Stroke is the third leading cause of death in the United States, and “the leading cause of serious, long-term disability among middle-aged and older adults.” Stroke causes brain injury which leads to paralysis and impairs speech, vision and balance. It is most common among adults 65 years and older. This age group is already at a high risk for falls, so having a stroke makes falls even more likely for older adults. A study showed that Tai Chi reduces falls among stroke survivors compared to other physical activities.
Every year, about 15 million people around the world suffer from a stroke. In the United States, the number is 700,000. Of those who survive, 14% will have another stroke “within 1 year, leading to long-term disability.” Stroke survivors fall about seven times as often as healthy adults because of vision problems, impaired inner-ear equilibrium (which affects balance) or the physical weakness caused by paralysis. Additionally increased falls may be the result of poor muscle control because of damage to the parts of the brain that communicate to your muscles when you move.
For 12 weeks, The study followed 89 older adults who had survived a stroke. 31 participants followed the Silver Sneakers program (an exercise program for seniors geared at total body conditioning), 30 practiced Tai Chi and 28 received the “usual care.” The usual care involved receiving weekly phone call encouraging participants to be active and providing them with “written material about participating in community-based physical activities.” The groups were made up of similar participants in terms of gender, age, income, type of stroke and mental state.
During the study period, the participants were asked to report the number of falls they suffered. Falls were defined as, “events in which subjects end up on the floor or ground when they did not expect to.” They also reported near-falls, which were defined as, “events in which subjects are able to catch themselves and regain balance without falling.” The Tai Chi group reported two-thirds fewer falls than the other two groups. Additionally, the Tai Chi group reported more near-falls, indicating that they were better equipped to regain balance than the other groups.
There are some theories why the Tai Chi group performed the best. Many traditional physical activities work on static or standing balance. In contrast, Tai Chi works on dynamic or moving balance.
Additionally, while other activities can be performed passively, Tai Chi focuses on mindfulness. It emphasizes being aware of how you move and the interaction between your body and the external environment. This may lead to fewer falls due to the recognition of dysfunctional movements and avoiding tripping hazards.
Tai Chi may also help symptoms of hemiparesis. Hemiparesis is weakness on one side of the body as a result of a stroke. Proprioception and kinesthetic awareness are very important for balance. Both diminish with age and are further impaired by stroke. If the sense of your body position and movement in space. Proprioception is the way your brain communicates with your body through the nervous system. Your nerves are constantly sending information to your brain from your tendons and muscles, informing your mind about the position, actions and coordination of your body parts.
If you cannot sense the position of your limbs you probably cannot detect changes and make compensatory movements to stop yourself from falling. A person who has suffered a stroke may still try to move like they did before the brain and physical injury, however, his or her body is no longer the same. Therefore, what may have once been the steps to correct movements may not produce the same physical result. Tai Chi involves slow movements while focusing on awareness and correct body position. This may help stroke patients relearn and redevelop proprioception and kinesthetic awareness to match the mind-body changes they have experienced.
While a stroke is a serious and debilitating event, all may not be lost. Tai Chi may be an effective choice of physical activity to improve balance in survivors. Unlike other activities, it focuses on dynamic balance, mindful movement and improves proprioception and kinesthetic awareness. This is important to reduce the elevated risk of falls among stroke survivors.
Sources:
Effect of Tai Chi on Physical Function, Fall Rates and Quality of Life Among Older Stroke Survivors.
By Ruth E Taylor-Piliae, Tiffany M. Hoke, Joseph T. Hepworth, L. Daniel Latt, Bijan Najafi, Bruce M. Coull. Archives of physical medicine and rehabilitation. 2014 May;95(5):816-24. doi: 10.1016/j.apmr.2014.01.001. Epub 2014 Jan 17