The Effect of Tai Chi on Chronic Obstructive Disease

A Pilot Randomised Study of Lung Function, Exercise Capacity and Diaphragm Strength

Ruichao Niu, Ruoxi He, Bai-ling Luo, Chengping Hu
Heart, Lung and Circulation (2014) 23, 347-352

The current study, unlike many of its predecessors, evaluated the effects of tai chi quan on chronic obstructive pulmonary disease (COPD) looking specifically at three components, lung function, exercise capacity and diaphragm strength. The study was designed as a single blinded randomised trial. Forty-six CPOD sufferers were randomly placed in two groups, a control group that was offered a non-specific form of low-impact exercise (walking and associated medical care) and the tai chi group. The trial lasted six months. The tai chi cohort participated in four supervised sessions each week and was provided with a booklet and DVD for home use. At the end of the trial outcome measurements were assessed by two physicians who had no knowledge of the study design or the group (control or test) in which the participants were enrolled.

Outcomes of lung function, exercise capacity and diaphragm were all improved in both groups; however, the tai chi group saw a greater improvement in each category. Previous studies investigating tai chi quan use in patients with COPD have shown similar results but used flawed research designs making the observations inconsistent. This study provides preliminary data to support the use of tai chi in respiratory rehabilitation for patients with COPD.  The authors stressed that this is a pilot and a larger trial is needed for detailed results and to clarify the significance of tai chi quan as a means of pulmonary rehabilitation.

Tai Chi and medical research- peer reviewed published papers

Jimenez-Martin PJ, Melendez-Ortega A, Albers A and Schofield D.  A Review of Tai Chi Chuan and parameters related to balance.  European Journal of Integrative Medicine 2013; 5(6):469-475.

Background: Previous systematic reviews of the literature on tai chi and balance have focussed on one of two topics, either examining the quality of the research design, which has had great variance, or offering a general description of the studies included in the review. The current review is an analysis of the factors that affect balance.
Methodology: The authors searched seven data bases for publications relating to tai chi and balance between 1996 and 2012. The inclusion criteria were randomised trials written in English.
Results: A total of 397 articles were identified. Once the inclusion filter was added a total of 27 random controlled studies were eligible of analysis.
Conclusion: Analysis of the eligible papers confirmed that tai chi chuan practice improves both static and dynamic balance and has a positive effect on those factors that influence balance. No studies were found examining whether there was an improvement in balance in those individuals suffering from deterioration of brain function. One study examined the effects of tai chi chuan on people with vestibular problems.
Comment: The paper by Jimenez-Martin et al is one of the on-going looking at the effects of tai chi chuan on balance. Falls remain a significant healthcare problem around the world. Being able to elucidate the types of therapies that can help relieve this will have a dramatic effect not only on the individuals who are suffering from problems with balance, but, with the addition of tai chi chuan, also with the cost of treatment and care. This work should be better known throughout the healthcare community.


Cheon S-M, Chae B-K, Sung H-R, et al. The Efficacy of Exercise Programs for Parkinson’s Disease: Tai Chi versus Combined Exercise. Journal of Clinical Neurology. 2013; 9:237-243.

Background: Exercise if recommended for every patient suffering from Parkinson’s Disease. The effectiveness of different exercise regimes has not been clearly elucidated. The paper compares the effectiveness of tai chi chuan compared to combined stretching-strengthening exercise.
Methodology: Patients with mild to moderate Parkinson’s Disease were recruited to join either a combined stretching-strengthening group, the tai chi group or the non-interventional control group. The two activity groups met three times each week for 8 weeks. The tai chi group was led by a certified instructor based on the Tai-Chi-for-arthritis program. The combined exercise group did a mix of folk dancing, stepping and elastic band exercises. The functional fitness, Parkinson symptoms, Quality of Life and depression were evaluated.
Results: Both exercise groups showed better overall functional fitness following the 8 week intervention. However, the Parkinson group did not reveal any improvement in symptoms. Reviewing the Quality of Life aspects, the stretching-strengthening group did batter with regard to the domain while the tai chi group fared better in the emotional domain. The control group showed continued decline for Quality of Life and depression. Post-intervention assessment revealed that the Tai Chi group improved compared to the control group.
Conclusion: Exercise shows improved functional fitness and Quality of Life in Parkinson’s Disease patients, with Tai Ch giving better results in the Quality of Life and functional fitness overall.
Comment: It is obvious from this study that exercise, in general, is beneficial for Parkinson’s patients. In particular, it was noted that the improvements between the two exercise groups differed, indicating that for these patients it may be most useful to combine both tai chi with some other form of exercise if there is to be a full range of improvements.


Ng L, Chiang LK, Tang R, et al. Effectiveness of incorporating Tai Chi in a pulmonary rehabilitation program for Chronic Obstructive Pulmonary Disease (COPD) in primary care- A pilot randomized controlled trial. European Journal of Integrative Medicine. 2014; 6:248-258.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major public health concern throughout the industrialized world. Studies have shown that pulmonary rehabilitation and tai chi chuan are beneficial for those patients suffering from this disease. This study was aimed at determining whether the self-efficacy and quality of life of CIPD patients who were active in a pulmonary rehabilitation program either with or without tai chi would improve.
Methodology: 192 COPD patients were recruited from primary care clinics. They were randomly assigned to wither the tai chi group or the pulmonary rehabilitation group. Both groups received 2 sessions/week for 6 weeks. Data collection was performed at baseline, 2 and 6 months post intervention.
Results: An intention to treat analysis was preformed revealing the groups were matched. Improvements were seen in exercise capacity, health status and self-efficacy within both groups at
 6 months post-intervention. Though more favourable improvements were noted with the tai chi group, only the functional exercise capacity revealed a statistical improvement.
Conclusion: The effect of incorporating Tai Chi into pulmonary rehabilitation programs showed a modest benefit.
Comment: In the case of this research we see a modest improvement in exercise capacity of the tai chi participants. Given the very short time frame that this research project used it is quite conceivable that a longer study would reveal greater effects of tai chi chuan.


Nery RM, Zanini M, Ferrari JN et al. Tai Chi Chuan for Cardiac Rehabilitation in Patients with Coronary Arterial Disease. Arquivos Brasileiros de Cardiologia. 2014; 102(6).

Background: Studies have shown that the practice of tai chi chuan can improve cardiac function in patients with heart disease. This paper is a systematic review of the literature assessing the effectiveness of tai chi chuan on patients suffering from coronary artery disease.
Methodology: The following databases were searched for papers in English, Portuguese and Spanish looking at the effects of tai chi chuan on patients with coronary artery disease; MEDLINE, ENBASE, LILACS and the Cochrane Register of Controlled Trials. Three independent investigators extracted and assessed the data for methodology and quality.
Results: The initial search found 201 papers dealing with tai chi and coronary artery disease. Following the critical review and analysis, 12 studies were considered for inclusion. After a full analysis, an additional 9 were excluded leaving three papers meeting the full criteria for inclusion. These studies included patients who had a confirmed diagnosis of coronary artery disease and were considered stable and able to exercise. Each study had a control group that either practiced a structured exercise or were given counselling for exercise. Follow-up ranged from 2 to 12 months.
Conclusion: The preliminary evidence based on the three studies used in this review suggests that tai chi chuan can be utilized as a form of cardiac rehabilitation for patients with stable coronary artery disease. The methodological problems and small sample sizes in each study indicate that further research into this area is needed.
Comment: Non-pharmacological approaches to many of the diseases we see are becoming an important consideration for care, especially self-care. This paper, while expressing reservations due to methodology and small sample size gives us an entrance into further, future research that most practitioner s can easily incorporate into their practices.


Dr. Mark J. Langweiler is a long time practitioner of Wu style Tai Chi Chuan and is a disciple of Sifu Wu Kwong Yu. He is currently a Senior Lecturer in Anatomy at the University of South Wales and chief instructor at the South Wales Wu Style Tai Chi Chuan Teaching Centre. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..

Tai Chi 'improves body and mind'

The ancient Chinese martial art of Tai Chi can help to improve people's health, research suggests.

Doctors in the United States analysed 47 studies looking at the impact Tai Chi had on people with chronic health problems, like heart disease or MS.

They found that it could improve balance control, flexibility and even the health of their heart.

Writing in The Archives of Internal Medicine, they said it also reduced stress, falls, pain and anxiety.

Deep breathing

Tai Chi originated in China where it has been used for hundreds of years.

It combines deep breathing with relaxation and postures that flow from one to another through slow movements.

Practitioners say it can have a positive effect on people's health, improving memory, concentration, digestion, balance and flexibility.They say it is also helpful for people with psychological problems, such as depression, anxiety or stress.This latest study by doctors at Tufts-New England Medical Center in Boston suggests there is medical evidence to back up those claims.Their findings are based on a review of studies published in English and Chinese."Overall, these studies reported that long-term Tai Chi practice had favourable effects on the promotion of balance control, flexibility and cardiovascular fitness and reduced the risk of falls in elders," the researchers said.They said the martial art helped to reduce "pain, stress and anxiety in healthy subjects".But it also had benefits for people with serious conditions, such as heart disease and high blood pressure."Benefits were reported by the authors of these studies in cardiovascular and respiratory function in healthy subjects and in patients who had undergone coronary artery bypass surgery as well as in patients with heart failure, hypertension, acute myocardial infarction, arthritis and multiple sclerosis."'Well documented'Bob Weatherall, secretary of the British Council of Chinese Martial Arts, welcomed the findings."The health aspects of Tai Chi are well documented," he told BBC News Online."It is used extensively in hospitals in China to improve the health of patients. Hospitals in England have started using it too."Tai Chi is all about breathing and posture. It's about getting the mind and body to work together. Some people call it moving meditation."Most people practice it for its health benefits and for stress relief."

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