Public Health Report : Tai Chi for Chronic Fatigue
Author : Eric L. Zielinski
Of all the chronic diseases people struggle with, one of the most troubling and confusing for physicians and patients is chronic fatigue syndrome (CFS). Relatively new on the medical radar, scientists are still baffled on how to treat it. Thankfully, researchers have proven that people who regularly practice Tai Chi are more equiped to manage the debilitating symptoms associated with CFS.
Chronic Fatigue Syndrome
As defined by the Mayo Clinic, chronic fatigue syndrome is a “complicated disorder characterized by extreme fatigue that can’t be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn’t improve with rest.” Since there is no single test to diagnosis CFS, physicians heavily rely on clinical presentations and past history to determine if someone has CFS.
According to the Mayo Clinic, CFS has “eight official symptoms,” in addition to the primary complaint that gives the condition its name:
- Loss of memory or concentration.
- Sore throat.
- Enlarged lymph nodes in your neck or armpits.
- Unexplained muscle pain
- Pain that moves from one joint to another without swelling or redness.
- Headache of a new type, pattern or severity.
- Unrefreshing sleep.
- Extreme exhaustion lasting more than 24 hours after physical or mental exercise.
Although the data suggests that it affects women who are in their 40s and 50s more often than any other demographic, researches have yet been able to determine risk factors leading to CFS Overweight and inactive people also seem to develop CFS more often than others.
Medical Research and Management
According to the Centers for Disease Control and Prevention (CDC), “Managing chronic fatigue syndrome can be as complex as the illness itself.” Currently, there is no cure and no prescription drugs exist to treat CFS directly. Although many theories exist as to the cause, no one knows exactly why people get affected. Subsequently, medical management focuses on symptom relief.
The CDC states, “A team approach that involves doctors and patients is one key to successfully managing CFS. Patients and their doctors can work together to create an individualized treatment program that best meets the needs of the patient with CFS. This program should be based on a combination of therapies that address symptoms, coping techniques, and managing normal daily activities.” In essence, people suffering from CFS may see the following health care providers: primary care physicians, occupational therapists, rehabilitation specialists, mental health professionals, and physical therapists.
Oftentimes, treatment centers on managing the most profound symptom as prioritized by the patient. For instance, since most people suffering from CFS experience sleeping disorders, physicians often advise the following sleep hygiene techniques as outlined by the CDC:
- Establish a regular bedtime routine.
- Avoid napping during the day.
- Incorporate an extended wind-down period.
- Use the bed only for sleep and sex.
- Schedule regular sleep and wake times.
- Control noise, light, and temperature.
- Avoid caffeine, alcohol, and tobacco.
- Try light exercise and stretching earlier in the day, at least four hours before bedtime because this may also improve sleep.
In addition, as many CFS patients also experience headaches and deep pain in their muscles and joints, physicians will often prescribe muscle relaxers and pain relievers like aspirin, ibuprofen, and Tylenol.
Memory and concentration are also affected by CFS. Subsequently, medical doctors may prescribe stimulants to help correct any cognitive issues. However, these drugs oftentimes lead to what the CDC refers to as a “push-crash cycle (do too much, crash, rest, start to feel a little better, do too much once again, and so on) and cause relapse.”
Finally, depression and anxiety symptoms that are associated with CFS is managed by taking antidepressants of various classes and may lead to “other effects that might worsen other CFS symptoms and cause side effects,” states the CDC.
Research showing Tai Chi’s ability to help manage Chronic Fatigue Syndrome
According to the Mayo Clinic, alternative therapies such as Tai Chi have been promoted for chronic fatigue syndrome. However, primarily referencing its effect on pain management, conventional medical sources neglect to mention the widespread benefits patients with CFS experience with Tai Chi; namely, its effect on sleep disorders, memory and attention, depression, anxiety symptoms.
Tai Chi helping with the main symptom of CFS: Fatigue
• Ever since a 1989 study published in the Journal of Psychosomatic Research, the benefits of those practicing Tai Chi has been extensively researched in regards to total health and wellness, including fatigue. In this now classic text, La Trobe University researchers assessed 33 Tai Chi novices and 33 regular practitioners. It was observed in both groups that “Tai Chi raised heart rate, increased noradrenaline excretion in urine, and decreased salivary cortisol concentration. Relative to baseline levels, subjects reported less tension, depression, anger, fatigue, confusion and state-anxiety, they felt more vigorous, and in general they had less total mood disturbance.” This study has laid the groundwork for researchers to follow suit and tell the world confidently that Tai Chi is a fantastic tool to employ against chronic diseases like CFS.
• Evaluating its effect on rheumatoid arthritis (RA) patients, Daejeon University researches published an article in the Korean journal Taehan Kanho Hakhoe Chi in 2006 highlighting Tai Chi’s ability to help with pain, balance, daily life performance, and fatigue. Comparing the results to 29 people in a no-exercise control group, 32 people in an experimental group participated in 50 minute Tai Chi sessions for 12 weeks. According to researchers, “Pain and fatigue significantly decreased in the experimental group,” indicating the benefit RA patients experience when participating in Tai Chi activities.
• In 2012, Evidence-Based Complementary and Alternative Medicine printed a study that analyzed the effects a 28-week Tai Chi program had on middle-aged women with fibromyalgia; a condition often associated with CFS. Thirty-two women participated in three 60-minute Tai-Chi sessions each week which included the following protocol: 15 minutes of warm-up with stretching, mobility, and breathing techniques; 30 minutes of Tai-Chi exercises principles and techniques, and 15 minutes of various relaxation methods. The intervention consisted of 8 forms from Yang Style Tai Chi taught by a Tai Chi Master who accommodated the exercise for patients with fibromyalgia. For instance, due to excessive fatigue, some participants could only perform some exercises while sitting during the first month. The outcome measures were based on the widely accepted Fibromyalgia impact questionnaire (FIQ) and Short Form Health Survey 36 (SF-36). Not only did the patients show improvements in regards to pain and symptoms related to fibromyalgia, they realized significant benefits including six SF-36 subscales (bodily pain, vitality, physical functioning, physical role, general health, and mental health) and improved FIQ scores and six subscales (stiffness, pain, fatigue, morning tiredness, anxiety, and depression).
• Also in 2012, Annals of Behavioral Medicine published a random control trial that assessed the manner in which a four-month Tai Chi-type Qigong intervention program could affect people with chronic fatigue and chronic fatigue syndrome. Sixty-four participants were randomly assigned to either a Qigong group or a control group and outcome measures included fatigue symptoms, physical functioning, mental functioning, and telomerase activity. Telomeres are protective DNA sequences that ensure chromosomal stability and shortened telomere length has been linked stress disorders, various disease processes like chronic fatigue syndrome, and premature mortality. According to the researchers, “Fatigue symptoms and mental functioning were significantly improved in the Qigong group compared to controls. Telomerase activity increased in the Qigong group from 0.102 to 0.178 arbitrary units. The change was statistically significant when compared to the control group.”
Although certainly not conclusive as this is only one study, this article is of paramount importance in that it suggests Tai Chi may be able to help prevent chronic fatigue syndrome from occurring. More studies on the relationship between Tai Chi and telomere activity is greatly needed.
Tai Chi helping with secondary CFS symptoms: sleep disorders, memory and attention, depression, and anxiety.
• In 2004, the Journal of American Geriatrics Society printed an article that highlights the work completed by Oregon Research Institute researchers. With the expressed purpose to determine the effectiveness of Tai Chi on sleep quality and daytime sleepiness in older adults who reported moderate sleep complaints in comparison to low-impact exercises, one hundred eighteen women and men aged 60 to 92 were recruited for the trial and the experimental group participated in 24 consecutive weeks of Tai Chi, three times per week, for 60-minute sessions. Researchers discovered that, “Tai Chi participants reported significant improvements in five of the PSQI [Pittsburgh Sleep Quality Index] subscale scores (sleep quality, sleep-onset latency, sleep duration, sleep efficiency, sleep disturbances), PSQI global score, and ESS [Epworth Sleepiness Scale] scores in comparison with the low-impact exercise participants.” In addition, “Tai Chi participants reported sleep-onset latency of about 18 minutes less per night and sleep duration of about 48 minutes more per night than low-impact exercise participants.” Thus, proving Tai Chi can speed the time it takes people to fall asleep, it increases upwards to one hour of precious rest for sleep-deprived people per night.
• Researchers from The Hong Kong Polytechnic University published a study in the Journal of Alternative and Complementary Medicine in 2010 that investigated whether elderly Tai Chi practitioners had improved attention and memory in comparison to older people who regularly exercises and with those who did not. In total, 135 people aged 60 years and older volunteered for the study. The Tai Chi group consisted of 42 individuals recruited from Tai Chi clubs in Hong Kong, the exercise group included 49 people recruited from various community centers, and 44 people from various elderly centers who reported not exercising comprised the final group. According to the researchers, “The main finding was that the three groups differed in attention and memory functions, and the Tai Chi group had demonstrated better performance than the other two groups in most subtests.”
• Just recently, the Journal of Investigative Medicine published in article in which University of New Mexico researchers conducted a literature review evaluating how people with post-traumatic stress disorder (PTSD) respond to mind-body practices like Tai Chi. Of the 96 articles identified, 16 were used for the review and the researchers discovered, “Mind-body practices incorporate numerous therapeutic effects on stress responses, including reductions in anxiety, depression, and anger, and increases in pain tolerance, self-esteem, energy levels, ability to relax, and ability to cope with stressful situations. In general, mind-body practices were found to be a viable intervention to improve the constellation of PTSD symptoms such as intrusive memories, avoidance, and increased emotional arousal.” The authors encouraged readers, clinicians and patients to explore individualized treatment plans “enhanced by mind-body interventions as part of ongoing self-care.”
Although limited research has been done to determine the benefits Tai Chi has on people with chronic fatigue syndrome, several studies have been conducted proving Tai Chi’s effectiveness in managing symptoms associated with CFS. Researchers would do well to investigate this further as regularly practicing Tai Chi may, in fact, prove to help prevent this debilitating disease entirely.
Medical Studies and Resources
Evidence-Based Complementary and Alternative Medicine
Annals of Behavioral Medicine
Journal of American Geriatrics Society
Taehan Kanho Hakhoe Chi
Journal of Alternative and Complementary Medicine
Journal of Investigative Medicine
Journal of Psychosomatic Research
Public Health Report : Tai Chi for Chronic Fatigue Syndrome
Author : Eric L. Zielinski