Ancient Exercises Keep People With Arthritis Moving

From the WebMD Archives

Jan. 4, 2001 -- The people practicing t'ai chi appear as if in a dream, their actions are so precise and in such slow motion. The movements and philosophy have been touted in China for more than 1,000 years as a way to peace and health. Now medical experts are scientifically demonstrating that it may provide major benefits for some people who suffer from diseases like arthritis.

The Journal of the American Geriatrics Society recently published a study showing that a group of 18 osteoarthritis patients felt better about the state of their health and ability to manage their symptoms after participating in 12 weeks of t'ai chi training.

The study's lead author, Catherine Hartman, MS, of the Dana Farber Cancer Institute in Boston, says that the ancient Chinese exercises didn't significantly change how well the participants' hips and knees worked. However, she says that participants did report being better able to bend, keep their balance, and do general household tasks.

Hartman tells WebMD she hypothesized that the dancelike style of t'ai chi might be an appropriate way for older, arthritic patients to exercise. The average age of those in the study was 68.

The training included two 1-hour classes each week for 12 weeks for those learning t'ai chi. A control group, whose members resembled the t'ai chi group in age, gender, race, weight, and height, continued with their normal day-to-day activities. They did not show the improvement exhibited by the individuals learning the exercises. At the end of the study, those who participated in the t'ai chi exercises reported improvements in their arthritis symptoms, their level of tension, and their satisfaction with general health status.

"Recently, physicians have been recommending physical activity for people with arthritis. But they're finding that older adults just are not doing the types of activities being recommended," Hartman says. "I thought that the slower, less intense mind/body exercise might be attractive to them."

A Beijing t'ai chi master agreed to conduct the classes and even adapted the movements for one man who was dependent on a walker: The elderly man had access to parallel bars like those used in gymnastic routines so that he could grab them if he thought he was going to fall over.

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Hartman says she was able to measure a significant increase in the patients' confidence in dealing with their pain and a decrease in their levels of tension and stress.

"The most impressive thing was how much they enjoyed the study," she says. "The attendance was incredible." More than half of them continued the t'ai chi class after the study was over.

In addition to finding a new way to exercise, the patients gained confidence in themselves and increased their contact with others.

"A lot of these people don't have bikes at home, or equipment. They don't belong to gyms, and they don't want to go for a walk by themselves," says Hartman. "The group bonding was very important."

David Karp, MD, PhD, says that dozens of studies have shown the benefits of appropriate exercise programs for any patient with arthritis, not only in treating the disease itself but also for improving cardiovascular function, stamina, and overall sense of well-being.

"T'ai chi helps with all of these and also with balance and to promote better body mechanics," says Karp, who is an assistant professor of immunology at UT Southwestern Medical Center in Dallas. He says it especially aids in strengthening the muscles in the front of the knee, increasing how much walking is possible and lessening pain at night.

"The problem is that most studies are three months to a year [long], and as soon as the study is over, the people revert to their bad habits and stop doing the exercises," Karp tells WebMD.

He concurs with Hartman that it improves socialization. "You get arthritic and get a housebound mindset," he says.

Karp says that his 81-year-old mother-in-law studied t'ai chi in China for two weeks and came back feeling wonderful. But he cautions, "They were doing it eight hours a day. You have to be willing to put in the time."

He says that many major community centers have exercise and swimming programs aimed specifically at those with arthritis, and the Arthritis Foundation has a series called PACE -- People with Arthritis Can Exercise.

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"The care of a patient with arthritis is a much more global effort. Giving medication is only part of it," advises Karp. "Medication should be the last part of treatment. Losing weight, [proper] diet, and exercise are much more important in helping them remain mobile. Once you limit your mobility, it's a self-fulfilling prophecy."

It is recommended that patients consult with a physician prior to beginning any exercise program.

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