Sitting tai chi improves recovery outcomes in older stroke survivors

(ORDO NEWS) — Stroke survivors who practiced the seated form of tai chi experienced equal or greater improvements in hand and arm strength, shoulder range of motion, balance control, symptoms of depression, and daily living after three months compared to those who participated in a standard exercise program.

For stroke rehabilitation, according to new research published today in Stroke, the peer-reviewed leading journal of the American Stroke Association, a division of the American Heart Association.

The American Heart Association and American Stroke Association guidelines for early management of acute ischemic stroke recommend starting stroke rehabilitation within seven days and continuing up to six months after stroke. However, many stroke survivors refuse rehabilitation therapy because they lack physical resilience or cannot fully use their hands.

The Association also notes in the Scientific Statement on Physical Activity and Exercise Recommendations for Stroke Survivors that flexibility and muscle strength training, including yoga and tai chi, is reported to help stroke survivors improve balance, quality of life, and mental health. health, and reduce the fear of falling.

Tai chi, a traditional Chinese martial art, consists of a series of slow, careful movements of the arms, hands, neck, legs, and torso, combined with deep breathing.

The novelty of this study is that scientists have developed a seated tai chi exercise regimen for people who have recently had an ischemic stroke (blockage of a blood vessel in the brain) and experienced arm and hand weakness or partial paralysis.

“Tai chi has a long history as a form of exercise in China. We have redefined tai chi movements for people with weakness or partial paralysis. It is adapted so that participants can move with one hand with their healthy hand,” said Jie Zhao, Ph.D. , lead author of the study and lecturer at Yunnan University of Traditional Chinese Medicine in Yunnan, China.

The study was conducted at two traditional Chinese medicine hospitals in Kunming, China. The researchers recruited 160 adults (mean age 63 years; 81 men and 79 women) who had had their first ischemic stroke within six months of study entry and were still able to use at least one arm.

Among study participants, half were randomly assigned to a seated tai chi program and the other half were part of a control group that followed a standard exercise program for stroke rehabilitation (hospital-recommended upper limb movements; volume, execution strategies, and caregiver responsibilities were similar to the tai chi group) .

The participants in the sitting tai chi group received one-on-one training from a tai chi instructor for one week during their hospitalization and self-study video at home three days a week for 11 weeks. The control group received a videotape of standard home exercises for 12 weeks.

Family members and caregivers supervised home exercise in both groups. Sixty-nine people in the seated Tai Chi group and 65 people in the control group completed a 12-week program and a 4-week follow-up.

Physical function and psychological well-being were measured in all study participants using questionnaires and assessment tools at baseline and four more times during the 16-week program, and the results of the two groups were compared.

The researchers analyzed questionnaires and assessment tools and found the following:

Participants in the sitting tai chi group had better hand and arm function and balance control while sitting compared to participants in the standard stroke rehabilitation group.

Participants in the seated tai chi group had significantly reduced symptoms of depression, improved shoulder range of motion, and significant improvements in daily living and quality of life compared to the control group.

More than half of the people in the Tai Chi group continued to practice after the 12-week course. The improvement in these scores continued throughout the 4-week follow-up period in the tai chi group.

“Seated tai chi can be practiced in a chair or in a wheelchair, and it’s very convenient because it can be practiced at home. The program costs next to nothing, no special equipment or travel time,” Zhao said.

This is the first randomized controlled trial of a modified sitting tai chi program and has shown improved short-term outcomes in a group that has difficulty adhering to a standard exercise program for stroke rehabilitation.

The results obtained indicate that this body-spiritual practice is an effective means to improve balance, coordination, strength and flexibility, especially for stroke survivors with arm and hand weakness or partial paralysis.

“My follow-up study will assess the long-term effects of sitting tai chi,” Zhao said. “Most likely, people will have to do sitting tai chi exercises for more than 12 weeks to get a positive long-term effect.”

One limitation is that the study was conducted at only two centers. In addition, the doctors and medical staff at these centers are trained in Traditional Chinese Medicine and support the study, so the results may not reflect the rehabilitation available to stroke survivors who receive care at other hospitals.

According to the American Heart Association, stroke is the fifth leading cause of death in the United States and the leading cause of long-term disability.

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