Dr. Kristi Kirschner wasn’t surprised by recent study results that showed tai chi may reduce falls among older adult stroke survivors. She’s been referring patients with disabilities to tai chi classes for years.
“The combination of slow, controlled movement with deep breathing can have both physical and mental health benefits. And it’s very gentle, it’s safe, it does work on balance, so stroke is certainly one group of patients that it really could benefit,” Kirschner, a professor of clinical medical humanities and bioethics at the Feinberg School of Medicine, said.
Led by registered nurse Ruth Taylor-Piliae, the study from the University of Arizona College of Nursing in Tucson, found that tai chi, an ancient Chinese martial art, may reduce the incidence of falls among adults 70 years and older.
Adult stroke survivors 65 years and older are seven times more likely to fall than healthy adults in the same age bracket, she said.
Study participants who practiced tai chi for 12 weeks fell nearly three times less than those who participated in either the usual stroke physical therapy regimen or the SilverSneakers program, an exercise program for older adults who qualify for Medicare.
These results were announced earlier this month at an American Stroke Association Meeting in Honolulu.
But how does tai chi help reduce falls?
Tai chi instructor Anna York of Hyde Park said three core components of tai chi—posture, breathing and pace—can help reduce falls by contributing to improved balance, muscle strength and flexibility.
“Reducing falls is not just about what you do with your feet,” she said. “Reducing falls has to do with the flexibility of the body and the ability to move and balance your torso through shifts and changes.”
York, has been teaching tai chi and qi gong, an ancient Chinese energy practice that combines deep breathing with slow, flowing movements, for over 14 years. She taught both practices at the Rehabilitation Institute of Chicago for three years.
Kirschner said she typically sends her patients to York after they’ve completed the usual three-month intensive physical therapy after their stroke because of York’s dedication to tai chi, as well as her personal experience with the practice.
York, 67, has had multiple sclerosis for 47 years and has treated the potentially debilitating disease with Western treatments such as physical therapy and medication. But it wasn’t until she started practicing tai chi that York noticed a huge change.
“When I started going to tai chi class, my whole circumstance began to turn around...and it actually saved my life. I began to recover and get stronger and eventually the number of attacks did reduce,” she said.
Working with stroke patients on posture and proper gait are essential for them to regain their balance. People who have had a stroke often suffer from hemiparesis, one-sided weakness or paralysis that usually makes it difficult to stand upright and straight, York said.
To counteract the effects of the condition, she helps her patients learn what it looks and feels like to have good posture from the feet, up through the spine, all the way to their shoulders. She also emphasizes the positioning of the knees to make sure they don’t collapse inward.
As patients work on posture and flow through different movements, they also practice deep breathing, which can improve balance and flexibility by relaxing areas of the body that have tightened.
“When the stroke occurs, a lot of times the chest tightens up. We teach various techniques of breathing that open up the abdomen, open the rib cage and open up the chest,” York said.
Deep breathing also benefits pulmonary function, or how well the lungs take in and release air and how well oxygen circulates through the body. This increase in oxygen intake can also increase someone’s ability to be alert and focused, Kirschner added.
And finally, the slow pace of the ancient Chinese exercise completes the triple threat.
Moving slowly and fluidly through postures and stances while breathing deeply can open up a part of the body that is tight and immobile even more, York said.
“And the slow movement is actually more effective at building the strength and … provides an opportunity for mental focus,” she added. “If you can perform a movement slowly, you have to concentrate on it, so it engages the mind and the intention.”
But despite the benefits of tai chi therapy, Kirschner and York said they don’t think the Eastern practice should replace intensive stroke therapy altogether.
Strokes can impact different parts of the body and physical functioning depending on the part of the brain that’s affected, Kirschner said.
Because of this, stroke rehabilitation is typically very individualized, and some patients have to rely heavily on intensive stroke therapy because they’re so severely impacted, she explained.
But Kirschner insisted tai chi could definitely play a powerful role in the rehabilitation process after the first three months of initial therapy.
Only about 10 percent of patients will continue therapy exercises at home once their initial rehabilitation ends. As a result, their physical progress will slow or plateau, Kirschner said.
But her patients who have started taking tai chi are highly enthusiastic about the practice and have kept up with their post-stroke rehab.
York agreed that the social aspect of tai chi helps patients stay committed to their rehabilitation.
But she thinks tai chi can play an integral role in the rehabilitation process even while the patient is going through intensive therapy.
“I am for fully integrative work," she said. "I believe in bringing every resource to bear that one can bring to help the healing process."