Posture

Improve Physical Function and Postural Control Complexity in Older Adults with Peripheral Neuropathy with Tai Chi

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Improve Physical Function and Postural Control Complexity in Older Adults with Peripheral Neuropathy with Tai Chi

 

By John M. de Castro, Ph.D.

 

“slow and fluid movements improve the body’s alignment, posture, strength, flexibility, coordination, balance, and stamina. Many of these benefits of Tai Chi are consistent with many other forms of low-impact exercise, with the added benefit of focus on improved posture, balance, and alignment.” – Robert Humphries

 

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.

 

Peripheral neuropathy can compound the effects of aging on motor ability. It involves damage to the peripheral nerves carrying information to the spinal cord and brain. This results in deficits in sensory information from the body and motor control. Peripheral neuropathy can impair muscle movement, prevent normal sensation in the arms and legs, and cause pain. In this way peripheral neuropathy may further impair older adults motor abilities and increase the likelihood of falls.

 

Tai Chi training is designed to enhance and regulate the functional activities of the body through posture, regulated breathing, mindful concentration, and gentle movements. It includes posture and 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 improving postural control. This interesting speculation has not been previously investigated in older patients with peripheral neuropathy.

 

In today’s Research News article “Complexity-based measures inform Tai Chi’s impact on standing postural control in older adults with peripheral neuropathy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640896/), Manor and colleagues recruited older adults (average age 71 years) with peripheral neuropathy. They were provided 3 1-hour Tai Chi classes per week for 24 weeks. They were measured before and after training for foot sole sensation, leg strength, mobility, functional ability, and postural control, including measures of balance, speed, area under the curve, and complexity of postural control while standing.

 

They found that in comparison to baseline, after Tai Chi training there were significant improvements in foot sole sensation, leg strength, mobility, and physical function, including knee extension, walking, and speed. There was also a significant increase in postural control complexity. In addition, they found that the greater the increase in postural control complexity the greater the improvements in foot sole sensation, mobility, and functional ability.

 

This study did not have a control condition so conclusions must be tempered with the understanding that the results may have been due to time-based confounding variables. Nevertheless, the results suggest that Tai Chi practice improves the physical condition and abilities of older adults with peripheral neuropathy. Aging is associated with a loss of motoric complexity. The improvement in postural complexity observed in the present study may then represent the ability of Tai Chi practice to restore this complexity and thereby help the older adults’ physical abilities.

 

So, improve physical function and postural control complexity in older adults with peripheral neuropathy with Tai Chi.

 

“We work to maintain great posture for a 60-120 minute class, reap the benefits, feel great, and then go home and try to emulate the posture in our natural environment.” – Scott

 

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

 

Manor, B., Lipsitz, L. A., Wayne, P. M., Peng, C. K., & Li, L. (2013). Complexity-based measures inform Tai Chi’s impact on standing postural control in older adults with peripheral neuropathy. BMC complementary and alternative medicine, 13, 87. https://doi.org/10.1186/1472-6882-13-87

 

Abstract

Background

Tai Chi training enhances physical function and may reduce falls in older adults with and without balance disorders, yet its effect on postural control as quantified by the magnitude or speed of center-of-pressure (COP) excursions beneath the feet is less clear. We hypothesized that COP metrics derived from complex systems theory may better capture the multi-component stimulus that Tai Chi has on the postural control system, as compared with traditional COP measures.

Methods

We performed a secondary analysis of a pilot, non-controlled intervention study that examined the effects of Tai Chi on standing COP dynamics, plantar sensation, and physical function in 25 older adults with peripheral neuropathy. Tai Chi training was based on the Yang style and consisted of three, one-hour group sessions per week for 24 weeks. Standing postural control was assessed with a force platform at baseline, 6, 12, 18, and 24 weeks. The degree of COP complexity, as defined by the presence of fluctuations existing over multiple timescales, was calculated using multiscale entropy analysis. Traditional measures of COP speed and area were also calculated. Foot sole sensation, six-minute walk (6MW) and timed up-and-go (TUG) were also measured at each assessment.

Results

Traditional measures of postural control did not change from baseline. The COP complexity index (mean±SD) increased from baseline (4.1±0.5) to week 6 (4.5±0.4), and from week 6 to week 24 (4.7±0.4) (p=0.02). Increases in COP complexity—from baseline to week 24—correlated with improvements in foot sole sensation (p=0.01), the 6MW (p=0.001) and TUG (p=0.01).

Conclusions

Subjects of the Tai Chi program exhibited increased complexity of standing COP dynamics. These increases were associated with improved plantar sensation and physical function. Although more research is needed, results of this non-controlled pilot study suggest that complexity-based COP measures may inform the study of complex mind-body interventions, like Tai Chi, on postural control in those with peripheral neuropathy or other age-related balance disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640896/

 

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/