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MS research update - Is Tai Chi beneficial for people with MS? - 26 August 2014

Summary

Tai Chi is a Chinese martial art that incorporates gentle physical exercise with mindfulness training. This study aimed to investigate the effect of a six month long programme of Tai Chi on people with MS.

32 people with MS in Germany took part in the study. 15 participants took part in a six month Tai Chi programme where they took part in a 90 minute class every week and 17 were the control group and did no Tai Chi.

The study found that the participants who had taken part in the Tai Chi programme had significant improvements in their balance, coordination and depression. Participants in this group were also more satisfied with life after the programme. Levels of fatigue remained relatively stable in the Tai Chi group, but increased in the control group.

The study results indicate that Tai Chi could be useful for people with MS. It appeared to have a beneficial effect on balance and coordination as well as psychological wellbeing. The authors conclude that further larger studies are needed to confirm their results as they only looked at a small group to test the programme they had designed.

Background

In the past people with MS were advised to avoid physical activity, but there is now a growing body of evidence that suggests that exercise has several beneficial effects for people with MS. Previous research has shown it can improve muscle strength, mobility, mood, fatigue and quality of life. However some people with MS remain physically inactive. There is also very little information on the best types of exercise to do and how often they should be done.

Tai Chi is a Chinese martial art that incorporates gentle physical exercise with mindfulness training. Previous research in people with MS reported that Tai Chi improved wellbeing, symptom management and mental health. However these studies only looked at Tai Chi programmes that lasted less than two months and as the benefits of Tai Chi are believed to increase over time those studies may have underestimated the effects it could have on people with MS. This study aimed to investigate the effect of a six month long programme of Tai Chi on people with MS.

How this study was carried out

32 people with MS in Germany took part in the study. To be included the participants had to be able to walk without a walking aid, have an EDSS score of less than 5 and not had a relapse for four weeks prior to the start of the study. All participants took part in a series of tests which assessed balance, fatigue, depression and quality of life before and after the six month study period.

17 participants received treatment as usual (control group), so they were instructed to consult their medical professionals as they usually would, but they did no Tai Chi.

15 participants took part in a six month Tai Chi programme. This consisted of a 90 minute Tai Chi class every week. The programme was developed based on the Yang-style of Tai Chi, which is the one of the most popular forms.

The exercise programme was structured so that during each class, the same essential elements were repeated. This enabled any participants who had missed a session to join in and catch up without any difficulties and the repetition helped learning. Participants were only required to do the exercises in the group sessions, they were no asked to do any training at home.

What was found

The study found that the participants who had taken part in the Tai Chi programme had significant improvements in their balance, coordination and depression. Participants in this group were also more satisfied with life after the programme. Levels of fatigue remained relatively stable in the Tai Chi group, but increased in the control group.

What does it mean?

The study results indicate that Tai Chi could be useful for people with MS. It appeared to have a beneficial effect on balance and coordination as well as psychological wellbeing. The authors conclude that further studies are needed to confirm their results as they only looked at a small group to test the programme they had designed. They suggest this future research should look at larger groups of people and also groups with different symptoms, to try and work out how Tai Chi has its effect.

Burschka JM, Keune PM, Oy U, et al.
Mindfulness-based interventions in multiple sclerosis: beneficial effects of Tai Chi on balance, coordination, fatigue and depression..
BMC Neurol. 2014 Aug 23;14(1):165. [Epub ahead of print]
abstract
Read the full text of this paper (PDF)

More about Tai Chi and MS

Tai Chi is a form of gentle exercise that combines deep breathing and relaxation techniques with slow, graceful movements. Because Tai Chi is largely based on technique, it does not require great strength or flexibility. It can be carried out individually or in groups. There are several forms of Tai Chi, each with different movements and styles. This study used the Yang style, which is the most popular and widely practiced form. This form has a set of movements that can be learned a few at a time, and then put together to create longer sequences.

Although there has been little research done on the effects of Tai Chi in MS, the physical and psychological effects of Tai Chi have been examined extensively in both older people and those with chronic conditions. Previous research has shown that Tai Chi has a medical benefit for those with chronic health problems, including multiple sclerosis. Long-term Tai Chi practice was found to have favourable effects on the promotion of balance control, flexibility and cardiovascular fitness and reduced the risk of falls in older people. It was also found to reduce pain, stress and anxiety.

You can read more about Tai Chi in the A-Z of MS. As there are different styles and different ways they can be taught, it is a good idea to watch a class or attend a free taster session before signing up for a course, to make sure it will be suitable for you. In all classes, you can tell the teacher that you have MS. They may be able to adapt the postures for you if needed and keep the room cool. They are used to hearing about people's physical conditions and will keep it confidential if you want them to.

Research by topic areas...

Causes of MS

Pakpoor J, Goldacre R, Schmierer K, et al.
Testicular hypofunction and multiple sclerosis risk: A record-linkage study.
Ann Neurol. 2014 Aug 18. [Epub ahead of print]
abstract

Co-existing conditions

Brass SD, Li CS, Auerbach S.
The underdiagnosis of sleep disorders in patients with multiple sclerosis.
J Clin Sleep Med. 2014 Sep 15;10(9).
abstract

Disease modifying treatments

Ziemssen T, Bajenaru OA, Carrá A, et al.
A 2-year observational study of patients with relapsing-remitting multiple sclerosis converting to glatiramer acetate from other disease-modifying therapies: the COPTIMIZE trial.
J Neurol. 2014 Aug 14. [Epub ahead of print]
abstract
Read the full text of this paper

Totaro R, Lugaresi A, Bellantonio P, et al.
Natalizumab treatment in multiple sclerosis patients: a multicenter experience in clinical practice in Italy.
Int J Immunopathol Pharmacol. 2014 Apr-Jun;27(2):147-54.
abstract

Other treatments

Sexton M, Cudaback E, Abdullah RA, et al.
Cannabis use by individuals with multiple sclerosis: effects on specific immune parameters.
Inflammopharmacology. 2014 Aug 19. [Epub ahead of print]
abstract

[No authors listed]
Delta-9-tetrahydrocannabinol + cannabidiol. A reasonable option for some patients with multiple sclerosis.
Prescrire Int. 2014 Jun;23(150):145-8.
abstract

Physical activity

Motl RW, McAuley E.
Physical activity and health-related quality of life over time in adults with multiple sclerosis.
Rehabil Psychol. 2014 Aug 25. [Epub ahead of print]
abstract

Provision of care

Rasová K, Martinkova P, Cattaneo D, et al.
Physical therapy in multiple sclerosis differs across Europe: Information regarding an ongoing study.
J Int Med Res. 2014 Aug 12. [Epub ahead of print]
abstract
Read the full text of this paper

Psychological aspects

Jones KH, Jones PA, Middleton RM, et al.
Physical disability, anxiety and depression in people with MS: an internet-based survey via the UK MS Register.
PLoS One. 2014;9(8):e104604.
abstract
Read the full text of this paper

Levin AB, Hadgkiss EJ, Weiland TJ, et al.
Meditation as an adjunct to the management of multiple sclerosis.
Neurol Res Int. 2014;2014:704691.
abstract
Read the full text of this paper

Quality of life

Cioncoloni D, Innocenti I, Bartalini S, et al.
Individual factors enhance poor health-related quality of life outcome in multiple sclerosis patients. Significance of predictive determinants.
J Neurol Sci. 2014 Jul 28. [Epub ahead of print]
abstract

Mikula P, Nagyova I, Krokavcova M, et al.
Social participation and health-related quality of life in people with multiple sclerosis.
Disabil Health J. 2014 Jul 16. [Epub ahead of print]
abstract

Rehabilitation

Kalron A, Pasitselsky D, Greenberg-Abrahami M, et al.
Do textured insoles effect postural control and spatiotemporal parameters of gait and plantar sensation in people with multiple sclerosis?
PM R. 2014 Aug 18. [Epub ahead of print]
abstract

Tacchino A, Bove M, Roccatagliata L, et al.
Selective impairments of motor sequence learning in multiple sclerosis patients with minimal disability.
Brain Res. 2014 Aug 19. [Epub ahead of print]
abstract

van der Linden ML, Hooper JE, Cowan P, et al.
Habitual functional electrical stimulation therapy improves gait kinematics and walking performance, but not patient-reported functional outcomes, of people with multiple sclerosis who present with foot-drop.
PLoS One. 2014;9(8):e103368.
abstract
Read the full text of this paper

Socie MJ, Motl RW, Sosnoff JJ.
Examination of spatiotemporal gait parameters during the 6-min walk in individuals with multiple sclerosis.
Int J Rehabil Res. 2014 Aug 11. [Epub ahead of print]
abstract

Miller DM, Thompson NR, Cohen JA, et al.
Factors associated with clinically significant increased walking time in multiple sclerosis: Results of a survival analysis of short-term follow-up data from a clinical database.
Mult Scler. 2014 Aug 11. [Epub ahead of print]
abstract

De Souza LH, Frank AO.
Problematic clinical features of powered wheelchair users with severely disabling multiple sclerosis.
Disabil Rehabil. 2014 Aug 11:1-7. [Epub ahead of print]
abstract
Read the full text of this paper

Relapses

Grau-López L, Teniente-Serra A, Tintore M, et al.
Similar biological effect of high-dose oral versus intravenous methylprednisolone in multiple sclerosis relapses.
Mult Scler. 2014 Aug 21. [Epub ahead of print]
abstract

Symptoms and symptom management

Harrison AM, Bogosian A, Silber E, et al.
'It feels like someone is hammering my feet': Understanding pain and its management from the perspective of people with multiple sclerosis.
Mult Scler. 2014 Aug 11. [Epub ahead of print]
abstract

Work

Van der Hiele K, Middelkoop HA, Ruimschotel R, et al.
A Pilot Study on Factors Involved with Work Participation in the Early Stages of Multiple Sclerosis.
PLoS One. 2014;9(8):e105673.
abstract
Read the full text of this paper

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