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Disclosures There are no conflicts of interest or relevant financial
interests that have been disclosed by these presenters or the rest of the planners and presenters that apply to this learning session.
Dr. Yang and Dr. Krieger will not discuss off-label and/or investigational use in this presentation.
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Traditional taiji & qigong:
a simple but profound path
to daily tranquility, happiness,
vitality and better sleep
Yang Yang, Ph.D.
Center for Taiji and Qigong Studies, New York, NY
Integrative Medicine Service, Memorial Sloan Kettering Cancer Center &
Ana C. Krieger, MD, MPH
Director, Center for Sleep Medicine – Weill Cornell Medical College
NewYork-Presbyterian Hospital, New York, NY
Integrative Healthcare Symposium
February 26, 2016
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Goals
Science
Tradition
Take home
Sleep: Active or Passive?
Sleep Physiology
REM
Sleep
Functions of Sleep
o Restoration
o Rejuvenation
o Enhances learning
o Memory
o Problem solving
o Reaction time
o Regulates mood
o Immune function
Synchronized to day/night
Self-sustained oscillations
• Connected to the brain – melatonin release
Connected to the body by peripheral oscillators
Sleep Pacemaker Cells
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Integration of Cycles
Lancet 1997,2007
Effects of Jet Lag
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Fatigue
Physical
Mental
Irritability
Headaches
Fragmented sleep
Decreased appetite
Gastrointestinal problems
Circadian Rhythm of Sleep
Day 1 Day 2
Time of day (hr)
0 6 12 18 24 6 12 18 24
Sleep
Causes of Sleep Loss
o Schedule
o Worries - ? About sleep
o Leisure – Use of Electronic Devices
o Effect on MELATONIN
Clock Change and Sleep Loss
Average 10% slowing in Reaction Time after DST
Effect lasted for several days
Medina D, Ebben M, Milrad S, Atkinson B, Krieger AC. J Clin Sleep Med 2015; 11:879-44.
Sleep Duration –
Past 50 Years in the U.S.
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5
6
7
8
9
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1960 1970 1980 1990 2000 2011
National Sleep Foundation
Home and Office Computers
Handheld Devices
hours
✜
70 million
adults
14 Van Dongen, 2003
PVT lapses
Cognitive Effect of Short Sleep
Consequences of SD
CNS changes in cognitive functions
speech, memory and complex verbal arithmetic (Kim, 2001)
Increased resting BP (Kato, 2000)
Increased IL-6 levels (Vgontas, 2002)
Bacterial translocation (Everson, 2000)
Falleti, 2004
National Sleep Foundation, 2013
Lack of Sleep and
Stress Response
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“The Ultimate Home Office”
Food and Sleep
Alcohol
Caffeine
Nicotine
Chocolate
Oatmeal
Cherries
Banana
Milk
Behavioral Strategies
Timed light exposure
Regular schedule
Nighttime rituals
Improve Physical and Mental Health
Optimize overall health
Stress/Stimuli reduction
Adequate nutrition
Relaxation/Meditation
Approaches for a Better Sleep
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Sleep Benefits of TaiJi
Du S, Dong J, Zhang H, Jin S, Xu G, Liu X, Chen L, Yin H and Sun Z. Taichi
exercise for self-rated sleep quality in older people: A systematic review and
meta-analysis. Int J Nurs Studies 2014; 52(1):366-79.
Therapy
a personal story #1
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Martial Art Champion
in early 80s
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“you are not in the circle yet…”
The Older, The Stronger
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What Is Taiji/Qigong?
Multidimensional
Multimodal
“Multi”:
Combined benefit of
Meditation & Moderate Exercise
Tranquility and Happiness
A doorman’s story
Nothing is personal
Before/after marriage; Eyes open/close.
Superior/small man focuses on good/bad.
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Meditation Research
Emotional Mind Body
Stress Focus/attention Pain resilience
Depression Information processing Heart disease
Anxiety Decision making Stroke
Mood/depression Memory recall Immunity
Emotional intelligence Creativity Anti-inflammatory
Psychological well-being Increases grey matter Blood pressure
A partial list of positive effects:
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Exercise Research
Lowered Risk Mind Body
Cardiovascular disease Depression Weight control
Type II diabetes Anxiety Bone/muscle strengthening
Metabolic syndrome Mood Daily tasks
Some cancers Brain plasticity Anti-inflammatory
Premature mortality
“Everybody knows that . . .”
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Antibody Response
to Flu Vaccine
0 5 10 15 20 25
0.5
1.5
2.5
3.5
4.5
CON
TQ
*
TQ Intervention
*
Time Post-Vaccination (wk)
Geometric Mean Anti-Influenza
Antibody Titer (
+99.2% CI)
Yang, Y., Mariani, R. A., Reed, M., Rosengren, K. S., and Woods, J.A. Effects of
taiji and qigong on the antibody response to influenza vaccine in the elderly. Am J
Chin Med, 2007: 35(4): 597-607.
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UIUC Research
Strength & Force Control
Lower body (knee extensor) strength &
force control improved concurrently
Christou E. A., Yang Y., & Rosengren K. S. Taiji training improves knee extensor strength and force control in older adults. J Gerontol A Biol Sci Med Sci . 2003: 58: M763–M766.
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Ability to Utilize
Vestibular Information
Yang, Y., Verkuilen, J., Grubisich, S., et al. Strategic and sensory mechanisms for
improved balance afforded by combined Qigong and Taiji training for older
adults: a randomized controlled trial. Med Sci Monit, 2007: 13(8): CR339–348.
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Taiji & Pain:
Fibromyalgia
Wang C, et al. A randomized trial of tai chi for fibromyalgia.
N Engl J Med 2010; 363: 743-754.
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Exercise Intensity
“No Pain, More Gain . . .”
immunosuppression 1-3
higher mortality (v. moderate) 4-5
injury
High intensity exercise associated with:
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Spiritual: see reality
Mental: interact w/ reality
Physical: cultivate vitality
Integrative Approach
“Balance” => mind & energy
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Stronger, Happier
& Wiser
Tranquility
Happiness
Cognition
Cardiovascular
Immune function
Sleep
Balance
Internal power
Vitality
Agility
Posture
Sexual function
Maximizing Human Potential:
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Training Components
Static
Dynamic
Push-hands (two-person)
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Static:
Standing Meditation
Sleep
Economy of movement
Posture
Santi Foot Position
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Left
(front)
~ 30o
~ 3o
Tranquility and Happiness
A physician’s story
Before full, stop eating; before hitting
fatigue, stop working
Fortune/Disaster: Dao De Jing #58
Purpose of life
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Static:
Sitting Meditation
See daily reality
Interact w/ reality
Functional Meditation:
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Static:
Sitting Meditation
Yin/Yang: difference and transformation
Everyone is seeking their best interest
Nothing is personal
Meaning of life
Awareness of daily reality:
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Static:
Sitting Meditation
Gratitude
Everyone is my teacher
No expectation
Moderation/Wu Wei
Principles for interacting w/ reality:
Kindness/Golden Rule
Big Heart
Righteousness
Resilience
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Static:
Lying-Down Meditation
Sleep
Pain prevention
Alignment
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Dynamic:
Moving Qigong
Grand opening and closing
Washing organs
Golden Rooster Shaking its Wings
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Dynamic:
Agility
Core strength
Elongation
10 Years Younger
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Dynamic:
Form
Concentration
Balance
Cognition
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Holistic
药补不如食补,食补不如气补,气补不如神补o
Yào bŭ bù rú shí bŭ, shí bŭ bù rú qì bŭ, qì bŭ bù rú shén bŭ.
To improve your health,
medicine is not as good as food/nutrition;
food/nutrition is not as good as qi(gong);
qi(gong) is not as good as spiritual nourishment.
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Suggested Routine
5 -5 -5 -5 -5
anytime
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Trial Design
Curriculum
Intervention or interventionist?
“One word from a knowledgeable
teacher can save ten years of hard work”
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TQdos=
[Tc + f(Tcurr, Tm, X) + g(∑iDi, ∑jSj ψ, Ppos, Pmbs, Pphi)
+ h(Ik, Iped) + k(Satt, Smot, Seng, Sund)]
[(Tc + TSP) + m(Cdes, Iapt, Sapt)] =
= Quantity + Quality
Trial Design:
Dosage
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References
1. Spence L, Brown WJ, Pyne DB, et al. Incidence, etiology, and symptomatology of upper respiratory illness in elite
athletes. Med Sci Sports Exerc. 2007;39(4):577–86.
2. Murphy EA, Davis JM, Carmichael MD, Gangemi JD, Ghaffar A, Mayer EP. Exercise stress increases
susceptibility to influenza infection. Brain Behav Immun. 2008 Nov;22(8):1152-5. doi:
10.1016/j.bbi.2008.06.004. Epub 2008 Jun 21.
3. Martin SA, Brandt DP, Woods JA. Exercise and Respiratory Tract Viral Infections. Exerc Sport Sci Rev. 2009 Oct;
37(4): 157–164. doi: 10.1097/JES.0b013e3181b7b57b
4. Lowder T, Padgett DA, Woods JA. Moderate exercise protects mice from death due to influenza virus. Brain
Behav Immun. 2005;19(5):377–80.
5. Schnohr P, O’Keefe J, Marott J, Lange P, Jensen G. Dose of jogging and long-term mortality: the Copenhagen
city heart study. J Am Coll Cardiol. 2015;65(5):411-419. doi:10.1016/j.jacc.2014.11.023
6. Yang Y, Mariani,RA,, Reed , Rosengren KS, Woods JA. Effects of taiji and qigong on the antibody response to
influenza vaccine in the elderly. Am J Chin Med, 2007: 35(4): 597-607.
7. Christou E A, Yang Y, Rosengren KS. Taiji training improves knee extensor strength and force control in older
adults. J Gerontol A Biol Sci Med Sci . 2003: 58: M763–M766.
8. Yang Y, Verkuilen J, Grubisich S, et al. Strategic and sensory mechanisms for improved balance afforded by
combined Qigong and Taiji training for older adults: a randomized controlled trial. Med Sci Monit, 2007: 13(8):
CR339–348.
9. Wang C, Schmid C, Kalish R. et al. A randomized trial of tai chi for fibromyalgia. N Engl J Med 2010; 363: 743-
754.
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Take Home
Agility
Moving Qigong
Standing Meditation
Sitting Meditation
Lying Down Meditation
Fun
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Contact Information
Center for Taiji and Qigong Studies
New York, NY
phone: 646-717-2838
www.centerfortaiji.com
yang@centerfortaiji.com
Integrative Medicine Service at Memorial Sloan-
Kettering Cancer Center
yyang2@mskcc.org
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Thank You
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