The Best Tai Chi for Seniors

**Note: There is no handout for this article, as it is much better to watch the video of the forms or take a class yourself. See bottom of article for video and class resources.**

When I hear the words “Tai Chi” I usually think of someone standing in a park, holding a squat-like position, while moving their hands in smooth, choreographed gestures.

What I didn’t realize (before becoming certified in Tai Ji Quan Moving for Better Balance) is that Tai Chi (also known as “Tai Ji Quan”) consists of many forms that have been adapted throughout history.

Additionally, Tai Ji Quan has a variety of purposes, including promoting self defense, enhanced fitness, mental well-being, performance and competition, and even communication (for example, think about the communities that form in the park where people are practicing Tai Ji Quan)!1

In this article, we will explore a specific tai chi for seniors program, Tai Ji Quan Moving for Better Balance, and discuss its extensive benefits, including being scientifically-proven to decrease fall risk.

The Components of Balance

Balance is one of those great things that we don’t usually have to think about if we have it, right? Most of us don’t walk around all day thinking stay balanced, stay balanced. If you do, you likely have an issue with your balance, and you know how frustrating it can be when balance doesn’t come easily.

There are 3 systems within our bodies that contribute to our balance:

1. Vestribular system

2. Proprioception

3. Vision

In the next few sections, I will explain each of these componenets in more detail. What’s important to remember is that all three of these systems are important to balance, so when one is diminished, it can severely impact our ability to balance.

Additionally, when it comes to training balance, physical therapists target each of these systems differently to help them respond more quickly, which enables your balance to improve.

Tai Ji Quan: Movement for Better Balance also targets each system, which is one of the many wonderful things about this program.

The Vestibular System

This system does not just help with balance, but also contributes to the following:

*Postural control

*Muscle tone

*Spatial orientation

*Alertness

*Eye movement

So you can see that it’s very important to our ability to be upright, move around in our environment, and adjust our eyes to what we want and need to look at.

The vestibular system lives within our inner ear (which is appropriately called “the vestibule”).

When our head moves, the vestibular system receives information, which it relays to the brain. The brain then can process where we are in space and how fast/slow we are moving.2

Proprioception

Proprioception is the ability to know where we are in space through signals from our joints and muscles.

We have nerves called sensory nerves that are found in our skin, muscles, and joints. Our brain gets information from these nerves and is able to identify where are joints are and adjust our position as needed.4

Vision

While we all know what vision is, what you may not know is that when our eyes are open, 2/3 of our brain’s electrical activity is being used just to process vision!6

Most of us rely a lot on our vision- even more than we may think.

Although it’s a great thing to have, sometimes are vision can more or less play tricks on us (think about an optical illusion), so it’s really important that we learn how much we rely on our vision, and ensure that the other systems are working to help us balance as well.

What Happens to the Components of Balance with Age?

As we get older, the vestibular system experieces changes. These changes lead to decreased speed of the signals between the movement, the vestibular system, and the brain. 3

When our vestibular system isn’t working as well, this may present itself as bumping into things, balance deficits, and falls.2

In terms of propioception, the receptors in our muscles are impacted by the decrease in muscle mass that occurs with aging. Also, the signals received by our sensory nerves travel less quickly to the brain.5

Many of you may have experience with changes that occur to vision as we get older. A condition called “presbyopia” (basically difficulty seeing things that are too close) is common and may require you to wear readers.7

Also, conditions like glaucoma, dry-eyes, cataracts, macular degeneration, and temporal arteritis (inflammation of the temporal artery, which may cause vision loss) can also occur and contribute to decreased ability to see.7

If These Systems Are Impacted by Age, Then Why Do Exercises?

We have a saying in therapy that goes, “The test is the treatment and the treatment is the test.”

Basically, we identify issues with balance through testing the different components by taking them away. For example, when a PT has you stand on one foot then close your eyes, he/she/they is determining how much you rely on your vision for balance.

By testing it, and finding out where the problem lies, we can then continue to practice those “tests” or tasks, if you will, in order to help you improve.

While aging does impact our bodies, exercising can help combat the impact of aging. Just because we lose muscle mass as we age, doesn’t mean we just say, “Oh well, that’s life,” and move on. No way! We workout to get stronger so we can stay independent!

The same is true for balance exercises and focusing on the components of balance.

Training these systems usually involves “taking one away” (like having you perform an activity with eyes closed (visual), or moving your head right and left (vestibular)) to strengthen the responsiveness of the others.

These exercises enable our brain to learn to respond more quickly, and help decrease risk of falls.

What is Tai Ji Quan: Moving for Better Balance (TJQMBB)?

Tai Ji Quan Moving for Better Balance was created by Fuzhong Li, Ph.D., a Senior Scientist at the Oregon Research Institute.

The official website for TJQMBB states, “Although its origin can be traced to the contemporary simplified 24-form Tai Ji Quan routine, TJQMBB represents a significant paradigm shift in the application of Tai Ji Quan, moving the focus from its historical use as a martial art or recreational activity to propagating health by addressing common, but potentially debilitating, functional impairments/deficits.”8

Why is TJQMBB More Beneficial Than Traditional Tai Chi?

The TJQMBB program consists of participants completing one hour of TJQMBB, two times per week, for 24 weeks.

I can’t specifically speak to the benefits of Tai Chi, but I will say that TJQMBB program has research backing up it’s efficacy for reducing fall risk. (Keep in mind, the research findings are based on completing a 24-week program).9

As an instructor and physical therapist, I describe TJQMBB as Tai Chi forms with added balance challenges.

For example, TJQMBB focuses on eight forms, and as previously mentioned, these eight forms were adapted from the traditional 24 forms.

Instead of performing the form to find “center” (or where you feel stable), the eight forms require you to use your own body to “push” (which can be a simple lift of the heel or actually lifting your foot off of the floor) outside of your “center”.

It’s those challenges to our balance that I believe provide participants the ability to improve their overall balance, which leads to decreased fall risk.

It’s just like with anything we do- if we want to make gains, we have to challenge ourselves. If we lift the same weight at the gym for the whole year, we won’t get bigger muscles, we’ll just get better at lifting that same weight. The push provides the added challenge that requires our bodies to adapt.

How Does TJQMBB Challenge the Components of Balance?

In addition to the eight forms, there are what’s called “mini therapeutic exercises,” which are performed during the TJQMBB course as well.

Within these exercises, participants are gradually introduced to increasing the challenge of these moves as well.

*Remember that in order to increase the responsiveness of the systems, another system is sometimes “removed”.*

Challenges to balance components include the following:

*Movements with eyes closed (removing visual)

*Head Turning (challenging vestibular)

*Self-administered “push” (removing proprioceptive as part of or whole foot is off of the floor)

*Shifting and stepping in different directions (challenging visual/removing visual when one moves backwards)

* Stepping around a chair (challenging proprioceptive and removing visual when one moves backwards)

Why Does Dr. Katie Reccommend TJQMBB?

I’ve seen it work! This program is really incredible, and my clients reported amazing results! One participant no longer needed to use a walker after completing the course!

Also, I love how functional this program is!

For example, how many often do you move your head during the day?

You likely fell into one of two answer camps:

1. “I have no idea because I do it without thinking about it.”

2. “I don’t move my head because it hurts my back/neck/shoulder and/or makes me dizzy, so I just use my eyes.”

TJQMBB requires us all to move our heads with forms and with the mini therapeutic exercises, because we need to do that to be able to get around in the world safely!

We must turn our heads to drive, put something in the cabinet, turn when our grandchild calls our name, etc.

Unfortunately, many people either replied to the question with answer #2, or they don’t realize they haven’t really been using their full range of motion in their neck, and now it’s not moving as well. It’s a use it or lose it, and we definitely don’t want to lose it!

In addition to head movements, I love that TJMBB utilizes stepping in all directions.

Many of my clients repot not stepping backwards/avoiding any backwards stepping when they can. The problem with that is twofold:

1. Sometimes (like in a small bathroom stall) we can’t avoid backwards steps.

2. If we start falling bakcwards our brain is no longer trained to respond with a backwards step.

That can lead to us falling to the ground and possibly injuring ourselves. Practicing stepping and moving in all directions is vital to maintinaing safety and independence!

Lastly, it introduces cognitive challenges into the exercises.

It’s fine to stand on a foam mat and practice balancing on uneven surfaces, but that’s not very similar to what we do in real life.

TJQMBB has one do movements and head movements while walking across a room of moving people, and that’s real life! That’s being at Walmart on Saturday morning.

It’s the practice we need to be able to do in order to live our lives to the fullest!

How Can You Take a Class in TJQMBB?

Check your local rec center and/or senior center. Virtual classes are being performed by many instructors!

Check out this website for more information: betterbalance.net

Here is a link to the names and locations of instructors (mostly in Washington, CA, OR, and NV): https://www.betterbalance.net/class-locations

Here is a video I have of the 8 forms:

https://youtu.be/uNzRtQRz7Kc

**Please note, that while I personally and professionally believe these forms are benefical in improving balance, the studies are based on completing the 24-week program and no results can be assumed and/or guaranteed based on doing the 8 forms alone. **

Have the Strength the Live Life to the Fullest!

Sources:

  1. Guo, Y., Qiu, P., & Liu, T. (2014). Tai Ji Quan: An overview of its history, health benefits, and cultural value. Journal Of Sport And Health Science3(1), 3-8. doi: 10.1016/j.jshs.2013.10.004
  2. How our Vestibular System works and why this is important for learning. (2021). Retrieved 13 January 2021, from https://www.griffinot.com/vestibular-system/
  3. Allen, D., Ribeiro, L., Arshad, Q., & Seemungal, B. (2016). Age-Related Vestibular Loss: Current Understanding and Future Research Directions. Frontiers In Neurology7. doi: 10.3389/fneur.2016.00231
  4. Proprioception: What It Is, Problems, Diagnosis, Treatment & More. (2021). Retrieved 13 January 2021, from https://www.healthline.com/health/body/proprioception
  5. Ferlinc, A., Fabiani, E., Velnar, T., & Gradisnik, L. (2019). The Importance and Role of Proprioception in the Elderly: a Short Review. Materia Socio Medica31(3), 219. doi: 10.5455/msm.2019.31.219-221
  6. Davis, N. (2021). The Connection Between Vision & Balance. Retrieved 13 January 2021, from https://vestibular.org/article/diagnosis-treatment/vision-hearing/the-connection-between-vision-balance/
  7. Aging Eyes: Vision Changes & Common Problems. (2020). Retrieved 13 January 2021, from https://my.clevelandclinic.org/health/articles/8567-common-age-related-eye-problems
  8. Tai Ji Quan: Moving for Better Balance. Retrieved 13 January 2021, from https://tjqmbb.org/
  9. Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Akers, L., & Chou, L. et al. (2018). Effectiveness of a TherapeuticTai Ji QuanIntervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling. JAMA Internal Medicine178(10), 1301. doi: 10.1001/jamainternmed.2018.3915
  10. All images from canva.com

Author