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This may tie in with the barefoot running debate...in the way that sometimes the simple things need to be relearnt.
One of the comments I have noticed in a few of the treads has been the need for people to 'learn to run'...and the replies that they should know how to run by now.
One thing i have noticed as a Tai chi instructor and with various international discussion groups is that some people have trouble doing what should be a natural movement.
Now we teach Tai chi at a very advanced level...not your regular Grandmother Tai chi and we find that due to poor core muscle stability we have to reeducate to achieve 'natural' movement.
It would be interesting to test core muscle stabiltiy in relation to running injuries...maybe it has been done and I'm unaware of it...poor scholar that I am.
Tai chi taught correctly is a great tool for assisting the patient develop core strength...but sadly the level of instructors is very poor with many doing weekend workshop to become instructor for things like 'Tai chi for Arthritis'.
It is just another tool I use to try and engage my patients to participate in their own health.
Effect of tai chi on body balance: randomized controlled trial in elderly men with dizziness
Maciaszek J, Osinski W. Am J Chin Med. 2012;40(2):245-53.
Quote:
The purpose of this study was to assess the effect of 18-week Tai Chi training on body balance in a dynamic trial among elderly men with dizziness. The study covered subjects aged 60 to 80 years. We identified 40 men who reported a history of dizziness. The subjects were recruited using direct mailings and a community information campaign. The participants were randomly assigned to either the exercise intervention (n = 20) or control group (n = 20). The Tai Chi group participated in an 18-week exercise class held for 45 minutes twice a week. Body balance was studied in two ways: using the "8 foot up and go test" (Rikli and Jones 2001) and using a Computer Posturographic System PE 90 (manufactured by Military Institute of Aviation Medicine in Warsaw and outfitted with Pro-Med modified software). The ability to perform specific tasks (maximal deflections in four directions) was measured on the posturographic platform. The variation in results obtained on the first and second date of tests in the experimental and control groups was confirmed statistically using four parameters, i.e. "8 foot up to and go test (H = 8.21;p = 0.003), forward deflection (H = 3.70;p = 0.050), backward deflection (H = 5.04;p = 0.024) and maximum sway area (H = 8.86;p = 0.002). Consequently, we found that the 18-week period of Tai-Chi exercises, with a frequency of twice a week for 45 minutes, is beneficial for dynamic balance, which is important for the reduction of fall risk factors among elderly men with dizziness.
I discussed this in a recent Falls prevention round table for one of the Padman Aged care facilities.
WHO also supports Tai Chi for falls prevention but finds that it needs to be implemented early rather than later with the efficacy diminishing with the "Frail Aged".
Like most things there are "Real" Tai chi instructors and those that do a quickie weekend course. Understanding Biomechanics assists me when I teach Tai Chi...and we integrate it into the clinical environment.
This may tie in with the barefoot running debate...in the way that sometimes the simple things need to be relearnt.
One of the comments I have noticed in a few of the treads has been the need for people to 'learn to run'...and the replies that they should know how to run by now.
One thing i have noticed as a Tai chi instructor and with various international discussion groups is that some people have trouble doing what should be a natural movement.
Now we teach Tai chi at a very advanced level...not your regular Grandmother Tai chi and we find that due to poor core muscle stability we have to reeducate to achieve 'natural' movement.
It would be interesting to test core muscle stabiltiy in relation to running injuries...maybe it has been done and I'm unaware of it...poor scholar that I am.
Tai chi taught correctly is a great tool for assisting the patient develop core strength...but sadly the level of instructors is very poor with many doing weekend workshop to become instructor for things like 'Tai chi for Arthritis'.
It is just another tool I use to try and engage my patients to participate in their own health.
Don't many foot & knee problems originate from the hip/pelvic region?.
Don't many foot & knee problems originate from the hip/pelvic region?.
Yes, in the sense that the force of gravity acting on the trunk and contralateral leg, that is in swing phase, will load the foot that is on the ground. Did you have some other mechanism in mind?
Press Release: Tai Chi exercise may reduce falls in adult stroke survivors
Quote:
HONOLULU, Feb. 6, 2013 — Tai Chi may reduce falls among adult stroke survivors, according to research presented at the American Stroke Association’s International Stroke Conference 2013.
Compared to survivors receiving usual care or participating in a national fitness program for Medicare-eligible adults called SilverSneakers®, those practicing Tai Chi had the fewest falls.
Tai Chi is a martial art dating back to ancient China. It includes physical movements, mental concentration and relaxed breathing.
“Learning how to find and maintain your balance after a stroke is a challenge,” said Ruth E. Taylor-Piliae, Ph.D., R.N., the study’s principal investigator and assistant professor at the University of Arizona College of Nursing in Tucson, Ariz. “Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls. Tai Chi is readily available in most U.S. cities and is relatively inexpensive.”
Stroke survivors experience seven times as many falls each year than healthy adults, Taylor-Piliae said. These falls can cause fractures, decrease mobility and increase fear of falling that can result in social isolation or dependence. Tai Chi has significantly reduced falls in healthy older adults.
Researchers recruited 89 stroke survivors — most of whom had ischemic strokes — for a randomized prospective study outside of a hospital setting. Participants were an average 70 years old, 46 percent were women and most Caucasian, college educated and living in the Tucson area, and suffered a stroke on average three years prior to beginning the study.
Among the participants, 30 practiced Tai Chi, 28 took part in usual care and 31 participated in SilverSneakers®. The Tai Chi and SilverSneakers® groups participated in a one-hour exercise class three times each week for 12 weeks. The usual care group received a weekly phone call and written material about participating in community-based physical activity.
During the 12-week trial, there were a total of 34 reported falls in participants’ homes mainly from slipping or tripping: five falls in the Tai Chi group; 15 falls in the usual care group; and 14 falls in the Silver Sneakers group. Only four people sought medical treatment.
Yang-style Tai Chi, as practiced in the study, is the most popular of five styles used in the United States because of its emphasis on health benefits, both physical and psychosocial benefits, researchers said.
“The main physical benefits of Tai Chi are better balance, improved strength, flexibility and aerobic endurance,” Taylor-Piliae said. “Psycho-social benefits include less depression, anxiety and stress, and better quality of life.”
Co-authors are: Tiffany Hoke, R.N.; Bijan, Najafi, Ph.D.; and Bruce Coull, M.D. Author disclosures are on the abstract.
An American Heart Association Scientist Development Grant and a Robert Wood Johnson Foundation Nurse Faculty Scholars Grant funded the study.
Complexity-based measures inform tai chi's impact on standing postural control in older adults with peripheral neuropathy.
Manor B, Lipsitz LA, Wayne PM, Peng CK, Li L. BMC Complement Altern Med. 2013 Apr 16;13(1):87.
Quote:
BACKGROUND:
Tai Chi training enhances physical function and may reduce falls in older adults with and without balance disorders, yet its effect on postural control as quantified by the magnitude or speed of center-of-pressure (COP) excursions beneath the feet is less clear. We hypothesized that COP metrics derived from complex systems theory may better capture the multi-component stimulus that Tai Chi has on the postural control system, as compared with traditional COP measures.
METHODS:
We performed a secondary analysis of a pilot, non-controlled intervention study that examined the effects of Tai Chi on standing COP dynamics, plantar sensation, and physical function in 25 older adults with peripheral neuropathy. Tai Chi training was based on the Yang style and consisted of three, one-hour group sessions per week for 24 weeks. Standing postural control was assessed with a force platform at baseline, 6, 12, 18, and 24 weeks. The degree of COP complexity, as defined by the presence of fluctuations existing over multiple timescales, was calculated using multiscale entropy analysis. Traditional measures of COP speed and area were also calculated. Foot sole sensation, six-minute walk (6MW) and timed up-and-go (TUG) were also measured at each assessment.
RESULTS:
Traditional measures of postural control did not change from baseline. The COP complexity index (mean+/-SD) increased from baseline (4.1+/-0.5) to week 6 (4.5+/-0.4), and from week 6 to week 24 (4.7+/-0.4) (p=0.02). Increases in COP complexity---from baseline to week 24---correlated with improvements in foot sole sensation (p=0.01), the 6MW (p=0.001) and TUG (p=0.01).
CONCLUSIONS:
Subjects of the Tai Chi program exhibited increased complexity of standing COP dynamics. These increases associated with improved plantar sensation and physical function. Results of this non-controlled pilot study suggest that complexity-based COP measures may inform the study of complex mind-body interventions, like Tai Chi, on postural control in those with peripheral neuropathy or other age-related balance disorders.
Hi,
Goldpods had a visiting orthopaedic specialising in hip and knee surgery last week.Dr.Liu commented that he did advise patients investigate and practice improving there core strength prior to surgery- there was a possibility this would manage or alleviate symptoms.
My limited understanding of biomechanics, orthotic therapy and core strength is they go hand in hand.
Maybe that is why barefoot runners/walkers benefit, smaller stride length placing less force through the lower limb?
Has any one else been noticing the difficulty in patient's abilty to purchase shoe wear that actually accommodates width? I don't know if it is just a Qld / Gold Coast problem, a DM T2 thing but I have too many patient's with extra width issues.
Cheers,
JoBB
Tai chi and core muscle stability
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