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/

 

Improve Health and Cognitive Ability in the Elderly with Tai Chi

Improve Health and Cognitive Ability in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

Tai chi is a gentle exercise that helps seniors improve balance and prevent falls. Studies have found that tai chi also improves leg strength, cardiovascular endurance, flexibility, immune system, sleep, happiness, sense of self-worth, and the ability to concentrate and multitask during cognitive tests.” – DailyCaring

 

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body. It is inevitable and cannot be avoided. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability, and in emotion regulation. There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, 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 with aging

 

In today’s Research News article “The Effects of Tai Chi on Markers of Atherosclerosis, Lower-limb Physical Function, and Cognitive Ability in Adults Aged Over 60: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427726/), Zhou and colleagues recruited healthy elderly (aged 60-79 years) who were not practicing Tai Chi or other mindful movement practices and randomly assigned them to engage in one of three different Tai Chi practices for 12 weeks. The practices contained either 24, 42, or 56 different movements. They attended 3 times weekly Tai Chi classes. For the first 6 weeks the classes were 60 minutes while for the second 6 weeks the classes were 90 minutes. They were measured at baseline and at 6 and 12-weeks of practice for resting heart rate and as markers of atherosclerosis resting ankle brachial index and ankle pulse wave velocity. They were also measured for cognitive ability and movement tests of chair rise, walking, balance, and up-and-go test.

 

They found that for both males and females all three Tai Chi practices produced significant improvements in health-related outcomes at 6 and 12 weeks including improvements in walking, balance, up-and-go test, and ankle brachial index. Compared to the 24-movement practice, the 42- and 56-movement practices produced significantly better results for walking and balance and the resting ankle brachial index indicator of atherosclerosis. There were no adverse events recorded.

 

These results have to be interpreted with caution as there wasn’t a control condition such as a different exercise and there was no long-term follow-up. Nevertheless, the results suggest that Tai Chi practices is safe and effective treatment to produce significant improvements in the elderly’s movements, balance, and atherosclerosis. The 24-movement practice appears to be inferior to Tai Chi practices containing a greater number of distinct movements. Supporting these findings is the fact that these improvements including improved balance, movement, cardiovascular performance have also been documented in prior research.

 

Tai Chi practice is gentle and completely safe, can be used with the elderly and sickly, are 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. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. All of these characteristics make Tai Chi practice an excellent practice to improvement the health of the elderly.

 

So, improve health and cognitive ability in the elderly with Tai Chi

 

Practicing Tai Chi regularly is known to enhance health and fitness. It can also help seniors with a better sense of balance and strength.” – MedicalAlert

 

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

                 

Zhou, S., Zhang, Y., Kong, Z., Loprinzi, P. D., Hu, Y., Ye, J., … Zou, L. (2019). The Effects of Tai Chi on Markers of Atherosclerosis, Lower-limb Physical Function, and Cognitive Ability in Adults Aged Over 60: A Randomized Controlled Trial. International journal of environmental research and public health, 16(5), 753. doi:10.3390/ijerph16050753

 

Abstract

Objective: The purpose of this study was to investigate the effects of Tai Chi (TC) on arterial stiffness, physical function of lower-limb, and cognitive ability in adults aged over 60. Methods: This study was a prospective and randomized 12-week intervention trial with three repeated measurements (baseline, 6, and 12 weeks). Sixty healthy adults who met the inclusion criteria were randomly allocated into three training conditions (TC-24, TC-42, and TC-56) matched by gender, with 20 participants (10 males, 10 females) in each of the three groups. We measured the following health outcomes, including markers of atherosclerosis, physical function (leg power, and static and dynamic balance) of lower-limb, and cognitive ability. Results: When all three TC groups (p < 0.05) have showed significant improvements on these outcomes but overall cognitive ability at 6 or 12 weeks training period, TC-56 appears to have superior effects on arterial stiffness and static/dynamic balance in the present study. Conclusions: Study results of the present study add to growing body of evidence regarding therapeutic TC for health promotion and disease prevention in aging population. Future studies should further determine whether TC-42 and TC-56 are beneficial for other non-Chinese populations, with rigorous research design and follow-up assessment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427726/

 

Improve Balance and Mobility and Prevent Falls in Parkinson’s Disease Patients with Tai Chi

Improve Balance and Mobility and Prevent Falls in Parkinson’s Disease Patients with Tai Chi

 

By John M. de Castro, Ph.D.

 

“There is still so much to learn from research about exactly how exercise improves the physical and mental well-being of people with living with Parkinson’s disease, as well as which combinations or activities yield the best outcomes, but there is no doubt whatsoever that exercise remains one of the best therapies for preserving and enhancing quality of life.” – Davis Phinney

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially cognitive decline, anxiety, and depression. All of these symptoms result in a marked reduction in the quality of life.

 

There are no cures for Parkinson’s Disease or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, Tai Chi practice has been shown to improve the symptoms of Parkinson’s Disease. Hence, Tai Chi  may be an excellent treatment for the symptoms of Parkinson’s Disease.

 

In today’s Research News article “Effects of Tai Chi Exercise on Reducing Falls and Improving Balance Performance in Parkinson’s Disease: A Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409066/), Liu and colleagues review, summarize, and perform a meta-analysis on the effectiveness of Tai Chi practice to improve balance and mobility and reduce falls in Parkinson’s Disease (PD) patients. They found and reviewed 5 published randomized controlled trials that compared Tai Chi practice to no intervention, stretching/resistance training, and walking control conditions.

 

They report that the trials found that in comparison to baseline and the control conditions Tai Chi  practice significantly improved balance and functional mobility in the Parkinson’s Disease patients and reduced the number who experienced a fall. This is important as the compromised motor ability of patients with Parkinson’s Disease makes them much more vulnerable to falls and the resultant compromised health. By improving balance and mobility in these patients Tai Chi practice produces enhanced health and well-being.

 

The results of the published research strongly suggests that Tai Chi  practice should be routinely prescribed for patients with Parkinson’s Disease. Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It 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 excellent gentle practice to improve the well-being of patients with Parkinson’s Disease.

 

So, improve balance and mobility and prevent falls in Parkinson’s Disease patients with Tai Chi.

 

Daily Tai Chi practice is extremely helpful to those with chronic ailments and illnesses like cancer, heart disease, stroke, Parkinson’s, Alzheimer’s, osteoporosis, peripheral neuropathy, respiratory problems and irritable bowel syndrome to name a few,” – Mwezo

 

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

 

Liu, H. H., Yeh, N. C., Wu, Y. F., Yang, Y. R., Wang, R. Y., & Cheng, F. Y. (2019). Effects of Tai Chi Exercise on Reducing Falls and Improving Balance Performance in Parkinson’s Disease: A Meta-Analysis. Parkinson’s disease, 2019, 9626934. doi:10.1155/2019/9626934

 

Abstract

Introduction

Parkinson’s disease (PD) is a common neurodegenerative disorder that may increase the risk of falls, functional limitation, and balance deficits. Tai Chi was used as an option for improving balance in people with PD. The aim of this meta-analysis was to evaluate the effects of Tai Chi on falls, balance, and functional mobility in individuals with PD.

Method

The literature search was conducted in PubMed, the Cochrane Library, CINAHL, PEDro, Medline, Embase, sportDISCUS, Trip, and the National Digital Library of Theses and Dissertations in Taiwan. Randomized controlled trials (RCTs) analyzing the effects of Tai Chi, compared to no intervention or to other physical training, on falls, functional mobility, and balance in PD patients were selected. The outcome measurements included fall rates, Berg Balance Scale (BBS), Functional Reach (FR) test, and the Timed Up and Go (TUG) test. Two reviewers independently assessed the methodological quality and extracted data from the studies using the PEDro scale.

Results

Five RCTs that included a total of 355 PD patients were included in this review. The quality of evidence in these studies was rated as moderate to high. Compared to no intervention or other physical training, Tai Chi significantly decreased fall rates (odds ratio = 0.47, 95% confidence interval (CI) 0.30 to 0.74, and p=0.001) and significantly improved balance and functional mobility (BBS mean difference (MD) = 3.47, 95% CI 2.11 to 4.80, and p < 0.001; FR MD = 3.55 cm, 95% CI 1.88 to 5.23, and p < 0.001; TUG MD = −1.06 s, 95% CI −1.61 to −0.51, and p < 0.001) in people with PD.

Conclusion

This meta-analysis provides moderate- to high-quality evidence from five RCTs that Tai Chi could be a good physical training strategy for preventing falls and improving balance and functional mobility in people with PD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409066/

 

Improve Movement and Flexibility in Older Women with Tai Chi

Improve Movement and Flexibility in Older Women 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” – 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. 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 “Effect of Yang-Style Tai Chi on Gait Parameters and Musculoskeletal Flexibility in Healthy Chinese Older Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968961/ ), Zou and colleagues recruited elderly women (> 65 years of age) and randomly assigned them to either a Tai Chi practice or no-treatment control conditions. Tai Chi was practiced under the supervision of a Tai Chi master for 90 minutes, 3 times per week for 8 weeks. They were measured before and after practice for physical activity and hip and foot flexibility. They also walked a short distance and their movements of the knee, hip, and ankle were analyzed through a kinematic analysis.

 

They found that the Tai Chi group and not the control group after the 8-week practice period had significant improvements in their walking including stride length, gait speed, stance phase, swing phase, and double support time. They also had significant improvements in their hip and foot flexibility and range of motion of the knee, hip, and ankle. No adverse events as a result of Tai Chi practice were reported by the participants.

 

These findings conclusively document the ability of Tai Chi practice to help maintain the flexibility and range of motion of elderly women. This is particularly important as it suggests that these women would be less likely to fall and maintain a high quality of life. In addition, as Tai Chi is gentle and safe, is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, 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 maintain the health and well-being of the elderly.

 

So, improve movement and flexibility in older women with Tai Chi.

 

“Unlike other exercises, TCE may contribute to improving the quality of life and reducing depression in patients with chronic diseases.” – X. Wang

 

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., Wang, C., Tian, Z., Wang, H., & Shu, Y. (2017). Effect of Yang-Style Tai Chi on Gait Parameters and Musculoskeletal Flexibility in Healthy Chinese Older Women. Sports, 5(3), 52. http://doi.org/10.3390/sports5030052

 

Abstract

The purpose of the present study was to examine the effect of Yang-style Tai chi (TC) on gait parameters and musculoskeletal flexibility in healthy Chinese female adults. Sixty-six female adults aged >65 years were randomly assigned to either an experimental group (67.9 ± 3.2 years of age) receiving three 90-min simplified 24-form TC sessions for eight weeks, or a control group (67.4 ± 2.9 years of age) who maintained their daily lifestyles. All study participants were instructed to perform a selected pace walking for recording gait parameters (stride length, gait speed, swing cycle time, stance phase, and double support times) at both baseline and after the experiment. Low-limb flexibility and range of motion at specific musculoskeletal regions (hip flexion, hip extension, and plantar flexion, as well as anterior and lateral pelvic tilts, pelvic rotation, and joint range of motion (hip, knee, and ankle)) were also assessed in the present study. Multiple separate 2 × 2 Factorial Analysis of Variance (ANOVA) with repeated measures were used to examine the effects of TC on the abovementioned outcomes between baseline and posttest in the two groups. When compared to those in the control group, older female adults who experienced the 8-week Tai chi intervention demonstrated significant improvements in most of the outcome measures. More specifically, positive changes in the TC group were found, including gait parameter (p < 0.001 for all; stride length (1.12 to 1.24, +8.6%), gait speed (1.06 to 1.21, +13.9%), stance phase (66.3 to 61.8, −5.5%), swing phase (33.7 to 38.4, +10.1%), double support time (0.33 to 0.26, −21.1%)), flexibility-related outcomes (hip flexion (90.0 to 91.9, 22.6%, p < 0.0001), single hip flexor (6.0 to 2.0, −61.5%, p = 0.0386), and plantar flexion (41.6 to 49.7, +17.5%, p < 0.0001)), and range of motion (anterior pelvic tilt (9.5 to 6.2, −34.7%, p < 0.0001), lateral pelvic tilt (6.6 to 8.3, +23.8%, p = 0.0102), pelvic rotation (10.3 to 14.7, 28.2%, p < 0.0001), hip range of motion (29.8 to 32.9, +13.5%, p = 0.001), and ankle range of motion (28.0 to 32.6, +11.1%, p < 0.0001)). The present study supports the notion that the practice of TC has a positive effect on healthy older female adults in improving gait parameters and flexibility, counteracting the normal functional degeneration due to age.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968961/