National Multiple Sclerosis Society
All Rights Reserved
Contact the National MS Society-Michigan Chapter at 800-243-344-4867, option 1 for information on yoga, t'ai chi, aquatic and other exercise programs in your area.