Five Questions For Health Professionals About Tai Chi And Qigong
Helping health professionals navigate the world of tai chi and qigong.
Helen leading a tai chi in the park class.
“I can’t speak highly enough of the course you run and will definitely promote the course to fellow colleagues”
If you’re a physiotherapist, occupational therapist or other allied health professional who is interested in implementing tai chi or qigong into your practice where do you begin?
You may see tai chi and qigong frequently mentioned in the media and know that it is recommended in the physical activity guidelines in the UK and other countries. In addition, a plethora of research appears to support the use of tai chi and qigong for a range of health conditions in different settings.
We understand you’re busy and want some simple answers to your questions about using tai chi and qigong in your practice.
When you search for practical information, or clinical guidance, what you might find instead is information full of woolly, or even magical thinking, that presents tai chi and qigong as a panacea for all ills.
In this post, we aim to answer five of the most common questions a busy health professional might have about tai chi and qigong. We hope you find them helpful.
If you have some more questions you’d like us to answer do get in touch, we’re here to help.
1. What is tai chi and qigong?
Phil leading tai chi in the park class
Tai chi and qigong are forms of choreographed physical movements originating from China and recognisable for their slow, graceful, flowing or meditative style. Their origins are complex. We will try and summarise them here.
Modern scholars agree that taijiquan, taiji, or tai chi as we now know it today, originated in a small village, called Chen Village, in the Chinese province of Henan, in the 17th century. It has traditionally been practiced for multiple purposes, including self-defence, mindful nurturing of well-being, and fitness enhancement.
Overtime successive teachers around the world have brought their own ideas and experience to create the many off-shoots of tai chi that people enjoy today.
Qigong is a modern term, coined in 1950’s in communist China, that describes a range of embodied movement and meditative practices originating in China. Archaeological evidence date these practices to the 3rd century BCE.
Collectively, these physical and mental practices, more accurately called, Daoyin (meaning to guide and pull), are part of a broad cultural umbrella of health-promoting concepts called, Yangsheng 养生 — meaning to nourish or cultivate life.
Today, we could say that tai chi and qigong represent a series of physical and meditative exercises that integrate, elements of mindful practice with slow, purposeful movements of the body. We could call it a mind-body practice or embodied philosophy.
(Li and Harmer, 2014, Guo, Qiu and Liu, 2014, Jahnke et al., 2010)
Reproduction of an silk scroll (168 BC) from an archeological site in central China showing ladies and gentleman enjoying daoyin exercises for health.
2. Are tai chi and qigong safe for my patients?
Yes, research shows that both tai chi and qigong are safe for patients with a wide range of health conditions when led, or supported by, qualified health professionals.
A 2016 review of clinical trials for the Canadian Family Physician Journal, by Huston and Macfarlane, reports:
“ There were no studies that found tai chi worsened a condition.
More recently, a 2019 meta-analysis on adverse events (AE) by Cui et al, concluded that:
“ Findings indicate that TC [tai chi] does not result in more AEs than active and inactive control conditions, and produces fewer AEs than inactive control conditions for heart failure patients.
3. What benefits do tai chi and qigong offer patients?
Tai chi can be attractive to patients because the slow, elegant, meditative and low-impact movements appear easy and manageable. Studies suggest one of the most significant benefits of tai chi and qigong for both patients and health professionals is that they are perceived as gentle, or non-threatening. (Salmoirago‐Blotcher et al., 2017).
Kinesophobia (fear of movement or physical activity) can be a significant barrier to engagement in rehabilitation. (Luque-Suarez, Martinez-Calderon, & Falla, 2019).
Gentle tai chi or qigong movements can help allay those patient fears. This in turn can help increase motivation and self-efficacy to engage in other exercise programmes later on.
We understand that patients living with chronic health conditions, injuries or illnesses can also experience mental health issues. Most commonly depression and anxiety as a result of living with chronic pain, trauma and disability.
Tai chi and qigong can provide a biopsychosocial approach to support these patients. Dr. Peter M. Wayne, at Harvard Medical School, describes tai chi as having a number of active ingredients,
“ Perhaps what makes Tai Chi so special is that this holistic, multicomponent exercise affects us at physical, psychological, social and philosophical levels. Its multilevel effects are especially important for complex chronic diseases that involve many systems throughout the body… (Wayne and Fuerst, 2013)
Helen leading tai chi in the park class
4. Which patients would benefit from tai chi?
“ Regular physical activity, in combination with standard medical care, has an important role in the management and prevention of many long-term conditions. (Reid et al., 2021)
In our role as health professionals, we aim to tailor exercise and rehabilitation to our patients to restore movement, reduce pain, promote independence and enable activities of daily living.
Once we frame tai chi and qigong as exercise, the same as any other exercise, we can see those movements as just another tool in our toolbox. We can use our clinical and critical thinking skills to assess our patients and choose the appropriate ‘tools’ for rehabilitation.
We can take into consideration not only physical limitations but also address motivations, both intrinsic and extrinsic, personal goals or interests, patient skills, habits and routines, including their environment, etc.
Physiotherapists and occupational therapists have the knowledge and skills to assess this range of criteria. This means we already have the skills to understand tai chi and qigong movement and decide if they are a good fit for our patients.
5. What qualifications do I need to use tai chi and qigong in my healthcare setting?
In a 2018 paper by Oh et al, which investigated the standards of accreditation for practitioners, they state that;
“ To date, there are no government regulations for TQ [tai chi and qigong] instructors or for training institutions in China and Western countries…
We agree with the general recommendations of this paper and its proposals that qualified and registered health professionals are well equipped to offer tai chi and qigong to patient populations.
For now, as a health professional, you will need to use your critical skills to look at the evidence, or guidelines, for your setting.
Be warned if you search for tai chi or qigong via PubMed you will find a lot of returns. If you are interested in understanding more about how to use tai chi or qigong with your patients, we can help you critically navigate this research in whatever arena you work in.
Our six-week blended learning course, Tai Chi for Therapists, for health professionals investigates the state of the art and science around tai chi and qigong in clinical settings. We demonstrate common tai chi and qigong movements that you can start using straight away with your patients.
Helen and Phil leading a workshop with physiotherapists and physiotherapy students
We’re here to help health professionals implement tai chi and qigong movements into their practice for the benefit of their patients.
You can find out more about our class leading course, Tai Chi for Therapists, at our course page.
If you have a colleague, friend or family member, you think might enjoy this blog post please do share it with them.
If you have some questions or comments please do get in touch.
We look forward to seeing you.
All the best,
Phil & Helen
References
Cui H, Wang Q, Pedersen M, et al. The safety of tai chi: A meta-analysis of adverse events in randomized controlled trials. Contemporary Clinical Trials. 2019;82:85–92. doi:10.1016/j.cct.2019.06.004
Guo Y, Qiu P, Liu T. Tai Ji Quan: An overview of its history, health benefits, and cultural value. Journal of Sport and Health Science. 2014;3(1):3–8. doi:10.1016/j.jshs.2013.10.004
Jahnke, R., Larkey, L., Rogers, C., Etnier, J. and Lin, F. (2010). A Comprehensive Review of Health Benefits of Qigong and Tai Chi. American Journal of Health Promotion, [online] 24(6), pp.e1–e25. doi:10.4278/ajhp.081013-lit-248.
Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Akers, L., Chou, L.-S., Pidgeon, D., Voit, J. and Winters-Stone, K. (2018). Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling. JAMA Internal Medicine, [online] 178(10), p.1301. doi:10.1001/jamainternmed.2018.3915.
Luque-Suarez, A., Martinez-Calderon, J., & Falla, D. (2019). Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. British Journal of Sports Medicine, 53(9), 554–559. https://doi.org/10.1136/bjsports-2017-098673
Oh, B., Yeung, A., Klein, P., Larkey, L., Ee, C., Zaslawski, C., Knobf, T., Payne, P., Stener-Victorin, E., Lee, R., Choi, W., Chun, M., Bonucci, M., Lang, H.-D., Pavlakis, N., Boyle, F., Clarke, S., Back, M., Yang, P. and Wei, Y. (2018). Accreditation Standard Guideline Initiative for Tai Chi and Qigong Instructors and Training Institutions. Medicines, [online] 5(2). doi:10.3390/medicines5020051.
Reid, H., Ridout, A. J., Tomaz, S. A., Kelly, P., & Jones, N. (2021). Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions. British Journal of Sports Medicine, bjsports-2021–104281. https://doi.org/10.1136/bjsports-2021-104281
Salmoirago‐Blotcher, E., Wayne, P.M., Dunsiger, S., Krol, J., Breault, C., Bock, B.C., Wu, W. and Yeh, G.Y. (2017). Tai Chi Is a Promising Exercise Option for Patients With Coronary Heart Disease Declining Cardiac Rehabilitation. Journal of the American Heart Association, [online] 6(10). doi:10.1161/jaha.117.006603.
Wayne, P.M. and Fuerst, M. (2013). The Harvard medical school guide to tai chi : 12 weeks to a healthy body, strong heart, and sharp mind. Boston: Shambhala.
