Add tai chi to spice up your exercise program & improve your breathing

Over the past decade, tai chi, the ancient Chinese martial arts form that emphasizes gentle, flowing movements and meditative breathing techniques has received increasing research attention for a range of benefits including stress-relief, balance/coordination, and aerobic conditioning among people with various health conditions (91 studies published in 2010 alone).

While the amount of past tai chi research related to COPD is scant (less than a handful of studies in total), there are some intrepid researchers who continue to investigate tai chi for COPD patients for some very valid and specific reasons, including:

1. Long-term adherence to exercise programs is a significant problem among COPD patients. Past tai chi research studies related to other health conditions have shown that including tai chi as part of an ongoing exercise program notably lengthens the span of time an exercise program is maintained. The reigning thought behind why this happens is that over time traditional exercise programs become boring/tedious and that participating in group tai chi sessions keeps exercise fun/interesting and therefore improves adherence. Thus far, however, no studies have either explored or reported such exercise compliance improvements among COPD patients. 
2. Past studies among patients with poor heart health have shown that tai chi boosts exercise capacity and physical conditioning. While recent COPD studies have shown modest improvements in physical condition/exercise capacity among patients in a tai chi program, the improvements have not yet been shown to be clinically significant and certainly have not been tested yet head-to-head against the proven COPD treatment pulmonary rehabilitation. 
3. Past COPD studies have shown that those participating in a tai chi program report less severe breathlessness symptoms than COPD patients that don’t exercise. For those unwilling or unable to participate in a traditional exercise program, tai chi is viewed as a potential method of boosting physical activity and reducing perceived breathlessness. Researchers believe that the meditative breathing techniques taught/practiced in tai chi programs are the prime drivers of this effect. 
4. Poor balance and coordination is a common symptom of sedentary COPD patients. The less physically active a person is the weaker muscles and bones become. Over time, this weakness results in poor balance/coordination. Past tai chi studies among elderly patients and those with muscular dysfunction have shown a marked improvement in balance/coordination. Since one of the core principles of tai chi as a martial arts form is to maintain balance when defending oneself against an attacker, the tai chi movements taught and practiced are intended to explicitly improve balance.

On the heels of this past research and hypotheses comes a new study published this month in the journal Respiratory Care seeking to confirm whether tai chi improves exercise capacity and perceived breathlessness among COPD patients. (Yeh GY, et al. Tai Chi Exercise for Patients With Chronic Obstructive Pulmonary Disease: A Pilot Study. Respir Care. 2010;55(11):1475-1482)

The study, conducted at a Boston area hospital, involved 10 COPD patients split into two groups (5 who participated in a 12-week group tai chi program, and 5 who did not participate in an exercise program of any kind). The researchers measured all 10 patients exercise capacity at the beginning of the study and again after the 12-week tai chi program had concluded. In addition, the study participants completed standard quality of life/respiratory symptom questionnaires at the outset of research effort and again at the end. The investigators then evaluated the changes between the baseline and end-of-study measures for each of these diagnostic tools in both groups.

The 12-week tai chi program took place twice each week for one hour each session and included warm-up exercises, 5 simplified tai chi movements, visualization techniques, and traditional breathing techniques. Tai chi participants were provided a 35 minute instructional video that outlined the exercises presented in class and patients were encouraged to practice the movements at home in between sessions (most did).

At the end of the study, the researchers reported that the most pronounced difference between the two groups was in their self-reported breathlessness ratings on the respiratory symptoms questionnaire. The tai chi group rated a 33% improvement in their sense of breathlessness at the end of the program compared to their pre-tai chi ratings. This was sharply higher than the 7% improvement in perceived breathlessness reported by the control/non-exercising group.

Further, while the research team did not comment on their findings related to balance and coordination, we found an intriguing result in their data that may point to balance/coordination benefits of tai chi for COPD patients. One of the quality of life/respiratory symptom questionnaire sections completed by study participants examines mastery of activities of daily living (an evaluation of how often COPD patients participate in every-day activities and how they feel about their ability to participate these activities). The tai chi group in the study reported a 54% jump in their mastery ratings at the end of the study while the control/non-exercising group registered a 5% drop in mastery. In our opinion, the perceived improvement in mastery ratings by the tai chi group is likely driven by greater confidence in moving around as a result of improved balance and coordination gained through the tai chi sessions.

With regard to exercise capacity, the researchers found a small improvement (6%) in the distance walked by study participants in 6 minutes (a standard diagnostic test to assess physical condition in respiratory health studies) in comparison to a 10% drop in distance walked for the non-exercising/control group. These variances were not considered statistically significant enough by the study authors to declare that tai chi improves exercise capacity but they do show some benefit. We reported a similar finding in an article we wrote about a March 2010 tai chi COPD study you can read by clicking here.

So for those of you seeking to start or spice up an exercise program, tai chi may be an option worth exploring. Tai chi classes are widely offered in health clubs and in community centers across the country and are likely available in your local area (many of these classes are geared specifically for elderly and less mobile participants). Additionally, there are a range of videos in DVD/CD format that demonstrate the basic movements that you can use to try tai chi at home. We’ve highlighted a few of these instructional videos in our Breathe Better Marketplace hosted by amazon.com. Click on the link titled tai chi DVDs in the right hand side bar of the Breathe Better Marketplace site to learn more about the titles we selected.