Posts Tagged ‘balance’

Tai Chi Helps Stroke Survivors Reduce Falls

Tai Chi can enhance balance, lower blood pressure, and improve mood, which are all important for stroke survivors.

People who have had strokes often suffer damage to the parts of the brain that help in maintaining balance.

Many people who suffer these problems with balance are more prone to falling and injuring themselves.

A handful of studies have evaluated Tai Chi as a rehabilitation exercise for stroke survivors.

Now Arizona researchers have found that stroke survivors who learned Tai Chi had fewer falls compared with those who participated in an exercise program for older adults or those who received usual care to help them recover from a stroke.

“Learning how to find and maintain your balance after a stroke is a challenge,” said Ruth E. Taylor-Piliae, Ph.D., R.N., the study’s principal investigator and Assistant Professor at the University of Arizona College of Nursing in Tucson, AZ.

“Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls.”

Taylor-Piliae presented the results of the study at the recent American Stroke Association’s International Stroke Conference 2013 in Honolulu.

The study included 89 stroke survivors, average age 70, who had suffered a stroke an average of 3 years prior to enrolling in the study.

The researchers randomly assigned the stroke survivors to one of three groups.

One third received Tai Chi instruction for 12 weeks.

Another third took a 12-week SilverSneakers® exercise class that focused on improving muscle strength and range of movement.

A third group received weekly follow-up phone calls along with written information encouraging them to be physically active.

The Tai Chi and SilverSneakers® classes met three times a week for an hour-long workout.

During the 12-week study, the researchers found that the Tai Chi group had the fewest number of falls (5) compared to those in the usual care group (15) and in the SilverSneakers® group (14).

Only four people who fell required medical treatment.

“The main physical benefits of Tai Chi are better balance, improved strength, flexibility, and aerobic endurance,” Taylor-Piliae said.

“Psycho-social benefits include less depression, anxiety and stress, and better quality of life.”

Previous studies have shown that Tai Chi may help improve clinical measurements of balance, for example, the ability to maintain balance or to reach and lean both forward and backwards.

“What’s noteworthy about this small, but strong, study is the researchers measured actual falls, and showed that Tai Chi translated into a reduction in falls,” says Peter Wayne, PhD, Assistant Professor of Medicine, Harvard Medical School, and Director of Research, Osher Center for Integrative Medicine at Brigham and Women’s Hospital and Harvard Medical School, and author of the upcoming The Harvard Medical School Guide to Tai Chi.

Wayne and his colleagues, as well as other researchers, have shown that Tai Chi improves balance and the gait of people with various neurological conditions.

New studies are now underway to study Tai Chi in Parkinson’s disease.

“Tai Chi training has the potential to translate into practical improvement in daily activities,” says Wayne.

“It can help people get stronger and more flexible, and improve balance, including those with severe neurological injuries.

Tai Chi also reduces the fear of falling, which helps promote a more active lifestyle.”

So the bottom line is that Tai Chi not only helps you feel better and have better balance, but you are less likely to fall.

Tai Chi: One of the Best Exercises for Balance

Tai Chi may be one of the better exercises you can do to maintain balance and prevent falls, based on systematic reviews.

“The diverse, multiple active ingredients inherent in Tai Chi allow you to compensate for deficiencies in the physiological and cognitive components that underlie balance loss,” says Peter Wayne, PhD, Assistant Professor of Medicine at Harvard Medical School and Director of Research, Osher Center for Integrative Medicine Division of Preventive Medicine Brigham and Women’s Hospital and Harvard Medical School.

Keeping your balance is a complex task, involving the co-ordination between muscles and sensors that detect balance and are part of the nervous system.

In older people many factors, such as reduced muscle strength, stiff joints, delayed reaction times, and changes in the sensory system, all add up to a reduced ability to maintain balance.

A new Cochrane Review indicates that regular exercise helps older people improve their balance and reduces their risk of falling.

The new review included 94 studies that involved a total of nearly 10,000 participants.

The following types of exercise are the most effective, according to the review:

* exercise that targeted a person’s walking, balance, and co-ordination

* strengthening exercises

* 3-dimensional exercises, including Tai Chi, dance, and yoga

* general physical activity such as walking or cycling

* computerized balance training that uses visual feedback

* exercise involving vibrating platforms

In general, the effective programs ran 3 times a week for a duration of 3 months and involved exercises that challenged people’s balance while they were standing.

Dr. Wayne explains how Tai Chi helps balance:

* It’s a weight-bearing exercise.

* It sensitizes sensory systems.

* It helps coordinate neuromuscular patterns.

* It reduces the fear of falling, which is one of the biggest predictor of falls.

Tai Chi Prevents Falls and Boosts Balance Confidence

Tai Chi has been shown to be very safe for elderly, frail, and de-conditioned people who often have poor balance.

In older people, good balance prevents falls and provides confidence to sustain physical and social activities.

Not surprisingly, Tai Chi is increasingly being adopted in community programs for balance rehabilitation and fall prevention.

Two new meta-analyses show that Tai Chi is, indeed, a good exercise for fall prevention and balance.

One overview analyzed 35 systematic reviews assessing the health effects of Tai Chi.

The Korean and British researchers found Tai Chi helps to reduce the risk of falls and to improve balance in older people.

The second systematic review examined 30 studies that looked at balance confidence among older adults.

The Israeli researchers found Tai Chi was the most beneficial in increasing balance confidence when compared to exercise and other multifactorial interventions.

How does Tai Chi help?

The effectiveness of Tai Chi is due to its multiple components, says Peter Wayne, PhD, Director of Tai Chi and Mind-Body Research Programs, Harvard Medical School’s Osher Research Center.

1. Tai Chi is a weight bearing exercise.

It involves a constant shifting of weight from one leg to the other and lots of one-legged standing with the knees bent, which facilitates improved dynamic standing balance and strength of the legs, ankles, and feet.

2. With Tai Chi, your sensory systems become sensitized, which leads to better balance and function.

Tai Chi’s continuous, slow, even tempo facilitates sensory awareness of the speed, force, trajectory, and execution of movements, as well as awareness of the external environment.

3. The sequencing, timing, and combinations of different muscle groups in Tai Chi helps coordinate neuromuscular patterns.

The quiet standing of Tai Chi enhances the ability to stand upright with optimal efficiency.

More importantly, it also improves your balance as you move and helps you deal with perturbations in balance, for example, when you walk on a rocky road.

4. Tai Chi improves balance and reduces falls by reducing the fear of falling.

Many studies show that Tai Chi reduces the fear of falling, which is one of the biggest predictors of falls.

This is probably because Tai Chi is such a holistic intervention that enhances awareness, cognitive training, and provides more confidence from better strength.

“Based on systematic reviews of exercise and falls prevention, Tai Chi may be one of the better exercises you can do,” says Wayne.

“The diverse, multiple active ingredients inherent in Tai Chi allow you to compensate for deficiencies in the physiological and cognitive components that underlie balance loss.”