INTRODUCTION
Peripheral neuropathy (PN) affects many people. There are approximately 20 million suffer from the disease in United States along. PN can lead to significant balance and mobility problems.
Tai Chi has been successfully used in aging and fragile population as rehabilitation tool for balance and mobility. The purpose of this study was to examine the effect of Tai Chi training for balance and mobility problems with PN.
METHODS
Individuals diagnosed with PN were recruited from the community and then randomly assigned to either Tai Chi or control group. Tai Chi group practiced Tai for six weeks (three times a week) between the pre and post tests. The control group did not receive any exercise intervention.
Plantar pressure sensitivity (PPS) was assessed at five weight-bearing sites on the right foot sole with a 5.07 gauge monofilament. The number of sites with intact sensation was totaled to produce a PPS score ranging from 0-5.
Mobility was evaluated by a 6-mininute walk (6MWD) test and the duration of a Timed Up-and-Go (TUG) test. For the 6MW, participants were instructed to walk as far as possible around two cones placed 30 meters apart down a well lit hallway. Distance covered (m) was recorded. For the TUG, participants sat with their back against a chair and feet on the floor with a cone three meters in front of the chair. The time (sec) taken to stand up, walk around the cone, and sat back down was recorded.
Eyes-closed standing balance was assessed by the average velocity (VEL, cm/s) and the area of an ellipse enclosing 95% (AREA, cm2) of the body center of pressure during quiet stance. The average of two, 30sec trials was recorded.
Isokinetic knee joint strength was examined using a Biodex dynamometer (Biodex Medical, Shirley, NY) at 60 deg/sec. Both knee extensor (KE, Nm) and flexor peak torque (KF, Nm) were computed from five maximal effort trials. Peak torque of the best three trials was averaged and used for further analysis.
Two-factor ANOVA with repeated measures was used for data analysis. Tukey post hoc analysis used if needed. Alpha = .05.
RESULTS AND DISCUSSION
There were 30 participants for each of the Tai Chi and control group. Participants for the Tai Chi group (9 men, 21 women, mean ¡À SD age = 68.3 ¡À 10.9 yrs, height = 149.9 ¡À 8.3 cm, body mass=87.6 ¡À 25.5 kg) had been diagnosed with PN for 6.0 ¡À 3.7 years. Participants for the control group (15 men, 15 women, age = 71.0 ¡À 9.8 yrs, height = 146.6 ¡À 29.3 cm, body mass=78.6 ¡À 21.3 kg) had been diagnosed with PN for 6.4 ¡À 3.9 years. One tailed T-test revealed there was no difference between the groups for all the measurements mentioned here.
Among
the seven measured parameters, there was no group or training difference
observed among PPS, VEL and KF. Significance observed from the following tests:
group, pre-post and interaction for 6MWD; group and training effects for TUG;
training effects and group X training interaction for AREA, as well as training
effects and group X training interaction for KE. Significant interactions for
these parameters are presented in the following figures. * indicates
significant differences among concerned variables.
Figure 1. 6MWD after Tai
Chi training was significantly greater than that of the pre training in the
same group or that of post training with the control group.
Figure 2. TUG after Tai
Chi training was significantly less than the averages of the other three
groups.
Figure 3. AREA after Tai
Chi training was significantly reduced in the training group.
Figure 4. KE increased significantly
in the Tai Chi training group.
SUMMARY/CONCLUSIONS
Six weeks of Tai Chi training effectively increased the functional performance among people with peripheral neuropathy. They walk longer distance with 6-minute walk, using less time for timed up-and-go, reduced the movement of center of pressure while standing quietly, and also strengthened their knee extensors. In contrast, results from the control group show physical performance will not improve or even decline if left along. We conclude that Tai Chi can be used as an effective rehabilitation tool for PN.
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