An ancient form of gentle movement may offer help for a modern-day concern: A new study suggests that tai chi can reduce the number of falls in adults who have survived a stroke.
Researchers found that stroke survivors who learned tai chi had the fewest number of falls compared with people who participated in an exercise program for older adults as part of their stroke recovery or people who received usual care to help them recover from a stroke.
For the study, researchers randomly assigned 89 stroke survivors, whose average age was 70, to one of three groups. A third of the men and women received tai chi instruction for 12 weeks; another group took a 12-week SilverSneakers ® exercise class that focused on improving muscle strength and range of movement; and a third group of stroke survivors received weekly follow-up phone calls along with written information encouraging them to be physically active.
Both the tai chi and SilverSneakers ® classes met three times a week for an hour-long workout. On average, people had suffered a stroke three years prior to enrolling in the study.
During the three-month experiment, a total of 34 falls at home were reported by the study participants, typically as a result of tripping or slipping. Researchers found that the tai chi group had the fewest number of spills. Among tai chi practitioners, just five falls occurred. People in the usual care group had the most tumbles and falls — 15. And people who participated in the SilverSneakers ® group had a similar number of falls — 14. Only four people who fell required medical treatment.
The findings were presented today (Feb. 6) at the American Stroke Association's International Stroke Conference 2013 in Honolulu.
Stroke affects balance
Most stroke survivors have balance problems, regardless of where the stroke occurred in the brain, said study author Ruth Taylor-Piliae, an assistant professor at the University of Arizona College of Nursing in Tucson.
There are many reasons why balance is off following a stroke, she said. "It could be that a person has vision problems, or someone's inner ear equilibrium is not working right, or an individual is experiencing physical weakness on one side of the body," Taylor-Piliae said.
This makes stroke survivors more prone to falling: They experience seven times as many falls as healthy adults. With its slow, gentle, whole-body movements, tai chi struck Taylor-Piliae as an effective way to help people who have suffered a stroke feel steadier on their feet and regain muscle strength.
How tai chi helps
"Tai chi combines physical movements with mental concentration and relaxation," Taylor-Piliae pointed out. "It's often described as moving meditation." She suspects that tai chi's blend of body and mind benefits is what helps prevent falls in stroke survivors.
Though people who participated in the SilverSneakers ® program focused on strengthening muscles and improving range of movement, they nonetheless had nearly three times the number of falls as those taking tai chi. Taylor-Piliae said that unlike a traditional exercise program, which mostly works on static, or standing balance, tai chi seems to benefit a person's dynamic, or moving balance.
For example, she said when practicing tai chi, people learn how to shift their weight from leg to leg as they move their arms, yet still maintain their balance. In addition to improving balance and strengthening muscle, tai chi teaches people to be mindful, which is a valuable mental component.
To perform tai chi, "You have to be present, you have to be in the moment," Taylor-Piliae said. "Some of this may translate into real life with stroke survivors becoming more aware of what they are doing." And this increased awareness and attentiveness may lead to fewer falls.
While this study taught participants Yang-style tai chi, one of the most popular types practiced in the U.S., Taylor-Piliae thinks that any form of this ancient Chinese practice would benefit stroke survivors. She recommends that stroke survivors check to see if their local community or senior center or YMCA offers classes in the discipline
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