Taiji is no longer shrouded in mystery for those seeking to understand this eastern-based art.
That also includes the western Medical World. Thanks to the efforts of Doctors such as Fuzhong Li, Ph.D, Dr Yang Yang and many others we are now seeing the long awaited marriage of Eastern and Western philosophies regarding health. Maybe in my optimistic state of mind I’m jumping the gun, so let me rephrase the above statement. “The engagement announcement of Eastern and Western philosophies regarding health”. It seems that we still have a ways to go. You might say that the parents of this couple have more than a few hurtles in front of them and they are not exactly holding their glasses high and toasting one and other (yet). However, they are beginning to understand each other better and actually agreeing on certain concepts (or sitting in the same room so to speak). One of those being Taiji as a viable tool for treating some of the diseases that continue to challenge western medicine. The New England Journal of Medicine is no stranger to controversy related to what they will publish. It is certainly not always in accordance with typical western medicine’s way of thinking. Last week an article was published based on the works of Fuzhong Li, Ph.D., Peter Harmer, Ph.D., M.P.H., Kathleen Fitzgerald, M.D., Elizabeth Eckstrom, M.D., M.P.H., Ronald Stock, M.D., Johnny Galver, P.T., Gianni Maddalozzo, Ph.D., and Sara S. Batya, M.D.
I commend them and greatly appreciate the efforts of Fuzhong Li, Ph.D and his colleagues. Also with his permission I present to you a condensed version of their report including their conclusion as posted on the site of The New England Journal of Medicine.
Tai Chi and Postural Stability in Patients with Parkinson's Disease
Background
Patients with Parkinson's disease have substantially impaired balance, leading to diminished functional ability and an increased risk of falling. Although exercise is routinely encouraged by health care providers, few programs have been proven effective.Methods
We conducted a randomized, controlled trial to determine whether a tailored tai chi program could improve postural control in patients with idiopathic Parkinson's disease. We randomly assigned 195 patients with stage 1 to 4 disease on the Hoehn and Yahr staging scale (which ranges from 1 to 5, with higher stages indicating more severe disease) to one of three groups: tai chi, resistance training, or stretching. The patients participated in 60-minute exercise sessions twice weekly for 24 weeks. The primary outcomes were changes from baseline in the limits-of-stability test (maximum excursion and directional control; range, 0 to 100%). Secondary outcomes included measures of gait and strength, scores on functional-reach and timed up-and-go tests, motor scores on the Unified Parkinson's Disease Rating Scale, and number of falls.Results
The tai chi group performed consistently better than the resistance-training and stretching groups in maximum excursion (between-group difference in the change from baseline, 5.55 percentage points; 95% confidence interval [CI], 1.12 to 9.97; and 11.98 percentage points; 95% CI, 7.21 to 16.74, respectively) and in directional control (10.45 percentage points; 95% CI, 3.89 to 17.00; and 11.38 percentage points; 95% CI, 5.50 to 17.27, respectively). The tai chi group also performed better than the stretching group in all secondary outcomes and outperformed the resistance-training group in stride length and functional reach. Tai chi lowered the incidence of falls as compared with stretching but not as compared with resistance training. The effects of tai chi training were maintained at 3 months after the intervention. No serious adverse events were observed.Conclusions
Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson's disease, with additional benefits of improved functional capacity and reduced falls. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00611481.)Supported by a grant (NS047130) from the National Institute of Neurological Disorders and Stroke.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
No potential conflict of interest relevant to this article was reported.
We thank all the study participants (in Eugene, Corvallis, Salem, and Portland) for their support and dedication to this research project; the neurologists for providing medical clearance and Parkinson's disease stage diagnoses for their participating patients; the project instructors (Vicki Anderson, Denise Thomas-Morrow, Don Hildenbrand, Brian McCall, James Lusk, Nancy Nelson, Teena Hall, Machiko Shirai, and Julie Tye); the research assistants (Debbie Blanchard, Kristen Briggs, Ruben Guzman, Daehan Kim, Lisa Marion, Arissa Fitch-Martin, Kimber Mattox, Julia Mazur, Donna McElroy, Jordyn Smith, and Rachel Tsolinas); the physical therapists (Andrea Serdar, Jeff Schlimgen, Jennifer Wilhelm, Ryan Rockwood, and Connie Amos at Oregon Health and Science University); the study data analyst, Shanshan Wang; Kathryn Madden and the members of the institutional review board at the Oregon Research Institute for their careful scrutiny of the study protocol; and Ron Renchler for proofreading earlier drafts of the manuscript.
Source Information
From the Oregon Research Institute (F.L.), the Oregon Medical Group (K.F.), and the PeaceHealth Medical Group–Oregon (R.S.) — all in Eugene; Willamette University (P.H.) and BPM Physical Therapy Center (J.G.) — both in Salem, OR; Oregon Health and Science University, Portland (E.E.); Oregon State University, Corvallis (G.M.); and Oregon Neurology Associates, Springfield (S.S.B.).Address reprint requests to Dr. Li at the Oregon Research Institute,
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