Tai Chi and Parkinson's Disease

Move slowly...

Originating in China as a form of martial arts, Tai Chi is a balance-based exercise that consists of gentle, rhythmic flowing movements that encourage balance and flexibility. It involves deep breathing and places very little stress on joints and muscles resulting in fewer injuries. This “meditation in motion” exercise is a low-impact activity, suitable for all ages and fitness levels.

In China, Tai Chi is thought to have numerous benefits. These include delayed ageing, improved flexibility, stress reduction, improved muscle strength, and for treatment of a variety of illnesses such as heart disease, high blood pressure, digestive disorders, arthritis, mood disorders, cancer and neurological diseases including Parkinson’s. But does scientific evidence exist to support these claims, particularly as Tai Chi relates to Parkinson’s?

Postural instability is one of the cardinal symptoms of Parkinson’s disease that unlike tremor is less likely to improve with conventional treatment. Unfortunately because it can lead to frequent falls, this imbalance also significantly impacts a person’s quality of life.

A study published in 2012 in the New England Journal of Medicine was the first to seemingly show the benefits of Tai Chi in Parkinson’s disease. 195 patients with Parkinson’s were randomized into 3 groups. One group met for Tai Chi classes twice weekly for 60 minutes, the second group underwent resistance training with weights and the third was assigned seated stretching.

After 6 months, the results were clear. Those in the Tai Chi group were more flexible and able to lean farther forward and backward without losing their balance or falling. Compared to the other groups, their movements were also smoother and they were able to take longer strides while walking. Similar to those that exercised with weights, those that took Tai Chi walked more swiftly, had increased leg strength and were able to stand from a seated position more quickly. The most startling improvement however was in the number of falls, with those that practiced Tai Chi falling less than half the number of times compared to the subjects in the two other groups. Interestingly, the Tai Chi group also experienced less dyskinesia as they were able to adopt strategies that resulted in more controlled movement.

All these improvements remained for three months following completion of the study. The authors concluded that “Clinically, these changes indicate increased potential for effectively performing daily life functions, such as reaching forward to take objects from a cabinet, transitioning from a seated to a standing position (and from standing to seated), and walking, while reducing the probability of falls.”

Beyond the motor symptoms of this disease are the nonmotor manifestations that can really affect quality of life for patients. A recent pilot study (2014) explored the benefits of Tai Chi on some of these aspects. One group participated in 60-minute Tai Chi classes three times weekly while the other group served as controls. Upon completion of the study they found that although there was some improvement when they looked at measurements of cognition, specifically attention and working memory, it didn’t reach statistical significance. However there was significant improvement in patients’ reports on quality of life specifically their perception of their disease and their emotional well-being. This study was limited by its sample size (only 21 participants enrolled) but did show some promise, supporting the need for further study.

So should you add Tai Chi into your fitness routine? Based on the gentle and meditative quality of this exercise as well as the scientific support of its use specifically in Parkinson’s disease, a case can be made to incorporate it into your physical practice.