Health Studies
Tai Chi and Postural Stability in Patients with Parkinson's Disease
Exercise is an integral part of the management of Parkinson's disease because physical activity has been shown to retard the deterioration of motor functions and to prolong functional independence. Resistance-based exercises that address deficits in balance and strength have shown positive effects. However, they require safety monitoring and are equipment-dependent. Research on alternative forms of exercise that could improve balance, gait, and function in patients with Parkinson's disease is scarce.
Tai chi, a balance-based exercise, has been shown to improve strength, balance, and physical function and to prevent falls in older adults. Two pilot studies suggest that it may also improve axial symptoms of Parkinson's disease, such as postural stability.
Abstract:
Methods:
Li Fuzhong conducted a randomized, controlled trial to determine whether a tailored tai chi program could improve postural control in patients with idiopathic Parkinson's disease.
Participants:
There were 195 patients with stage 1 to 4 disease on the Hoehn and Yahr staging scale (which ranges from 1 to 5, with higher stages indicating more severe disease).
Interventions:
The patients were randomly assigned to one of three groups: tai chi, resistance training, or stretching. The patients participated in 60-minute exercise sessions twice weekly for 24 weeks.
Main Outcome Measures:
The primary outcomes were changes from baseline in the limits-of-stability test (maximum excursion and directional control; range, 0 to 100%).
Secondary outcomes included measures of gait and strength, scores on functional-reach and timed up-and-go tests, motor scores on the Unified Parkinson's Disease Rating Scale, and number of falls.
Results:
The tai chi group performed consistently better than the resistance-training and stretching groups in maximum excursion (between-group difference in the change from baseline, 5.55 percentage points; 95% confidence interval [CI], 1.12 to 9.97; and 11.98 percentage points; 95% CI, 7.21 to 16.74, respectively) and in directional control (10.45 percentage points; 95% CI, 3.89 to 17.00; and 11.38 percentage points; 95% CI, 5.50 to 17.27, respectively). The tai chi group also performed better than the stretching group in all secondary outcomes and outperformed the resistance-training group in stride length and functional reach. Tai chi lowered the incidence of falls as compared with stretching but not as compared with resistance training. The effects of tai chi training were maintained at 3 months after the intervention. No serious adverse events were observed.
Conclusion:
Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson's disease, with additional benefits of improved functional capacity and reduced falls
Link:
Li, Fuzhong et al. “Tai chi and postural stability in patients with Parkinson's disease.” The New England journal of medicine vol. 366,6 (2012): 511-9. doi:10.1056/NEJMoa1107911
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So what does this mean for me?
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