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      A systematic review of the health benefits of Tai Chi for students in higher education

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          The poor health consequences of stress are well recognized, and students in higher education may be at particular risk. Tai Chi integrates physical exercise with mindfulness techniques and seems well suited to relieve stress and related conditions.


          We conducted a systematic review of the health benefits of Tai Chi for students in higher education reported in the English and Chinese literature, using an evidence hierarchy approach, allowing the inclusion of studies additional to randomized controlled trials.


          Sixty eight reports in Chinese and 8 in English were included — a combined study sample of 9263 participants. Eighty one health outcomes were extracted from reports, and assigned evidence scores according to the evidence hierarchy. Four primary and eight secondary outcomes were found. Tai Chi is likely to benefit participants by increasing flexibility, reducing symptoms of depression, decreasing anxiety, and improving interpersonal sensitivity (primary outcomes). Secondary outcomes include improved lung capacity, balance, 800/1000m run time, quality of sleep, symptoms of compulsion, somatization and phobia, and decreased hostility.


          Our results show Tai Chi yields psychological and physical benefits, and should be considered by higher education institutions as a possible means to promote the physical and psychological well-being of their students.


          • We reviewed the benefits of Tai Chi in 9263 tertiary students from 76 studies.
          • Tai Chi is likely to yield psychological and physical benefits for tertiary students.
          • Physical benefits include improved flexibility, lung capacity and balance.
          • Psychological benefits include reduced symptoms of depression and anxiety.
          • Education institutions should consider such benefits for the well-being of students.

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          Most cited references 44

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          Evidence based medicine: what it is and what it isn't.

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            Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

            To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted. The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development. Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.
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              Allostatic load biomarkers of chronic stress and impact on health and cognition.

              The allostatic load model expands the stress-disease literature by proposing a temporal cascade of multi-systemic physiological dysregulations that contribute to disease trajectories. By incorporating an allostatic load index representing neuroendocrine, immune, metabolic, and cardiovascular system functioning, numerous studies have demonstrated greater prediction of morbidity and mortality over and beyond traditional detection methods employed in biomedical practice. This article reviews theoretical and empirical work using the allostatic load model vis-à-vis the effects of chronic stress on physical and mental health. Specific risk and protective factors associated with increased allostatic load are elucidated and policies for promoting successful aging are proposed.

                Author and article information

                [a ]Centre for Medical and Health Sciences Education and Department of Anaesthesiology, University of Auckland, Private Bag 92-019, Auckland 1142, New Zealand
                [b ]Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
                [c ]Department of Psychology, Auckland University of Technology, Auckland, New Zealand
                [d ]Medical Programme Directorate, University of Auckland, Auckland, New Zealand
                Author notes
                [* ]Corresponding author. c.webster@
                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                23 December 2015
                June 2016
                23 December 2015
                : 3
                : 103-112
                26844196 4733099 S2211-3355(15)00178-3 10.1016/j.pmedr.2015.12.006
                © 2015 The Authors

                This is an open access article under the CC BY-NC-ND license (

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