February is traditionally a time when people think about things of the heart. T'ai Chi is wonderful for the heart! The slow, graceful movements of T'ai Chi, along with the deep breathing that accompanies each movement, strengthens the heart through a process known as oxygenation. In addition, the heart is a muscle and responds positively to moderate exercise. That's what The National Institutes of Health wrote in its section about the health benefits of T'ai Chi: "Aerobic exercise has benefits to the heart and possibly to cholesterol levels. This type of exercise causes the heart to work harder to pump blood more quickly and forcefully. The body adds oxygen to the blood faster, and the person breathes more quickly." Deep breathing also increases the amount of oxygen taken from the hemoglobin and used in exercising muscles (oxygen extraction).

T'ai Chi is a low-impact, cardiorespiratory exercise, meaning it benefits the heart and lungs and all the physical components connected to them while being easy for the body to perform. The American College of Sports Medicine lists the many benefits of cardiorespiratory exercise. Here are some of the benefits the ACSM mentioned for the heart: reduction in blood pressure, increased HDL cholesterol, decreased total cholesterol, increased heart function, decreased resting heart rate, increased heart volume, increased maximum cardiac output, increased maximum oxygen consumption, increased capillary density and blood flow to active muscles, increased total blood volume.

T'ai Chi is not a fad exercise. People have been practicing aspects of it for at least 3,000 years. The Chinese have known about the heart health properties of T'ai Chi for centuries and it's great to see Western nations experiencing the benefits as well. Here are some insights to those benefits from health experts around the world.

University of Maryland Medical Center

"Tai chi is both a preventive and a complementary therapy for a wide range of conditions. Specifically, it is beneficial for chronic pain, gout, heart disease, high blood pressure, arthritis, osteoporosis, headaches, and sleep disorders. Tai chi is also beneficial for the immune system and the central nervous system, which makes it especially good for people with a chronic illness, anxiety, depression, or any stress-related conditions. The deep breathing of tai chi regulates the respiratory system, helping to treat respiratory ailments such as asthma, bronchitis, and emphysema. It also stimulates the abdomen, which aids digestion and helps relieve constipation and gastrointestinal conditions. Many studies indicate that elderly people who practice tai chi are much less prone to falls, a serious health risk to people in that age group. "

The British Heart Foundation

"The British Heart Foundation said the study [U.S. study about patients with heart problems responding positively to T'ai Chi practice] was "excellent news" and Tai Chi could be adopted into treatment programmes in the UK in the future."

John Hopkins University Medicine

"A recent study has raised some questions about the effectiveness of exercise alone for controlling high blood pressure in older adults, but there is some evidence that the regular practice of tai chi may achieve a modest reduction in blood pressure. A study conducted several years ago by Johns Hopkins researchers found that tai chi lowered systolic blood pressure almost as much as moderate aerobic exercise in individuals age 60 and older who previously were sedentary ... Similar to what is seen with other types of exercise, the long-term practice of tai chi appears to improve cardiovascular fitness and oxygen uptake and may delay the decline of cardiovascular and respiratory function."

Harvard Medical School Osher Institute

"The mind-body movement therapy Tai Chi can enhance the quality of life and functional capacity in patients with chronic HF [Heart Failure] who are already managed with optimal medical therapy."

Mayo Clinic

"Anyone, regardless of age or physical ability, can practice tai chi. It doesn't take physical prowess. Rather, tai chi emphasizes technique over strength ... Tai chi is generally safe for people of all ages and levels of fitness. Older adults may especially find tai chi appealing because the movements are low impact and put minimal stress on muscles and joints. Tai chi may also be helpful if you have arthritis or are recovering from an injury. Despite its ancient history, tai chi has been studied scientifically only in recent years. And that research is suggesting that tai chi may offer numerous other benefits beyond stress reduction, including: Reducing anxiety and depression, Improving balance and coordination, Reducing the number of falls, Improving sleep quality, such as staying asleep longer at night and feeling more alert during the day, Slowing bone loss in women after menopause, Lowering blood pressure, Improving cardiovascular fitness, Relieving chronic pain, Improving everyday physical functioning."

Tufts-New England Medical Center

".. long-term tai chi had favorable effects on the promotion of balance control, flexibility and cardiovascular fitness and reduced the risk of falls in the elderly."

American Cancer Society

"Research has shown tai chi is useful as a form of exercise that may improve posture, balance, muscle mass and tone, flexibility, stamina, and strength in older adults. Tai chi is also recognized as a method to reduce stress that can provide the same cardiovascular benefits as moderate exercise, such as lowered heart rate and blood pressure."

University of North Dakota School of Medicine and Health Sciences

"A growing body of evidence supports what has been found by researchers at UND: Tai chi is beneficial to cardio-respiratory function, flexibility and balance control, and aids the immune system. It also helps alleviate pain, such as that caused by arthritis. Some studies have gone further, looking at the benefits to people with heart disease. Those recovering from heart attacks or other cardiac issues usually are prescribed some sort of aerobic fitness training as part of their new ongoing routine. Tai chi fits the bill. Although considered just a moderate-intensity exercise, it gives participants a workout."

Beverly Johnson, D.S.C., Director of Clinical Education in the Physical Therapy Department of the University of North Dakota School of Medicine and Health Sciences

"In addition to better balance, researchers also discovered improvements in breathing and flexibility and a significant decrease in blood pressure among participants.  With these improvements, some people may be able to put off the need for medication for these issues, Johnson said."

Stanford University School of Medicine

"Tai Chi is a graceful martial arts form. It uses slow and precise movements which research in several countries has shown its protective effects on arthritis, high blood pressure, poor balance, stress, among others."

Columbia University College of Physicians and Surgeon (Ozgen Dogan MD FACC, Assistant Professor of Clinical Medicine)

"Be sure to make exercise part of your daily routine. Regular exercise promotes a healthy weight, lowered blood pressure, increased HDL, and a reduced risk of developing adult onset diabetes. Regular exercise lowers LDL, (bad cholesterol), and raises HDL (good cholesterol). Before starting an exercise program or enrolling in a gym, check with your doctor. If possible, choose an exercise buddy, and remember to start with an activity that is comfortable for you and build strength gradually. In other words, use common sense, and don't run the marathon the first day! Short segments of exercise throughout the day are equally beneficial to one long exercise session. Combining exercise with relaxation techniques like yoga, tai chi, or qi gong will especially help people with stressful jobs. The combination of a Type A personality plus emotional stress may place these people as much as four times more at risk for heart disease than others."

Dr. Clive Bowman, BUPA Care Services Medical Director, United Kingdom

"Rehabilitation after suffering a stroke can be difficult, stressful and frustrating as people adapt to their new situation. The slow controlled movements of tai chi can provide a really positive contribution to rehabilitation through a combination of relaxation, fitness and confidence building."

International Journal of Rehabilitation Research

27(4):303-304, December 2004 (Hart, Jacob 1; Kanner, Hava 2; Gilboa-Mayo, Ronit 1; Haroeh-Peer, Osnat 1; Rozenthul-Sorokin, Naomi 1; Eldar, Reuben 1)

Tai Chi Chuan practice in community-dwelling persons after stroke.

"Eighteen community-dwelling first-stroke survivors, aged 45 to 65, underwent following examinations: Romberg's Test, standing on the unaffected leg, Emory Fractional Ambulation Profile, the Berg Balance Test, the Timed 'Up and Go' Test and the Duke Health Profile. They were then randomly divided into two matched groups of 9 subjects each. The study group (SG) received Tai Chi exercises and the control group (CG) physiotherapy exercises focused on improvement of balance, both groups for 1 h twice weekly for 12 weeks. On completion of exercises, SG subjects showed improvement in social and general functioning whereas CG subjects showed improvement in balance and speed of walking. It is concluded that there are potential and no adverse effects in Tai Chi practice in stroke survivors."

American Journal of Chinese Medicine

Lan, C., Chou, S., Chen, S., Lai, J. & Wong, M. (2004)

The aerobic capacity and ventilatory efficiency during exercise in Qigong and Tai Chi Chuan practitioners.

"Thirty-six community-dwelling men with a mean age of 59 years participated in this study. Each group (Qigong, TCC and control) included 12 subjects with matched age and body size. The Qigong group practiced Qigong regularly for 2 years and the Tai Chi group practiced Tai Chi for 5 years. Heart rate (HR) responses were measured during the practice of Qigong and Tai Chi. Additionally, breath-by-breath measurement of cardiorespiratory function was performed during the incremental exercise of leg cycling. RESULTS: The mean HR during Qigong and Tai Chi practice was 91 and 129, respectively. At the peak exercise and the ventilatory threshold (VeT), the Tai Chi group displayed the highest oxygen uptake (VO2), O2 pulse and work rate among the three groups. The Qigong group also showed higher oxygen uptake and O2 pulse than the control group. At the same relative exercise intensity, the Qigong group had the highest tidal volume among the three groups. In conclusion, Qigong and Tai Chi show a beneficial effect aerobic capacity in older individuals, but Tai Chi displays a better training effect than Qigong due to its higher exercise intensity. However, Qigong can enhance breathing efficiency during exercise due to the training effect of diaphragmatic breathing."

Journal of Cardiovascular Nursin

Taylor-Piliae, R. & Froelicher, E. (2004)

Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis.

"A computerized search of 7 databases was done. Aerobic capacity was expressed as peak oxygen uptake (VO2peak). RESULTS: Of 441 citations obtained, only 7 focused on aerobic capacity in response to Tai Chi exercise. Aerobic capacity was higher in subjects performing classical Yang style (108 postures) Tai Chi, a 52-week Tai Chi exercise intervention, compared with sedentary subjects."

Postgraduate Medical Journal

Channer, K. S., Barrow, D., Barrow, R., Osborne, M., and Ives, G. (1996)

Changes in haemodynamic parameters following Tai Chi Chuan and aerobic exercise in patients recovering from acute myocardial infarction.

"In this study, 126 patients were randomized to Tai Chi (38), aerobic exercise (41) or a non-exercise support group (47) following acute myocardial infarction. Patients attended twice weekly for three weeks and then weekly for a further five weeks. Heart rate and blood pressure were recorded before and after each session. RESULTS: Over the 11 sessions of exercise there was a negative trend in diastolic blood pressure only in the Tai Chi group. Significant trends in systolic blood pressure occurred in both exercise groups. Only four (8%) patients completed the support group eight-week programme which was less than the number completing Tai Chi (82%) and aerobic exercise groups (73%)."

Medical Science Monitor

Ko, G., Tsang, P. & Chan, H. (2006)

A 10-week Tai-Chi program improved the blood pressure, lipid profile and SF-36 scores in Hong Kong Chinese women.

"Twenty female subjects received 2 Tai-Chi sessions per week for 10 weeks. Each session lasted for one hour. RESULTS: At the end of the study, systolic blood pressure, total cholesterol and low-density lipoprotein cholesterol levels significantly reduced. Among all SF-36 items, Vitality and Mental Health significantly improved after the 10-week Tai-Chi program."

Health Promotion International

Thornton, E., Sykes, K. & Tang, W. (2004)

Health benefits of Tai Chi exercise: improved balance and blood pressure in middle-aged women. , 19, 33-8.

"Seventeen relatively sedentary but healthy normotensive women were recruited into a three times per week, 12-week Tai Chi exercise programme. RESULTS: Dynamic balance measured by the Functional Reach Test was significantly improved following Tai Chi, with significant decreases in both mean systolic (9.71 mmHg) and diastolic (7.53 mmHg) blood pressure."

Family Practice

Verhagen, A., Immink, M., van der Meulen, A. & Bierma-Zeinstra, S. (2004)

The efficacy of Tai Chi Chuan in older adults: a systematic review.

"A systematic review was carried out according to the Cochrane standards. A computerized literature search was carried out. Studies were selected when they had an experimental design; the age of the study population was >50; one of the interventions was a form of TCC; and when falls, balance or cardiorespiratory functions were used as an outcome measure. A total of seven studies were included, with in total 505 participants, of whom all but 27 were healthy seniors, age between 53 and 96 years. RESULTS: In most studies, the intervention of TCC was a modified Yang style, varying from 10 to 24 forms. The intensity of TCC varied from 1 h weekly for 10 weeks to 1 h every morning for 1 year. One study used falls as outcome measure and reported a beneficial effect of 47% in the TCC group. All studies mention a beneficial effect of TCC, but in most studies this conclusion was based on a pre-post analysis."

Journal of Gerontology A Biological Science and Medical Science

Wolf, S., O'Grandy, M., Easley, K., Guo, Y., Kressig, R. & Kutner, M. (2006)

The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in trasitionally frail older adults.

"This 48-week randomized clinical trial was provided for 291 women and 20 men, who were transitionally frail, >or=70 years old, and had fallen at least once within the past year. Physical performance (freely chosen gait speed, reach, chair-rises, 360 degrees turn, picking up an object from the floor, and single limb support) and hemodynamic outcomes (heart rate and blood pressure) were obtained at baseline and after 4, 8, and 12 months. RESULTS: Mean percent change (baseline to 1 year) for gait speed increased similarly in both the tai chi and wellness education cohorts. However, time to complete three chair-rises decreased 12% for TC and increased 14% for WE. Baseline to 1 year mean percent change decreased among TC and increased within WE cohorts for: body mass index, systolic blood pressure, and resting heart rate (-6% vs 5%; p <.0001). Tai Chi significantly improved chair-rise and cardiovascular performance. Because TC training reduced fall occurrences in this cohort, factors influencing functional and cardiovascular improvements may also favorably impact fall events."

Archives of Physical Medicine & Rehabilitation

Lan, C., Lai, J. S., Wong, M. K., and Yu, M. L. (1996)

Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners.

"A case-control study evaluated seventy-six community-dwelling senior persons in a Tai Chi group and a control group of sedentary subjects with matched age and body size. The Tai Chi group had practiced Tai Chi regularly. Each session included 20 minutes of warm-up, 24 minutes of Tai Chi training, and 10 minutes of cool-down. Exercise intensity was estimated to exceed 70% of maximal heart rate. RESULTS: The Tai Chi group showed 19% higher peak oxygen uptake in comparison with their sedentary counterparts. In addition, the Tai Chi practitioners had greater flexibility and lower percentage of body fat in comparison with their sedentary counterparts."

Preventive Cardiology

Pippa, L., Manzoli, L., Corti, I., Congedo, G., Romanazzi, L., & Parruti, G. (2007)

Functional capacity after traditional Chinese medicine (qi gong) training in patients with chronic atrial fibrillation: a randomized controlled trial. Evidence indicates that low energy expenditure protocols derived from traditional Chinese medicine may benefit patients with cardiac impairment.

"The authors carried out a randomized controlled trial to test a 16-week medically assisted qi gong training program for the physical rehabilitation of patients with chronic atrial fibrillation. RESULTS: Trained patients walked an average 114 meters more (27%) at the end of treatment (P<.001) and 57 meters more (13.7%) 16 weeks later."

Alternative Therapies Health Medicine

Taylor-Piliae, R., Haskell, W., Stotts, N. & Froelicher, E. (2006a)

Improvement in balance, strength, and flexibility after 12 weeks of Tai Chi exercise in ethnic Chinese adults with cardiovascular disease risk factors.

"Thirty-nine adults with at least 1 cardiovascular disease (CVD) risk factor attended a 60-minute tai chi class 3 times per week for 12 weeks. Subjects were below the 50th percentile of fitness at baseline compared to age- and gender-specific normative US data. RESULTS: Statistically significant improvements were observed in all balance, muscular strength and endurance, and flexibility measures after 6 weeks, and they increased further after 12 weeks. "

American Journal of Medicine

Yeh, G., Wood, M., Lorell, B., Stevenson, L., Eisenberg, D., Wayne, P., Goldberger, A., Davis, R. & Phillips, R. (2004)

Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic failure: a randomized controlled trial.

"Thirty patients with chronic stable heart failure and left ventricular ejection fraction were randomly assigned to receive usual care, which included pharmacologic therapy and dietary and exercise counseling, or 12 weeks of tai chi training in addition to usual care. Tai chi training consisted of a 1-hour class held twice weekly. Primary outcomes included quality of life and exercise capacity. Secondary outcomes included serum B-type peptide and plasma catecholamine levels. RESULTS: At 12 weeks, patients in the tai chi group showed improved quality-of-life scores, increased distance walked in 6 minutes, and decreased serum B-type peptide levels compared with patients in the control group. A trend towards improvement was seen in peak oxygen uptake."

Taehan Kanho Hakhoe Chi

Lee, E.

The effects of a tai chi exercise program on blood pressure, total cholesterol and cortisol levels in patients with essential hypertension.

"Twenty-eight hypertensive patients participated in a 6- week program of Tai Chi exercise. In order to evaluate the effects of the Tai Chi program, blood pressure, total cholesterol, and cortisol levels were measured before and after week 6. RESULTS: After the 6-week Tai Chi program, there were significant differences in systolic blood pressure and diastolic blood pressure in the experimental group when compared to the control group."

Journal of Alternative Complementary Medicine

Tsai, J., Wang, W., Chan, P., Lin, L., Wang, C., Tomlinson, B., Hsieh, M., Yang, H. & Liu, J. (2003)

The beneficial effects of Tai Chi Chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial.

"76 healthy subjects with blood pressure at high-normal or stage I hypertension received a 12-week Tai Chi exercise training program 3 times per week. Each session included 10-minute warm-up, 30-minute Tai Chi exercises and 10-minute cool-down experience. Exercise intensity was estimated to be approximately 64% of maximal heart rate. Blood pressure, lipid profile and anxiety status (State-Trait Anxiety Inventory; STAI) were evaluated. RESULTS: After 12-weeks of Tai Chi training, the treatment group showed significant decreases in systolic blood pressure of 16 mm Hg and diastolic blood pressure of 9 mm Hg. The serum total cholesterol level decreased 15 mg/dL and high-density lipoprotein cholesterol increased 5 mg/dL. Both trait anxiety and state anxiety were decreased."

Hu Li Za Zhi

Jong, S.Y., Fang, Y.Y. & Chao, Y.F. (2004)

The effect of Tai-Chi-Qui-Gong exercises on patients' pulmonary function, exercise capacity, and quality of life after lobectomy.

"The purpose of this study was to evaluate the effect of Tai-Chi-Qui-Gong (TCQG) practice on patients' pulmonary function, activity capacity, and quality of life after lobectomy. Subjects in the experimental group received a training class on 10 motions of TCQG two days before surgery. They began to practice the TCQG exercises twice per day from the first postoperative day. They started with three motions on the first day, increasing to 10 on the fifth day. The control group received standard post-lobectomy care, which did not include the TCQG exercises. All subjects received measures on pulmonary function and six-minutes walk distance (6MWD) two days prior to the operation, as well as one week, and one month after the operation. Quality of life was measured two days before the operation and one month after the operation. RESULTS: The results indicated that subjects in the experimental group had significant improvement in their tidal volume and 6MWD after lobectomy, while subjects in the control group did not. The 6MWD of the subjects in the experimental group reverted to the preoperative status at the end of the first week, and was even better one month later. The postoperative quality of life of the subjects in the experimental group was significantly better than that of in the control group."

This monthly newsletter is written by Mark McGee, a senior instructor in T'ai Chi Ch'uan and other Chinese systems of exercise, fitness and martial arts. He is a senior student of Grand Master Robert Xavier, Lineage Holder of Hwa Yu T'ai Chi Ch'uan (Grand Master Xavier received the lineage from Grand Master John Chung Li who brought Hwa Yu to the United States from China in 1968). Mr. McGee's desire is to help you discover new ways to breathe, stretch and move that will enhance your health and fitness for the rest of your life.

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