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Strong push for Tai Chi

The positive qualities of the age-old Chinese exercise routine have been recognised by Australian health authorities who are now considering adopting it. By Flynn Murphy

It’s half-past seven on a frozen December morning in Beijing. Inside the Dongwangzhuang residential complex in the city’s north-west, urban professionals in thick tailored coats hurry to work, slipping occasionally on sleet, while the older residents help local law enforcement to clear the roads of snow.

They rake and sweep it into thick piles, sprinkling salt and uncooked rice on the ground for traction.

The temperature in Beijing has remained below freezing for four consecutive days, a 14-year record for the period. The snow is 30cm deep in some places. But within the hour, the urban park at the centre of the complex is bustling with the very same older residents as they prepare for their morning exercises.

Lu Zhongsi, 72, is leading the group through a series of tai chi forms.

“It’s great for your health,” he tells Aged Care Insite during a break. “Here’s the secret: if you walk for exercise, it’s better to walk quickly. Walking slowly won’t have any real benefit. But with Tai chi, it’s the opposite: the slower you do it, the more effective it is.”

Lu slows his movements down to half speed, maintaining an impressive fluidity of motion as he sweeps his hands through the air and pivots on the spot. “That’s how you do it right. It builds strength and improves your constitution, but you need to practise every day.”

Lu says he has done tai chi here for two hours every morning since he retired, 12 years ago.

Xu Jinmei has been doing the same since 2004. “In that whole time, I’ve never had a cold,” she says as she sweeps her foot slowly through the snow.

The stories continue; of not getting sick or falling over, of improved mobility, reversed arthritis and diminished pain – all attributed to the regular practice of tai chi. And the regularity is all too clear as they practice their forms in the Beijing snow.

They might be right. A large amount of scientific studies has demonstrated the positive benefits of tai chi for older people. It has been shown to decrease stress, improve balance, posture, and confidence in movement. Significantly, it increases muscle strength in the lower body, which it is believed increases mobility and reduces the risk of falling.

Scientific research

The scientific community is divided though. A 2010 meta-study found there was still insufficient evidence to conclude whether the practice was of benefit to the elderly. There were simply too many variables. But in Australia, state and federal health departments have explored tai chi as a public health option, and certain forms are endorsed officially by Arthritis Australia for sufferers of the chronic disease.

A trial published in 2006 by the NSW Health Department found that just one class a week for 16 weeks could significantly reduce the risk of older people falling. In the report, the department acknowledged the massive strain that falls place on the nation’s aged care industry, and the scope of resources devoted to managing their consequences.

Falls are a major cause of injury-related hospital stays for the elderly, and it is estimated that by 2051, NSW alone will require 440,000 public hospital bed days per year to treat them, at a cost of more than $640 million to the health system (more than three times the current cost). Of course, while many falls do not require hospital treatment, they still impact on the resources of aged care facilities.

Personally, a fall can have a deep impact on an older person’s confidence in their movement, which can reduce their quality of life by leading them to exclude themselves from social and physical activities.

The health department report predicted that tai chi, “promoted at a population level”, would have a significant impact on mobility in the elderly, and recommended it as an effective and sustainable public health intervention.

China is far ahead. Most city-dwellers live in residential compounds just like Dongwangzhuang, and almost all of these have a designated urban space such as a park or a square where older people gather each morning to exercise and socialise.

But like Australia, China is struggling to prepare for an aging population. In 2010 the People’s Republic had 110 million people over 65, and the number is expected to eclipse 200 million by the year 2030.

The nation is already facing a shortage of residential facilities and nursing services for elderly people. Better healthcare and lower mortality rates – as well as the care imbalance created by the one-child policy – will create profound issues for Chinese governance in the future, and squeeze the country’s vital manufacturing sector.

Chinese exercise forms like tai chi and its politically-loaded cousin Qigong (various forms of which are banned in the mainland following a series of co-ordinated protests against the central government throughout the 1990s) claim lineages dating back thousands of years. But their histories are fractured, and they have been incorporated into various martial arts, meditative practices for Buddhists and Daoists, self-cultivation rituals for Confucians, and so on.

“Certainly there are very early forms of what people would call gymnastics which rely on qi [or energy],” explains Nancy Chen, a professor of anthropology at the University of California, Santa Cruz.

“But there’s also a more recent history linked to contemporary masters in the 20th century. As scholars we always talk about how tradition is invented.” Chen did her field work in Beijing in the 1990s. She has studied the way older people in China exercise and believes the effects of morning exercises stretch far beyond the physical.

Social engagement

“For older people in China there is much more social engagement. The parks are a unique space where older people with more leisure time tend to socialise. They have a long history. They are not commercialised; you might find vendors or souvenir shops selling items at the bigger parks, but for the most part there is a sense that you go there just for down time.

“There are all sorts of age groups present … but throughout the country, they are really, predominantly for the elderly, in the early mornings, so that they can get together for communal social time. We don’t really have those types of spaces in the US and other parts of the world.”

In other words, regular morning exercises don’t just improve the physical health of China’s older people, they improve their mental well-being. Perhaps that is one reason why China’s older people tend to remain in their homes well into old age.

“It’s a very easy way to engage in self-care and self-cultivation, which promotes mental health – rather than having it prescribed to you in the form of a pill or medication, or having exercise prescribed officially by a physician. It’s something people participate in willingly because they have found a good friend group that they see on a daily basis,” says Chen.

So when it comes to China’s ageing population, does the stereotype that people in China have a greater sense of filial piety than those in the West hold water? Well Chinese adults are legally mandated to care for their parents in old age, and failing to do so can, and does, result in litigation. But an increasing number of people in China are failing in this responsibility, whether out of neglect or genuine inability to do so.

Increasingly, stories circulate online and in the Chinese media naming and shaming individuals who have failed to take care of their older relatives, or who have cut them off. The one child policy means many families only have one shot at care. But despite this, there is a growing trend away from bolstering the independence of elderly parents, and towards the institutionalisation of the elderly.

Chen says there is certainly an ethos in China of providing for one’s elderly relatives: “It’s there in the familial sense but in the state institutional sense as well. Those two are tied, and there’s a huge demographic concern about trying to make sure the elderly are cared for.

“In the US, you need to pay to visit a private gym. But in most Chinese urban parks and residential compounds there are free work-out units specifically for the elderly. Very simple and utilitarian joggers, and so on.”

The Chinese state organises its urban spaces to provide low-cost maintenance for elderly people. The exercise units include bars for stretching, simple jogging machines and exercise bikes, and even weighted equipment.

“I think it’s a really excellent, simple but profound solution on how to encourage an ageing and elderly population to exercise. If they’re not going to go to the park, the park is going to go to them. If it’s too difficult to ride the bus or make a commute, they will still have exercise equipment available to them to take advantage of.”

At the back of the Dongwangzhuang park, Lu greets Chen Yujia, who is stretching his hamstrings on a horizontal bar installed next to a jogging machine. The migrant farmer from Guangdong province in China’s south looks to be the youngest person in the park. He is 60, and he says he jogs two kilometres a day.

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