Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Participants
2.3. Tai Chi Intervention
2.4. Outcome Measures
2.5. Data Analysis
3. Results
3.1. Participant Characteristics
3.2. Adherence to Tai Chi Sessions and Self-Practice at Home
3.3. Clinical Reasoning Underlying Tai Chi Adaptations
3.4. Tai Chi Performance in Different Situations
Upper Limb Impairment Level
3.5. Insufficient Balance and Falls
3.6. Shoulder Pain
3.7. Spasticity
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Langhorne, P.; Bernhardt, J.; Kwakkel, G. Stroke rehabilitation. Lancet 2011, 377, 1693–1702. [Google Scholar] [CrossRef]
- Dawson, J.; Pierce, D.; Dixit, A.; Kimberley, T.J.; Robertson, M.; Tarver, B.; Hilmi, O.; McLean, J.; Forbes, K.; Kilgard, M.P.; et al. Safety, Feasibility, and Efficacy of Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Ischemic Stroke. Stroke 2016, 47, 143–150. [Google Scholar] [CrossRef] [PubMed]
- Langhorne, P.; Coupar, F.; Pollock, A. Motor recovery after stroke: A systematic review. Lancet Neurol. 2009, 8, 741–754. [Google Scholar] [CrossRef]
- Mazzoleni, S.; Sale, P.; Franceschini, M.; Bigazzi, S.; Carrozza, M.C.; Dario, P.; Posteraro, F. Effects of proximal and distal robot-assisted upper limb rehabilitation on chronic stroke recovery. NeuroRehabilitation 2013, 33, 33–39. [Google Scholar] [PubMed]
- Mohd Nordin, N.A.; Aziz, N.A.; Abdul Aziz, A.F.; Ajit Singh, D.K.; Omar Othman, N.A.; Sulong, S.; Aljunid, S.M. Exploring views on long term rehabilitation for people with stroke in a developing country: Findings from focus group discussions. BMC Health Serv. Res. 2014, 14, 118. [Google Scholar] [CrossRef] [PubMed]
- Thorsen, A.M.; Holmqvist, L.W.; de Pedro-Cuesta, J.; von Koch, L. A randomized controlled trial of early supported discharge and continued rehabilitation at home after stroke: Five-year follow-up of patient outcome. Stroke 2005, 36, 297–303. [Google Scholar] [CrossRef] [PubMed]
- Wayne, P.M.; Kaptchuk, T.J. Challenges inherent to t’ai chi research: Part I--t’ai chi as a complex multicomponent intervention. J. Altern. Complement. Med. 2008, 14, 95–102. [Google Scholar] [CrossRef] [PubMed]
- Lan, C.; Chen, S.Y.; Lai, J.S.; Wong, A.M. Tai chi chuan in medicine and health promotion. Evid. Based Complement. Alternat. Med. 2013, 2013, 502131. [Google Scholar] [CrossRef]
- Wolf, S.L.; Coogler, C.; Xu, T. Exploring the basis for Tai Chi Chuan as a therapeutic exercise approach. Arch. Phys. Med. Rehabil. 1997, 78, 886–892. [Google Scholar] [CrossRef]
- Lan, C.; Chen, S.Y.; Wong, M.K.; Lai, J.S. Tai Chi training for patients with coronary heart disease. Med. Sport Sci. 2008, 52, 182–194. [Google Scholar] [PubMed]
- Chen, K.M.; Snyder, M.; Krichbaum, K. Clinical use of tai chi in elderly populations. Geriatr. Nurs. 2001, 22, 198–200. [Google Scholar] [CrossRef] [PubMed]
- Clarke, T.C.; Black, L.I.; Stussman, B.J.; Barnes, P.M.; Nahin, R.L. Trends in the use of complementary health approaches among adults: United States, 2002–2012. Natl. Health Stat. Rep. 2015, 10, 1–16. [Google Scholar]
- Tousignant, M.; Corriveau, H.; Roy, P.M.; Desrosiers, J.; Dubuc, N.; Hebert, R. Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: A randomized controlled trial. Disabil. Rehabil. 2013, 35, 1429–1435. [Google Scholar] [CrossRef] [PubMed]
- Leung, D.P.; Chan, C.K.; Tsang, H.W.; Tsang, W.W.; Jones, A.Y. Tai chi as an intervention to improve balance and reduce falls in older adults: A systematic and meta-analytical review. Altern. Ther. Health Med. 2011, 17, 40–48. [Google Scholar] [PubMed]
- Park, M.; Song, R. [Effects of Tai Chi on fall risk factors: A meta-analysis]. J. Korean Acad. Nurs. 2013, 43, 341–351. [Google Scholar] [CrossRef] [PubMed]
- Taylor-Piliae, R.E.; Hoke, T.M.; Hepworth, J.T.; Latt, L.D.; Najafi, B.; Coull, B.M. Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors. Arch. Phys. Med. Rehabil. 2014, 95, 816–824. [Google Scholar] [CrossRef] [PubMed]
- Kim, H.; Kim, Y.L.; Lee, S.M. Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients. Int. J. Rehabil. Res. 2015, 38, 156–161. [Google Scholar] [CrossRef] [PubMed]
- Au-Yeung, S.S.; Hui-Chan, C.W.; Tang, J.C. Short-form Tai Chi improves standing balance of people with chronic stroke. Neurorehabil. Neural. Repair. 2009, 23, 515–522. [Google Scholar] [CrossRef] [PubMed]
- Cheung, S.Y.; Tsai, E.; Fung, L.; Ng, J. Physical benefits of Tai Chi Chuan for individuals with lower-limb disabilities. Occup. Ther. Int. 2007, 14, 1–10. [Google Scholar] [CrossRef] [PubMed]
- Pei, Y.C.; Chou, S.W.; Lin, P.S.; Lin, Y.C.; Hsu, T.H.; Wong, A.M. Eye-hand coordination of elderly people who practice Tai Chi Chuan. J. Formos. Med. Assoc. 2008, 107, 103–110. [Google Scholar] [CrossRef]
- Varghese, R.; Hui-Chan, C.W.; Bhatt, T. Effects of Tai Chi on a Functional Arm Reaching Task in Older Adults: A Cross-Sectional Study. J. Aging Phys. Act. 2015, 23, 361–368. [Google Scholar] [CrossRef] [PubMed]
- Kwok, J.C.; Hui-Chan, C.W.; Tsang, W.W. Effects of aging and Tai Chi on finger-pointing toward stationary and moving visual targets. Arch. Phys. Med. Rehabil. 2010, 91, 149–155. [Google Scholar] [CrossRef] [PubMed]
- Tsang, W.W.; Kwok, J.C.; Hui-Chan, C.W. Effects of aging and tai chi on a finger-pointing task with a choice paradigm. Evid. Based Complement. Alternat. Med. 2013, 2013, 653437. [Google Scholar] [CrossRef] [PubMed]
- Yan, J.H. Tai chi practice reduces movement force variability for seniors. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 1999, 54, M629–M634. [Google Scholar] [CrossRef]
- Tsang, W.W.; Gao, K.L.; Chan, K.M.; Purves, S.; Macfarlane, D.J.; Fong, S.S. Sitting tai chi improves the balance control and muscle strength of community-dwelling persons with spinal cord injuries: A pilot study. Evid. Based Complement. Alternat. Med. 2015, 2015, 523852. [Google Scholar] [CrossRef] [PubMed]
- Pan, S.; Kairy, D.; Corriveau, H.; Tousignant, M. Adapted Tai Chi Enhances Upper Limb Motor Control in Chronic Stroke Patients: A Pilot Study. J. Nov. Physiother. 2017, 7, 335. [Google Scholar] [CrossRef]
- Gowland, C.; Stratford, P.; Ward, M.; Moreland, J.; Torresin, W.; Van Hullenaar, S.; Sanford, J.; Barreca, S.; Vanspall, B.; Plews, N. Measuring physical impairment and disability with the Chedoke-McMaster Stroke Assessment. Stroke 1993, 24, 58–63. [Google Scholar] [CrossRef] [PubMed]
- Chen, B. Learning Authentic Chen-Style Tai Chi from the Very Beginning; Liaoning Science and Technology Publishing House: Shenyang, CHN, 2012. [Google Scholar]
- Cheng, M. Master Cheng’s New Method of Taichi Chuan Self-Cultivation; North Atlantic Books: Berkeley, CA, USA, 1999. [Google Scholar]
- Rosas-Carrasco, O.; Gonzalez-Flores, E.; Brito-Carrera, A.M.; Vazquez-Valdez, O.E.; Peschard-Saenz, E.; Gutierrez-Robledo, L.M.; Garcia-Mayo, E.J. [Assessment of comorbidity in elderly]. Rev. Med. Inst. Mex. Seguro. Soc. 2011, 49, 153–162. [Google Scholar] [PubMed]
- Bohannon, R.W.; Smith, M.B. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys. Ther. 1987, 67, 206–207. [Google Scholar] [CrossRef] [PubMed]
- Gregson, J.M.; Leathley, M.J.; Moore, A.P.; Smith, T.L.; Sharma, A.K.; Watkins, C.L. Reliability of measurements of muscle tone and muscle power in stroke patients. Age Ageing 2000, 29, 223–228. [Google Scholar] [CrossRef] [PubMed]
- Price, D.D.; McGrath, P.A.; Rafii, A.; Buckingham, B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983, 17, 45–56. [Google Scholar] [CrossRef]
- Pomeroy, V.M.; Frames, C.; Faragher, E.B.; Hesketh, A.; Hill, E.; Watson, P.; Main, C.J. Reliability of a measure of post-stroke shoulder pain in patients with and without aphasia and/or unilateral spatial neglect. Clin. Rehabil. 2000, 14, 584–591. [Google Scholar] [CrossRef] [PubMed]
- McCormack, H.M.; David, J.D.L.; Sheather, S. Clinical applications of visual analogue scales: A critical review. Psychol. Med. 1988, 18, 1007–1019. [Google Scholar] [CrossRef] [PubMed]
- Boonstra, A.M.; Preuper, H.R.S.; Reneman, M.F.; Posthumus, J.B.; Stewart, R.E. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int. J. Rehabil. Res. 2008, 31, 165–169. [Google Scholar] [CrossRef] [PubMed]
- Rabadi, M.H. Review of the randomized clinical stroke rehabilitation trials in 2009. Med. Sci. Monit. 2011, 17, RA25–RA43. [Google Scholar] [CrossRef] [PubMed]
- Tsu, A.P.; Abrams, G.M.; Byl, N.N. Poststroke upper limb recovery. Semin. Neurol. 2014, 34, 485–495. [Google Scholar] [PubMed]
- Barecca, S.; Bohannon, R.; Charness, A.; Fasoli, S.; Gowland, C.; Griffiths, J.A.; Hajek, V.; Huijbregts, M.; Wolf, S.L.; O’Brien, M.A. Management of the Post Stroke Hemiplegic Arm and Hand: Treatment Recommendations of the 2001 Consensus Panel; Heart and Stroke Foundation of Ontario: Toronto, ON, Canada, 2001. [Google Scholar]
- Waller, S.M.; Whitall, J. Bilateral arm training: Why and who benefits? NeuroRehabilitation 2008, 23, 29–41. [Google Scholar]
- Stewart, K.C.; Cauraugh, J.H.; Summers, J.J. Bilateral movement training and stroke rehabilitation: A systematic review and meta-analysis. J. Neurol. Sci. 2006, 244, 89–95. [Google Scholar] [CrossRef] [PubMed]
- Summers, J.J.; Kagerer, F.A.; Garry, M.I.; Hiraga, C.Y.; Loftus, A.; Cauraugh, J.H. Bilateral and unilateral movement training on upper limb function in chronic stroke patients: A TMS study. J. Neurol. Sci. 2007, 252, 76–82. [Google Scholar] [CrossRef] [PubMed]
- Oujamaa, L.; Relave, I.; Froger, J.; Mottet, D.; Pelissier, J.Y. Rehabilitation of arm function after stroke. Literature review. Ann. Phys. Rehabil. Med. 2009, 52, 269–293. [Google Scholar] [CrossRef] [PubMed]
- Taylor-Piliae, R.E.; Haskell, W.L. Tai Chi exercise and stroke rehabilitation. Top. Stroke Rehabil. 2007, 14, 9–22. [Google Scholar] [CrossRef] [PubMed]
- Cheng, M.-C.I.; Lo, B.P.J.; Cheng, T. Cheng Tzu’s Thirteen Treatises on T’ai Chi Ch’uan; North Atlantic Books: Berkeley, CA, USA, 1985. [Google Scholar]
- Desrochers, P.; Kairy, D.; Pan, S.; Corriveau, H.; Tousignant, M. Tai chi for upper limb rehabilitation in stroke patients: The patient’s perspective. Disabil. Rehabil. 2017, 39, 1313–1319. [Google Scholar] [CrossRef] [PubMed]
Subject | Age | Gender | Dominant-Side Hemiparesis | Stroke Type | Time after Onset (Months) | CIRS-G Severity Index (Max 4) | Technical Aids for Transfer | Initial CMSA (Arm) | Initial CMSA (Hand) | Spasticity (MAS) (Max 4) | BTX Injection | Initial Shoulder Pain (VAS) (Max 10) |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 41 | M | No | Hem | 50 | 3.0 | Cane | 2 | 2 | 4 | Yes | 3 |
2 | 62 | M | No | Isc | 24 | 0 | Cane | 2 | 2 | 3 | Yes | 3 |
3 | 53 | M | Yes | Isc | 14 | 0 | Cane | 2 | 2 | 3 | Yes | 0 |
4 | 54 | M | Yes | Isc | 10 | 0 | Independent | 3 | 2 | 2 | No | 0 |
5 | 46 | M | No | Hem | 13 | 3.3 | Cane | 3 | 4 | 1 | No | 0 |
6 | 65 | F | Yes | Isc | 56 | 2.0 | Independent | 3 | 2 | 0 | No | 0 |
7 | 87 | M | Yes | Isc | 10 | 4.0 | Wheel chair | 3 | 5 | 1 | No | 9 |
8 | 63 | M | No | Hem | 41 | 0 | Independent | 3 | 4 | 2 | No | 0 |
9 | 47 | M | No | Isc | 8 | 3.0 | Independent | 6 | 6 | 0 | No | 7 |
10 | 67 | M | No | Isc | 12 | 2.5 | Independent | 6 | 6 | 0 | No | 0 |
11 | 68 | F | No | Isc | 12 | 3.0 | Independent | 7 | 7 | 0 | No | 0 |
© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Pan, S.; Kairy, D.; Corriveau, H.; Tousignant, M. Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study. Medicines 2017, 4, 72. https://doi.org/10.3390/medicines4040072
Pan S, Kairy D, Corriveau H, Tousignant M. Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study. Medicines. 2017; 4(4):72. https://doi.org/10.3390/medicines4040072
Chicago/Turabian StylePan, Shujuan, Dahlia Kairy, Hélène Corriveau, and Michel Tousignant. 2017. "Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study" Medicines 4, no. 4: 72. https://doi.org/10.3390/medicines4040072