The value of Tai Chi to enhance physical and psychosocial health for people with multiple sclerosis

Background: The contribution of exercise to physical and psychosocial health is beyond dispute. Especially individuals with chronic diseases, such as multiple sclerosis (MS), have much to gain from being physically active. MS predominantly occurs during young adulthood. Dependent on disease activity, it leads to a gradual decline of mobility, social participation, and quality of life. A long-term perspective is essential for effective MS management. Research interest: Pharmacological treatment primarily relies on early intervention to counter disease activity. To detect functional impairment as early as possible, the development of assessment tools is necessary. Further strategies to impede or even restore functional damage are scarce. Only recently, exercise has been recognised as an essential part of MS management. Despite substantial evidence in support of physical activity, specific recommendations on choice and dose of available exercise programs are lacking. There are strong arguments in favour of Tai Chi, a Chinese martial art, to meet the specific needs of this target population. Particularly the principle of mindfulness, which is entangled with the concept of Tai Chi, could be a valuable asset in coping with MS. Strategies: We evaluated dynamic characteristics of walking behaviour, comparing 37 persons with MS to 25 healthy controls. To describe the change of speed in walking behaviour, we analysed its approximation to three different velocity profiles in two time-framed walking tests. In sum, the observed differences varied depending on test duration (6 versus 12 minutes), disease severity (mild versus moderate disability level) and observed parameter (mean walking speed versus temporal change of walking speed). Our findings indicate an early influence of MS on walking behaviour. We present the linear decline of walking speed as a new, clinically relevant feature of walking ability in persons with MS. The decline in walking speed is particularly suitable to assess walking behaviour with regard to fatigue, because it better reflects the individual’s subjective constraints than the commonly assessed parameter mean walking speed. We analysed both the concept of Tai Chi and research on Tai Chi with special regard to methodology. The concept of Tai Chi is highly pluralistic. Scientific research on Tai Chi is just as manifold. Such divergent investigation makes it difficult to collect convergent evidence. The complexity within this field should receive more attention. Tai Chi is a complex intervention that requires an elaborate and well-designed scientific approach. A first step into this direction is to improve the quality of reporting and standardisation. In addition, the inclusion of high quality qualitative research should be pushed forward. We devised a standardised Tai Chi program and analysed its therapeutic value for persons with MS.We evaluated the program within a 6-month intervention, comparing a Tai Chi group (n = 15) to a group that received treatment as usual (n = 17). We found a consistent pattern of beneficial effects on the following parameters: balance, coordination, fatigue, depression, and life satisfaction. Conclusion: Dynamic characteristics of walking behaviour could support improved monitoring of mobility in MS. Tai Chi is a promising opportunity for persons with MS to engage in long-term physical activity and foster both physical and psychosocial resources.

Level thesis:degree_level

thesis.doctoral

Grantor dc:publisher

Universität Bayreuth

Year

2015

Author dc:creator

• Burschka, Janina M.

Contributors dc:contributor

• Kuhn, Peter

Repository record source_url

https://epub.uni-bayreuth.de/id/eprint/2171/

OAI identifier oai:identifier

oai:epub.uni-bayreuth.de:2171