新型物理疗法杂志

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Adapted Tai Chi Enhances Upper Limb Motor Control in Chronic Stroke Patients: A Pilot Study

Shujuan Pan, Dahlia Kairy, Hélène Corriveau and Michel Tousignant

Background: Tai Chi has been reported as beneficial for improving balance post stroke, yet no study examined the use of Tai Chi for upper limb rehabilitation. The objective of this study was to evaluate the efficacy and acceptability of Tai Chi for upper limb rehabilitation post stroke.

Methods: Twelve chronic stroke survivors with a persistent paretic upper limb underwent 60-min adapted Tai Chi sessions twice a week for eight weeks and a 4-week follow-up. A 10-min Tai Chi home program was recommended for the days without sessions. Session attendance and duration of self-practice at home were recorded. Motor function of the paretic arm (Fugl-Meyer Assessment upper-limb section (FMA-UL)), Wolf Motor Function Test (WMFT) and paretic arm use in daily life(Motor Activity Log (MAL)) were measured at baseline, post-treatment and follow-up. A feedback questionnaire was used to evaluate participants’ perception of the use of Tai Chi at follow-up.

Results: Eleven participants completed the 8-week study. Participants with varying profiles including severely impaired upper limb, poor balance, shoulder pain, and severe spasticity, were able to practice an adapted version of Tai Chi. They attended all 16 sessions and practiced Tai Chi at home more than recommended (a total of 16.51 ± 9.21 hours). Participants demonstrated significant improvement over time in the FMA-UL (p=0.009), WMFT functional scale (p=0.003), WMFT performance time (p=0.048) and MAL Amount of Use scale (p=0.02). Moreover, participants confirmed the usefulness and ease of practicing the adapted Tai Chi.

Conclusion: Tai Chi was acceptable and found to be effective for upper limb rehabilitation post stroke after adaptation of movements. Further large-scale randomized trials evaluating Tai Chi for upper limb rehabilitation are warranted.