The New England Journal of Medicine: Tai Chi Helps Parkinson's Disease Patients
February 26, 2012 -
Research Institute (ORI) exercise study conducted in four Oregon cities has
shown significant benefits for patients with mild-to-moderate Parkinson's
disease. In an original article published in the February 9, 2012 issue of the
England Journal of Medicine (NEJM), ORI scientist Fuzhong Li, Ph.D.
and colleagues report that a tailored program of twice-weekly Tai Chi training
resulted in improved postural stability and walking ability, and reduced falls
in the participants.
"These results are clinically significant because they suggest that Tai Chi, a
low-to-moderate impact exercise, may be used, as an add-on to current physical
therapies, to address some of the key clinical problems in Parkinson's disease,
such as postural and gait instability. Since many training features in the
program are functionally oriented, the improvements in the balance and gait
measures that we demonstrated highlight the potential of Tai Chi-based movements
in rehabilitating patients with these types of problems and, consequently,
easing cardinal symptoms of Parkinson's disease and improving mobility,
flexibility, balance, and range of motion," noted Dr. Li.
In the 4-year project funded by the National Institute of Neurological Disorders
and Stroke, the investigators randomly assigned 195 patients to one of three
exercise groups: Tai Chi, resistance training, or stretching. The patients
participated in 60-minute exercise sessions twice weekly for 24 weeks.The
results of the study showed that the Tai Chi group performed consistently better
than the stretching group in how far they could lean in any direction without
losing balance as well as demonstrating better levels of directional control of
the body and walking ability (i.e., longer stride length). Tai Chi participants
also outperformed those in the resistance training group on the balance and
stride length measures. Finally, Tai Chi training was shown to significantly
lower the incidence of falls compared to stretching and to be as equally
effective as resistance training in reducing falls.
Impaired movement, especially the loss of ability to maintain standing balance,
adversely affects function and quality of life in patients with Parkinson's
disease. With progression of the disease, patients lose stability and have
trouble walking, difficulty managing activities of daily living, and experience
frequent falls. Exercise is an important part of the management of Parkinson's
disease because physical activity has been shown to retard the deterioration of
motor function and to prolong functional independence. However, research on
alternative forms of exercise, such as Tai Chi, that could improve balance,
gait, and function in patients with Parkinson's disease is scarce.
The Tai Chi program developed by Dr. Li consisted of six Tai Chi movements
integrated into an eight-form routine that focused on weight-shifting,
controlled-displacement of the center of gravity over the base of support, ankle
sway, and front-to-back and sideways stepping. Natural breathing was integrated
into the training routine.
"There are a number of practical advantages to using Tai Chi to improve motor
dysfunction of Parkinson's disease - it is a low cost activity that does not
require equipment, it can be done anywhere, at any time, and the movements can
be easily learned. It can also be incorporated into a rehabilitation setting as
part of existing treatment. Similarly, because of its simplicity, certain
aspects of this Tai Chi program can also be prescribed to patients as a
self-care/home activity," Dr. Li added.
This research was funded by a grant from the National Institute of Neurological
Disorders and Stroke, National Institutes of Health (grant NS047130).
Founded in 1960, Oregon Research Institute is a non-profit behavioral research
center with offices in Eugene & Portland, Oregon, and in Albuquerque, New Mexico.