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

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/

 

Slow Age-Related Physical Decline with Tai Chi

Slow Age-Related Physical Decline with Tai Chi

 

By John M. de Castro, Ph.D.

 

“This peaceful type of moving meditation is primarily used to improve strength, balance, flexibility and posture. Recent studies of Tai Chi shows that this mind-body practice is able to alleviate pain, improve mood, increase immunity and support heart health.” – World Health net

 

We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research. But, it has been found to be effective for an array of physical and psychological issues. It appears to strengthen the immune systemreduce inflammation and increase the number of cancer killing cells in the bloodstream. Because Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. Tai Chi has been shown to help the elderly improve attentionbalance, reducing fallsarthritiscognitive functionmemory, and reduce age related deterioration of the brain.

 

In today’s Research News article “Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397616/, Lou and colleagues recruited individuals from a senior living community (mean age 63 years) and randomly assigned them to either receive Tai Chi Softball Training for 7 weeks, four times a week, for 90 minutes each, or a no-treatment control group. Tai Chi Softball Training requires practitioners to hold a racket and control a softball on the surface of the racket while performing Tai Chi. Participants were measured before, at 7 weeks, and after training for lower limb strength and balance, and upper limb shoulder mobility, handgrip strength, and fine motor control.

 

They found that while the control group had deterioration in all measures, the participants in Tai Chi Softball Training had significant improvements in these same measures, including fine motor control, fine motor function, handgrip strength, hand and forearm strength, shoulder mobility, leg strength, and dynamic balance. The practice was found to be safe, as there were no significant adverse effects observed for participation in Tai Chi Softball Training.

 

These are wonderful results demonstrating that Tai Chi Softball Training is very effective in improving physical functional health in the elderly. This is particularly important as the progressive decline in motor ability in this group impacts their quality of life, health, and even their longevity. It would be interesting in future research to compare Tai Chi Softball Training to regular Tai Chi practice and other exercise programs to determine if one is superior to the others. Hence, Tai Chi because it is effective and gentle, is almost an ideal program for the elderly.

 

So, slow age-related physical decline with tai chi.

 

“tai chi may be an easier and more convenient than brisk walking as an anti-aging choice. Previous studies have shown tai chi also improves balance and may help boost brain functioning.” – Linda Melone

 

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

 

Lou, L., Zou, L., Fang, Q., Wang, H., Liu, Y., Tian, Z., & Han, Y. (2017). Effect of Taichi Softball on Function-Related Outcomes in Older Adults: A Randomized Control Trial. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 4585424. http://doi.org/10.1155/2017/4585424

 

Abstract

The purpose of this present study was to examine the effect of Taichi softball (TCSB) on physical function in Chinese older adults. Eighty Chinese older adults were randomly assigned into either an experimental group experiencing four 90-minute TCSB sessions weekly for seven consecutive weeks or a control group. At baseline and 7 weeks later, all participants were asked to perform physical functional tests for both lower and upper limbs. Multiple separate Analyses of Variance (ANOVA) with repeated measures were applied to evaluate the effects of TCSB on function-related outcomes between baseline and postintervention in the two groups. The findings indicate that a short-term and intensive TCSB training program does not only improve low limb-related physical function such as dynamic balance and leg strength, but also strengthen upper limb-related physical function (e.g., arm and forearm strength, shoulder mobility, fine motor control, handgrip strength, and fine motor function). Health professionals could take into account TCSB exercise as an alternative method to help maintain or alleviate the inevitable age-related physical function degeneration in healthy older adults. In addition, researchers could investigate the effect of TCSB exercise on physical function in special populations such as patients with different chronic diseases or neurological disorder (e.g., Parkinson’s disease).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397616/

Improve Health with Qigong

Improve Health with Qigong

 

By John M. de Castro, Ph.D.

 

“Qigong is an ancient Chinese system of exercise and meditation that makes the mind and spirit tranquil, improves performance in sports, and cultivates health, well-being, and long life.” – Annie Bond

 

Qigong and Tai Chi have been practiced for thousands of years with benefits for health and longevityQigong and Tai Chi trainings are designed to enhance function and regulate the activities of the body through controlled breathing, mindful concentration, and gentle movements. Only recently though have the effects of these practices been scrutinized with empirical research. This research has found that they are effective for an array of physical and psychological issues. They appear to strengthen the immune systemreduce inflammation and increase the number of cancer killing cells in the bloodstream, improve cardiovascular healthreduce arthritis painimprove balance and reduce falls. They also appear to improve attentional ability and relieve depression.

 

In today’s Research News article “A Systematic Review and Meta-Analysis Baduanjin Qigong for Health Benefits: Randomized Controlled Trials.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359459/

Zou and colleagues review the published research literature on the effects of one particular Qigong practice, Baduanjin Qigong, on health.  Baduanjin Qigong involves only 8 simple movements and “is characterized by interplay between symmetrical physical postures and movements, mind, and breathing exercise in a harmonious manner.” They discovered 19 published randomized controlled trials employing adults. About 1/3 of the participants were healthy and 2/3 were ill with a variety of diseases including “type 2 diabetes mellitus, cancer, Parkinson’s disease, hypertension, knee osteoarthritis, and chronic fatigue syndrome-like illness.”

 

The published research revealed that Baduanjin Qigong produced significant improvements in quality of life (6 studies), sleep quality (6 studies), balance (6 studies), handgrip strength (5 studies), trunk and hip flexibility (4 studies), leg power (2 studies), walking performance (2 studies), systolic and diastolic blood pressures (9 studies), respiratory efficiency (6 studies), and cardiorespiratory endurance (4 studies). The small number of studies (2) that measured leg power and walking performance makes conclusions about these improvements tentative. But, the rest of the improvements would appear to be solid findings of a magnitude to be considered of clinical significance.

 

These are exciting results. The range of different areas of physical improvement produced by Baduanjin Qigong and the range of illnesses improved are impressive. Since, this ancient gentle practice is completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned as only 8 movements are involved, it would appear to be an excellent treatment for sickly individuals, especially the elderly. It remains to be seen how effective Baduanjin Qigong might be for mental and emotional problems.

 

So, improve health with qigong.

 

“Sometimes Qigong and Tai Chi are called a moving meditation in which the mind and body are led to a state of balance and equilibrium also known as homeostasis. A Harvard medical publication said it should also be called “moving medication.” The advantages of improving strength, flexibility and balance are pretty obvious but the advantages of peace that comes from the moving flowing meditative aspect of Qigong and Tai Chi are equally important.” – Denise Nagel

 

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

Zou, L., SasaKi, J. E., Wang, H., Xiao, Z., Fang, Q., & Zhang, M. (2017). A Systematic Review and Meta-Analysis Baduanjin Qigong for Health Benefits: Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 4548706. http://doi.org/10.1155/2017/4548706

 

Abstract

Objective. To investigate the effects of practicing Baduanjin Qigong on different health outcomes. Methods. Six electronic databases were used for literature search through entering the following key words: Baduanjin Qigong, quality of life, sleep quality, and health-related outcomes. Results. Nineteen randomized controlled trials were used for meta-analysis. The aggregated results from this systematic review have shown significant benefits in favour of Baduanjin Qigong on quality of life (SMD, −0.75; 95% CI −1.26 to −0.24; P = 0.004), sleep quality (SMD, −0.55; 95% CI −0.97 to −0.12; P = 0.01), balance (SMD, −0.94; 95% CI −1.59 to 0.30; P = 0.004), handgrip strength (SMD, −0.69; 95% CI −1.2 to −0.19; P = 0.007), trunk flexibility (SMD, −0.66; 95% CI −1.13 to −0.19; P = 0.006), systolic (SMD, −0.60; 95% CI −0.94 to −0.27; P = 0.0004) and diastolic blood pressure (SMD, −0.46; 95% CI −0.73 to −0.20; P = 0.0005), and resting heart rate (SMD, −0.87; 95% CI −1.47 to −0.27; P = 0.005). The aggregated results of meta-analyses examining the effect of Baduanjin Qigong on leg power, cardiopulmonary endurance, and pulmonary function remain unclear because of a small number of studies. Conclusions. The aggregated results from this systematic review show that Baduanjin Qigong practice is beneficial for quality of life, sleep quality, balance, handgrip strength, trunk flexibility, systolic and diastolic blood pressure, and resting heart rate. Further studies are necessary to confirm the effects of Baduanjin Qigong on leg power, cardiopulmonary endurance, and pulmonary function (e.g., vital capacity), while considering a long-term follow-up.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359459/

Yoga Helps the Blind Maintain Balance

“One of the many misconceptions about the blind is that they have greater hearing, sense of smell and sense of touch than sighted people. This is not strictly true. Their blindness simply forces them to recognize gifts they always had but had heretofore largely ignored. – Rosemary Mahoney
Falls are a standard of slapstick comedy and Americas Funniest Home Videos. But, falls are far from funny. They can cause serious injury and even death. “One out of five falls causes a serious injury such as broken bones or a head injury. Each year, 2.5 million older people are treated in emergency departments for fall injuries. Over 700,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture. Each year at least 250,000 older people are hospitalized for hip fractures. More than 95% of hip fractures are caused by falling,6 usually by falling sideways. Falls are the most common cause of traumatic brain injuries (TBI). Adjusted for inflation, the direct medical costs for fall injuries are $34 billion annually.” (Centers for Disease Control). Approximately 9,500 deaths in older Americans are associated with falls each year, making falls the leading cause of death from injury among people 65 and older.

 

Physical and sensory fitness and balance are important for the prevention of falls. The visual system is particularly important for maintaining balance and avoiding obstacles. Hence, it is not surprising that the visually impaired are 1.7 times more likely to have a fall and 1.9 times more likely to have multiple falls compared with fully sighted populations. The odds of a hip fracture are between 1.3 and 1.9 times greater for those with reduced visual acuity. So, finding methods to improve balance in the visually impaired may greatly reduce falls and subsequent injury.

 

Yoga has been shown to improve muscular strength, endurance, and flexibility (see http://contemplative-studies.org/wp/index.php/2015/08/11/improve-physical-health-with-yoga/) and to improve balance (see http://contemplative-studies.org/wp/index.php/2015/12/26/improve-physical-well-being-with-bikram-yoga/). So, it would seem reasonable to predict that yoga training may improve coordination, flexibility, and balance in the visually impaired and as a result reduce injuries.

 

In today’s Research News article “Ashtanga-Based Yoga Therapy Increases the Sensory Contribution to Postural Stability in Visually-Impaired Persons at Risk for Falls as Measured by the Wii Balance Board: A Pilot Randomized Controlled Trial”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1159236467433611/?type=3&theater

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129646

Jeter and colleagues developed and pilot tested a yoga program for the legally blind and compared the results to those obtained from a wait-list control group. The participants practiced yoga once a week with an instructor and twice a week at home for eight weeks. As expected yoga produced an increase in lower body strength and flexibility. Using a balance on an unstable platform test they found that after yoga training the blind participants were better able to use somatosensory and vestibular information to maintain balance.

 

These findings suggest that yoga improves blind individuals physically and increases their balance by making them more sensitive to the information provided by touch and by the balance (vestibular) system. There was no direct test of propensity to fall, but the results suggest that the yoga training would improve balance and thereby lower the likelihood of a fall. It will take further research to directly test this conclusion.

 

It is clear, however, that yoga can improve sensitivity of the tactile and vestibular stimuli that are important for balance. So, practice yoga to improve balance in the blind.
“To be blind is not miserable; not to be able to bear blindness, that is miserable.”

John Milton
CMCS – Center for Mindfulness and Contemplative Studies