Positive impact of Tai Chi Chuan participation on biopsychosocial quality of life compared to exercise and sedentary controls: a cross-sectional survey

Alex Baxter 1  and Andrew J. P. Francis 1
  • 1 RMIT University, Bundoora, 3083, Australia
Alex Baxter and Andrew J. P. Francis


Tai Chi Chuan (TCC) is a traditional Chinese medicine practice and martial art with biopsychosocial aspects. This study aimed to examine the impact of participation in TCC on multiple domains of Quality of Life (QoL) and to assess the involvement of the psychological factors of self-efficacy, Locus of Control (LoC) and Hope in these effects. A total of 68 participants from the general community (13 males and 55 females) aged between 18 and 68 (M=43.55 years) and not currently suffering from a mental or physical illness took part in the study. It was found that TCC participants, as a group, scored significantly better than those in sedentary (book club) and active (gym exercise) control conditions on Psychological and Physical QoL, and that the Physical QoL benefits of TCC continue to accrue with years of practice. The three psychological factors were shown to variously mediate (self-efficacy) and moderate (internal LoC and Hope) this latter relationship. Whilst the results bear limitations (in particular small sample sizes), it is hoped that these findings will encourage further research into TCC, and consideration of TCC as part of the range of treatment options available in community-based mental and physical health management.

  • 1.

    Alonso Y. The biopsychosocial model in medical research: the evolution of the health concept over the last two decades. Patient Educ Counsel 2004;53(2):239–44. doi: 10.1016/s0738–3991(03)00146–0

  • 2.

    Havelka M, Lucanin JD, Lucanin D. Biopsychosocial model-the integrated approach to health and disease. Coll Antropol 2009;33(1):303–10.

  • 3.

    Adler RH. Engel’s biopsychosocial model is still relevant today. J Psychosom Res 2009;67(6):607–11.

  • 4.

    Kirana PS, Rosen R, Hatzichristou D. Subjective well-being as a determinant of individuals’ responses to symptoms: a biopsychosocial perspective. Int J Clin Pract 2009;63(10):1435–45.

  • 5.

    Suls J, Rothman A. Evolution of the biopsychosocial model: Prospects and challenges for health psychology. Health Psychol 2004;23(2):119–25. doi: 10.1037/0278–6133.23.2.119

  • 6.

    Larkey LK, Jahnke R, Etnier J, Gonzalez J. Meditative movement as a category of exercise: Implications for research. J Phys Act Health 2009;6:230–8.

  • 7.

    Seaward BL. Managing stress. Principles and stratergies for health and wellbeing. Sudbury: Jones and Bartlett Publishers, LLC, 2009.

  • 8.

    Liao W. T’ai chi classics (W. Liao, Translator). Boston: Shambhala Publications, 2000.

  • 9.

    Wang WC, Zhang AL, Rasmussen B, Lin L, Dunning T, Kang SW, et al. The effect of tai chi on psychosocial well-being: A systematic review of randomized controlled trials. J Acupunct Meridian Stud 2009;2(3):171–81.

  • 10.

    Wang Y. Tai chi exercise and the improvement of mental and physical health among college students. In: Y. Hong, editor. Medicine and sport science, Vol. 52. Basel: Karger, 2008: 135–45.

  • 11.

    Li F, Harmer P, McAuley E, Fisher KJ, Duncan TE, Duncan SC. Tai chi, self-efficacy, and physical function in the elderly. Prev Sci 2001;2(4):229–39. doi: 10.1023/a:1013614200329

  • 12.

    Baron R.M, Kenny D.A. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Personal Soc Psychol 1986;51(6):1173–82.

  • 13.

    Zhang J.-G, Ishikawa-Takata K, Yamazaki H, Morita T, Ohta T. The effects of Tai Chi Chuan on physiological function and fear of falling in the less robust elderly: An intervention study for preventing falls. Arch Gerontol Geriatr 2006;42(2):107–16. doi: 10.1016/j.archger.2005.06.007

  • 14.

    Kuramoto AM. Therapeutic benefits of tai chi exercise: Rsearch review. Wis Med J 2006;105(7):42–6.

  • 15.

    Wong, AMK, lan C. Tai chi and balance control. In: Y. Hong, editor. Madicine and sport science, Vol. 52. Basel: Karger, 2008: 115–23.

  • 16.

    Yau M.K.S, Packer TL. Health and well-being through T’ai Chi: perceptions of older adults in Hong Kong. Leisure Stud 2002;21(2):163–78.

  • 17.

    Lee, L. Y. K., Lee, D. T. F., & Woo, J. (2007). Effect of Tai Chi onstate self-esteem and health-related quality of life in older Chinese residential care home residents. Journal of Clinical Nursing, 16(8), 1580–1582.

  • 18.

    Hui, SSC, Woo J, Kwok T. Evaluation of energy expenditure and cardiovascular health effects from tai chi and walking exercise. Hong Kong Med J 2009;2:4–7.

  • 19.

    Li XI, Hong Y, Chan KM. Tai chi: Physiological characteristics and beneficial effects on health. Br J Sports Med 2001;35(148–56).

  • 20.

    Lan C, Chen S.-Y, Lai J.-S. Changes of aerobic capacity, fat ratio and flexibility in older TCC practitioners: a five-year follow-up. Am J Chin Med 2008;36(6):1041–50.

  • 21.

    Dechamps A, Quintard B, Lafont L. Effets d’une intervention courte en tai-chi-chuan sur le sentiment d’efficacité, l’anxiété et les troubles émotionnels chez des étudiants ayant un style de vie sédentaire. Effects of a short-term tai-chi-chuan mind-body approach on self-efficacy, anxiety and mood among sedentary lifestyle students. Eur Rev Appl Psychol 2008; 58(2):125–32. doi: 10.1016/j.erap.2007.06.001

  • 22.

    Abbott RB, Hui KK, Hays RD, Li MD, Pan T. A randomized controlled trial of tai chi for tension headaches. Evid Based Complementary Altern Med 2007;4(1):107–13. doi: 10.1093/ecam/nel050

  • 23.

    Jin P. Changes in heart rate, noradrenaline, cortisol and mood during Tai Chi. J Psychosom Res 1989;33(2):197–206. doi: 10.1016/0022–3999(89)90047–0

  • 24.

    Jin P. Efficacy of tai chi, brisk walking, meditation, and reading in reducing mental and emotional stress. J Psychosom Res 1992;36(4):361–70. doi: 10.1016/0022–3999(92)90072-a

  • 25.

    Taylor-Piliae RE, Haskell WL, Waters CM, Froelicher ES. Change in perceived psychosocial status following a 12-week Tai Chi exercise programme. J Adv Nurs 2006;54(3):313–29. doi: 10.1111/j.1365–2648.2006.03809.x

  • 26.

    Yunfa L, Kanichi M, Lixin W, Komei I. Psychological and physiological effects of 24-Style taijiquan. Neuropsychobiology 2005;52(4):212.

  • 27.

    Wang C, Bannuru R, Ramel J, Kupelnick B, Scott T, Schmid CH. Tai chi on psychological well-being: Systematic review and meta-analysis. BMC Complement Altern Med 2010;10(23). doi: 10.1186/1472-6882-10-23

  • 28.

    Baron LJ, Faubert C. The role of Tai Chi Chuan in reducing state anxiety and enhancing mood of children with special needs. J Bodyw Mov Ther 2005;9(2):120–33. doi: 10.1016/j.jbmt.2004.03.004

  • 29.

    Gemmell C, Leathem JM. A study investigating the effects of Tai Chi Chuan: Individuals with traumatic brain injury compared to controls. Brain Inj 2006;20(2):151–6. doi: 10.1080/02699050500442998

  • 30.

    Klein PJ, Adams WD. Comprehensive therpeutic benifits of Taiji: A critical review. Am J Phys Med Rehabil 2004;83(9):735–45.

  • 31.

    Golden J, Conroy RM, Lawlor BA. Social support network structure in older people: Underlying dimensions and association with psychological and physical health. Psychol Health Med 2009;14(3):280–90. doi: 10.1080/13548500902730135

  • 32.

    Cornwell EY, Waite LJ. Social disconnectedness, perceived isolation, and health among older adults. J Health Soc Behav 2009;50(1):31–48.

  • 33.

    Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev 1977;84(2):191–215. doi: 10.1037/0033–295x.84.2.191

  • 34.

    Bandura A. Self-efficacy mechanism in human agency. Am Psychol 1982;37(2):122–47. doi: 10.1037/0003–066x.37.2.122

  • 35.

    Skinner EA. A guide to constructs of control. J Personal Soc Psychol 1996;71(3):549–70. doi: 10.1037/0022–3514.71.3.549

  • 36.

    Lightsey OR Jr, Burke M, Ervin A, Yee C, Henderson D. Generalized self-efficacy, self-esteem, and negative affect. Can J Behav Sci 2006;38(1):72–80. doi: 10.1037/h0087272

  • 37.

    Kreitler S, Peleg D, Ehrenfeld M. Stress, self-efficacy and quality of life in cancer patients. Psycho Oncol 2007;16(4):329–41.

  • 38.

    Levenson, HL. Differentiating among internality, powerful others, and chance. In: H. M. Lefcourt, Research with the locus of control construct (Vol. 1): assessment methods. New York: Academic Press, 1981:15–63.

  • 39.

    Armstrong M, Boothroyd R. Predictors of emotional well-being in at-risk adolescent girls: Developing preventative intervention stratergies. J Behav Health Serv Res 2008;25(4):435–53.

  • 40.

    Hasson-Ohayon I, Walsh S, Roe D, Kravetz S, Weiser M. Personal and interpersonal perceived control and the quality of life of persons with severe mental illness. J Nerv Ment Dis 2006;194(7):538–42. doi: 10.1097/01.nmd.0000225116.21403.34

  • 41.

    Ruhrmann S, Paruch J, Bechdolf A, Pukrop R, Wagner M, Berning J, et al. Reduced subjective quality of life in persons at risk for psychosis. Acta Psychiatr Scand 2008;117(5):357–68. doi: 10.1111/j.1600–0447.2008.01152.x

  • 42.

    Twenge JM, Zhang L, Im C. It’s beyond my control: A cross-temporal meta-analysis of increasing externality in locus of control, 1960–2002. Personal Soc Psychol Rev 2004;8(3):308–19. doi: 10.1207/s15327957pspr0803_5

  • 43.

    Ryan M, Francis A.J.P. Locus of control beliefs mediate the relationship between religious functioning and psychological health. J Relig Health. doi: 10.1007/s10943–010–9386-z

  • 44.

    Anthony WA. Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosoc Rehabil J 1993;16(4):11–23.

  • 45.

    Deegan P. Recovery: The lived experience of rehabilitation. Psychosoc Rehabil J 1988;11(4):11–19.

  • 46.

    Deegan P. Recovery as a journey of the heart. Psychiatric Rehabil J 1996;19(3):91–7.

  • 47.

    Snyder CR. Conceptualizing, measuring, and nurturing hope. J Counsel Develop 1995;73(3):355–60.

  • 48.

    Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon ST, et al. The will and the ways: Development and validation of an individual-differences measure of hope. J Personal Soc Psychol 1991;60(4):570–85. doi: 10.1037/0022–3514.60.4.570

  • 49.

    Landeen J, Pawlick J, Woodside H, Kirkpatrick H, Byrne C. Hope, quality of life, and symptom severity in individuals with schizophrenia. Psychiatric Rehabil J 2000;23(4):364–9.

  • 50.

    Hasson-Ohayon I, Kravetz S, Meir T, Rozencwaig S. Insight into severe mental illness, hope, and quality of life of persons with schizophrenia and schizoaffective disorders. Psychiatry Res 2009;167(3):231–8.

  • 51.

    Western H. Altered living: coping, hope and quality of life after stroke. Br J Nurs 2007;16(20):1266–70.

  • 52.

    Murphy B, Herrman H, Hawthorne G, Pinzone T, Evert H. Australian WHOQOL instruments: User’s manual and interpretation guide. Melbourne: Australian WHOQOL Field Study Centre, 2000.

  • 53.

    Skevington SM, Lotfy M, O’Connell KA. The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A Report from the WHOQOL Group. Qual Life Res 2004;13(2):299–310. doi: 10.1023/b:qure.0000018486.91360.00

  • 54.

    Schwarzer R, Jerusalem M. Generalized self-efficacy scale. In: J. Weinman S. Wright, M. Johnston, editors. Measures in health psychology: A user’s portfolio. Causal and control beliefs. Windsor: NFER-NELSON, 1995:35–7.

  • 55.

    Scholz U, Doña BG, Sud S, Schwarzer R. Is general self-efficacy a universal construct? Psychometric findings from 25 countries. Eur J Psychol Assess 2002;18(3):242–51. doi: 10.1027//1015–5759.18.3.242

  • 56.

    Walkey FH. Internal control, powerful others, and chance: A confirmation of levenson’s factor structure. J Personal Assess 1979;43(5):532–5.

  • 57.

    Brosschot JF, Gebhardt WA, Godaert, GLR. Internal, powerful others and chance locus of control: Relationships with personality, coping, stress, and health. Personal Individ Differ 1994;16(6):839–52. doi: 10.1016/0191–8869(94)90228–3

  • 58.

    Babyak MA, Snyder CR, Yoshinobu L. Psychometric properties of the hope scale: A confirmatory factor analysis. J Res Personal 1993;27(2):154–69. doi: 10.1006/jrpe.1993.1011

  • 59.

    Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Personal Assess 1988;52(1):30–41.

  • 60.

    Kazarian SS, McCabe SB. Dimensions of social support in the MSPSS: Factorial structure, reliability, and theoretical implications. J Commun Psychol 1991;19(2):150–60.

  • 61.

    SPSS Inc. PASW Statistics GradPack 18 [computer program]. USA: SPSS

  • 62.

    Brown DR, Wang Y, Ward A, Ebbeling CB, Fortlage L, Puleo E, et al. Chronic psychological effects of exercise and exercise plus cognitive strategies. Med Sci Sports Exerc 1995;27(5):765–75.

  • 63.

    Kerr CE, Shaw JR, Wasserman RH, Chen VW, Kanojia A, Bayer T, et al. Tactile acuity in experienced tai chi practitioners: Evidence for use dependent plasticity as an effect of sensory-attentional training. Experim Brain Res 2008;188(2):317–22. doi: 10.1007/s00221–008–1409–6.

  • 64.

    Posadzki P, Jacques S. Tai chi and meditation: A conceptual (re)synthesis? J Holist Nurs 2009;27(2):103–14.

  • 65.

    Rogers CE, Larkey LK, Keller C. A review of clinical trials of tai chi and qigong in older adults. West J Nurs Res 2009; 31(2):245–79.

  • 66.

    Sandlund ES, Norlander T. The effects of Tai Chi Chuan relaxation and exercise on stress responses and well-being: An overview of research. Int J Stress Manage 2000; 7(2):139–49.

  • 67.

    Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol 2006;62(3):373–86.

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The Journal of Complementary and Integrative Medicine focuses on evidence concerning the efficacy and safety of complementary and alternative medical (CAM) whole systems, practices, interventions and natural health products, including herbal medicines.