The Effects of Tai Chi on Bone Mineral Density in Postmenopausal Women: A Systematic Review Peter M. Wayne, PhD, Douglas P. Kiel, David E. Krebs, PhD, Roger B. Davis, ScD, Jacqueline Savetsky-German, MPH, MAOM, Maureen Connelly, MD, Julie E. Buring, ScD
ABSTRACT. Wayne PM, Kiel DP, Krebs DE, Davis RB,
2007 by the American Congress of Rehabilitation Medi-
Savetsky-German J, Connelly M, Buring JE. The effects of Tai
cine and the American Academy of Physical Medicine and
Chi on bone mineral density in postmenopausal women: a sys-
tematic review. Arch Phys Med Rehabil 2007;88:673-80. Objective: To evaluate the evidence for Tai Chi as an inter-
vention to reduce rate of bone loss in postmenopausal women. THE 2004 SURGEON GENERAL’S highlights that
among U.S. women, osteoporosis and osteopenia—2 con-
Data Sources: Literature search using Medline, Science
ditions characterized by lower than average bone mineral den-
Citation Index, Cochrane databases, China Biological Medi-
sity (BMD)—are a serious and growing public health issue. In
cine Database, and additional manual reference searches of
2002, the number of osteoporotic and osteopenic women over
retrieved articles and personal libraries.
the age of 50 in the United States was estimated at 44 million. Study Selection: Randomized controlled trials (RCTs), pro-
Because of baby-boomer driven anticipated changes in demo-
spective cohort studies, and cross-sectional studies that in-
graphics, this number is expected to increase substantially in
cluded Tai Chi as an intervention, and had at least 1 outcome
Tai Chi (also referred to as Tai Chi Chuan, Taijiquan) is a
related to measurement of bone mineral density (BMD).
meditative, mind-body exercise that is growing in popularity in
Data Extraction: Authors critically reviewed studies, eval-
the United States. Over the past century, millions of Chinese
uated methodologic quality, and synthesized study results in a
have practiced Tai Chi’s flowing, meditative movements to
cultivate and maintain health and well-being. Because of its
Data Synthesis: Six controlled studies were identified by
reputed health benefits, apparent safety, low cost, and growing
our search. There were 2 RCTs, 2 nonrandomized prospective
popularity, Tai Chi has become an increasingly recognized
parallel cohort studies, and 2 cross-sectional studies. The 2
preventive and rehabilitative therapeutic tool by the conven-
RCTs and 1 of the prospective cohort studies suggested that Tai
tional medical community. Recent studies have begun to ad-
Chi-naive women who participated in Tai Chi training exhib-
dress the safety and efficacy of Tai Chi as a therapeutic inter-
ited reduced rates of postmenopausal declines in BMD. Cross-
vention for a variety of health concerns including: balance and
sectional studies suggested that long-term Tai Chi practitioners
had higher BMD than age-matched sedentary controls, and had
slower rates of postmenopausal BMD decline. No adverse
spiratory fitness and functional multiple
effects related to Tai Chi were reported in any trial. Conclusions: Conclusions on the impact of Tai Chi on BMD
are limited by the quantity and quality of research to date. This
limited evidence suggests Tai Chi may be an effective, safe,
review have recently been published. The 2004
and practical intervention for maintaining BMD in postmeno-
Surgeon General’s report on osteoporosis specifically recom-
pausal women. In combination with research that indicates Tai
mends Tai Chi as a good exercise for fall and Tai
Chi can positively impact other risk factors associated with low
Chi is increasingly recommended to osteoporotic women as a safe
BMD (eg, reduced fall frequency, increased musculoskeletal
and effective exercise for bone density maintenance. Although
strength), further methodologically sound research is warranted
the fundamental principles of Tai Chi and some clinical re-
to better evaluate the impact of Tai Chi practice on BMD and
search suggest that it may help to maintain bone density in
fracture risk in postmenopausal women.
postmenopausal women, to date there have been few attempts
Key Words: Bone mineral density; Exercise; Osteopenia;
to systematically evaluate the evidence for this claim.
Osteoporosis; Rehabilitation; Tai Chi.
This review examines the use of Tai Chi as a potential inter-
vention for postmenopausal women with low BMD. We begin byhighlighting the growing prevalence and public health impact ofosteoporosis and osteopenia, and the current standard of care forthese conditions. We then review the fundamental principles of
From the New England School of Acupuncture, Watertown, MA (Wayne,
Tai Chi that may make it beneficial for women with low BMD,
Savetsky-German); Institute for Aging Research, Hebrew SeniorLife, Boston, MA(Kiel); MGH Institute of Health Professions, Massachusetts General Hospital, Boston,
and critically review clinical studies that have evaluated the im-
MA (Krebs); and Osher Institute, Harvard Medical School, Boston, MA (Wayne,
pact of Tai Chi on BMD. We also summarize research on the
impact of Tai Chi on other risk factors associated with osteopo-
Supported by the National Center for Complementary and Alternative Medicine
rosis and osteopenia. Last, we offer suggestions for future research
(grant no. 5 U19 AT002022-02 and 7 R21 AT003503-02).
No commercial party having a direct financial interest in the results of the research
that will improve our ability to evaluate the benefits of Tai Chi for
supporting this article has or will confer a benefit upon the author(s) or upon any
both prevention and treatment of low BMD.
organization with which the author(s) is/are associated.
Reprint requests to Peter M. Wayne, PhD, Harvard Medical School Osher Institute,
Low BMD: Definitions and Prevalence
401 Park Dr, Ste 22A, Boston, MA 02215, e-mail: [email protected].
Osteoporosis is a skeletal disorder characterized by compro-
0003-9993/07/8805-11004$32.00/0doi:10.1016/j.apmr.2007.02.012
mised bone strength that predisposes one to an increased risk of
Arch Phys Med Rehabil Vol 88, May 2007 TAI CHI AND BONE MINERAL DENSITY, Wayne
fracture. Bone strength primarily reflects the integration of
Tai Chi and Its Rationale as a Treatment for Women
bone density and bone quality. Because bone density can be
With Low BMD
easily measured, people are often classified as having osteopo-
Tai Chi has its roots in the martial arts; yet for the past
rosis or osteopenia based on the value of their BMD. Osteo-
century millions of Chinese have practiced its flowing, medi-
porosis is technically defined by the World Health Organiza-
tative movements to cultivate and maintain health. Considered
tion as a BMD T score of less than Ϫ2.5 (ie, 2.5 standard
one of the treasures of Chinese medicine, Tai Chi is based on
deviations [SDs] below a healthy, young white adult refer-
the same basic principles that underlie acupuncture and Chi-
whereas osteopenia is often used to characterize BMD
nese herbal therapies. It employs detailed regimens of physical
T scores between Ϫ1.0 and Ϫ2.5. Because bone tends to be
movement, breathing techniques, and cognitive tools (both
lost with aging, untreated osteopenic women are at risk of
visualization and focused internal awareness) to strengthen the
body, calm the mind, and “balance the flow of Qi” (life
BMD is a strong risk factor for future bone fractures in asymp-
A number of characteristics of Tai Chi practice that might
tomatic postmenopausal It is estimated that 4 in 10
make it an effective therapy for maintaining bone density and
white women 50 years or older in the United States will
improving postural control have been explored in recent re-
experience a hip, spine, or wrist fracture sometime during the
These intended characteristics and their pur-
remainder of their Models based on meta-analyses indi-
ported effects include: (1) a constant shifting of weight from 1
cate a doubling of relative risk for fracture with each SD
leg to the other, which facilitates improved lower-extremitystrength and/or mechanical load and dynamic standing balance;
decline in A recent prospective of more than
(2) an emphasis on maintaining a vertical posture with an
200,000 women over the age of 50 reported that relative to
extended head and trunk position, which promotes a less flexed
those with normative BMD, women with osteopenia and os-
posture; (3) the use of different parts of the body taking turns
teoporosis had 1.8-fold and 4.0-fold increases in fracture rates,
playing the role of stabilizer and mover, which enables move-
respectively. Although the relative risk of fracture was higher
ments to be executed smoothly without compromising balance
in osteoporotic women, because of the far greater number of
and stability; (4) a continuous, slow, even tempo that facilitates
osteopenic women (40% vs 7%), the absolute numbers of
sensory awareness of the speed, force, trajectory, and execution
fractures were much higher among osteopenic women, making
of movements, as well as awareness of the external environ-
osteopenia a potentially more widespread public health
ment; (5) the symmetrical and diagonal arm movements of Tai
Chi, which promote arm swing in gait and increase trunk
Fractures associated with low bone density are a significant
rotation around the waist; (6) moderate knee flexion, which
cause of The downward spiral in health after
lowers the body’s center of gravity; and (7) flowing circular
osteoporosis-related hip fractures is associated with up to 20%
and spiraling movements, which promote joint flexibility. Al-
higher mortality rates in the year after a Recent
though we are not aware of any studies that have been explic-
from Sweden have shown increased mortality after
itly designed to examine Tai Chi’s impact on mechanical load
spine fractures as well as hip fractures. Medical costs associ-
and BMD in postmenopausal women, a handful of studies have
ated with managing hip and other fractures are high, and were
shown that Tai Chi improves lower-extremity biomechanic
estimated to be $13.8 billion in the United States in 1995,
efficiency during activities of daily Such changes
are likely to translate into increased mechanical load on key
Despite the high prevalence of osteoporosis and osteopenia,
regions of the skeleton including the femur, hip, and lowerspine.
and the substantial burden on the health care system, onlylimited progress has been made in developing effective, pre-
ventive, and sustainable interventions aimed at reducing ratesof fractures associated with low BMD. For example, recent
Clinical Trials Examining Tai Chi’s Effect on BMD in
suggest that although calcium with vitamin D sup-plementation in relatively healthy women without known os-
Postmenopausal Women
teoporosis may result in modest improvement in hip bone
To systematically review the evidence evaluating Tai Chi for
density, it does not reduce the risk of hip fractures, and it may
reducing rates of postmenopausal BMD loss, we conducted a
increase the risk of kidney stones. Pharmacologic treatment to
literature search using Medline, Science Citation Index, and
“prevent” further bone loss and fractures in women with os-
Cochrane Database of Randomized Controlled Trials. Search
teopenia has been shown not to be a cost-effective strategy
strategies for each of these databases included using the fol-
lowing statements and key words: Tai Chi or Tai Chi Chuan orTaijiquan and bone or osteoporosis or menopause, and in-
Current guidelines for the treatment of osteoporotic and
cluded the period 1966 through April 2006. We also conducted
osteopenic women generally include the recommendation of
a separate literature search using China Biological Medicine
regular There is currently no consensus regarding
Database for Chinese-language randomized trials using the key
the optimal types and regimens of exercise for treating low
words Taijiquan, bone, and osteoporosis. Finally, we manually
BMD, however, or for addressing other risk factors associated
searched the bibliographies of retrieved articles and our per-
with osteoporosis and osteopenia (eg, poor balance, decreased
sonal libraries for additional relevant citations.
muscle strength, diminished agility). Moreover, among post-
Because only a small number of the studies we retrieved
menopausal women, compliance with conventional exercise
were randomized controlled trials (RCTs), and because RCTs
regimens is often low, due to health factors that may limit
employing Tai Chi interventions are not amenable to double-
certain types of exercise, lack of motivation, and inability to
blinding, we chose not to use a more traditional instrument (eg,
sustain long-term interest, among other The 2004
Jadad to evaluate study methodologic quality. Rather,
Surgeon General’s on osteoporosis stresses the need for
study quality was descriptively characterized with respect to
new, creative, sustainable exercise programs for women at risk
reporting of the following criteria: randomization (yes or no);
details of randomization methods; clear inclusion and exclu-
Arch Phys Med Rehabil Vol 88, May 2007 TAI CHI AND BONE MINERAL DENSITY, Wayne Table 1: Quality of Design and Methodologic Features of Studies Evaluating Tai Chi for Low BMD
Abbreviation: NA, not applicable. Legend: ͌, design and methodology feature adequately reported; Ϫ, design and methodology feature not adequately reported.
sion criteria; blinding of outcomes assessors; description of
ferences between Tai Chi and age-matched sedentary con-
withdrawal and dropouts; sample size estimates and justifica-
trols were observed in an earlier study conducted by the
tion; use of appropriate statistical analyses; details of Tai Chi
same research group in a similar This earlier
intervention (eg, style, training schedule); and experience of Tai
study also tracked changes in BMD over a 12-month period
and found that rates of both trabecular and cortical BMD
Our database searches of Medline, Science Citation Index,
loss in the distal tibia (assessed using peripheral quantitative
and Cochrane identified a total of 191 citations. Titles and
computerized tomography [pQCT]) were approximately
abstracts of these citations were manually reviewed and con-
50% lower in the Tai Chi group (Pϭ.044, Pϭ.031). The Tai
sidered eligible only if they described a prospective or cross-
Chi group also exhibited a nonsignificant trend toward lower
sectional study that employed Tai Chi as an intervention, and
BMD loss in the femur (measured with DXA). Another
had at least 1 outcome related to measurement of BMD. A total
cross-sectional study also reported greater spine and femur
of 9 citations met these criteria. Six of these 9 citations were
BMD among long-term female Tai Chi practitioners (nϭ18)
limited to abstracts of proceedings from scientific meetings andwere thus excluded; the remaining 3 were included in this
when compared with age- and sex-matched controls (nϭ22)
review. Two additional eligible citations were identified using
the China Biological Medicine Database for Chinese-language
Second, Tai Chi-naive women who undergo Tai Chi train-
randomized trials, and 1 was identified in the personal library
ing exhibit reduced rates of postmenopausal BMD decline.
One methodologically sound RCT of postmenopausal
The 6 eligible studies identified by our search are summa-
women observed that those randomized to 12 months of
regular Tai Chi training (nϭ67) exhibited 3.6-fold (trabec-
prospective parallel cohort and 2 were static cross-
ular) to 2.3-fold (cortical) reductions in rates of BMD de-
sectional Tai Chi practitioners were com-
cline in the distal tibia as measured with pQCT (PϽ.005), as
pared with age-matched sedentary controls in 5
compared with a no-exercise control group (nϭ65). No
1 compared Tai Chi with rope skipping and vigorous martial
significant differences between groups were reported for
and 1 compared Tai Chi with acupuncture and Chinese
BMD of the spine or femur as measured with A
herbal The duration of the Tai Chi intervention in
second, less methodologically sound observed that
the 3 prospective studies with naive practitioners ranged from
DXA measures of BMD at the lumbar spine significantly
8 to 12 months. Five of the 6 studies were conducted in China
increased (1.81%) after 10 months of Tai Chi whereas
sedentary controls decreased (1.83%). Another intervention
The methodologic quality of most studies was poor, as
arm in this study—Tai Chi pushing hands (a 2-person inter-
summarized in Of the 2 RCTs, only 1 provided ade-
active exercise that involves a continuous issuing and re-
quate details of randomization methods, inclusion and exclu-
ceiving of gentle pushes)— exhibited even greater increases
sion criteria, dropout rates, and justification for sample sizes.
in lumbar BMD (3.4%). This study also reported significant
None of the 6 studies indicated that outcome assessors wereblinded, none included any information on the experience of
BMD increases of the same magnitude in the distal ulna and
Tai Chi instructors, and for all the non-RCT studies, dropout
radius. Finally, another methodologically weak, nonrandom-
rates, sample size justifications, and characteristics of the Tai
ized study reported that 4 months of Tai Chi training re-
Chi intervention were poorly described.
sulted in a 7.3% increase in bone density (skeletal location
Results across the 6 studies summarized in suggest
not indicated) as measured with broadband ultrasound at-
the following: First, long-term postmenopausal Tai Chi
tenuation This study also reported that serum
practitioners have higher BMD than age-matched sedentary
osteocalcin, a biomarker for bone formation, increased sig-
controls, and have slower rates of bone loss. In 1 cross-
nificantly in the Tai Chi group. No BMD or osteocalcin data
sectional study of postmenopausal women, Qin et aused
for the control group were provided.
dual-energy x-ray absorptiometry (DXA) to compare BMD
Third, 1 nonrandomized cross-over provided quali-
of 48 long-term Tai Chi practitioners with 51 age-matched
tative data suggesting that Tai Chi improves perimenopausal
sedentary controls. Subjects in the Tai Chi group had sig-
symptoms including hot flashes and abdominal distention.
nificantly higher BMD in the lumbar spine (7.1%), the
Finally, Tai Chi appears to be safe for peri- and postmeno-
greater trochanter (7.2%), and Ward’s area (7.1%) of the
pausal women. No significant adverse effects were reported in
proximal femur (PϽ.05). Similar magnitudes of BMD dif-
Arch Phys Med Rehabil Vol 88, May 2007 Table 2: Summary of Studies Evaluating Impact of Tai Chi on BMD in Peri- and Postmenopausal Women DENSITY,
quad strength and balancein Tai Chi vs control
Abbreviation: TCM, traditional Chinese medicine. TAI CHI AND BONE MINERAL DENSITY, Wayne DISCUSSION
being able to quantify true volumetric density as well as par-tition the 2 types of bone, trabecular and cortical, which may
Limitations of Reviewed Studies Evaluating Tai Chi’s
respond differently to exercise. Moreover, it has the potential to
Impact on BMD
have higher In the study by Chan et themagnitude of both cortical and trabecular BMD loss in the tibia
Although the 6 studies summarized in suggest Tai
decreased by approximately 1% in response to Tai Chi. In
Chi may improve BMD of postmenopausal women, these re-
contrast, a recent conventional exercise study that employed
sults should be considered inconclusive and interpreted with
QCT to monitor BMD dynamics observed that a 2-year inter-
vention combining high- and low-impact training exhibited
First, the majority of these studies have design and method-
markedly greater impact on cortical versus trabecular BMD of
ologic limitations. Only 2 of the 6 studies were randomized
the spine (Ϸ3 % vs 1%, Again, direct compar-
trials. Although cross-sectional studies enable investigations of
ison between studies is limited by the different locations that
long-term effects of Tai Chi, absence of randomization and
BMD was assessed. Nevertheless, because cortical and trabec-
longitudinal monitoring introduces great potential for bias.
ular BMD are known to contribute differently to the mechan-
Sample sizes across all studies were small, with an average of
ical strength of bone, future Tai Chi studies should consider
31 participants in Tai Chi and control groups. Additionally,
using QCT to better understand the impact of this weight-
information on Tai Chi interventions, eligibility criteria, blind-
bearing exercise on bone morphology and quality, and the
ing methods, and qualification of instructors were not available
relationship between BMD compartmentalization and fracture
or poorly described (see Finally, because of both the
risk. Even though cost is greater and radiation dosage is higher
diversity of approaches used to characterize BMD (ie, DXA,
with QCT (radiation dosage is comparable to the background
pQCT, BUA) and the diversity of skeletal sites at which BMD
radiation dose obtained over the course of a year), it is justi-
was assessed, comparisons and synthesis across studies is dif-
fiable to use this technology when testing new therapies be-
ficult. Moreover, some of the specific methods used to charac-
cause it is essential to understand how potential improvements
terize BMD, such as BUA, are known to have very low
precision; the 1 study employing BUA that reported a 7.3%increase in bone density after only 4 months of Tai Chi most
Tai Chi May Also Impact Other Risk Factors Associated
likely reflects a measurement artifact.
Second, the studies in include women with a range of
With Low BMD
baseline BMD scores, ranging from normative to severely
Independent of changes in BMD, Tai Chi may be of benefit to
osteoporotic. Results of conventional exercise studies suggest
women with low bone density because of its positive effect on
that the responsiveness of BMD to exercise may vary with
postural balance and fall risk. Systematic which
developmental stage and degree of BMD loss
include numerous randomized trials, suggest that Tai Chi practice
This makes it difficult to evaluate the potential benefits of Tai
can directly reduce risk of and/or positively impact factors
Chi for women that differ in their magnitude of fracture risk
associated with postural control including fear of
(eg, normative BMD vs osteopenic vs osteoporotic).
Third, all but 1 of the 6 studies in were conducted in
China and included only Asian women. It is well established
daily Drawing on these data, a cost-benefit analysis
that the prevalence of osteopenia and osteoporosis, and patterns
concluded that Tai Chi could significantly reduce costs asso-
of postmenopausal BMD loss vary in a predictable manner
ciated with fall-related hip Noteworthy across these
with respect to race and ethnicity—for example, African Amer-
studies is that the majority have focused on older people,
icans have the lowest, Hispanics intermediate, and whites and
including and adults, and as in the trials
Asians the highest prevalence of Consequently,
reviewed above, few adverse effects have been reported. This
results of these studies are of only limited use in predicting the
suggests that the findings are relevant to postmenopausal
responses of racially diverse populations of women.
women, and that Tai Chi can be safely practiced well into laterstages of life. The Impact of Tai Chi Versus Conventional Exercise on
Only 1 of the studies included in this systematic review
BMD in Postmenopausal Women
reported data on fracture rates. During their 12-month prospec-tive RCT, observed 1 fracture in the Tai Chi group
The results of the most methodologically credible RCT we
compared with 3 in the control group. Because this study was
reviewed suggests that 12 months of Tai Chi training for Tai
not designed and powered to compare fracture rates, and be-
Chi-naive practitioners resulted in a clinically and statistically
cause so few fractures were observed, this data should not be
significant reduction in the magnitude of tibial BMD loss of
overinterpreted. Surprisingly, none of the cross-sectional Tai
approximately 1.0%, as measured with QCT. The magnitude of
Chi studies we reviewed included information on prevalence of
this retardation in bone loss is similar to that reported in a
falls or fractures. Future long-term prospective and cross-
meta-analysis characterizing the effects of walking exercise on
sectional studies evaluating Tai Chi for bone health should also
reductions in rate of BMD loss in postmenopausal women’s
include data on prevalence of fractures.
BMD (1.31% and 0.92% retardation in bone loss for hip andspine, respectively, assessed using This comparison,however, must be made cautiously, because BMD estimates
CONCLUSIONS
were made at different anatomic sites and using different
Conclusions on the efficacy of Tai Chi for reducing rates of
instrumentation. Moreover, it is difficult to measure “exercise
BMD loss in postmenopausal women are limited by the small
dosage” across varied types of exercise and studies. Because no
number and generally low quality of studies to date. Acknowl-
studies have directly compared Tai Chi with walking, there is
edging these limitations, the totality of the available evidence
no exact comparability in terms of exercise, intensity, and
suggests Tai Chi may be an effective, safe, and practical
intervention for maintaining BMD is postmenopausal women.
The use of QCT to assess BMD in Tai Chi studies is
One methodologically sound prospective RCT suggests Tai
In contrast to DXA, QCT has the advantage of
Chi reduces rates of tibial BMD loss, 2 sound cross-sectional
Arch Phys Med Rehabil Vol 88, May 2007 TAI CHI AND BONE MINERAL DENSITY, Wayne
studies suggest long-term Tai Chi practitioners have higher
9. McGibbon C, Krebs D, Wolf S, Wayne P, Scarborough D, Parker
lumbar and femur BMD than age-matched sedentary controls.
S. Tai Chi and vestibular rehabilitation effects on gaze and whole-
Other sound research summarized above indicates that Tai Chi
body stability. J Vestib Res 2004;14:467-78.
can be of benefit to women with low BMD by improving
10. McGibbon C, Krebs D, Parker S, Scarborough D, Wayne P, Wolf
balance, reducing fall frequency, and increasing musculoskel-
S. Tai Chi and vestibular rehabilitation improve vestibulopathic
etal strength. Finally, Tai Chi has been shown to be very safe
gait via different neuromuscular mechanisms: preliminary report.
in aging, frail, and deconditioned does not
require equipment, and is relatively inexpensive to adminis-
11. Wayne P, Scarborough D, Krebs D, et al. Tai Chi for vestibulo-
As such, Tai Chi may be a logical and practical response
pathic balance dysfunction: a case study. Altern Ther Health Med
to the Surgeon General’s recent call for novel exercise pro-
12. Lan C, Lai J, Chen S, Wong M. Tai Chi Chuan to improve
Further research is warranted to better characterize the po-
muscular strength and endurance in elderly individuals: a pilot
tential of Tai Chi, both as a therapy for women with low BMD
study. Arch Phys Med Rehabil 2000;81:601-7.
and as a preventive intervention for women at risk for osteo-
13. Lan C, Lai J, Wong M. Cardiorespiratory function, flexibility, and
porosis. This research should include appropriately powered
body composition among geriatric Tai Chi Chuan practitioners.
randomized trials that include women representing a variety of
Arch Phys Med Rehabil 1996;77:612-6.
races and ethnicities. This research should also explore the use
14. Lan C, Lai J, Wong M. 12-month Tai Chi training in the elderly:
of alternatives to DXA for the measure of BMD, including
its effect on health fitness. Med Sci Sports Exerc 1998;30:345-51.
QCT, as has been suggested by the Surgeon Long-
15. Wu G. Evaluation of the effectiveness of Tai Chi for improving
term prospective studies and cross-sectional studies should also
balance and preventing falls in the older population—a review.
include data on incidence of fractures. Combining the use of
sensitive markers of BMD dynamics with objective measures
16. Channer K, Barrow D, Barrow R, Osborne M, Ives G. Changes in
of Tai Chi’s impact on biomechanic (eg, mechanical load at
haemodynamic parameters following Tai Chi Chuan and aerobic
specific skeletal sites), physiologic, and psychosocial outcomes
exercise in patients recovering from acute myocardial infarction.
could provide important insight into the mechanisms by which
Tai Chi impacts bone health. Finally, because low BMD is not
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a condition limited to future trials specifically eval-
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18. Young D, Appel L, Lee S. The effects of aerobic exercise and T’ai
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UNIVERSIDAD AUTÓNOMA DE QUERÉTARO FACULTAD DE FILOSOFÍA COORDINACIÓN DE EDUCACIÓN CONTINUA Convocan al CURSO "CÓMO PENSAR EN TIEMPOS DE CRISIS" HORAS TOTALES: 50 hrs INICIO DE ACTIVIDADES: 13 DE ABRIL DE 2013 HORAS POR SESIÓN: 5 hrs. SESIONES POR SEMANA: 1 NÚMERO DE SEMANAS: 10 (Termina JUNIO 2013) HORARIO DE LAS SESIONES: SÁBADOS 9:00 A 14:00 hrs. DIRI
Bianco - Nero Vademecum per vivere al meglio l’esperienza Cos’è il Kenya? Lingua: Kiswahili, inglese e altre 42 lingue etniche Presidenti: Kenyatta, Moi e Kibaki (dal 2001) Mortalità infantile (primo anno di vita): 77 bambini morti su 1.000 nati Mortalità infantile (primi cinque anni di vita): 120 bambini morti su 1.000 nati Debito estero pro-capite: 205 €