Parkinson's Disease & TAI CHI THERAPY
By Bill Douglas
In a special to CNN, the Mayo Clinic's mayoclinic.com reported that, "Parkinson's disease is progressive, meaning the signs and symptoms become worse over time. But although Parkinson's may eventually be disabling, the disease often progresses gradually, and most people have many years of productive living after a diagnosis." This would indicate that there may be effective interventions that could perhaps slow the progress of the disease. When we get such a diagnosis, our first reaction might be to withdraw and give up. However, the old adage "use it or lose it tells us that just the opposite is true. If you have Parkinson's, you'd likely be best off to use everything your body is, every which way, on a regular basis.
Tai Chi movement's gentle balance enhancing motions can obviously help the Parkinson's patient by helping to reduce the gradual loss of balance that Parkinson's sufferers often experience. However, there may be much more it offers. For example, Tai Chi movements rotate the human body in about 95% of the ways the body can move, when a long form is practiced. This is far beyond what other exercise offers, and in fact the closest would be several swimming strokes, which together would only rotate the body in about 65% of the ways it can move. For Parkinson's sufferers, or anyone for that matter, this would indicate that by "using 95% of the body's possible motion several times a week, the possibility of "losing the ability to do so diminishes accordingly. This isn't rocket science, but simple common sense.
Yet, perhaps Parkinson's patients have even more to gain from Tai Chi. A few years ago I taught several classes at local medical centers. I was continually frustrated because although I'd seen emerging reports that Tai Chi was beneficial to people with Parkinson's Disease, or arthritis, or chronic hypertension, etc., even though the departments that specialized in those conditions were often just down the hall from my Tai Chi class...they might as well have been a million miles away. Because the physicians who ran those departments were either ignorant of or unwilling to refer their patients to the possibilities that Tai Chi offered their lives.
I remember though, that at one medical center a visionary neurologist began to refer patients with balance disorders to my Tai Chi classes and the result was very beneficial for his patients. Another physician actually wrote prescriptions for my Tai Chi classes to treat the chronic hypertension of his patients, who'd seen a significant drop in their blood pressure since beginning the classes weeks before. A clinical psychologist brought me in to teach Qigong (Chi Kung) meditation and Tai Chi to her patient group to enhance their sense of well being and provide effective stress management training. So, even back then some physicians were seeing the potential Tai Chi offered their clients, and even more are now, but the number of physicians who are still not informing their patients of Tai Chi's direct therapeutic or at the least adjunct therapy benefits to their patient's efforts to deal with their conditions and life, is increasingly indefensible in this day and age. Given the research that has exposed the many physical, mental, and emotional benefits Tai Chi offers, for physicians to not educate themselves on this and share their knowledge with each and every patient is tantamount to mal-practice. Health educators should likewise be making such therapies part of their medical student education programs as well.
Tai Chi for Parkinson's is being recommended increasingly by support groups and some progressive medical centers, but until everyone that has Parkinson's knows about it, then our work at World Tai Chi & Qigong Day is not done, nor is the medical community's. There are many obvious reasons everyone with Parkinson's should be doing Tai Chi, but it's the ones that are not yet obvious that may be the most intriguing. One obvious reason is that Tai Chi is the most powerful balance and coordination enhancing exercise known. In many studies at major universities Tai Chi was found to be TWICE as effective in reducing falls as the other balance enhancing exercises being studied. For people with Parkinson's, who often see their balance deteriorate as their condition progresses, it is unforgivable for them to not be informed of Tai Chi's potential benefits at the earliest stage possible while their balance is still good.
Now, regarding the less obvious reasons Tai Chi may benefit Parkinson's patients. Both my wife and daughter, who co-taught a Tai Chi class together noticed that a young man with severe Parkinson's tremors...completely lost his tremors once he joined the class in flowing through the Tai Chi movements in class. In another class I was teaching an older man with advanced Parkinson's attended my classes for many months, and he always came in very slow with his walker. Once we began the Tai Chi movements he no longer used his walker, and had learned the entire long form of Tai Chi I taught, which was over 15 minutes of continuous changing forms. His form was unique and tailored for his limitations, but nonetheless a challenging set of exercises he was able to accomplish without the use of his walker. What do these anecdotal experiences portend for others with Parkinson's? I don't know, but there should be massive research dollars coming from the National Institutes of Health to find out. Given the promise Tai Chi seems to offer people on so many profound physical, emotional, and mental fronts from preliminary research, the current total research money earmarked for complimentary and alternative medicine's (CAM) is a mere pittance.
The National Center for Complementary and Alternative Medicine (NCCAM), now in its sixth year, supports more than 300 research projects and has an estimated budget of over $120 million for 2005 (up from $50 million in 1999). Total spending on CAM by all NIH institutes and centers is expanding as well, and is expected to reach $315 million by 2005.
Sounds like a lot? However, $120 million is less than "one half of one percent of the total NIH FY2005 budget. According to the Association of American Medical Colleges the NIH's total annual budget for FY 2005 is $28.8 billion (http://www.aaas.org/spp/rd/05pch8.htm). Remember, we are talking about only spending much much less than one half of one percent to study an exercise that preliminary research has shown to: n Lower High Blood Pressure (about 1/3 of Americans have hypertension - roughly over 90 million Americans) n Boost Immune Function profoundly (a study sited at drkoop.com indicates that a Tai Chi practicing group was TWICE as resistant to the shingles virus, and researchers believed this would carry over to other viral resistance as well.) n Dramatically reduce falling injuries by about half (complications from falling injuries in older Americans is the 6th leading cause of death for seniors in America)
If Tai Chi only addressed this chronic condition affecting 1/3 of Americans, while boosting the immune system of all practitioners profoundly, and cutting in half the sixth leading cause of death for seniors, without any negative side effects, that would seem to be, for the rational person a reason for pouring massive resources into researching it further. However, Tai Chi's benefits only begin with the above preliminary findings. We also know that it may very well relieve depression, anxiety, and mood disturbance, as well as reduce ADHD symptoms in teenagers diagnosed with Attention Deficit and Hyperactivity Disorder. There are indications that Tai Chi may greatly reduce or even eliminate chronic pain conditions, and lessen allergic and asthmatic reactions, and improve overall respiratory function.
My point is, "where is the massive attention this would garner on talk shows, and in health newspaper sections, if this were a drug or surgery that could provide such a seemingly massive breakthrough in health treatment? Peter Chowka, in a brilliant two part series for Natural Health Line, entitled "Complementary & Alternative Medicine in 2000, wrote, "Conflicts of interest are not uncommon in most aspects of life. But in medicine, the biggest business in the U.S. (over $1.5 trillion a year constituting over 14 percent of the Gross Domestic Product, according to the National Academy of Science's Institute of Medicine report issued January 10, 2001), serious conflicts are particularly well entrenched." Mr. Chowka wrote of physicians like Dr. Marcia Angell voicing concerns of the "troubling result massive research money from drug and medical-equipment companies was having on the scientific process. In the New England Journal of Medicine's May 18, 2000 issue, Dr. Angel wrote an editorial entitled, "Is Academic Medicine for Sale? She wrote, "As we spoke with research psychiatrists about writing an editorial on the treatment of depression...we found very few who did not have financial ties to drug companies that make antidepressants...The problem is by no means unique to psychiatry. We routinely encounter similar difficulties in finding editorialists in other specialties, particularly those that involve the heavy use of expensive drugs and devices."
So, who can make a multi-billion dollar fortune teaching Tai Chi to people? No one can. Tai Chi cannot be bottled, or mass marketed. It is a decentralized labor intensive industry that employees many people, but keeps the profits small and local. Yes, there are videos and DVDs that teach Tai Chi effectively, but ultimately even those who utilize videos are drawn to live class like structures. As I mentioned before with the "anecdotal experiences of my students with Parkinson's, Tai Chi seems to offer something profoundly beneficial to the quality of life of Parkinson's sufferers. It needs further study. We are in a catch 22, where many health professionals feel they cannot recommend Tai Chi because too much of the preliminary research is anecdotal. However, when Tai Chi is jockeying for position to get a crumb of the.5% of total NIH money going to ALL complimentary and alternative medical therapies...the result will be many long years of millions of people suffering needlessly from conditions or symptoms of those conditions that Tai Chi could likely safely lessen or even eliminate.
WHAT DO WE KNOW ABOUT TAI CHI AND PARKINSONS?
Tai Chi is being recommended by some forward thinking medical institutions already. The Cleveland Clinic of Neuroscience Center encourages Parkinson's Disease patients to seek out a hobby or activity they can enjoy and stick with such as "Tai Chi and other activities. The Alexian Neurosciences Institute in Illinois offers a course in their The Parkinson's Disease and Movement Disorders Center. Also, the American Parkinson's Disease Association at Stanford University Medical Center, in it's "Beyond Pills.... Alternative Approaches to Coping with Parkinson's Disease program, offered "Tai Chi, The Art for Living with Parkinson's by Mwezo & Jane of Kujiweza Healing Arts. The Parkinson's Society of Canada recommends Tai Chi for Parkinson's patients, suggesting "Tai Chi may prevent or at least slow down the onset of degenerative diseases; in the long run, it can reduce need for rehabilitative care."
In the United Kingdom a Parkinson's Tai Chi study was conducted at Camborne Redruth Community Hospital, Cornwall. Their conclusion of the study was such, "Tai Chi training was well tolerated by PD patients in this study, but had no measurable effect on motor performance using UPDRS score or GAG time. There was a non-significant improvement in quality of life scores (PDQ 39). Larger studies would be needed fully to evaluate the value and efficacy of Tai Chi. However our results are encouraging, and provide evidence for its safety and tolerability and would support the feasibility of further study."
WCHS TV during a news report focusing on Tai Chi's ability to boost immune system function, also reported that "Tai Chi has also been shown to help illnesses such as Parkinson's disease, multiple sclerosis, fibromyalgia and arthritis."
The Neurology Channel reported, "The slow flowing movements of Tai Chi help maintain flexibility, balance, and relaxation. The Struthers Parkinson's Center in Minneapolis, which teaches a modified form of Tai Chi, consistently reports benefits achieved by patients in all stages of Parkinson's."
Physicians at the Mayo Clinic recommend Tai Chi for Parkinson's therapy, under their Parkinson's "self-care section for avoiding falls, where they suggest you "Ask your doctor or physical therapist about exercises that improve balance, especially tai chi. Originally developed in China more than 1,000 years ago, tai chi uses slow, graceful movements to relax and strengthen muscles and joints. "
At a popular health website called RemedyFind.com viewers can vote on therapies they"ve found benefited their condition, or didn't benefit it. The rating there for Tai Chi as a Parkinson's therapy received a rating of 9.8 out of a possible 10. (http://remedyfind.com/rem.asp?ID=13945)
A Study at the University of Florida in Jacksonville found that patients who attended Tai Chi classes for one hour each week for 12-weeks were less likely than a group of control patients to experience an increase in the severity of their condition and a decrease in motor function....[of alternative therapies] the most popular therapies being Tai Chi, yoga, and acupuncture.
The Atlanta Journal Constitution reported, "Parkinson's Meets It's Match in Tai Chi." In this article they write that Dr. Mark Guttman, director of the Centre for Movement Disorders in Markham, Ontario, recommends people with Parkinson's do exercises that involve a lot of stretching, similar to the movements of tai chi.
"Tai chi is wonderful; it can help people with disabilities as well as people with Parkinson's," he says. He added that studies on animals show exercise induces a change in the brain that prevents the symptom's of Parkinson's from emerging.
The Tai Chi teacher for this program, Ms. Embree, spoke of how people with fibromyalgia, multiple sclerosis, cystic fibrosis, and Parkinson's often attend her classes..."Doctors are now sending people here," adds Ms Embree. (for the entire article, go to: PARKINSON"S MEETING IT"S MATCH IN TAI CHI, April, 13, 2005.
At the National Parkinson's Foundation site, Melanie M. Brandabur, MD NPF Center of Excellence, University of Illinois at Chicago and Jill Marjama-Lyons, MD NPF Center of Excellence, Shands Jacksonville, wrote, "Most patients derive a great deal of benefit from today's medications and surgical therapies for Parkinson's Disease...However, benefits of these therapies can be limited. As time goes by, the medications may not seem as effective as they once were. Side effects or unpredictable response may develop. Surgical therapies are not curative and often treat only selected aspects of Parkinson's Disease. For these reasons, patients may decide to explore other modalities, such as massage therapy, Tai Chi, yoga, or herbal preparations to augment their Parkinson's medication...Many patients with Parkinson's Disease have become interested in complementary therapies to supplement medications and other traditional PD treatments. These physicians also suggest that as Tai Chi and other modalities benefits are exposed by clinical research, physicians will advocate their use more widely.
World Tai Chi & Qigong Day joins a growing number of health professionals specializing in fields like Parkinson's who believe that much more research needs to be done to illuminate the full spectrum of benefits Tai Chi offers all people as well as those specifically with chronic conditions. This will enable more physicians to make Tai Chi a regular prescription written as therapy or adjunct therapy for a host of maladies many are already enjoying the benefits of for their condition, but paying out of pocket for. Ultimately more and more health insurance plans should and will make Tai Chi classes a deductible medical expense for their clients. The end result of this shift may portend the savings of hundreds of billions of dollars annually in saved health care costs as patients are better trained in self care techniques, training the great visionary Thomas Edison referred to as "the care and maintenance of the human frame, which Edison envisioned would more and more reduce the need for expensive surgeries and life long dependence on medications as human beings maximized their own self healing abilities. Traditional Chinese Medicine has spent centuries developing and evolving self healing technologies like Tai Chi. Now the west can learn about their results, and physicians can prescribe them to their patients and our entire society will be healthier and more abundant for it.
Copyright 2005 Bill Douglas
About The Author
Bill Douglas is the Tai Chi Expert at DrWeil.com, Founder of World T'ai Chi & Qigong Day (held in 50 nations each year), and has authored and co-authored several books including a #1 best selling Tai Chi book "The Complete Idiot's Guide to T"ai Chi & Qigong." Bill's been a Tai Chi source for The Wall Street Journal, New York Times, etc. You can learn more about Tai Chi & Qigong, and also contact Bill Douglas at http://www.worldtaichiday.org
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