Tai Chi for PTSD A Rational:
Tai Chi
For Health Can Decrease Stress, and Improve
Functional Outcomes for Post Traumatic Stress ( PTSD )
by Dr. Paul Lam and Jef Morris, Master
Trainer
On our many visits to the Miami Veterans Health Care
Center, we recognized the overwhelming needs of this
population and became very interested in a
collaborative effort for physical therapists to care
for these individuals.
The Veterans returning from the wars in the Middle
East pose many post traumatic stress related and
physical mobility challenges for physical therapists
involved in their care.
One of the keys to effective outcomes for these
clients may be the incorporation of modified Tai Chi
exercises to help to effectively manage the time spent
in rehabilitation, to re-focus these clients in the
tasks at hand in spite of stress, pain, stiffness and
fatigue.
Dr. Paul Lam, a family physician, in Sydney Australia,
suggests Tai Chi practice will lead to better health
and harmony. Health means improved balance,
flexibility, strength and fitness or cardiovascular
respiratory functions 1, 2, 3, 4, 5, 6, as well as
improvement of mental concentration and reduction of
stress.
Dr. Paul Lam, lives with Arthritis, and is a Tai Chi
gold medal winner. Dr. Lam created the Tai Chi for
Health program over 10 years ago. Today, Dr. Lam, and
his team of Master Trainers, have certified more than
8,000 Instructors, in 11 countries.
Dr. Lam's Tai Chi for Health instructor certification
workshop series provides the foundation for our
program. For more information visit Dr. Lam's
website: www.taichiproductions.com
Dr. Lam's collaboration with physical therapy and Tai
Chi for Health requires an understanding of the Tai
Chi modified exercises, the health benefits, and the
effectiveness of Tai Chi exercises.
The key to effective outcomes is in the application of
the Tai Chi movements, in the method of teaching, and
how the physical therapy client learns.
Tai Chi For PTSD: A Rational
Tai Chi originated from ancient China as a martial
art. Most of its forms are slow, with continuous,
circular movements while maintaining a greater sense
of balance thorough out the sequence.. To move in this
way, one moves from a state of balance, and
transitions to another state of balance. When the
essential Tai Chi Principles are applied, the focus
shifts to a greater awareness of one's posture,
breathing, and perception of the moment to articulate
each joint and to move in harmony 7.
To practice the art of Tai Chi, the client learns how
to progressively relax. In general, one of the
intentions of Tai Chi exercises is to move the body in
such a way the clients mental focus shifts from random
thoughts to focus on how to relax their muscular
skeletal structure, to maintain a sense of balance
both mentally and physically.
Combined with the breathing control, clients'
breathing pattern shifts to a deeper state, which
induces a chain reaction of the nervous system, the
brain functions, and the hormones of the participant.
Consistent practice of the Tai Chi can improve the
strength and flexibility of the body, while dispersing
mental activity for moments of time to relax. This
window to relax, and to simply focus on what you are
doing, while you are doing it, creates a foundation to
increase one's ability to focus, and experience calmer
physical states.
Tai Chi Benefits for PTSD
Tai Chi practice leads to better health and
harmony. Harmony means a better self-perception and
self worth, and a more balanced mental state or a
sense of serenity.
Studies have shown Tai Chi not only decreases
self-assessment scores of these cognitive emotions
(anger, depression, anxiety), but also increases a
subject's confidence in balance and movement.
Another important effect of Tai Chi is its training of
the mind 5. Tai Chi improves relaxation as well as
mental concentration, to facilitate a positive mental
attitude 8, 9, 10, and relaxation.
Tai Chi achieves this through applying its essential
principles, by controlling the movements to be slow,
continual, together with precise body co-ordination,
posture and breathing. All this leads to mental focus
or being mindful in the terminology of Tai Chi body,
mind and spirit integration.
3 Keys to Effective Tai Chi Collaboration
Dr. Lam recommends to apply Tai Chi Essential
Principles to collaborate with physical therapy, there
are three key aspects to consider when planning your
sessions:
. safety;
. efficacy
. adherence
Safety
If the physical therapy client becomes injured as a
result of the session, it would not have benefited
either the client or the reputation of Tai Chi. This
is why you need to know what type of clients will
benefit from Tai Chi. Dr. Lam has outlined safety
precautions for the Tai Chi for Health program in his
book, Teaching Tai Chi Effectively.
Efficacy
Almost all Tai Chi studies are focused on confirming
its health benefits. What you going to teach, how you
teach it, and over what period of time are crucial.
Allow half the session time for learning new
movements, and half of the session time for practice
and consolidation. During the learning phase,
people are moving slowly and often clumsily. They
cannot gain much of Tai Chi's benefits because they
are not yet doing real Tai Chi.
The great health benefits of Tai Chi come from
following its essential principles, such as moving
smoothly, being well-balanced and having a serene
mind. You cannot achieve these during the learning
phase. Plan your sessions so that there is adequate
time to practice the movements, so that the subjects
can gain health benefits, strength and flexibility.
Allow adequate time to teach the exercise movements
well. If you try to cover too many exercises and rush
through your teaching, you will get worse results
rather than better. It is better to learn
fewer movements, and practice them regularly than
learning many exercise movements poorly.
Different health benefits may take different periods
of time to generate. For example, for people with
arthritis, two separate studies 11, 12 have shown that
3 months are required to deliver the benefits of less
pain, better ability to perform daily activities and
better balance.
When measurement was done after 6 weeks, no benefits
were recorded. Health benefits like cardiovascular
fitness, diabetes control and problems relating to
chronic conditions may take even longer than 3 months.
Therefore, studies with longer duration may have a
much greater chance of demonstrating the many health
benefits of Tai Chi.
Adherence
Dr. Lam advocates facilitating enjoyment leads to
adherence. "If people don't enjoy doing something,
they will soon stop doing it." Helping clients to
enjoy their Tai Chi and its benefits are very
powerful motivators for adherence.
For those of us who are enthused about Tai Chi,
practicing Tai Chi gives us a wonderful feeling in our
body and mind. Tai Chi intrinsically is an enjoyable
exercise/art/sport. It is this enjoyment that urges us
to practice and to share our enthusiasm with others.
Dr. Lam finds it helpful to tell beginners what to
expect:
"I tell them that Tai Chi is very different from the
western sports and lifestyle they are used to. Most
western sports emphasize fast and strong movement in a
straight line and, in our modern world, we often move
too fast, and are always looking for short cuts to
make it quicker.
With Tai Chi, we move slowly, and in a curve instead
of a straight line, because these ways bring us back
to harmony with nature and our body.
I tell beginners that Tai Chi is so different it will
take them time to get used to it. I ask them to allow
themselves and their teachers time so that they can
get used to Tai Chi. I tell them that most people will
become comfortable with it in three months and stress
the enjoyment and health benefits they will get out of
it if they persevere.
I want them to understand, without actually saying it,
that if they do not achieve what they expect, in the
time they want to, it is not their fault, it is the
nature of the art. I also help them to appreciate and
cherish any progression they have made.
Sometimes they don't see the benefits of exercise
immediately, so if the teacher, or physical therapist,
can help them understand how Tai Chi works to
improve their health and why it takes some time to
produce results, this could help them to stay in the
class. It is our experience that most people will
stick with Tai Chi if they keep coming to classes for
around three months or more.
Many studies have shown the health benefits of Tai Chi
after just three months of practice, which should
provide more incentive for the clients to stay. When
they know what to expect, they are less likely to feel
incompetent and give up. Give them a goal and a time
frame to help them to persevere with Tai Chi."
REFERENCES
1 Wolf SL, Huiman X, Barnhart, Kutner NG, NcNeely E,
Coogler C, Xu T and Atlanta FICSIT Group: Reducing
frailty and falls in older persons: an investigation
of Tai Chi and computerized balance training.
J-Am-Geriatr-Soc. 1996 May; 44(5): 489-97.
2 Song, R, Lee, E-O; Lam, P; Bae, S-C: Effects of Tai
Chi Exercise on Pain, Balance, Muscle Strength, and
Perceived Difficulties in Physical Functioning in
Older Woman with Osteoarthritis: A Randomized Clinical
Trail The Journal of Rheumatology; 30(9), pp
2039-2044, 2003
3 Li, J.X; Hong, Y; Chan, K.M: â?oTai chi:
physiological characteristics and beneficial effects
on healthâ? British Journal of Sports Medicine; 35, pp
148-156, 2001
4 Wong, A.M; Lin, Y-C; Chou, S-W; Tang, F-T; Wong,
P-Y: Coordinated Exercise and Postural Stability in
Elderly People: Effect of Tai Chi Chuan Archives of
Physical Medicine and Rehabilitation; 82, pp 608-612,
2001
5 Hong, Y; Li, J.X; Robinson, P.D: Balance control,
flexibility, and cardiorespiratory fitness among older
Tai Chi practitioners British Journal of Sports
Medicine; 34, pp 29-34, 2000
6 Jacobson, B.H; Ho-Cheng, C; Cashel, C; Guerrero, L:
The Effect of Tai Chi Chuan Training on Balance,
Kinesthetic Sense, and Strength Perceptual and Motor
Skills; 84, pp 27-33, 1997
7 Dr Paul Lam and Nancy Kaye, Tai Chi for Beginners
and the 24 Forms, published by Limelight Publication
2006
8 La-Forge-R: Mind-body fitness: encouraging prospects
for primary and secondary prevention.
J-Cardiovasc-Nurs. 1997 Apr; 11(3): 53-65
9 Kutner-NG; Barnhart-H; Wolf-SL; McNeely-E; Xu-T:
Self-report benefits of Tai Chi practice by older
adults.J-Gerontol-B-Psychol-Sci-Soc-Sci. 1997 Sep;
52(5): P242-6.
10 Jin-P: Changes in heart rate, noradrenaline,
cortisol and mood during Tai Chi. J-Psychosom-Res.
1989; 33(2): 197-206.
Jin-P: Efficacy of Tai Chi, brisk walking, meditation,
and reading in reducing mental and emotional stress.
J-Psychosom-Res. 1992 May; 36(4): 361-70.
11 Choi JH, Moon JS and Song R, The effects of
Sun-style tai chi exercise on physical fitness and
fall prevention in fall-prone adult. Journal of
Advanced Nursing, 2005, 51(2), pp. 150â?"157.
12 Albert Bandura, Self-efficacy: The exercise of
control, WH Freeman and Company, New York, 1997
13 Alexander Voukelatos, A randomized, controlled
trial of tai chi for the prevention of falls: The
Central Sydney Tai Chi Trial, JAGS 55:1185- 1191, 2007
Alliance QiGong Taiji, Inc
