National Institute of Neurological Disorders
Exercise is important for a healthy lifestyle but it is also a key part of therapy, rehabilitation and disease management. For Parkinson’s disease, exercise routines are often recommended to help maintain stability and the coordinated movements necessary for everyday living. An NIH-funded study, reported in the February 9, 2012 issue of the New England Journal of Medicine,* evaluated three different forms of exercise – resistance training, stretching, and tai chi – and found that tai chi led to the greatest overall improvements in balance and stability for patients with mild to moderate Parkinson’s disease.
Individuals practicing tai chi exercises
Clinical trial participants assigned to the tai chi exercise group practice slow fluid arm movements in class. Photo credit: Courtesy of Fuzhong Li., Ph.D.
Parkinson’s disease is a movement disorder that is caused by the loss of brain cells which control coordinated and purposeful motions. This cell loss results in tremor, rigidity, slowed movement (known as bradykinesia) and impaired balance (postural instability). While some symptoms, such as tremor, at least benefit from drug therapy initially, the medications currently available to treat Parkinson’s are not as effective in restoring balance. This is a special concern for Parkinson’s patients because postural instability frequently leads to falls.
Several studies have demonstrated that resistance training, for instance with ankle weights or using weight-and-pulley machines, has positive effects on balance and gait. As a result, doctors often suggest exercise or prescribe physical therapy to address problems with instability.
Fuzhong Li, Ph.D., research scientist at the Oregon Research Institute in Eugene, was part of a team of researchers who, in 2007, published a pilot study showing that tai chi was a safe exercise for individuals with mild to moderate Parkinson’s disease. “We had been using tai chi for balance training in healthy older adults, “ Dr. Li commented, “and older adults and patients with Parkinson’s disease share some difficulties with falls.”
Tai chi is a balance-based exercise that originated in China as a martial art. While there are many different styles, all are characterized by slow, relaxed and flowing movements. In both the pilot study and the recent New England Journal of Medicine study, patients performed a tai chi routine designed to challenge patients’ stability and address the balance and stability-related symptoms of Parkinson’s. The routine included slow, intentional, controlled movements that maximized the swing time of arm and leg motions, and repeatedly incorporated gradual shifts of body weight from one side to another, varying the width of their base of support by standing with feet together or further apart.
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