MEDICAL CONDITIONS AND TAI CHI THERAPY PARKINSON’S DISEASE
MEDICAL CONDITIONS AND TAI CHI THERAPY
Many people affected by Parkinson’s disease decide to try Tai Chi and present to us with a range of challenges which we are able to stabilise and improve. It is vital to be aware that for many of the newly diagnosed fear and stress are major factors. They fear they will rapidly fall into the role of ‘cripple’ with no life quality. Whilst working with them we must seek to instil confidence that they are able to achieve improvement through their own efforts and to enjoy the experience of Tai Chi.
Parkinson’s disease is a progressive, degenerative, condition of the nervous system for which there is no cure. There is increasing difficulty in moving the arms and legs, often with the development of tremors and facial tics. There is often a fear of falling and gradually sufferers become less mobile.
Parkinson’s affects both men and women with onset usually around 65. Each year 10,000 people are diagnosed with the disease in the UK., of which one in twenty will be under 40. It develops slowly over time with trembling of the arms and legs, stiffness and rigidity of muscles and slowness of movement. Because it is gradually progressive most people have many productive years after diagnosis and do not always realise this.
CAUSE AND EFFECT WITHIN THE BODY
It is thought that the disease is caused by a chemical imbalance in the co-ordination centre of the brain, called the Striatum. There is cell death in another area, the Substantia Nigra which produces the chemical Dopamine. As the cells die, there is less Dopamine produced and taken to the Striatum which results in co-ordination problems
PRESENTATION SIGNS AND SYMPTOMS
Symptoms vary between patients and many years may pass before the early symptoms progress to the stage where they interfere with normal activities. A third of Parkinson’s sufferers also develop senile dementia.
Tremor usually begins in one hand or arm and is more obvious when that part of the body is at rest. It often becomes more noticeable when the person is anxious or excited. The tremor will usually decrease when that part of the body is being used.
Common things to look for are:
Ø A walking posture that is bent forward with a shuffling gait.
Ø A stiff facial expression, finding it difficult to make facial expressions.
Ø Slowness in starting and completing a movement
Ø A persistent tremor at rest, sometimes with Head nodding
Ø A ‘Pill rolling’ motion of the fingers
Ø Difficulty with balance and co-ordination (including getting out of a chair)
Ø Problems with swallowing
Ø Muscular rigidity or stiffness. They may experience problems turning round,
getting out of a chair, turning over in bed or making fine finger movements.
Ø Standing posture may become stooped.
Ø Depression, around half develop this at some stage.
Ø Sleep problems and tiredness
Ø Bradykinesia, slowness of movement: People often find that initiating movements becomes more difficult or takes longer to perform. Lack of co-ordination can also be a problem.
WESTERN MEDICAL TREATMENT
Patients are given Levodopa which is converted to Dopamine in the brain. This is often accompanied by physiotherapy, speech and occupational therapy aimed at maintaining independence
QIGONG EXERCISES FOR THE CONDITION
Tai Chi gathers and moves energy around the body, unblocking bottlenecks and massaging internal organs. It unites body and mind and reduces stress, all essential in Parkinson’s.
As posture is a major problem, Tai Chi is particularly appropriate as the exercises balance the body, develop the middle path, encourage rooting to the earth and enhance flexibility. At the same time Tai Chi relaxes yet energises the body.
It is essential to address the symptoms, aiming to produce a ‘feel good factor’ through the exercises and release of endorphins. We hope to produce a feeling that they are ‘fighting back’ doing something for themselves and under their own control.
The following are basic areas to focus on in respect of the particular difficulties:
Ø Balance Footwork, Knees, Hips
Ø Co-ordination Chinese Arm Swings, slow
One hand up one hand down
Side bending from waist
Ø Forward bent walking Middle path posture
Rolling round middle mountain
Ø Shuffling gait Rolling shoulders, Big bear
Swing arms whilst bouncing
Wave hands like clouds
Ø Muscular weakness Abdominal breathing
Tai Chi Circle and Loi
Cardiopulmonary breathing exercises
EFFECT OF THE QIGONG EXERCISES
There is evidence suggesting that Tai Chi slows the progress of Parkinson’s.
The gentle movements of Tai Chi improve balance, and move the body about 95% of the ways it can move. The likelihood of ‘losing’ movement is diminished. The phrase ‘Use it or Lose it’ is very relevant in this condition. In many major studies Tai Chi was found to be twice as effective at reducing falls as any other balance exercises.
The slow flowing, graceful movements not only strengthen muscles and joints, maintain flexibility, balance and relaxation but appeal to those who fear they are losing physical ability but also fear what they see as normal exercise including high impact Gym routines.
Tai chi has a calming yet uplifting effect on the mind, the feel good factor of releasing endorphins. This helps Parkinson’s sufferers feel better about themselves. This concept of the mind promoting ‘self health-improvement’ is being widely recognised within western medicine but has been known within Traditional Chinese Medicine for over 2000 years and is a key factor of Tai Chi. Meditation, another aspect of Tai Chi has been shown to produce significant increases in left sided brain activity, which is associated with positive emotional states
EXERCISES OR MOVEMENTS WHICH SHOULD NOT BE USED
Do not overextend or flex the neck, such as tipping back too far, bending forward too far to compromise balance or Leaning too far to the side.
Tell the student to move within their sphere of confidence and comfort, not overextending in any direction or causing discomfort.
Tai Chi is not a cure for Parkinson’s Disease but can significantly slow it’s progress and enhance life quality. It increases flexibility, balance and co-ordination, posture and improves muscle and joint strength and tone.
Ian V. Begbie. April 2010