Tuesday 30 September 2014

Tai Chi for patients with Parkinson’s disease

http://jhsacupuncture.co.uk/tai-chi-balance-patients-parkinsons-disease

There have been, for some time now, reports that Tai Chi has a positive effect for people who suffer from Parkinson's disease and from a teaching perspective I can understand how this would be true but I wanted to see if there was any peer reviewed literature that would support this.

So here are a few articles I have found that provide some quantatitive evidence to the positive effects that Tai Chi can bring to people with Parkinson's disease.

Effects of Tai Chi on balance and fall prevention in Parkinson's disease: a randomized controlled trial.

A Chinese research team has found that Tai Chi can improve balance and decrease fall risks in patients with Parkinson's disease (PD). Seventy-six patients with PD took part in 60 minutes of Tai Chi form three times a week for 12 weeks. The control group received no intervention.

The balance of subjects in the TC group was found to improve more than those in the control group.
During six-month follow-up, eight (21.6%) patients in the Tai Chi group experienced falls, compared to 19 (48.7%) patients in the control group.

 

Tai Chi Exercise can Improve the Obstacle Negotiating Ability of People with Parkinson's Disease: A Preliminary Study.

The purpose of this study was to examine the effects of Tai Chi based exercise on dynamic postural control during obstacle negotiation by subjects with mild or moderate Parkinson's disease (PD).

Twelve subjects (mean age, 65.3±6.1?years) diagnosed with idiopathic PD were enrolled for this study.
All the subjects were tested a week before and 12 weeks after the initiation of the TC exercise. In the test, they were instructed to negotiate an obstacle from the position of quiet stance at a normal speed. They were trained with TC exercise that emphasized multidirectional shift in weight bearing from bilateral to unilateral support, challenging the postural stability, three times per week for 12 weeks.

Center of pressure (COP) trajectory variables before and after TC exercise were measured using two force plates.
A comparison of the results between pre- and post-intervention showed a statistically significant improvement in anteroposterior and mediolateral displacement of COP.

Twelve weeks of TC exercise may be an effective and safe form of stand-alone behavioral intervention for improving the dynamic postural stability of patients with PD.

 
 

Tai Chi for improvement of motor function, balance and gait in Parkinson's disease: a systematic review and meta-analysis.

Recently, several studies assessed the effectiveness of Tai Chi for Parkinson's disease (PD), but the role of Tai Chi in the management of PD remained controversial. Therefore, the purpose of this systematic review is to evaluate the evidence on the efficacy of Tai Chi for PD.

Six English and Chinese electronic databases, up to April 2014, were searched to identify relevant studies. The risk of bias in eligible studies was assessed by Cochrane Collaboration's tools. The primary outcomes were motor function, balance and gait in individuals with PD. Standardized mean difference (SMD) and 95% confidence intervals (CI) of random-effect model were calculated. And heterogeneity was assessed based on the I2 statistic.
7 randomized controlled trials and 1 non-randomized controlled trial were eligible. 

The aggregated results suggested that Tai Chi showed beneficial effects in improving motor function (SMD, -0.57; 95% CI -1.11 to -0.04; p?=?0.03), balance (SMD, 1.22; 95% CI 0.80 to 1.65; p<0.00001) and functional mobility (SMD, 1.06; 95% CI 0.68 to 1.44; p<0.00001) in patients with PD, but not in improving gait velocity (SMD, -0.02; 95% CI -0.58 to 0.54; p?=?0.94), step length (SMD, -0.00; 95% CI -0.57 to 0.56; p?=?0.99), or gait endurance (SMD, 0.53; 95% CI -0.07 to 1.12; p?=?0.08). Comparing with other active therapies, however, Tai Chi only showed better effects in improving balance (SMD, 0.74; 95% CI 0.38 to 1.10; p<0.0001).

Tai Chi should be a valid complementary and alternative therapy for PD, especially in improving motor function and balance. However, more studies with long follow-up are warrant to confirm the current finding of Tai Chi for PD.


For the full article click here

Therapeutic effects of Tai Chi in patients with Parkinson's disease

The purpose of the study was to investigate the effects of a 12-week program of therapeutic Tai Chi on the motor function and physical function of idiopathic Parkinson's disease patients (PDs).

The participants were 22 clinically stable PDs in Hoehn-Yahr stages 1-2 randomly assigned to a therapeutic Tai Chi group (TTC, N = 11) or a control group (CON, N = 9). Two subjects in control group did not complete the study for personal reasons. Tai Chi was performed three days a week (60?min/session). Motor symptoms by the UPDRS were assessed, and tests of physical function were administered before and after the 12-week trial.
The Tai Chi group, as compared to the control group, showed changes in the mentation, behavior, mood, and motor scales of the UPDRS (P < 0.05, P < 0.01, resp.), with no significant main effects on the activities of daily living scale (ADL).

However, there was a significant interaction between the time and intervention group on ADL (P < 0.05). There were no significant main effects for any of the physical function variables. There were significant interaction effects in balance and agility (P < 0.05, resp.). Conclusions.

This study showed that TTC training had modest positive effects on the functional status of Parkinson's disease patients.