Harvard Health Letter

Tai chi helps Parkinson's patients with balance, movement

People doing tai chi look like they're moving in graceful slow motion, but something about those carefully controlled movements — and perhaps the mindset they put people in — seems to have health benefits. Tai chi has been tested in dozens of studies, and the findings suggest that it can help people with conditions ranging from heart failure to osteoporosis to fibromyalgia. Now it seems that Parkinson's disease can be added to that list.

Perhaps the most surprising thing about the Parkinson's study was that it wasn't done sooner. Parkinson's disease, a brain disorder that affects muscle control, causes trembling and stiffness. Balance is adversely affected, so falls are a major problem. Doctors already recommend that Parkinson's patients exercise, although perhaps not as often and as forcefully as they might. This study included 195 people with mild-to-moderate Parkinson's disease (1 to 4 on a scale of 5). They were randomly assigned to twice-weekly sessions of tai chi, strength-building (resistance) exercise, or stretching. After six months, the patients who did tai chi performed better on tests designed to measure balance and the ability to control movement than the patients in the other two groups. The difference was especially pronounced on the movement tests. The patients in the tai chi group also performed better on some secondary tests involving gait and reach and fell less often than those in the stretching group (the difference with strength-building wasn't large enough to reach statistical significance on those measures). The results were reported in the Feb. 9, 2012, issue of The New England Journal of Medicine.

These results affirm the general recommendation to exercise and then refine that with an endorsement of tai chi. More research — and a lot more convincing of doctors and patients — will have to take place before tai chi becomes a standard practice for Parkinson's disease patients. But, as the authors of this study point out, there's good reason to believe that tai chi would have special therapeutic value for people with the disease. Tai chi movements involve subtle shifts in weight, maintaining a relaxed but upright posture, and rotating the trunk, all of which can help with balance. Practicing controlled movement would seem to help the tremors and other extraneous movement. And, judging by this study, there's little risk of people coming to harm. The people in the tai chi group reported fewer adverse events (just two falls and one instance of muscle soreness) during their twice-weekly sessions than those working on strength or stretching.

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