Tai Chi for Neurological Conditions: The Research Evidence-Base
(last updated April 2020)
Tai Chi is being increasingly researched as an intervention for complex health conditions, including neurological conditions. These studies are published in both English and Chinese-language scientific journals, with the latter taking a while to reach an English-speaking professional readership. Some studies attract some publicity in the media and on social networks (see our facebook page for the latest), irrespective of the quality of the methodology and the limitations of the findings produced. As such I present below a set of statements around the evicdence-base for neurological conditions, organised both by condition type and outcome type. Where findings are based on group data I will note any limitations around generalisability (e.g., statistical power), and I will also include case study findings where relevant (but cautioning against extrapolation of findings, etc).
Meta-Analyses & Reviews of Strongest Evidence for Tai Chi in Neurological Conditions:
Parkinsons Disease:
Balance and mobility improvements found in meta-analyses by Jin et al., 2020; Mazzarin et al. 2017; Ni et al. 2014; Radder et al. 2017; Toh 2013; Yang et al. 2014; Zhou et al. 2015) in addition to depressive symptoms and quality of life (Jin et al., 2020).
Stroke:
Lyu et al. (2018): beneficial effect on activities of daily living, balance, limb motor function, walking quality, mood, and sleep from low quality evidence-based studies.
Qin et al (2016): compared to physically-orientated rehabilitation, significant gains in the areas of balance function, gait speed, anxiety and quality of life.
Ding (2010) Confers advantageous gains to stroke survivors in the domains of balance, mobility, quality of life, anxiety and depression.
Zou et al. (2018); Baduanjin qi gong produces gains in balance and other aspects of physical functioning plus reduction in depression.
Gains in balance is the most replicated finding across studies, concluded in reviews by Wu et al. (2018); Li et al. (2018; Zou et al. (2018).
Across Neurological Conditions:
Strongest evidence for increased balance and reduction in falls in people with Parkinsons Disease and Stroke, weaker evidence for other neurological conditions (Winser et al., 2018).
Evidence of Benefits for Condition Type:
Stroke: In their meta-analysis of 15 eligible studies (with acceptable design characteristics and statistical power) from both the English and Chinese-language scientific literature, Qin, Wei, Liu and Zhu (2016) found that when compared with standard physically-orientated rehabilitation, TJ conferred significant gains in the areas of balance function, gait speed, anxiety and quality of life. In contrast no advantages were evident for survivor levels of depression or functional walking quality. Taylor-Piliae and colleagues (2014) found Yang style Tai Chi for older stroke survivors (>50years) group to have had fewer falls than aerobic exercise and treatment as usual control groups. Both Tai Chi and aerobic control groups demonstrated greater aerobic endurance than treatment as usual. No group effect found for perceived mental health – all groups reported this. All other stroke studies are underpowered and so strong conclusions cannot be made from the group data in these studies.
Taylor-Piliae and colleagues (2012) reported that Tai Chi was a safe activity for stroke survivors. Of relevance to stroke services, is the review by Zheng and colleagues (2015) of the benefits of Tai Chi in the general population. They identify the beneficial reduction of key risk factors for the occurrence of stroke and cerebro-vascular disease, plus lower incidence of stroke in Tai Chi practitioner samples.
Traumatic Brain Injury: Gemmell and Leathem (2006) investigated the psychosocial benefits of Tai Chi for TBI survivors. However the groups in each condition were small (n=9) and the intervention was only 6 weeks. As such their claims for improvements in group scores for Tai Chi practitioners (VAMS ratings for sadness, confusion, anger, tension, fear plus increased energy) are encouraging but cannot be considered persuasive. Blake and Batson (2009) used a randomisation procedure to demonstrate improvements in mood and self-esteem but not physical functioning in a Tai Chi group versus control, but again the numbers in each condition were small (n=20) and the authors concluded that the results were inconclusive as a persuasive case for Tai Chi for TBI. Shapira and colleagues (2001) report three case studies where improvements were noted in aspects of mobility and subjective feelings of security when walking in TBI survivors who had participated in a Tai Chi intervention.
Multiple Sclerosis: Burschka and colleagues (2014) found small effect sizes (n= 32) for therapeutic gains from a 6 month twice-weekly Tai Chi group in balance, coordination and depression relative to a treatment as usual group. Tavee and colleagues (2011) found improvements in ratings of pain, physical and mental health functioning, and fatigue/energy levels for their small sample (n=22) of practitioners in a two month Tai Chi group compared to control condition. Other studies were pilot groups and so did not report persuasive group data.
Parkinsons Disease: Large sample group studies by Li and colleagues (2012) and Gao and colleagues (2014) have demonstrated gains in balance, postural stability and differing aspects of mobility relative to the control groups, validating similar findings in a smaller sample (Hackney & Earhart, 2008). Consistent findings from RCTs in the English and Chinese-language literature have been reviewed by Ni and colleagues (2014), Toh (2013), Yang and colleagues (2014) and Zhou and colleagues (2015), although several of these reviewers have cautioned against the consistency of findings around different mobility indices and maintenance of gains at follow-up data collection. A lower incidence of fall rates in the Tai Chi group versus controls during a follow-up period was reported by Gao and colleagues (2014).
Mixed Neurological Conditions Groups: Quinn and Jones (2012) reported a range of psychosocial gains from a small group of participants with mixed neurological conditions following completion of a Tai Chi group, but were unable to compare against a control group. Yeates (2019 a,b,c; in prep) has reported gains in depression, anxiety, fatigue and quality of life for some survivors of stroke, traumatic brain injury and post-tumour resection following a six month weekly unadapted tai chi pilot group in a mixed acquired brain injury sample. These gains were noted alongside no benefit and some negative outcomes for other participants.
Mild Cognitive Impairment: Sungkarat and colleagues (2017) demonstrated a reduction in falls in older adults with MCI, and a meta-analysis of 11 studies (moderate level of quality) by Yang and colleagues (2020) highlighted a range of improvements in cognitive functioning in Tai Chi participants versus control groups.
Cerebellar Ataxia: Winser and colleagues (2017; 2018a) found improvements in balance and functional independence for tai chi participants.
Evidence of Benefits for Different Outcomes
Balance: Stroke survivors (Au-Yeung et al., 2009; Hwang et al., 2018); Multiple Sclerosis (small effect size, Burschka et al., 2014); people with Parkinsons Disease (Gao et al., 2014; Li et al., 2012; Hackney & Earhart, 2008; Khuzema et al., 2020; Li et al., 2020); Cerebellar Ataxia (Winser et al., 2017; 2018a).
Coordination: Multiple Sclerosis (small effect size, Burschka et al., 2014).
Postural Control: people with Parkinsons Disease (see reviews by Ni et al., 2014; Toh, 2013; Yang et al., 2014; Zhou et al., 2015).
Mobility: Motor Functioning in stroke survivors compared to a balance control intervention (Xie et al., 2018); differing aspects of mobility for people with Parkinson’s Disease (Gao et al., 2014; Li et al., 2012; Hackney & Earhart, 2008; Khuzema et al., 2020; Li et al., 2020). Multiple Sclerosis and perceived physical functioning (small sample, Tavee et al., 2011).
Aerobic Endurance: Older stroke survivors (Taylor-Piliae et al., 2014)
Incidence & Fear of Falling: Older stroke survivors (Huang et al., 2019; Taylor-Piliae et al., 2014; Xie et al., 2018); People with Parkinsons Disease (Gao et al., 2014); Mild Cognitive Impairment (Sungkarat et al., 2017)..
Pain: People with Multiple Sclerosis (Tavee et al., 2011).
Fatigue/Energy Levels: Stroke/Cerebro Vascular Disorder (daytime energy levels improvement discernible from a sleep quality questionnaire measure, Wang et al., 2010); Multiple Sclerosis (small sample, Tavee et al., 2011); Mixed ABI case studies (Yeates, 2019a,b,c).
Psychological Functioning: Stroke survivors and depression (Wang et al., 2010; Xie et al., 2018); anxiety (see meta-analysis by Qin et al., 2016) and self-efficacy (Hwang et al., 2018); Multiple Sclerosis and depression (small effect size, Burschka et al., 2014); mood and self-esteem for survivors of Traumatic Brain Injury (but small sample size, Blake & Batson, 2009), Mixed ABI case studies (Yeates, 2019a,b,c).
Quality of Life: ÒStroke survivors (see meta-analysis by Qin et al., 2016); Life satisfaction in people with Multiple Sclerosis (Burschka et al., 2014), Mixed ABI case studies (Yeates, 2019a,b,c).
Functional Independence: Cerebellar Ataxia (Winser et al., 2017; 2018a).
Research Limitations
While general critiques of the literature include the lack of sufficiently-powered studies in some conditions (e.g., Traumatic Brain Injury, Multiple Sclerosis), three things were glaringly absent upon first reading of these studies, from my perspective as both a psychologist and Tai Chi instructor:
Au-Yeung, S.S.Y., Hui-Chan, C.W.Y. & Tang, J.C.S. (2009). Short-form Tai Chi improves standing balance of people with chronic stroke. Neurorehabilitation & Neural Repair, 23: 515–22.
Balchin T. (2011). The Successful Stroke Survivor. Lingfield: Bagwyn.
Bastille, J.V. & Gill-Body, K.M. (2004). A yoga-based exercise program for people with post-stroke chronic hemiparesis. Physical Therapy, 84: 33-48.
Bedard, M. Felteau, M. Gibbons, C. Klein, R. Mazmanian, D. Fedyk, K. Mack, G. (2005). A Mindfulness-Based Intervention to Improve Quality of Life Among Individuals Who Sustained Traumatic Brain Injuries: One-Year Follow-Up. The Journal of Cognitive Rehabilitation. Spring.
Bedard, M., Felteau, M., Marshall, S., Dubois, S., Gibbons, C., Klein, R. & Weaver, B. (2012). Mindfulness-based cognitive therapy: benefits in reducing depression following a traumatic brain injury. Advances in Mind-Body Medicine, 26: 14-20.
Bedard, M., Felteau, M., Mazmanian, D., Fedyk, K., Klein, R., Richardson, J., Parkinson, W & Minthorn-Biggs, M.B. (2003). Pilot evaluation of a mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries. Disability and Rehabilitation, 25: 722–731.
Bishop, S.R., Shapiro, S., Carlson, L., Anderson, N.D., Carmody, J., Segal, Z.V., Abbey, S., Speca, M., Velting, D. & Devins, G. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science & Practice, 11: 230–241.
Blake, H. & Batson, M. (2006). Exercise intervention in brain injury: A pilot randomized study of Tai Chi Qigong. Clinical Rehabilitation, 23(7): 589–598.
Burschka, J.M., Keune, P.M., Oy,.U., Oschman, P. & Kuhn, P. (2014). Mindfulness-based interventions in multiple sclerosis: beneficial effects of Tai Chi on balance, coordination, fatigue and depression. BioMedCentral Neurology, 14(1): 165.
Charmaz, K. (1990). ``Discovering'' chronic illness: Using grounded theory. Social Science & Medicine, 30: 1161-1172.
Csikszentmihalyi, M. (1990). Flow: The Psychology of Optimal Experience. New York: Harper & Row
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Csikszentmihalyi, M., Abuhamdeh, S. & Nakamura, J. (2005). Flow. In A. Elliot, Handbook of Competence and Motivation. New York: The Guilford Press, pp. 598–698
Davis, B. (2004). The Taijiquan Classics: An Annotated Translation. Berkeley: North Atlantic.
Deepak, K.K., Manchananda, S.K. & Maheswari, M.C. (1994). Meditation improves clinicoelectroencephalographic measures in drug-resistant epileptics. Biofeedback & Self-Regulation, 19(1): 25-40.
Detert, N. & Douglas, L. (2014). Mindfulness MBSR/MBCT improves general psychiatric symptom severity, depression, anxiety and perceived stress in neurological disorders in an NHS clinical setting. Neuro-Disability & Psychotherapy, 2(1/2):
Elliot, B. (2011). Arts-based and narrative inquiry in liminal experience reveal platforming as basic social psychological process. The Arts in Psychotherapy, 38, 96-103.
Gemmell, C. & Leathem, J.M. (2006). A study investigating the effects of tai chi chuan: individuals with traumatic brain injury compared to controls. Brain Injury, 20: 151-156.
Grossman, P., Kappos, L., Gensicke, H., D’Souza, M., Mohr, D., Penner, I. & Steiner, C. (2010). MS quality of life, depression and fatigue improve after mindfulness training. Neurology, 75: 1141-1149.
Hackney, M.E., Earhart, G.M. (2008). Tai Chi improves balance and mobility in people with Parkinson disease. Gait & Posture, 28: 456–60.
Hart, J., Kanner, H., Gilboa-Mayo, R., Haroeh-Peer, O., Rozenthul-Sorokin, N. & Eldar R. (2004). Tai Chi Chuan practice in community-dwelling persons after stroke. International Journal of Rehabilitation Research, 27: 303–304.
Husted, C., Pham, L., Hekking, A. & Niederman, R. (1999). Improving quality of life for people with chronic conditions: the example of t'ai chi and multiple sclerosis. Alternative Therapies in Health & Medicine, 5:70–74.
Jahnke, R., Larkey, L., Rogers, C., Etnier, J. & Lin, F. (2012). A comprehensive review of health benefits of qi gong and tai chi. American Journal of Health Promotion, 24(6): e1-e25.
Johansson, B., Bjhur, H. & Rönnbäck, L. (2012). Mindfulness-based stress reduction (MBSR) improves long-term mental fatigue after stroke and traumatic brain injury. Brain Injury, 26: 1621-1628.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present and future. Clinical Psychology: Science & Practice, 10: 144-156.
Kaltenmark, M. (1969). Lao Tzu and Taoism. Translated by Roger Greaves. Stanford: Stanford University Press.
Kim, D.K., Lee, K.M., Kim, J., Whang, M.C. & Kang, S.W. (2013).Dynamic correlations between heart and brain rhythm during Autogenic meditation. Frontiers in Human Neuroscience, 7: 414.
Lee, B. (2000). Striking Thoughts: Bruce Lee’s Wisdom for Daily Living. New York: Tuttle Publishing.
Li, F. (2013). Tai Ji Quan exercise for people with Parkinson’s disease and other neurodegenerative disorders. International Journal of Integrative Medicine, 1(4): 1-7.
Li, F., Harmer, P., Fisher, K.J., Junheng, Xu., Fitzgerald, K. & Vongjaturapat, N. (2007). Tai Chi-based exercise for older adults with Parkinson's disease: a pilot program evaluation. Journal of Aging & Physical Activity, 15:139–51.
Li, F., Harmer, P., Fitzgerald, K.J., Eckstrom, E. Stock, R., Galver, J., Maddalozzo,G. & Batya, S.S. (2012). Tai chi and postural stability in patients with Parkinson's disease. New England Journal of Medicine, 366:511–519
Little, J. & Lee, B. (2000). Bruce Lee: A Warrior’s Journey. (TV Documentary). Warner Home Video.
Luria, A.R. (1975). The Man with a Shattered World. Harmondsworth: Penguin Books.
Lyubimov, N.N. (1998). Changes in Electroencephalogram and Evoked Potentials during Application of the Specific Form of Physiological Training (Meditation). Human Physiology, 25:171–80.
Lynton, H., Kligler, B. & Shiflett, S. (2007).Yoga in stroke rehabilitation: A systematic review and results of a pilot study. Topics in Stroke Rehabilitation, 14(4): 1-8.
McCraty, R., Atkinson, M., Tiller, W.A., Rein, G., & Watkins, A. (1995). The effects of emotions on short term heart rate variability using power spectrum analysis. American Journal of Cardiology, 76: 1089-1093.
Merton, T. (1969). The Way of Chuang Tzu. New York: New Directions.
Mills, N., Allen, J. & Carey-Morgan, S (2000). Does Tai Chi/Qi Gong help patients with Multiple Sclerosis? Journal of Bodywork and Movement Therapies, 4(1): 39-48.
Quinn, D. (unpublished). The Tai Chi Movement for Wellbeing Effectiveness Measure.
Quinn, D. & Jones, K. (2012). Tai chi movement (TMW) and embodied mindfulness in mental and physical health. Inservice Presentation for Herefordshire Primary Care Trust, UK.
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Tai Chi is being increasingly researched as an intervention for complex health conditions, including neurological conditions. These studies are published in both English and Chinese-language scientific journals, with the latter taking a while to reach an English-speaking professional readership. Some studies attract some publicity in the media and on social networks (see our facebook page for the latest), irrespective of the quality of the methodology and the limitations of the findings produced. As such I present below a set of statements around the evicdence-base for neurological conditions, organised both by condition type and outcome type. Where findings are based on group data I will note any limitations around generalisability (e.g., statistical power), and I will also include case study findings where relevant (but cautioning against extrapolation of findings, etc).
Meta-Analyses & Reviews of Strongest Evidence for Tai Chi in Neurological Conditions:
Parkinsons Disease:
Balance and mobility improvements found in meta-analyses by Jin et al., 2020; Mazzarin et al. 2017; Ni et al. 2014; Radder et al. 2017; Toh 2013; Yang et al. 2014; Zhou et al. 2015) in addition to depressive symptoms and quality of life (Jin et al., 2020).
Stroke:
Lyu et al. (2018): beneficial effect on activities of daily living, balance, limb motor function, walking quality, mood, and sleep from low quality evidence-based studies.
Qin et al (2016): compared to physically-orientated rehabilitation, significant gains in the areas of balance function, gait speed, anxiety and quality of life.
Ding (2010) Confers advantageous gains to stroke survivors in the domains of balance, mobility, quality of life, anxiety and depression.
Zou et al. (2018); Baduanjin qi gong produces gains in balance and other aspects of physical functioning plus reduction in depression.
Gains in balance is the most replicated finding across studies, concluded in reviews by Wu et al. (2018); Li et al. (2018; Zou et al. (2018).
Across Neurological Conditions:
Strongest evidence for increased balance and reduction in falls in people with Parkinsons Disease and Stroke, weaker evidence for other neurological conditions (Winser et al., 2018).
Evidence of Benefits for Condition Type:
Stroke: In their meta-analysis of 15 eligible studies (with acceptable design characteristics and statistical power) from both the English and Chinese-language scientific literature, Qin, Wei, Liu and Zhu (2016) found that when compared with standard physically-orientated rehabilitation, TJ conferred significant gains in the areas of balance function, gait speed, anxiety and quality of life. In contrast no advantages were evident for survivor levels of depression or functional walking quality. Taylor-Piliae and colleagues (2014) found Yang style Tai Chi for older stroke survivors (>50years) group to have had fewer falls than aerobic exercise and treatment as usual control groups. Both Tai Chi and aerobic control groups demonstrated greater aerobic endurance than treatment as usual. No group effect found for perceived mental health – all groups reported this. All other stroke studies are underpowered and so strong conclusions cannot be made from the group data in these studies.
Taylor-Piliae and colleagues (2012) reported that Tai Chi was a safe activity for stroke survivors. Of relevance to stroke services, is the review by Zheng and colleagues (2015) of the benefits of Tai Chi in the general population. They identify the beneficial reduction of key risk factors for the occurrence of stroke and cerebro-vascular disease, plus lower incidence of stroke in Tai Chi practitioner samples.
Traumatic Brain Injury: Gemmell and Leathem (2006) investigated the psychosocial benefits of Tai Chi for TBI survivors. However the groups in each condition were small (n=9) and the intervention was only 6 weeks. As such their claims for improvements in group scores for Tai Chi practitioners (VAMS ratings for sadness, confusion, anger, tension, fear plus increased energy) are encouraging but cannot be considered persuasive. Blake and Batson (2009) used a randomisation procedure to demonstrate improvements in mood and self-esteem but not physical functioning in a Tai Chi group versus control, but again the numbers in each condition were small (n=20) and the authors concluded that the results were inconclusive as a persuasive case for Tai Chi for TBI. Shapira and colleagues (2001) report three case studies where improvements were noted in aspects of mobility and subjective feelings of security when walking in TBI survivors who had participated in a Tai Chi intervention.
Multiple Sclerosis: Burschka and colleagues (2014) found small effect sizes (n= 32) for therapeutic gains from a 6 month twice-weekly Tai Chi group in balance, coordination and depression relative to a treatment as usual group. Tavee and colleagues (2011) found improvements in ratings of pain, physical and mental health functioning, and fatigue/energy levels for their small sample (n=22) of practitioners in a two month Tai Chi group compared to control condition. Other studies were pilot groups and so did not report persuasive group data.
Parkinsons Disease: Large sample group studies by Li and colleagues (2012) and Gao and colleagues (2014) have demonstrated gains in balance, postural stability and differing aspects of mobility relative to the control groups, validating similar findings in a smaller sample (Hackney & Earhart, 2008). Consistent findings from RCTs in the English and Chinese-language literature have been reviewed by Ni and colleagues (2014), Toh (2013), Yang and colleagues (2014) and Zhou and colleagues (2015), although several of these reviewers have cautioned against the consistency of findings around different mobility indices and maintenance of gains at follow-up data collection. A lower incidence of fall rates in the Tai Chi group versus controls during a follow-up period was reported by Gao and colleagues (2014).
Mixed Neurological Conditions Groups: Quinn and Jones (2012) reported a range of psychosocial gains from a small group of participants with mixed neurological conditions following completion of a Tai Chi group, but were unable to compare against a control group. Yeates (2019 a,b,c; in prep) has reported gains in depression, anxiety, fatigue and quality of life for some survivors of stroke, traumatic brain injury and post-tumour resection following a six month weekly unadapted tai chi pilot group in a mixed acquired brain injury sample. These gains were noted alongside no benefit and some negative outcomes for other participants.
Mild Cognitive Impairment: Sungkarat and colleagues (2017) demonstrated a reduction in falls in older adults with MCI, and a meta-analysis of 11 studies (moderate level of quality) by Yang and colleagues (2020) highlighted a range of improvements in cognitive functioning in Tai Chi participants versus control groups.
Cerebellar Ataxia: Winser and colleagues (2017; 2018a) found improvements in balance and functional independence for tai chi participants.
Evidence of Benefits for Different Outcomes
Balance: Stroke survivors (Au-Yeung et al., 2009; Hwang et al., 2018); Multiple Sclerosis (small effect size, Burschka et al., 2014); people with Parkinsons Disease (Gao et al., 2014; Li et al., 2012; Hackney & Earhart, 2008; Khuzema et al., 2020; Li et al., 2020); Cerebellar Ataxia (Winser et al., 2017; 2018a).
Coordination: Multiple Sclerosis (small effect size, Burschka et al., 2014).
Postural Control: people with Parkinsons Disease (see reviews by Ni et al., 2014; Toh, 2013; Yang et al., 2014; Zhou et al., 2015).
Mobility: Motor Functioning in stroke survivors compared to a balance control intervention (Xie et al., 2018); differing aspects of mobility for people with Parkinson’s Disease (Gao et al., 2014; Li et al., 2012; Hackney & Earhart, 2008; Khuzema et al., 2020; Li et al., 2020). Multiple Sclerosis and perceived physical functioning (small sample, Tavee et al., 2011).
Aerobic Endurance: Older stroke survivors (Taylor-Piliae et al., 2014)
Incidence & Fear of Falling: Older stroke survivors (Huang et al., 2019; Taylor-Piliae et al., 2014; Xie et al., 2018); People with Parkinsons Disease (Gao et al., 2014); Mild Cognitive Impairment (Sungkarat et al., 2017)..
Pain: People with Multiple Sclerosis (Tavee et al., 2011).
Fatigue/Energy Levels: Stroke/Cerebro Vascular Disorder (daytime energy levels improvement discernible from a sleep quality questionnaire measure, Wang et al., 2010); Multiple Sclerosis (small sample, Tavee et al., 2011); Mixed ABI case studies (Yeates, 2019a,b,c).
Psychological Functioning: Stroke survivors and depression (Wang et al., 2010; Xie et al., 2018); anxiety (see meta-analysis by Qin et al., 2016) and self-efficacy (Hwang et al., 2018); Multiple Sclerosis and depression (small effect size, Burschka et al., 2014); mood and self-esteem for survivors of Traumatic Brain Injury (but small sample size, Blake & Batson, 2009), Mixed ABI case studies (Yeates, 2019a,b,c).
Quality of Life: ÒStroke survivors (see meta-analysis by Qin et al., 2016); Life satisfaction in people with Multiple Sclerosis (Burschka et al., 2014), Mixed ABI case studies (Yeates, 2019a,b,c).
Functional Independence: Cerebellar Ataxia (Winser et al., 2017; 2018a).
Research Limitations
While general critiques of the literature include the lack of sufficiently-powered studies in some conditions (e.g., Traumatic Brain Injury, Multiple Sclerosis), three things were glaringly absent upon first reading of these studies, from my perspective as both a psychologist and Tai Chi instructor:
- Firstly, the majority of these evaluative studies treated Tai Chi as solely a physical intervention – where psychological benefits where found (and these were often not planned primary outcomes in studies), there was no account for how these gains were achieved, no theory that links the practice of Tai Chi movements with psychological wellbeing (see the pages on How Does Tai Chi Work?).
- Secondly the groups included in these studies are selected to be as similar as possible. While this makes the interpretation of the results easier, this means that the findings may not speak to the needs of many people with neurological conditions who have multiple and diverse difficulties. For example, a common strategy in stroke Tai Chi research is to screen out people with cognitive difficulties – this is problematic as Tai Chi may be uniquely beneficial for this common aspect of stroke yet the existing studies cannot contribute to this consideration, given their research strategy. In any group of people with a neurological condition such as stroke, some people will have physical difficulties such as sensory loss, weakness or impaired mobility (but affecting different parts of the body), some may have unique cognitive difficulties such as praxis, memory, attention, planning and organising; others will struggle with forms of emotional distress or fatigue. Many will have unique combinations of this difficulties. So each person will require different adaptations to optimise their learning and practice of Tai Chi to gain maximum benefits. The self-selecting, homogenising scientific literature above does not contribute to the development of this important adaptation process.
- Finally, the Tai Chi interventions under study have mostly been 3 months or less in duration (with the notable exceptions of twice-weekly six-month Tai Chi groups in the studies by Burschka et al., 2014 and Li et al., 2012) and in the case of acquired neurological conditions have been offered in the early stage post-injury. These studies then cannot contribute to the traditional focus of Tai Chi practice – regular practice over long periods of time (a lifetime).
Au-Yeung, S.S.Y., Hui-Chan, C.W.Y. & Tang, J.C.S. (2009). Short-form Tai Chi improves standing balance of people with chronic stroke. Neurorehabilitation & Neural Repair, 23: 515–22.
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Bastille, J.V. & Gill-Body, K.M. (2004). A yoga-based exercise program for people with post-stroke chronic hemiparesis. Physical Therapy, 84: 33-48.
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