Au-Yeung Stephanie S Y, Hui-Chan Christina W Y, Tang Jervis C S
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Neurorehabil Neural Repair. 2009 Jun;23(5):515-22. doi: 10.1177/1545968308326425. Epub 2009 Jan 7.
Our previous findings showed that 4 weeks of intensive Tai Chi practice improved standing balance in healthy seniors. This study set out to investigate whether Tai Chi could improve standing balance in subjects with chronic stroke.
One hundred thirty-six subjects >6 months after stroke were randomly assigned to a control group (n = 62) practicing general exercises or a Tai Chi group (n = 74) for 12 weeks of training. Each week, 1 hour of group practice was supplemented by 3 hours of self-practice. We used a short-form of Tai Chi consisting of 12 forms that require whole-body movements to be performed in a continuous sequence and demands concentration. A blinded assessor examined subjects at baseline, 6 weeks (mid-program), 12 weeks (end-program), and 18 weeks (follow-up). The 3 outcome measures were (1) dynamic standing balance evaluated by the center of gravity (COG) excursion during self-initiated body leaning in 4 directions, (2) standing equilibrium evaluated in sensory challenged conditions, and (3) functional mobility assessed by Timed-up-and-go score. Mixed model repeated-measures analysis of variance was used to examine between-group differences.
When compared with the controls, the Tai Chi group showed greater COG excursion amplitude in leaning forward, backward, and toward the affected and nonaffected sides (P < .05), as well as faster reaction time in moving the COG toward the nonaffected side (P = .014) in the end-program and follow-up assessments. The Tai Chi group also demonstrated better reliance on vestibular integration for balance control at end-program (P = .038). However, neither group improved significantly in Timed-up-and-go scores.
Twelve weeks of short-form Tai Chi produced specific standing balance improvements in people with chronic stroke that outlasted training for 6 weeks.
我们之前的研究结果表明,为期4周的强化太极拳练习可改善健康老年人的站立平衡能力。本研究旨在调查太极拳是否能改善慢性中风患者的站立平衡能力。
136名中风后6个月以上的受试者被随机分为对照组(n = 62),进行一般锻炼,或太极拳组(n = 74),进行为期12周的训练。每周,1小时的集体练习辅以3小时的自主练习。我们使用了一种简化的太极拳,由12种招式组成,需要全身动作连续进行,并要求集中注意力。一名盲法评估者在基线、6周(项目中期)、12周(项目结束时)和18周(随访)对受试者进行检查。3项结局指标为:(1)通过在4个方向上自主身体倾斜时的重心(COG)偏移评估动态站立平衡;(2)在感觉受挑战的条件下评估站立平衡;(3)通过计时起立行走得分评估功能活动能力。采用混合模型重复测量方差分析来检验组间差异。
与对照组相比,太极拳组在项目结束时和随访评估中,向前、向后以及向患侧和非患侧倾斜时的COG偏移幅度更大(P < .05),并且将COG移向非患侧的反应时间更快(P = .014)。太极拳组在项目结束时对前庭整合进行平衡控制的依赖性也更好(P = .038)。然而,两组的计时起立行走得分均未显著改善。
为期12周的简化太极拳练习使慢性中风患者的特定站立平衡能力得到改善,且这种改善在训练结束6周后仍持续存在。