Friday 10 February 2012

Tai Chi May Help Parkinson's Patients

Practicing the ancient art of Tai Chi twice a week helped Parkinson's patients improve their balance and walking ability, a new study shows.


"Tai Chi has been suggested for a while [for those with Parkinson's], but it's not been scientifically or clinically validated," said study author Fuzhong Li, a research scientist at the Oregon Research Institute in Eugene.

The new research is published in the Feb. 9 issue of the New England Journal of Medicine. The U.S. National Institute of Neurological Disorders and Stroke funded the study.

Li and his team compared the effects of Tai Chi with resistance training and stretching. They randomly assigned 195 patients with mild to moderate Parkinson's to one of the three groups. Every patient put in 60-minute sessions twice a week for 24 weeks.

Parkinson's disease, a neurodegenerative brain disorder, affects about 1 million people in the United States, according to the National Parkinson Foundation. It typically progresses slowly, but as it does the ability to control movement declines and symptoms such as tremors, muscle stiffness and instability appear. Physical activity is known to help slow this deterioration of motor function.

The researchers looked at changes in what is called postural stability, which is important to maintain balance. They also looked at how the patients walked and their physical strength.

"Tai Chi did better in comparison to resistance training and stretching in terms of improvement in balance and walking ability," Li said.

It was better than stretching and equal to resistance training at reducing the number of falls, Li found.
Tai Chi includes gentle physical exercise and stretching. The postures or movement are done in a slow, graceful way. During a session, the body stays in motion as one movement flows into the next.
Other studies looking at Tai Chi for Parkinson's have also found benefit; Li's team found the benefits were maintained three months later.

The study reveals some important benefits of Tai Chi for walking and balance difficulties, said Dr. Michael Okun, national medical director of the National Parkinson Foundation.

"Tai Chi incorporates movement forms that are focused on improving concentration, awareness of the environment, large stepping and enhanced balance control," he said. "Therefore, it would make sense that this type of tailored therapy could be better on balance measures when compared to resistance training or stretching."

"It is however important that people reading the study understand that resistance training and stretching are both also beneficial in Parkinson's disease, but the right therapy has to be chosen for the right patient," he added.

Previous Tai Chi studies, he said, "have not shown the same levels of benefit in PD and one wonders whether it was the outcome measure they chose [balance] or the way they delivered the therapy. In science, replication is very important and it will be critical for other groups to replicate these potentially important findings."

Li said that Parkinson patients wanting to try Tai Chi should ask their doctors to refer them to a physical therapist familiar with the exercise so the therapist can give them home exercises to do. That, or a class, would be better than simply getting a DVD and teaching yourself, he said, because the instruction allows the exercise to be tailored to the patient and their symptoms.

SOURCES:
Fuzhong Li, Ph.D., research scientist, Oregon Research Institute, Eugene; Michael S. Okun, M.D., national medical director, National Parkinson Foundation; Feb. 9, 2012 New England Journal of Medicine

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