Research
In a review of 26 published studies examining the effectiveness of tai chi for high blood pressure, 85 per cent showed a reduction in blood pressure. Yeh GY, Wang C, Wayne PM, et al. The effect of tai chi exercise on blood pressure: a systematic review. Prev Cardiol. 2008; 11:82-89.

Comment
Matthew Rochford Director, Tai Chi Nation

“During our instructor training courses, the project our students undertake specifically asks them to look at research, quoting sources. Over the years I’ve also been party to other forms of research first-hand. For example, one of my students was a nursing student. She measured the participants’ blood pressure before and after the class and demonstrated that practising tai chi reduced blood pressure. To a large extent this qualified what we already knew from our own experience and anecdotal evidence, from individuals who came to our classes.

“However, it’s also crucial not to get carried away by research and make claims that might give class participants false expectations.

“In 16 years of teaching tai chi, I’ve found that the participant’s experience – rather than their age or any research into specific conditions they might have – has more of an impact on the way I teach them. Tai chi has an ‘internal’ approach – over time, students begin to understand tai chi from the inside out.

“The issue is how you teach a beginner and how they develop at their own pace, and less about research. It’s important participants are informed about what’s being taught, but it isn’t the main thing.”

Research
A research report into the therapeutic effects of yoga for health and wellbeing, prepared at the School of Health and Related Research (ScHARR) at the University of Sheffield, UK, for the British Wheel of Yoga (2013).

For example, among patients with cardiovascular disease, positive results included improvements in blood pressure, pulse rate, fitness, stress, flexibility and blood serum markers. Positive trends were also found for girth, quality of life and BMI. The studies of diabetes and cardiovascular disease often reported proxy outcomes relating to risk factors for disease, such as weight loss and lipid profiles. This is usual for studies into these conditions. Results across studies were mixed, but often displayed at least positive trends towards yoga.

Comment 
Richard Adamo Chair of the training committee, British Wheel of Yoga

“Our teacher training course at the British Wheel of Yoga is very thorough. As part of it, we go into common ailments people suffer from and cover how to adapt classes to suit them, in terms of enabling people to be included in a mixed ability class. Also, we provide specialist postgraduate modules that focus on specific areas of the population.

“Having said that, everyone is an individual, so one person’s experience of being ill is not going to be the same as someone else’s. It may be that in the future, as an organisation, we look to develop more postgraduate modules, but there’s also nothing to stop an individual with special conditions going to an ordinary class. This is one of the wonderful things about yoga – it’s a form of ‘controllable’ exercise, with a key focus on participants observing their own feelings during the class, so it’s ideal for a deconditioned user.

“In my experience, research is important but it’s also crucial, as a teacher, to be aware of the individuals in your class and encourage them to flourish, whatever their age or ability.”

Research
Schleip, R, Jager, H, Klingler, W (2012), ‘What is ‘fascia’? A review of different nomenclatures’, Journal of Bodywork & Movement Therapies 16, p 496-502.

The article includes the terminology from the International Fascia Research Congress (2012), defining fascia as a “soft tissue component of the connective tissue system that permeates the human body” and the “fibrous collagenous tissues that are part of a body-wide tensional force transmission system”.

Comment 
Chris Onslow, MD, Mbodies, Training Academy

“In pilates today, we regularly see instructors who have been taught simple ‘self release’ techniques using rollers or balls focusing first on fascial release before commencing with the focus of an exercise.

“This technique can prepare the body for exercise, including among special population groups. For example, a fascial focus is prevalent in training by The UK MS Society, which is working with mind-body instructor and MS sufferer Mariska Breland. For the MS sufferer, myofascial pain is very common and linked to spasticity in muscles. For this population, short duration releases are recommended pre-exercise, with long duration releases combined with stretching for post-exercise sessions.

“There is, however, the ever-present dilemma of ‘what is the role of the medical therapist and what is the role of the fitness instructor?’ There’s no question that, to maximise the benefits of fascial release for special populations, a practitioner will need to be medically trained or highly specialised as a non-medical therapist. However, fitness professionals are more than capable of understanding, learning and developing very effective sessions using surface level tissue release.”

Comment
PJ O’Clair, Master instructor trainer, Merrithew Health & Fitness and owner of Northeast Pilates, US

“A fascially-inspired group exercise class might include instruction on alignment and posture, breathing exercises using balls and bands to explore the fascial recoil of the respiratory diaphragm, bouncy spring-like elastic jumps in varying directions, and SMR (self myofascial release) techniques with rollers or balls.

“My students love how they feel after the fascially-inspired segments. We ask them to reflect on how they feel after doing exercises on one side before moving on to the other, and they’re motivated by how much better they feel on the side they have worked.

“The protocols in training the fascial body are quite simple and do not require a lot of time, advanced skill or knowledge by the participant: anyone can do some level of fascial workout without risk of injury, and we should be able to reach new markets, especially the deconditioned and special populations. Physios and doctors, when educated about these new types of programmes, could send patients to fascially-inspired classes with confidence.

“But while there’s a lot of talk about training the fascia, education on how to do it properly is currently limited.”