Public Health Report : Asthma and Tai Chi
Author : Eric L. Zielinski
Asthma is one of the leading chronic diseases of our times, with millions of sufferers worldwide. Although there are many allopathic treatments including bronchodilators and corticosteroids that focus on long-term control or immediate relief, there is no single medication that is effective against both the inflammatory and bronchoconstrictive components of asthma. Therefore, many sufferers turn to alternative or complementary therapies like Tai Chi in conjunction with their regular allopathic medications.
The National Institute of Health (NIH) defines asthma as “a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.” Affecting people of all ages, asthma generally starts during childhood. In the United States alone, it is reported that more than 25 million people are affected, of which seven million are children. See below for the most recent data of asthma prevalence as supplied by the NIH.
Most people who have asthma have allergies. As such, it is no wonder that the following allergens are known triggers of asthma attacks:
- Tobacco Smoke.
- Dust Mites.
- Outdoor Air Pollution.
- Cockroach Allergen.
- Smoke From Burning Wood or Grass.
- Other Triggers like infections, breathing in chemicals and acid reflux.
Medical Research and Management
The NIH claims that, “Asthma has no cure.” Even when people feel fine the NIH insists that they “still have the disease and it can flare up at any time.” Health conditions such as runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea also make asthma harder to manage. Consequently, the goal of asthma treatment is to manage symptoms in an effort to help people live as normal a life as possible.
Typical asthma action plans suggest that patients:
- Take their medicines properly – Currently, asthma is treated with two types of medicines: long-term control and quick-relief medicines. Reducing airway inflammation, long-term control medicines are used to prevent asthma symptoms. Quick-relief medicines, on the other hand, are designed as a rescue mechanism to help relieve flare-ups.
- Avoid known and potential triggers –One trigger that the NIH does not recommend avoiding, however, is exercise.
- Respond to worsening symptoms appropriately – Keeping an inhaler and/or your pills handy in case an attack comes.
- Seek emergency care when needed.
It has been reported that reducing inflammation helps prevent the cascade of respiratory symptoms that causes asthma. Believed to be the most effective treatment for the relief of the inflammation and swelling that characteristically irritates the airways, inhaled corticosteroids are the preferred medicine for long-term asthma control. Inhaled corticosteroids are also heralded for treating chronic obstructive pulmonary disease (COPD), which includes an asthmatic component.
Since inhaled corticosteroids deliver the medicine directly into the lungs, smaller doses of corticosteroid is are used to control asthma symptoms. Subsequently, the amount of corticosteroid that is absorbed systemically is minimized, thereby reducing known side effects that are normally experienced while taking long-term oral corticosteroids. Nonetheless, the side effects of long-term use of inhaled corticosteroids are still dangerous and include:
- Aseptic Necrosis (bone death).
- Elevated blood sugar.
- Eye problems like cataracts or glaucoma.
- Fluid retention and elevated blood pressure.
- Gastrointestinal ulcers or bleeding.
- Mood changes.
- Suppressed immune function causing infections like pneumonia and thrush.
- Weight gain.
Research showing Tai Chi’s ability to help improve asthma
According to an article published in the British Medical Journal, “The primary uses of hypnosis and relaxation techniques [like Tai Chi] are in anxiety, in disorders with a strong psychological component (such as asthma and irritable bowel syndrome), and in conditions that can be modulated by levels of arousal (such as pain). They are also commonly used in programs for stress management;” thereby focusing on known asthma triggers
- One of the first references to mind-body exercises and asthma control was in 1998. Printed in the The Journal of Alternative and Complementary Medicine, a Tai Chi-related exercise known as Qigong Yangsheng was performed on 30 asthma volunteers for twelve months up to seven times a week. During this time, participants kept a daily diary of five asthma-relevant symptoms (sleeping through the night, coughing, expectoration, dyspnea, and general well-being). After the 52 weeks, not only did the participants claim to have suffered fewer asthma attacks, they reported experiencing a 10 percent improvement in “peak-flow variability,” a common measure used to evaluate the severity of asthma symptoms. In addition, the researchers stated, “When comparing the study year with the year before the study, there was improvement also in reduced hospitalization rate, less sickness leave, reduced antibiotic use and fewer emergency consultations resulting in reduced treatment costs.”
- The Journal of Microbiology, Immunology and Infection printed an article in 2008 that investigated the effect Tai Chi has on the pulmonary function and daily symptoms of asthmatic children. Of the thirty children who participated 15 were randomly chosen to participate in a 12-week Tai Chi program and both groups were assessed via a three-day symptom questionnaire and pulmonary function test. After the 12 weeks, it was reported that children in the Tai Chi group experienced “significant improvement in pulmonary function compared to the control group” and children “had milder symptoms than those in the control group.” Subsequently, researchers concluded that their data proves that Tai Chi can “improve the pulmonary function of asthmatic children. However, long-term follow-up is required to determine the impact of [Tai Chi] on the severity of asthmatic symptoms.”
- Complementary Therapies in Clinical Practice printed a paper in 2012 in which University of Miami Medical School researchers conducted a review of “studies published during the last several years on exercise effects on overweight, growth, chronic illnesses, depression and anxiety in children and adolescents.” In addition to taking a look at aerobic exercise, they also included yoga and Tai Chi in their analysis. From their data, they were able to confirm, “Body mass index and lipid profiles have improved in overweight children, and those with asthma, diabetes and depression have also benefited from exercise.” Specifically interesting to look at asthma, the paper stated that the studies involving Tai Chi showed particular benefits for children suffering from asthma and ADHD. To explain this phenomenon, the authors suggested that the positive benefits produced by Tai Chi might be due to “the stimulation of pressure receptors leading to increased vagal activity, decreased stress hormones and increased production of anti-pain and antidepressant neurotransmitters such as serotonin.” In other words, by helping reset the internal regulatory system, Tai Chi improves neuroendocrine-immune interactions thereby improving every aspect of health at the cellular level. Hence, children with ADHD and asthma are greatly served by regular practice of Tai Chi.
- Research from Thailand presented at the 74rd annual meeting of the American College of Chest Physicians suggests that asthma sufferers are better able to control their breathing and improve their exercise performance by participating in Tai Chi. Scientists in Thailand enrolled 17 adult asthma patients to be part of a six-week Tai Chi training program. After this time, volunteers showed significant improvements in peak flow variability, asthma control, and quality-of-life measures. Moreover, according to WebMD, the “patients were more comfortable on a six-minute walk and increased their maximum work rate and maximum oxygen consumption after taking part in the exercises, the researchers say in a news release. The researchers conclude that Tai Chi can help people control asthma and prove to be an effective, non-pharmacologic adjunctive therapy for people with persistent asthma.”
- Of the three million reported people who participate in Tai Chi for health reasons in the U.S., Harvard Medical School researchers determined that there was significant use associated independently of musculoskeletal issues and asthma. As exercise is vital for the health of asthmatics, this gives hope for many who find it challenging to exercise because of common aches and pains.
The link between Tai Chi and asthma is clear:
- Immune system – as seen in several studies, Tai Chi has been proven to enhance immune system function thereby helping asthmatics combat reactions related to allergens, viruses, and other illnesses.
- Breathing – Tai Chi’s inherent focus on mindful, intentional breathing helps promote breath control and strengthens the muscles and tissues of the respiratory system. By learning to breathe more effectively, asthmatics gain better control of their symptoms and suffer fewer attacks.
- Relaxation – since asthma outbreaks are often triggered or aggravated by emotional and/or physical stress, the connection between Tai Chi’s proven ability to help reduce mental/physical stress and asthma is made all the more clear.
In summary, research has proven that Tai Chi is a viable alternative to not only prevent asthma attacks, but also help reduce their severity.
Evaluating the role of alternative and complementary treatments of asthma, University of Pretoria, South Africa researchers “concluded that therapies like … Tai Chi … are used by many asthma patients but it seems as if many patients do not communicate the use of such therapies to their medical practitioners.” Subsequently, even though “results from documented research, however, show alternative therapies for the treatment of asthma have a role to play and are effective to alleviate symptoms,” further research is needed to make any headway in changing the medical approach to include Tai Chi in asthmatic’s care plans. Otherwise, the proven benefits of techniques like Tai Chi will never reach the masses as most people with asthma rely on their physician’s advise for management and prevention.
Medical Studies and Resources
British Medical Journal
Journal of Alternative and Complementary Medicine
Journal of Microbiology, Immunology and Infection
Acupuncture and Electro-Therapeutics Research
Complementary Therapies in Clinical Practice
74rd annual meeting of the American College of Chest Physicians
Public Health Report : Asthma and Tai Chi
Author : Eric L. Zielinski