The ancient Chinese martial art tai chi may reduce falls among adult stroke survivors, researchers at the University of Arizona have found.
A handful of studies published in peer-reviewed journals have previously connected tai chi with health benefits, but none studied the improvement of physical functioning specifically among elderly stroke survivors, said principal investigator Ruth Taylor-Piliae, an assistant professor in the UA College of Nursing. Results of the UA research were presented for the first time at the International Stroke Conference in Hawaii Feb. 6.
Tai chi involves movement and meditation intended for defense training and health benefits. It improves balance, strength, flexibility and aerobic endurance, Taylor-Piliae says. In addition, she found tai chi to have other benefits like less anxiety and depression, more social support, more confidence to exercise and better moods.
Taylor-Piliae first became interested in the benefits of tai chi while working as a nurse in Hong Kong for 15 years, when she noticed the parks were filled with tai chi practitioners.
She conducted her study in January 2009 along with eight researchers. They recruited 89 participants who were at least 50 years old and had experienced a stroke three months or more beforehand.
Individuals were randomly assigned to one of three study groups, with the first practicing tai chi; the second doing Silver Sneakers, a publicly-funded fitness program for seniors; and a usual-care group, which provided regular post-stroke education.
Jeff Zauderer, a master instructor at Great Harmony Tai Chi Chuan, taught tai chi groups three times a week at both Tucson locations of HealthSouth, a rehabilitation institute. After 12 weeks of therapy, researchers say, participants in the tai chi program reported only one-third the falls as participants in the Silver Sneakers and usual-care groups.
Participants reported a total of 34 falls. Those in the Silver Sneakers group had 14, while people in the usual-care group reported 15, the study says. The tai chi group had five falls.
Al Freitchen, a participant in the tai chi group, says he is now addicted to the martial art and practices it twice a week. He had never tried tai chi before volunteering for the study, which he learned about from a nurse at the Tucson VA hospital.
"One of the realities is that you're never going to come back exactly the way you used to be, but what you can do is get as close to that as possible," he said. "This study gave me a way to gauge my improvement and that was huge for me. This is a win on many levels."
The follow-up study, at 24 weeks, rechecked balance, strength, walking speed and quality of life using an assessment developed by the National Institute on Aging for evaluating lower-extremity functioning in older people. The tai chi participants showed continued improvements, Taylor-Piliae said.
At his follow-up assessment, Freitchen learned his baseline physiological functioning had improved by 15 to 20 percent since the start of the study.
Falls are devastating to older adults and are even more of a risk for people who have had strokes.
"Stroke survivors experience up to seven times more falls every year because their balance is impaired and equilibrium is affected after a stroke," Taylor-Piliae said.
Strokes are the brain equivalent of a heart attack and kill more than 800,000 people annually, the Centers for Disease Control says.
The type of therapy needed by a stroke survivor depends on where in the brain it occurred. Some stroke survivors need occupational, speech and physical therapy.
Freitchen, 59, said that after his stroke he "couldn't put two words together."
"More than a sentence of reading would turn into mush," said Freitchen, who retired after more than 30 years with the city of Tucson and decided to take a two-month road trip across the country to visit national parks, historical monuments and relatives. While he was in Washington, D.C. his right arm became numb and he had a strange feeling in his neck, but he dismissed it.
Ten days later he returned home to Tucson and as he read a book in bed, his eyes lost focus and he couldn't lay his book down. Neighbors called 911 and Freitchen was taken to a hospital. It was a stroke. Five years after his stroke he volunteered for the UA study. At that time, he had regained his speech but had limited movement.
Now, he feels more improvement in his hips and shoulders and can do something new, too - a 360-degree turn. He said he notices small changes each time he practices tai chi.
The four-year UA study was funded by a $280,000 grant from the American Heart Association and a $350,000 grant from the Robert Wood Johnson Foundation. Taylor-Piliae has already started to write a grant proposal for a second research study.
"Next we hope to add more precise lab-based measurements to really look at how we can prevent falls further and tailor things into finer grain detail," she said.
Courtney L'Ecuyer is a University of Arizona student who is an apprentice at the Star. Contact her at 573-4117 or at firstname.lastname@example.org