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* BMJ Group, Wednesday 25 March 2009

The traditional Chinese exercise Tai Chi may help people who’ve had strokes regain their ability to balance. In a study, people were better able to balance after a 12-week course of Tai Chi than after a course of general exercise and stroke education.

What do we know already?

Having a stroke can damage the parts of the brain that help you keep your balance. Not everyone gets this problem, but some people find it hard to learn to walk again. Problems with balance can mean people are more likely to fall and injure themselves.

Tai Chi is a form of exercise where people learn to move slowly and deliberately through a sequence of standing poses. It’s usually done in smooth, flowing movements and requires a lot of concentration. It’s very popular in China, especially with older people, who often take part in outdoor classes in parks.
What does the new study say?

The study compared two groups of people who’d had strokes more than six months previously. One group had regular sessions of exercise therapy and the other did sessions of Tai Chi. Both groups had 12, weekly, hour-long sessions, and were encouraged to spend another three hours a week practising at home.

At the end of the study, and again four weeks later, the Tai Chi group performed better in tests of how good their balance was when they were standing. They were better able to shift their weight and lean forwards and backwards, and from one side to another. They were also better able to balance on a moving surface, with and without their eyes closed. The general exercise group didn’t show much improvement in these tests.

Neither group improved much in a test looking at speed of mobility, which measured how quickly people could get up from a chair, walk, turn around and sit back down.

How reliable are the findings?

The study only looked at 136 people, but seems to have been carried out well. The people allocated to practice Tai Chi were slightly younger, but the researchers adjusted their results to account for this. Both groups had similar test results at the start of the study.

The results are likely to be fairly reliable, but only looked at the short-term benefits of Tai Chi. It would be useful to know whether the benefits lasted, or whether doing Tai Chi could stop people falling and injuring themselves.
Where does the study come from?

The study was carried out by researchers at Hong Kong Polytechnic University, China. It was published in the medical journal Neurorehabilitation and Neural Repair, owned by the American Society of Neurorehabilitation. It was funded by the S.K. Yee Medical Foundation and by a grant from the Hong Kong Polytechnic University.
What does this mean for me?

If you’ve had a stroke and have problems with balance, this is an interesting study. But we don’t know whether the improved balance necessarily translates into fewer falls. Also, although the improvement lasted during the four weeks from the end of the study to the final test, we don’t know whether it would last longer than that. It might depend on whether people continued to practise.

What should I do now?

You could look to see whether there are any Tai Chi classes in your area. However, the study used an adapted form of Tai Chi that had been developed for people with arthritis. You should speak to an instructor to ask whether the type of Tai Chi they teach is suitable for people who’ve had a stroke. You may need extra help or support to make sure you don’t fall while taking part.
From: The Guardian web site, Health: best treatments

Au-Yeung SSY, Hui-Chan CWY, Tang JCS. Short-form Tai Chi improves standing balance of people with chronic stroke. Neurorehabilitation and Neural Repair. Published online January 2009.

© BMJ Publishing Group Limited (“BMJ Group”) 2009

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Tai Chi Short Form

Tai Chi Short Form DVD

Tai Chi Long Form

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