Falls

Reduce Falls in the Elderly with Tai Chi Practice

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Reduce Falls in the Elderly with Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“Seniors who practice tai chi – a Chinese meditation practice that combines deep breathing and slow, fluid movements – may be less likely to fall than their peers who don’t do this type of exercise.” – Lisa Rapaport

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the frequency of falls in the elderly. It is not known, however, if Tai Chi training is better or worse than other exercises for reducing falls in the elderly.

 

In today’s Research News article “Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233748/ ), Harmer and colleagues recruited  health elderly individuals, 70 years of age or older, who had fallen at least once in the last year and randomly assigned them to one of three groups, Tai Chi, stretching exercise, or multimodal exercise including aerobic exercise, balance, flexibility, and strength exercises. All groups practiced twice a week for 1 hour for 24 weeks. The participants were measured before, in the middle, at the end of training, and monthly follow-up telephone calls for falls, fall injuries, physical performance, and cognitive function.

 

They found that during the 12 weeks of training and 6-month follow-up period that the group that practiced Tai Chi had significantly fewer falls and fewer falls that caused moderate or serious injuries than the multimodal exercise group which, in turn, had fewer falls and injuries than the stretching group. In addition, at the end of training the participants in the Tai Chi group and the multimodal exercise group had significantly greater improvements in cognitive and physical performance than the stretching group.

 

The results are interesting and important. They suggest that engaging in Tai Chi exercise reduces falls and improves physical and cognitive performance in the elderly and that Tai Chi exercise is superior to multimodal exercise and stretching in reducing falls. This is important because of the comparisons of types of exercise showed a significant superiority for Tai Chi Exercise. They are also important because of the severity of the consequences of falling for longevity, health, and well-being of the elderly. As an additional bonus Tai Chi exercise appears to reduce the cognitive decline that routinely occurs with aging.

 

It is important to recognize that Tai Chi is a gentle and safe exercise that is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, such as stroke recovery. Also, Tai Chi is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an almost ideal gentle exercise to prevent falls in the elderly and improve their physical and cognitive health and well-being.

 

So, reduce falls in the elderly with Tai Chi practice.

 

“Balance training based on the Chinese martial arts discipline tai ji quan — better known as tai chi — reduced falling risks among the elderly more than conventional forms of exercise.” – Ashley Lyles

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Akers, L., Chou, L. S., Pidgeon, D., Voit, J., … Winters-Stone, K. (2018). Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial. JAMA internal medicine, 178(10), 1301-1310.

 

Key Points

Question

Is a fall prevention–specific tai ji quan intervention clinically more effective in reducing falls among older adults at high risk of falling than a stretching intervention (control) or a standard multimodal exercise intervention?

Findings

In a randomized clinical trial involving 670 adults 70 years or older with a history of falls or impaired mobility, the therapeutic tai ji quan intervention effectively reduced falls by 58% compared with the stretching exercise (control intervention) and by 31% compared with a multimodal exercise intervention.

Meaning

For older adults at high risk of falling, a therapeutically tailored tai ji quan intervention was more effective than stretching or multimodal exercises in reducing the incidence of falls.

Question

Is a fall prevention–specific tai ji quan intervention clinically more effective in reducing falls among older adults at high risk of falling than a stretching intervention (control) or a standard multimodal exercise intervention?

Findings

In a randomized clinical trial involving 670 adults 70 years or older with a history of falls or impaired mobility, the therapeutic tai ji quan intervention effectively reduced falls by 58% compared with the stretching exercise (control intervention) and by 31% compared with a multimodal exercise intervention.

Meaning

For older adults at high risk of falling, a therapeutically tailored tai ji quan intervention was more effective than stretching or multimodal exercises in reducing the incidence of falls.

Question

Is a fall prevention–specific tai ji quan intervention clinically more effective in reducing falls among older adults at high risk of falling than a stretching intervention (control) or a standard multimodal exercise intervention?

Findings

In a randomized clinical trial involving 670 adults 70 years or older with a history of falls or impaired mobility, the therapeutic tai ji quan intervention effectively reduced falls by 58% compared with the stretching exercise (control intervention) and by 31% compared with a multimodal exercise intervention.

Meaning

For older adults at high risk of falling, a therapeutically tailored tai ji quan intervention was more effective than stretching or multimodal exercises in reducing the incidence of falls.

 

Abstract

Importance

Falls in older adults are a serious public health problem associated with irreversible health consequences and responsible for a substantial economic burden on health care systems. However, identifying optimal choices from among evidence-based fall prevention interventions is challenging as few comparative data for effectiveness are available.

Objective

To determine the effectiveness of a therapeutically tailored tai ji quan intervention, Tai Ji Quan: Moving for Better Balance (TJQMBB), developed on the classic concept of tai ji (also known as tai chi), and a multimodal exercise (MME) program relative to stretching exercise in reducing falls among older adults at high risk of falling.

Design, Setting, and Participants

A single-blind, 3-arm, parallel design, randomized clinical trial (February 20, 2015, to January 30, 2018), in 7 urban and suburban cities in Oregon. From 1147 community-dwelling adults 70 years or older screened for eligibility, 670 who had fallen in the preceding year or had impaired mobility consented and were enrolled. All analyses used intention-to-treat assignment.

Interventions

One of 3 exercise interventions: two 60-minute classes weekly for 24 weeks of TJQMBB, entailing modified forms and therapeutic movement exercises; MME, integrating balance, aerobics, strength, and flexibility activities; or stretching exercises.

Main Outcomes and Measures

The primary measure at 6 months was incidence of falls.

Results

Among 670 participants randomized, mean (SD) age was 77.7 (5.6) years, 436 (65%) were women, 617 (92.1%) were white, 31 (4.6%) were African American. During the trial, there were 152 falls (85 individuals) in the TJQMBB group, 218 (112 individuals) in the MME group, and 363 (127 individuals) in the stretching exercise group. At 6 months, the incidence rate ratio (IRR) was significantly lower in the TJQMBB (IRR, 0.42; 95% CI, 0.31-0.56; P < .001) and MME groups (IRR, 0.60; 95% CI, 0.45-0.80; P = .001) compared with the stretching group. Falls were reduced by 31% for the TJQMBB group compared with the MME group (IRR, 0.69; 95% CI, 0.52-0.94; P = .01).

Conclusions and Relevance

Among community-dwelling older adults at high risk for falls, a therapeutically tailored tai ji quan balance training intervention was more effective than conventional exercise approaches for reducing the incidence of falls.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233748/Importance

 

Improve Balance in Stroke Victims with Tai Chi Practice

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Improve Balance in Stroke Victims with Tai Chi Practice

 

By John M. de Castro, Ph.D.

 

“Stroke can impair balance, heightening the risk of a debilitating fall. But  . . .  stroke survivors can improve their balance by practicing the Chinese martial art of tai chi.” – ScienceDaily

 

Every year, more than 795,000 people in the United States have a stroke and it is the third leading cause of death, killing around 140,000 Americans each year. A stroke results from an interruption of the blood supply to the brain, depriving it of needed oxygen and nutrients. This can result in the death of brain cells and depending on the extent of the damage produce profound loss of function. Even after recovery from stroke patients can experience residual symptoms. Problems with balance and falling are very common.

 

There are a number of risk factors for stroke that are unchangeable, such as family history, age, and genes. But there are a very large number of factors that are under our control including high blood pressure, smoking, high cholesterol, poor diet, sedentariness, and obesity. Given this list it is clear that basic physical fitness and exercise would be excellent for stroke prevention. Yoga practice is an exercise that can be adapted to the needs and limitations of stroke victims. The ancient mindful movement technique Tai Chi and Qigong are very safe forms of gentle exercise that appears to be beneficial for stroke victims including improving balance. It is difficult to get stroke survivors to engage in exercise. Perhaps the practice of Tai Chi , since it is adaptable, very gentle, and fun, might be acceptable and effective in the treatment of stroke survivors.

 

In today’s Research News article “Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289026/ ), Wu and colleagues review summarize and perform a meta-analysis of the published research literature on the effectiveness of Tai Chi in improving balance and preventing falls in stroke survivors. They identified 6 randomized controlled trials for inclusion in the analysis.

 

They found that the published research reported that after Tai Chi practice the stroke victims demonstrated significantly better balance and walking ability and fewer falls than stroke victims who performed physical therapy or other exercises. Hence, the published research supports the conclusion that Tai Chi practice is a safe and effective exercise for stroke victims to improve balance and decrease the likelihood of falls.

 

Tai Chi is a gentle and safe exercise that is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, such as stroke recovery. Also, Tai Chi is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an almost ideal gentle exercise to improve motor ability and balance and reduce falls in stroke victims.

 

So, improve balance in strike victims with tai chi practice.

 

“Stroke survivors are particularly at risk from falls, with evidence suggesting they suffer up to seven times as many falls per year than healthy adults. Tai Chi, an ancient Chinese martial art, could help prevent falls by improving people’s balance, muscle strength and endurance as well as providing psychological benefits.“ – Ruth Taylor-Piliae

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wu, S., Chen, J., Wang, S., Jiang, M., Wang, X., & Wen, Y. (2018). Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis. Medical science monitor basic research, 24, 210-215. doi:10.12659/MSMBR.911951

 

Abstract

Background

Tai Chi is an ancient form of physical activity that has been shown to improve cardiovascular function, but to date there had been no comprehensive systematic review on the effect of Tai Chi exercise on balance function of patients with stroke. This study evaluated the effect of Tai Chi exercise on balance function in stroke patients.

Material/Methods

PubMed, Cochrane library, and China National Knowledge Information databases and the Wan Fang medical network were searched to collect the articles. The random-effects model was used to assess the effect of Tai Chi exercise on balance function of stroke patients.

Results

Six studies were chosen to perform the meta-analysis according to the inclusion and exclusion criteria. There were significant improvements of balance on Berg Balance Scale score (MD=4.823, 95% CI: 2.138–7.508), the standing balance with fall rates (RR=0.300, 95%CI: 0.120–0.770), functional reach test and dynamic gait index in Tai Chi intervention group compared to the control intervention group. However, the short physical performance battery for balance (SPBB) showed Tai Chi did not significantly improve the ability of balance for stroke patients (MD=0.293, 95%CI: −0.099~0.685).

Conclusions

Tai Chi exercise might have a significant impact in improving balance efficiency by increasing BBS score and reducing fall rate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289026/

 

Reduce Fear of Falling in the Elderly with Yoga

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Reduce Fear of Falling in the Elderly with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga makes you have a strong core, so when moving around in your daily life, you are not just flapping around. You are stable, in control.” – Anne Bachner

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly. Yoga practice helps to develop strength, flexibility, and balance. It would seem likely, then, that practicing yoga would reduce the likelihood of falling by the elderly.

 

In today’s Research News article “A mixed methods evaluation of yoga as a fall prevention strategy for older people in India.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928579/ ), Keay and colleagues recruited elderly participants (> 60 years of age) and provided them with 2 1-hour yoga classes per week for 3 months. The program emphasized standing poses that develop balance. The participants were measured before and after training for overall health, body size, fear of falling, history of falls, physical performance, and blood pressure. At the end of training the participants also attended focus groups with discussion focused on “perceptions of the yoga program, perceived benefits of yoga and understanding fall injury/reporting falls.”

 

They found that there were no adverse events and no falls reported during the program. After the 3-month yoga program the elderly participants were significantly faster in the sit-stand test, had increased stride length while walking, and significantly lower body weight and fear of falling. Hence, participation in a yoga program improved the physical abilities of the elderly. It should be noted that there wasn’t a control or comparison condition so conclusions should be reached cautiously.

 

The results suggest that practicing yoga is beneficial for elderly men and women. These results are sufficiently encouraging to support conducting a large randomized controlled trial. The participants in the present study were quite healthy at the beginning of the trail, so ceiling effects may have prevented the detection of further benefits. Indeed, the participants all successfully passed the most difficult balance test during the baseline test, leaving no room for improvement, In a future trial, it would be good to include participants whose health and physical abilities weren’t quite as good. Regardless, the results suggest that yoga practice is beneficial for the elderly.

 

So, reduce fear of falling in the elderly with yoga.

 

“the number of falls in older adults declined 48 percent in the six months after they began attending yoga classes compared to the six months prior.” – Breann Schossow

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Keay, L., Praveen, D., Salam, A., Rajasekhar, K. V., Tiedemann, A., Thomas, V., … Ivers, R. Q. (2018). A mixed methods evaluation of yoga as a fall prevention strategy for older people in India. Pilot and Feasibility Studies, 4, 74. http://doi.org/10.1186/s40814-018-0264-x

 

Abstract

Background

Falls are an emerging public health issue in India, with the impact set to rise as the population ages. We sought to evaluate the acceptability, feasibility and likely impact of a yoga-based program aimed at improving balance and mobility for older residents in urban India.

Methods

Fifty local residents aged 60 years and older were recruited from urban Hyderabad, Andhra Pradesh. They were invited to attend a 1-h yoga class, twice weekly for 3 months. Mixed methods were used to evaluate the acceptability and feasibility (qualitative) and likely impact (quantitative). Two focus groups and eight interviews with participants were conducted to evaluate the acceptability and feasibility of a yoga program. Thematic analysis was conducted in context of perceptions, barriers and benefits of yoga participation and fall ascertainment. Physical performance using the Short Physical Performance Battery, fear of falling, blood pressure and weight loss were measured before and after the program.

Results

The interviews and focus groups provided insights into the preferred format for classes, including session times, level of supervision and location. Improvements were seen in the Short Falls Efficacy Scale-International (Short FES-I (15.9 ± 4.0 vs 13.8 ± 2.1 s, p = 0.002)), the number of steps taken in the timed 4-m walk (T4MW (9.0 ± 1.8 vs 8.6 ± 1.8, p = 0.04)), Short FES-I scores (9.4 ± 2.9 vs 8.6 ± 2.9, p = 0.02) and weight (63.8 ± 12.4 vs 62.1 ± 11.6, p = 0.004) were lower. No changes were seen in standing balance, blood pressure or T4MW time.

Conclusion

Yoga was well accepted and resulted in improved ability to rise from a chair, weight loss, increased step length and reduced fear of falling. These results provide impetus for further research evaluating yoga as a fall prevention strategy in India.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928579/

 

Balance and Fitness in the Elderly and Tai Chi Training

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Balance and Fitness in the Elderly and Tai Chi Training

 

By John M. de Castro, Ph.D.

 

“Tai chi is an ancient Chinese exercise that can help older adults improve their balance and lower their fall risk. And by reducing their risk of falls, seniors can lower their odds of suffering a debilitating fracture.” – Harvard Health Letter

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of fall in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. These studies, however, employ Tai Chi training over long time frames of 6 months to a year. It is not known if shorter term training would also be effective.

 

In today’s Research News article “Effects of 12 Weeks of Tai Chi Chuan Training on Balance and Functional Fitness in Older Japanese Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968980/ ), Takeshima and colleagues recruited older adults averaging 73 years of age and assigned them to either receive 12 weeks of Tai Chi training for 2 days per week for 60 minutes or to a no-treatment control group. They were measured before and after training for static balance, dynamic balance, and functional fitness, including upper and lower body strength, balance and agility, upper and lower body flexibility, and cardiorespiratory fitness.

 

Contrary to longer-term studies, they did not find any significant differences between the Tai Chi training and no-treatment control groups in static balance, dynamic balance, or functional fitness.  This lack of benefit of Tai Chi training may well be due to the relative shortness of the 12-week program relative to previous studies employing 6-month to one year trainings. Indeed, previous research by Holmes and colleagues also employing a 12 week program could not detect any overall improvement in balance, but could detect a subtle improvement in postural-respiratory coupling. This may be a precursor to improvements in overall balance. So, 12-weeks of training may produce subtle changes that, if continued over a longer period of time, will lead to improvements in balance.

 

Tai Chi movement patterns can be fairly complex and the elderly may have difficulty learning them over a few sessions. Indeed, it has been reported that it takes 8 to 16 sessions before the patterns are mastered. So, there may need for longer periods of training to master the technique and benefit from it. Hence, there is a need for further research on the amount of Tai Chi training needed to improve balance and reduce falls in the elderly.

 

“I’ve always been clumsy, so Tai Chi has offered me the opportunity to be able to think more about what I’m doing, pay attention to what I’m doing, and not fall. I’m able to catch myself if I trip over something because of Tai Chi,” – Velma Chapman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Takeshima, N., Islam, M. M., Kato, Y., Koizumi, D., Narita, M., Kitabayashi, Y., … Rogers, M. E. (2017). Effects of 12 Weeks of Tai Chi Chuan Training on Balance and Functional Fitness in Older Japanese Adults. Sports, 5(2), 32. http://doi.org/10.3390/sports5020032

 

Abstract

The purpose of this study was to determine the effects of Tai Chi Chuan on static and dynamic balance, and functional fitness in older adults. Forty-nine volunteers were divided into an exercise group (EX: 9 men and 16 women, average age 72 ± 5 years) and control group (13 men and 11 women, average age 73 ± 6 years). The EX participated in a 12-week supervised exercise program (60 min/day, 2 days/week) that consisted of 10-min warm-up and stretching, 40-min Tai Chi Chuan exercise (long-form Yang style with 108 movements), and 10-min cool-down/relaxation exercises. The control group was asked to not change their physical activity habits. Static (sway velocity standing on firm or foam surfaces with eyes open or closed) and dynamic balance (limits of stability (LOS)), as well as functional fitness measures of body mass; upper- and lower-body strength; and flexibility, mobility, and aerobic fitness were taken before and after the intervention. After the 12-week Tai Chi Chuan exercise program, there were no improvements in any functional fitness or balance variable although components of LOS tended to increase (13.1%, p = 0.052). These results indicate that 12 weeks of Tai Chi Chuan exercise has no significant effect on balance and functional fitness parameters in older Japanese adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968980/

 

Improve Balance in Breast Cancer Patients with Qigong Practice

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Improve Balance in Breast Cancer Patients with Qigong Practice

 

By John M. de Castro, Ph.D.

 

“In terms of qigong influence on my cancer, a bone density scan carried some months ago has shown that, not only have I not lost further bone material, but, bone density has improved and there is growth of new material. I attribute this to my qigong practice since this is beyond the power of medication to effect this kind of outcome.” – Jean Caron

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Cancer and its treatment often results in bone loss making the individual more vulnerable to fractures especially after falls.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, lower blood pressure and cortisol levels, improve balance and reduce the likelihood of falls. It is not known, however, if Qigong practice can help to strengthen bones and reduce the likelihood of fractures.

 

In today’s Research News article “Bone Mineral Density, Balance Performance, Balance Self-Efficacy, and Falls in Breast Cancer Survivors With and Without Qigong Training: An Observational Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5950950/ ), Fong and colleagues recruited breast cancer survivors who had undergone standard treatments and separated them into two groups; those who performed Qigong practice for at least 3 months and those who did not practice. They also recruited a healthy control group that did not engage in Qigong practice. The participants were measured for whole body, hip, and arm bone density, balance, history of falls and fear of falling.

 

They found that the Breast cancer group that performed Qigong practice had significantly better balance and lower fear of falling than those who did not practice. In fact, those who practiced were equivalent to healthy controls in balance and fear of falling. It was those who didn’t practice who were deficient. They did not find differences between the groups in bone density. So, although Qigong practice did not appear to strengthen bones in breast cancer survivors, it did appear to improve balance and reduce their fear of falling making fractures less likely.

 

Falls and the resultant bone fractures are a significant threat not only to the quality of life of breast cancer survivors but also to their longevity. Hence, the benefits of improvements in balance for these patients should not be underappreciated. They could well lead to longer and better lives.

 

So, improve balance in breast cancer patients with qigong practice.

 

“Tai Chi may lead to better physical balance and stronger circulation of blood and energy. Tai Chi is a complimentary method for both preparing and recovering from surgery. Practicing with a positive, motivated group of people who are interested in empowering themselves with mind/body tools is a great support group for people who like to take an active role in their journey to better health.” – Cancer Wellness TV

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Shirley S. M. Fong, Anna W. M. Choi, W. S. Luk, Timothy T. T. Yam, Joyce C. Y. Leung, Joanne W. Y. Chung. Bone Mineral Density, Balance Performance, Balance Self-Efficacy, and Falls in Breast Cancer Survivors With and Without Qigong Training: An Observational Study. Integr Cancer Ther. 2018 Mar; 17(1): 124–130. Published online 2017 Jan 4. doi: 10.1177/1534735416686687

 

Abstract

Purpose: A deterioration in bone strength and balance performance after breast cancer treatment can result in injurious falls. Therefore, interventions need to be developed to improve the bone strength and balance ability of breast cancer survivors. This cross-sectional exploratory study aimed to compare the bone mineral density (BMD), balance performance, balance self-efficacy, and number of falls between breast cancer survivors who practiced qigong, breast cancer survivors who did not practice qigong, and healthy individuals. Methods: The study included 40 breast cancer survivors with more than 3 months of qigong experience, 17 breast cancer survivors with no qigong experience, and 36 healthy controls. All the participants underwent dual-energy X-ray absorptiometry scans to measure their lumbar spine, total hip, femoral neck, and total radius BMDs. The participants also underwent a timed one-leg stand test to measure their single-leg standing balance. The participants’ balance self-efficacy was assessed using the activities-specific balance confidence scale, and the number of falls experienced by each participant was assessed in a face-to-face interview. Results: The lumbar spine, total hip, femoral neck, and total radius BMDs were similar between the 3 groups (P > .05). The breast cancer-qigong group outperformed the breast cancer-control group by 27.3% when they performed the one-leg stand test on a foam surface (P = .025), and they also had a higher balance self-efficacy score (P = .006). Nevertheless, the numbers of falls were comparable between the 3 groups (P > .05). Conclusion: Qigong may be a suitable exercise for improving the balance performance and balance self-efficacy of breast cancer survivors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5950950/

Improve Balance in the Elderly by Uncoupling Posture and Respiration with Tai Chi

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Improve Balance in the Elderly by Uncoupling Posture and Respiration with Tai Chi

 

By John M. de Castro, Ph.D.

“Practising the ancient martial art of Tai Chi is so beneficial to elderly people’s health that it should be “the preferred mode of training”, according to scientists.” – The Telegraph

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly. Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of fall in the elderly.

 

An interesting contributor to imbalance is the synchronization of respiration with postural sway. When a person stands erect, with eyes closed, there is a normal sway in the posture. When respiration occurs the expansion of the abdomen and chest produces a slight shift in the center of gravity and the body sways to compensate. When the normal sway becomes synchronized with the sway produced by respiration, it results in an exaggeration of the sway. This produces a greater imbalance. This is usually minor and of very little consequence. But, in the elderly, with compromised balance and muscular control, the small extra imbalance may be a contributor to falls.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the likelihood of falls in the elderly. One possible way that Tai Chi training may contribute to the decrease in falls is by decreasing posturo-respiratory synchronization. This interesting speculation has not been previously investigated.

 

In today’s Research News article “Tai Chi training reduced coupling between respiration and postural control.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695235/

Holmes and colleagues investigate the effect of Tai Chi training on posturo-respiratory synchronization. They recruited healthy males and females over 70 years of age and randomly assigned them to receive either Tai Chi training or education. Tai Chi training consisted of 12 weeks of instructor led group training for one hour, twice a week. The education condition involved health related lectures on the same schedule as the Tai Chi training. Before and after training the elderly were measured for postural sway, respiration and posturo-respiratory synchronization.

 

They found that after training neither group showed a change in postural sway or in respiration. Although the two groups did not differ in posturo-respiratory synchronization before training, after training the Tai Chi had significantly smaller posturo-respiratory synchronization than they did during baseline and in comparison to the education group. Hence, Tai Chi training reduced the contribution of posturo-respiratory synchronization to imbalance in the elderly. This may be one of the mechanisms by which Tai Chi training improves balance and reduces falls in the elderly.

 

Falls become more and more likely with age and the consequences of falls to the elderly can be devastating. So, a practice that can lower the risk of falls is important for the health and well-being of the elderly. Tai Chi is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects. So, it is well suited as an exercise for an elderly population. In addition, once learned it can be practiced at home or in groups, making it a flexible very low cost solution. Hence, it appears that Tai Chi should be recommended to the elderly to improve balance and reduce falls and thereby improve the health and well-being of the elderly.

 

So, improve balance in the elderly by uncoupling posture and respiration with tai chi.

 

“One of the greatest benefits of Tai Chi for the elderly is that even individuals who have physical limitations can practice this ancient healing art. Because it is comprised of a series of slow, relaxed movements, Tai chi is a non-strenuous activity that will not put added strain on weakened muscles. Tai Chi movements help encourage proper posture and rely on constant gentle movements that force the individual to concentrate and breathe deeply, two important techniques that are often overlooked in the elderly community.” – Delialah Falcon

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Holmes, M. L., Manor, B., Hsieh, W., Hu, K., Lipsitz, L. A., & Li, L. (2016). Tai Chi training reduced coupling between respiration and postural control. Neuroscience Letters, 610, 60–65. http://doi.org/10.1016/j.neulet.2015.10.053

 

 

  • Tai Chi training did not affect average sway speed& magnitude or respiratory rate
  • Yet tai Chi training reduced the impact of respiration on postural sway
  • The effects of Tai Chi on postural control could be optimized system interaction

Abstract

In order to maintain stable upright stance, the postural control system must account for the continuous perturbations to the body’s center-of-mass including those caused by spontaneous respiration. Both aging and disease increase “posturo-respiratory synchronization;” which reflects the degree to which respiration affects postural sway fluctuations over time. Tai Chi training emphasizes the coordination of respiration and bodily movements and may therefore optimize the functional interaction between these two systems. The purpose of the project was to examine the effect of Tai Chi training on the interaction between respiration and postural control in older adults. We hypothesized that Tai Chi training would improve the ability of the postural control system to compensate for respiratory perturbations and thus, reduce posturo-respiratory synchronization. Participants were recruited from supportive housing facilities and randomized to a 12-week Tai Chi intervention (n=28; 86±5yrs) or educational-control program (n=34, 85±6yrs). Standing postural sway and respiration were simultaneously recorded with a force plate and respiratory belt under eyes-open and eyes-closed conditions. Posturo-respiratory synchronization was determined by quantifying the variation of the phase relationship between the dominant oscillatory mode of respiration and corresponding oscillations within postural sway. Groups were similar in age, gender distribution, height, body mass, and intervention compliance. Neither intervention altered average sway speed, sway magnitude or respiratory rate. As compared to the education-control group, however, Tai Chi training reduced posturo-respiratory synchronization when standing with eyes open or closed (p<0.001). Tai Chi training did not affect traditional parameters of standing postural control or respiration, yet reduced the coupling between respiration and postural control. The beneficial effects of Tai Chi training may therefore stem in part from optimization of this multi-system interaction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695235/

 

Reduce Falls in the Elderly with Tai Chi

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Reduce Falls in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age,” – Peter Wayne

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

 

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of fall in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Because it is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for an elderly population. So, it would seem that tai chi practice would be well suited to improving balance and coordination in seniors and thereby reduce the likelihood of falls.

 

In today’s Research News article “Systematic review and meta-analysis: Tai Chi for preventing falls in older adults.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293999/

Huang and colleagues reviewed and summarized the published research findings on the effectiveness of Tai Chi practice in preventing falls in the elderly. They identified 18 research publications describing randomized controlled trials, 16 of which were included in a meta-analysis. The studies included employed Tai Chi practice with individuals over 60 years of age and measured falls.

 

They found that the published research indicated that with Tai Chi training there were more elderly individuals who did not experience any falls at all and of those who did fell less often. These improvements were associated with the frequency of training with the greater the training the greater the benefits. In addition, the style of Tai Chi mattered with the Yang style being superior to the Sun style in preventing falls. The Yang style Tai Chi is characterized by big and open movements and is the most popular form of tai chi studied today. Sun Style has movements that are continuous, slow, even and with agile steps, a higher stance, and less kicking and punching. So, it would appear that the large and open movements of the Yang style are important in improving balance and thereby making falls less likely.

 

These are important findings. Falls become more and more likely with age and the consequences of falls to the elderly can be devastating. So, a practice that can lower the risk of falls is important for the health and well-being of the elderly. Tai Chi is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects. So, it is well suited as an exercise for an elderly population. In addition, once learned it can be practiced at home or in groups, making it a flexible very low cost solution. Hence, it appears that Tai Chi should be recommended to the elderly to improve balance and reduce falls and thereby improve the health and well-being of the elderly.

 

So, reduce falls in the elderly with tai chi.

 

“Treatment of injuries, due to falls, is one of the most expensive health conditions. Evidence has shown tai chi being one of the two effective exercises to prevent falls.” – Paul Lam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Huang, Z.-G., Feng, Y.-H., Li, Y.-H., & Lv, C.-S. (2017). Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open, 7(2), e013661. http://doi.org/10.1136/bmjopen-2016-013661

 

Abstract

Objective

It remains unclear whether Tai Chi is effective for preventing falls in older adults. We undertook this systematic review to evaluate the preventive effect of Tai Chi by updating the latest trial evidence.

Design

Systematic review and meta-analysis.

Methods

The Cochrane Library, MEDLINE and EMBASE were searched up to February 2016 to identify randomised trials evaluating Tai Chi for preventing falls in older adults. We evaluated the risk of bias of included trials using the Cochrane Collaboration’s tool. Results were combined using random effects meta-analysis.

Outcome measures

Number of fallers and rate of falls.

Results

18 trials with 3824 participants were included. The Tai Chi group was associated with significantly lower chance of falling at least once (risk ratio (RR) 0.80, 95% CI 0.72 to 0.88) and rate of falls (incidence rate ratio (IRR) 0.69, 95% CI 0.60 to 0.80) than the control group. Subgroup analyses suggested that the preventive effect was likely to increase with exercise frequency (number of fallers: p=0.001; rate of falls: p=0.007) and Yang style Tai Chi was likely to be more effective than Sun style Tai Chi (number of fallers: p=0.01; rate of falls: p=0.001). The results might be influenced by publication bias as the funnel plots showed asymmetry. Sensitivity analyses by sample size, risk of bias and comorbidity showed no major influence on the primary results.

Conclusions

Tai Chi is effective for preventing falls in older adults. The preventive effect is likely to increase with exercise frequency and Yang style Tai Chi seems to be more effective than Sun style Tai Chi.

Strengths and limitations of this study:

  • This study is, to date, the most comprehensive systematic review evaluating Tai Chi for preventing falls in older adults. A number of recently published trials were included, which improved the precision of the estimated effects and enabled us to investigate various influential factors such as Tai Chi style and frequency.
  • Our confidence in the findings is further increased by significant dose–response effect, stable sensitivity analyses and stable analyses by adjusting for publication bias.
  • The findings are likely to be influenced due to the bias in some original trials.
  • The estimated preventive effect of Tai Chi may be overestimated due to publication bias.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293999/

Reduce Falls in the Elderly with Tai Chi

psyjdc 4 Comments

 

By John M. de Castro, Ph.D.

 

“Tai Chi is a sophisticated form of whole body Neuromuscular/skeletal movement re-education. With good use, the body moves easily – with balance and coordination; both mental and physical. Initially developed as a martial art, it has now become more widely practiced as an exercise for health and well-being. Its use of natural rotational, as well as linear movements, have placed this well above other falls training methods.” – Mark Peters

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly. Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to investigate methods to improve balance and decrease the number of fall in the elderly.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Because it is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for an elderly population. So, it would seem that tai chi practice would be well suited to improving balance and coordination in seniors and thereby reduce the likelihood of falls.

 

In today’s Research News article “Implementing an Evidence-Based Fall Prevention Program in an Outpatient Clinical Setting.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1265719523451971/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707656/

Li and colleagues recruited a large group (379) of seniors (> 65 years of age) who were deemed at risk for falls by their primary care physicians. They delivered a tai chi program that was designed to optimize balance for two one-hour sessions per week for 24 weeks. During the 24 weeks of the program 119 participants reported 261 falls. There was a significant reduction in the number of falls over the 6-month course of the program. For the month prior to the training the participants reported 0.5 falls per month while that number fell to 0.13 during the program. By the end of the program the fall rate declined to 0.05 per month.

 

Hence, they found clear evidence that tai chi practice reduces the incidence of falls in an at-risk population of elderly. These are excellent and important findings. It should be kept in mind, however, that the study did not include a control comparison condition. So, the results could be due to subject expectancy (placebo) effects. But, with this caveat, the results are very encouraging.

 

The marked reduction in falls suggests that seniors who practice tai chi will be a substantially less risk of injury from falling. This should not only improve health but also relieve a degree of the fear of falling. This should improve the quality of life and reduce consequent psychological problems. Hence, the practice should be of great benefit to the elderly. In addition, the safe and gentle exercise nature of tai chi practice make it well suited to the elderly. It can also be delivered very inexpensively as it can be taught in large groups and after training practiced at home or in a group without an instructor.

 

So, reduce falls in the elderly with tai chi.

 

“problems arise as the elderly become increasing frail, their senses and muscles degrade, and their ability to react to a slip is delayed enough that they can’t stop themselves from falling. Understanding the process helps inform the treatments . . . traditional interventions such as exercise and new glasses are effective. The Chinese martial art of tai chi is considered particularly helpful in improving balance and reducing falls.“ – Thurmon Lockhart

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Li, F., Harmer, P., Stock, R., Fitzgerald, K., Stevens, J., Gladieux, M., … Voit, J. (2013). Implementing an Evidence-Based Fall Prevention Program in an Outpatient Clinical Setting. Journal of the American Geriatrics Society, 61(12), 2142–2149. http://doi.org/10.1111/jgs.12509

 

Abstract

Objectives: Few evidence-based fall prevention programs have been evaluated for adoption in clinical settings. This study investigated the dissemination potential of a Tai Ji Quan-based program, previously shown efficacious for reducing risk of falls in older adults, through outpatient clinical settings.

Design: A single-group pre-post design in which participants attended a twice weekly Tai Ji Quan training program for 24 weeks.

Setting: Communities in Lane County, Oregon.

Participants: Referral patients (N = 379) aged 65 and older living independently.

Measurements: Using the RE-AIM framework, the primary outcome was the proportion of participating healthcare providers who made referrals. Secondary outcomes were the proportion of referred patients agreeing to participate and enrolling in the program, and measures of program implementation, maintenance, and effectiveness (on measures of falls, balance, gait, physical performance, and balance efficacy).

Results: Of the 252 providers invited to participate, 157 made referrals (62% adoption rate). Of 564 patients referred, 379 (67% reach) enrolled in the program, which was successfully implemented in senior/community centers with good fidelity. Of the total number of participants, 283 completed the program (75% retention) and 212 of these attended ≥75% of the total (48) sessions. Participants reported a reduction in falls with an incidence rate of 0.13 falls per person-month and showed significant improvement from baseline in all outcome measures. A 3-month post-intervention follow-up indicated encouraging levels of program maintenance among providers, patients, and community centers.

Conclusion: A protocol to refer patients at increased risk of falling to a Tai Ji Quan-based program was successfully implemented among healthcare providers. The evidence-based program appears readily scalable and exportable with potential for substantial clinical and public health impact.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707656/