Tai Chi Post Stroke Rehabilitation

Stroke is a leading cause of serious, long-term disability among middle-aged and older adults worldwide (1). After the age of 55, the risk of having a stroke doubles every ten years (2). Several factors are thought to be important for the long-term prognosis on functional recovery post stroke, including location and size of brain lesion, initial severity of motor impairment, spontaneous recovery capacities and the effects of rehabilitation (3). Active movement practice and repetition are thought to shape neural plasticity and enhance motor recovery. Its frequency and intensity correlate largely with stroke recovery (4). Currently, it is recommended to use rehabilitation programs involving intensive, repetitive, and task-specific movement training
However, no study had reported its use for upper limb rehabilitation post stroke. Tai Chi is a whole-body exercise, and muscle strength and flexibility of the upper limb have been shown to improve in the aged following Tai Chi (29-31). Furthermore, since muscular relaxation training has been suggested as a means to control involuntary muscular activity (32), the relaxation component of Tai Chi may have the potential to improve spasticity of paretic upper limb. Therefore Tai Chi may be a promising upper limb rehabilitation method. However, the presence of hemiparesis may be an important barrier to using Tai Chi for upper limb rehabilitation post stroke, potentially limiting the ability to actually perform the Tai Chi upper limb movements. Similarly, shoulder pain and severe spasticity of the affected arm may impact on the ability to perform Tai Chi movements. Furthermore, the standing position used in traditional Tai Chi styles poses difficulties for persons with poor balance. Although sitting Tai Chi has been reported to be used in persons with spinal cord injuries to improve muscle strength of upper limb (33), little is known about how to adapt Tai Chi for paretic upper limbs. Adapting Tai Chi to take into account these limitations may need to be considered in order to include it in post-stroke rehabilitation. Moreover, the feasibility and
More specifically, the objective was to evaluate the feasibility and effects of using adapted Tai Chi for upper limb rehabilitation post stroke, including (1) whether the adapted Tai Chi was doable and acceptable by participants; (2) whether the potential influencing factors such as upper limb impairment, insufficient balance, shoulder pain and spasticity constrained the practice of the adapted Tai Chi; (3) whether the adapted Tai Chi was effective in improving motor function of paretic upper limbs and activity of daily living of participants and (4) to document participants’ perception of the usefulness and ease of practicing the adapted Tai Chi. A second objective was to document the clinical reasoning underlying the adaptations made to Tai Chi based on the participants’ characteristics when used for upper limb rehabilitation post