Improve Physical Condition in Dialysis Patients with Tai Chi


By John M. de Castro, Ph.D.


“One of the best features of tai chi and qi gong is that they can be adapted to fit just about any fitness level. The gentle flowing low-impact movements are easy on your joints if you have arthritis. You can even do them seated or in a wheelchair if needed.” – Jodi Helmer


End-stage renal disease (ESRD) is a serious and all too common medical problem that results from a total and permanent failure of the kidneys. As a result, the body retains fluid and harmful wastes build up. Treatment, usually dialysis, is required to replace the work of the failed kidneys. Kidney dialysis uses a machine to filter harmful wastes, salt, and excess fluid from your blood. This restores the blood to a normal, healthy balance. Without dialysis or a kidney transplant the ESRD patient cannot survive It is estimated that ESRD occurs in more than 650,000 patients per year in the United States and is increasing by 5% per year. Those who live with ESRD are 1% of the U.S. Medicare population but account for 7% of the Medicare budget. Worldwide there are an estimated 2 million ESRD patients.


End-stage renal disease (ESRD) is frequently accompanied by a number of other serious diseases, such as cardiovascular disease and diabetes. Making matters worse is the fact that ESRD patients are most often sedentary. Moderate exercise, by improving cardiovascular performance and lowering insulin resistance, can be very helpful in preventing or coping with these comorbidities. But, great care must be used with exercise for the compromised ESRD patients.


Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It has been shown to have psychological and physical benefits particularly for the elderly. Because it is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for individuals with compromising conditions such as ESRD. So, it would seem that tai chi practice would be well suited as an exercise for dialysis patients.


In today’s Research News article “Evaluation of Exercise Tolerance in Dialysis Patients Performing Tai Chi Training: Preliminary Study.” See:

or see summary below or view the full text of the study at:

Dziubek and colleagues provided dialysis patients with tai chi training for 60 minutes, twice a week for 6-months. They were closely monitored during all sessions for blood pressure. Heart rate was also measured to insure it was maintained at 50% or less of the maximal heart rate appropriate for the patients age. At the beginning and end of training a 6-minute walk test was performed on a treadmill and a stress test for oxygen uptake was performed on an exercise bicycle.


They found that after tai chi training the patients walked significantly further and reported less fatigue on the 6-minute treadmill walk and lasted longer on the bicycle stress test with no differences in heart rate or blood pressure. Hence, tai chi training appeared to improve the physical condition of the patients. It should be noted that there wasn’t a comparison condition or control group. So, it is not known if the patients would have improved without training and if other forms of exercise might be superior. Further research is needed to clarify these issues. The results though show that tai chi training is a safe and effective exercise for ESRD patients on dialysis. This is important as the exercise is needed to help maintain the health of these compromised patients.


So, improve physical condition in dialysis patients with tai chi.


“Tai chi is often described as “meditation in motion,” but it might well be called “medicationin motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Harvard Health Blog


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+


Study Summary

Dziubek, W., Bulińska, K., Kusztal, M., Kowalska, J., Rogowski, Ł., Zembroń-Łacny, A., … Woźniewski, M. (2016). Evaluation of Exercise Tolerance in Dialysis Patients Performing Tai Chi Training: Preliminary Study. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 5672580.



Introduction. Patients with end-stage renal disease (ESRD) have poor physical performance and exercise capacity due to frequent dialysis treatments. Tai Chi exercises can be very useful in the area of rehabilitation of people with ESRD. Objectives. The aim of the study was to assess exercise capacity in ESRD patients participating in 6-month Tai Chi training.

Patients and Methods. Twenty dialysis patients from Wroclaw took part in the training; at the end of the project, 14 patients remained (age 69.2 ± 8.6 years). A 6-minute walk test (6MWT) and spiroergometry were performed at the beginning and after 6 months of training.

Results. After 6 months of Tai Chi, significant improvements were recorded in mean distance in the 6MWT (387.89 versus 436.36 m), rate of perceived exertion (7.4 versus 4.7), and spiroergometry (8.71 versus 10.08 min).

Conclusions. In the ESRD patients taking part in Tai Chi training, a definite improvement in exercise tolerance was recorded after the 6-month training. Tai Chi exercises conducted on days without dialysis can be an effective and interesting form of rehabilitation for patients, offering them a chance for a better quality of life and fewer falls and hospitalisations that are the result of it.


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