Tai chi helps Parkinson’s patients balance

Twice-a-week tai chi lessons can help people with Parkinson’s disease maintain their footing and lessen the risk of falls, a new study finds. Training in the Chinese martial art seems to improve ankle stability, posture control and walking ability in these patients.

Tai chi includes exercises and posture changes by which the body flows slowly from one position into another, with heightened awareness of balance, coordination and weight shifting. “We’re hoping that physical therapy will pick up some of these movements” for Parkinson’s patients, says study coauthor Fuzhong Li, a behavioral researcher at the Oregon Research Institute in Eugene. “They are very easy to incorporate into PT sessions.” The study appears in the Feb. 9 New England Journal of Medicine.

Parkinson’s disease gradually destroys brain cells that produce dopamine, a neurotransmitter essential for delivering brain signals that control muscle movement. People with the disease risk falling every day as they struggle to maintain balance in walking and performing common tasks.

Many Parkinson’s patients improve with medication or brain surgery (SN: 9/2/2006, p. 149). But those benefits have limits. “Surgical treatment and drugs make a person more mobile but don’t improve the ability to control balance,” says Lee Dibble, a physical therapist and Parkinson’s researcher at the University of Utah. The new report suggests that tai chi and to some extent resistance training do aid balance and limit falls. “You really need an intervention like this to improve and maintain function,” Dibble says.

Li and his colleagues randomly assigned 195 Parkinson’s patients to participate in one of three regimens for one hour twice a week — tai chi, resistance training to strengthen muscles or light stretching. The volunteers underwent standard tests of balance, posture and routine activities at the outset and again after 24 weeks of training.

The tai chi patients collectively reported 62 falls during the study period, compared with 186 in the light stretching group, Li says. The tai chi group also outperformed the stretching assignees in every movement tested.

Patients assigned to resistance training reported 133 falls, but the difference between that and the tai chi group’s 62 could have been due to statistical chance.  The tai chi group did show more improvement than the resistance group in two standard balance tests that measure the ability to lean in various directions without having to step or lift a heel. Patients getting tai chi training also gained more stride length and functional reach but scored the same as the resistance training group on other tests.

Other interventions, such as tango dancing, have also shown potential in aiding Parkinson’s patients’ balance. Therapists need to consider quality of life issues and try techniques that are appealing to their patients, says Madeleine Hackney, a kinesiologist at Emory University and the Veterans Affairs Medical Center in Atlanta. “They may know it’s great for them, but if they don’t enjoy it, that’s a problem,” she says.