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[2008 updates are highlighted in red]
| Description: |
Tai chi is a traditional Chinese martial art that has been practiced for centuries in China. There has been recent interest in tai chi in some Western countries. Tai chi is characterised by a series of body postures that are linked by slow, graceful movements. Tai chi may be modified for people with disabilities.
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| Rationale: |
Tai chi may be interpreted from a traditional Chinese or Western perspective. According to ancient Chinese philosophy, there are two opposing life forces, yin and yang. Tai chi is believed to be a way to stabilise these energies and create emotional balance. From a Western scientific perspective, tai chi may be viewed as a form of physical exercise that may produce beneficial neurological and cardiovascular effects. Specifically, tai chi may improve cardiovascular function and increase strength, coordination, and balance in a way similar to exercise.
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| Evaluation: |
In one study of tai chi in MS, 19 people with MS with variable levels of disability were enrolled in an eight-week tai chi programme. At the end of the program, there was improvement in walking speed and muscle stiffness. There was also improvement in vitality, social and emotional functioning, and ability to carry out physical and emotional roles. Significant limitations of this study are that it was relatively small, there was no placebo treated group, and non-standard measures and non-blinded assessment were used. Another study of 16 people with MS used the tai chi principle of “mindfulness of movement,” which involves developing moment-to-moment awareness of movement, breathing, and posture. Relative to the control group, which received “current available care,” the treated group did not improve in balance but did improve in multiple MS-associated symptoms, as assessed by patients and by their relatives. Relative to pre-treatment, the treated group improved in balance. This study had a relatively large drop-out rate, involved a small number of people, and did not use objective and “blinded” clinicians for assessment. Larger and more rigorous studies are needed to determine if tai chi is definitely effective for treating MS-related symptoms. |
| Risks: |
Tai chi is usually well tolerated. Mild side-effects include strained muscles and joints. It may worsen MS-related fatigue. There is a report of tai chi worsening electrical sensations in the arms and back (Lhermitte’s phenomena) in an individual with MS. It should be avoided or used with caution by those with severe osteoporosis, acute low back pain, significant joint injuries, and bone fractures. |
| Costs: |
Tai chi is low-moderate cost. |
| Committee opinion: |
In the opinion of the Committee, tai chi is a low-moderate cost, generally well-tolerated therapy that has produced improvement in multiple symptoms in one small MS study. Larger and more rigorous studies are needed. |
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