Health Studies
Recent Study Shows Tai Chi Is Safe And Effective At Managing Parkinsons Alongside Medication
Increasing evidence is being found that physiotherapy can benefit PD patients . Tai Chi is a balance-based exercise guided by the yin-yang theory of traditional Chinese medicine that combines deep-breath relaxation and slow and gentle movements with awareness. Tai Chi has been reported to reduce the incidence of falls in an elderly population, decrease blood pressure, improve lung and cardiac functions, alleviate menopausal osteoporosis, relieve psychological dysfunction, insomnia and low back pain, rehabilitate post-stroke syndromes, and slow the progression of rheumatic illness, and dementia. In light of these gains, Tai Chi shows potential to help both the motor dysfunction and non-motor complications of PD. However, the clinical benefit of Tai Chi in PD remains uncertain due to different study designs, small sample size and inconsistent methodological quality of the published clinical studies. Some trials even pose contradictory results for the same outcome.
To identity whether Tai Chi safely benefits PD patients, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) of Tai Chi for PD.
Our primary finding was that Tai Chi plus medication resulted in significantly greater benefit in terms of general motor symptoms, balance, mobility, and stride length, with few adverse events (AE). Rigidity is one of the main manifestations of PD, leading to impairments in postural stability, balance and gait performance, and these symptoms do not respond well to either first-line or sub-optimal medications. The movements of Tai Chi include weight shift, body rotation, slow strides and single-leg standing in different positions, requiring delicate joint control with muscle co-ordination; therefore Tai Chi possibly trains postural stability and balance. This suggests that the combination of Tai Chi and medications may be optimal for PD patients who are partially insensitive to the pharmacologic treatment alone, especially if they have poor mobility and balance.
Abstract:
Objectives:
The purpose of this review was to evaluate the efficacy and safety of Tai Chi for PD.
Design:
Randomized controlled trials (RCTs) of Tai Chi for PD were electronically searched by the end of December 2013 and identified by two independent reviewers. The tool from the Cochrane Handbook 5.1 was used to assess the risk of bias. A standard meta-analysis was performed using RevMan 5.2 software.
Results:
Ten trials with PD of mild-to-moderate severity were included in the review, and nine trials (n = 409) were included in the meta-analysis. The risk of bias was generally high in the blinding of participants and personnel. Improvements in the Unified Parkinson's Disease Rating Scale Part III (mean difference (MD) -4.34, 95% confidence interval (CI) -6.67--2.01), Berg Balance Scale (MD: 4.25, 95% CI: 2.83-5.66), functional reach test (MD: 3.89, 95% CI: 1.73-6.04), Timed Up and Go test (MD: -0.75, 95% CI: -1.30--0.21), stride length (standardized MD: 0.56, 95% CI: 0.03-1.09), health-related quality of life (standardized MD: -1.10, 95% CI: -1.81--0.39) and reduction of falls were greater after interventions with Tai Chi plus medication. Satisfaction and safety were high. Intervention with Tai Chi alone was more effective for only a few balance and mobility outcomes.
Conclusion:
Tai Chi performed with medication resulted in promising gains in mobility and balance, and it was safe and popular among PD patients at an early stage of the disease. This provides a new evidence for PD management. More RCTs with larger sample size that carefully address blinding and prudently select outcomes are needed. PROSPERO registration number CRD42013004989.
Link:
Ni, Xiaojia et al. “Efficacy and safety of Tai Chi for Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.” PloS one vol. 9,6 e99377. 13 Jun. 2014, doi:10.1371/journal.pone.0099377
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