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Tai Chi Stroke Rehabilitation

Qigong & Tai Chi for stroke recovery

Tai Chi Society Research

by Great Grand Master Kellen Chia

September 5, 2010

Qigong ( pronounced chee-gong ) and Tai Chi are ideal for people who have suffered strokes, as demonstrated by the recent experiences of a Sydney-based man being treated by Great Grand Master Kellen Chia. This research article relates his successful recovery, and explains why Qigong and Tai Chi are so beneficial for this significant health issue.

A stroke occurs when the flow of blood ( and oxygen ) to the brain is blocked by a clot or plaque in a blood vessel, or by a blood vessel on the surface of the brain rupturing and causing blood to leak into the space between the brain and the skull, or by a defective artery in the brain bursting. A larger stroke may cause total paralysis on one side, or a coma or even death due to the extent of the damage. If a stroke happens at the right side of the brain, then the left side is paralysed, whereas if it happens at the left, then the right side is paralysed. When a stroke occurs at the brain stem, which is in the lowest part of the brain, it is called a brain stem stroke; it can be more serious than other types of strokes. The brain stem controls heart rate, breathing, blood pressure, speech, eye movement, swallowing, body movement and hearing. A brain stem stroke can leave the patient with severe impairments – total paralysis or partial paralysis.

George P., at age 83, had a brain stem stroke at the left side of the brain in the first week of April 2009. He spent a few days in both the emergency and neurological units before being transferred to the stroke unit within the hospital where he learnt how to walk again. He needed help to get on his feet, he needed someone to support him as he walked, and then he managed to walk again albeit slowly with a walking frame. Two weeks later a physiotherapist gave him a few gentle exercises every day for two weeks before he could shower himself. For the next sixteen days before being discharged he stayed in the rehabilitation unit. Every day he spent one hour in the exercise room with a physiotherapist using a treadmill, an exercise bike and two stair-steps to practise walking up, resting between each exercise. He continued to walk with a walking stick for six months after leaving hospital, and had some physiotherapy for his legs and hips which felt as stiff as steel. Thirteen months later his neurologist at the hospital suggested that he take up Tai Chi because his balance on the right had not improved much. He could still not walk straight; always being pulled to the right after about three minutes of walking, and the stiffness from his hips all the way down to his feet had not abated. Also, his other medical problems had not diminished ; he was still feeling very depressed, had trouble swallowing and twice a day for about half a minute each he felt pain around his right eye like hot, piercing needles.

On April 19, 2010 Great Grand Master Kellen Chia met George and his wife Hannah, a healthy 75- year old. After an initial assessment on George for balance, mobility, strength and speed GGM Kellen Chia began training George and Hannah the healing art of Qigong – characterized by slow, relaxed and flowing movements - in a series of private lessons twice a week. In the first session George could do Qigong for only ten minutes. He practised for ten minutes every day, as suggested, and by the third session he could do it for fifteen minutes. Within two weeks his balance had improved remarkably. After three weeks, as his strength and cardio fitness continued to improve; he could do Qigong for about 30 minutes. By week four he could do ‘Rolling a giant wheel’ that involves shifting 90% of the body weight forward onto the front foot in a posture that reaches out, and then shifting weight onto the back foot in a posture that pulls back; he could do neither posture in the first session because of the pain experienced in his hips. By four weeks, though, the rigidity and stiffness in his legs and hips had disappeared with the one exception being his lower back right leg. After just seven weeks George was able to walk straight, feeling no pull to the right. Accompanied by Hannah and Great Grand Master Kellen Chia he walked for twenty minutes non-stop on a return trip. Darling Point Road was a little hilly at two intersections, but what GGM Kellen Chia and others would normally walk in seven minutes to reach half-way took George only ten minutes. Before his first Qigong session George could walk only very slowly, and always in fear of falling because of his balance being pulled to his right. Now, however, George can walk for at least twenty minutes, non-stop, without showing any of his previous medical conditions.

By the end of eight Qigong sessions in his first month of treatment George had achieved an almost complete recovery except for the stiffness in the back of his lower right leg. He felt good, fit and healthy. After seven weeks he could stand on one leg for sixteen seconds, whereas before he could not do it for even one second. A huge number of healthy people can not stand for sixteen seconds on one leg, and perhaps only a healthy few in their eighties can do it. The hot piercing needles of pain around his right eye had evaporated. In the second week of July, after two and a half months and twenty sessions of Qigong, GGM kellen Chia re-assessed George’s medical conditions. The stiffness from his hips to his feet had disappeared; a little stiffness in the back of his lower right leg returned only when walking up a hilly road. Also, George's swallowing problems had gone whereas just two months prior it caused great difficulty. He achieved all of this only by learning, with Hannah, the Twelve Wonders Qigong and the Nine Heavens Qigong from Great Grand Master Kellen Chia, his only other exercise being some short walks in the park with Hannah after the first month. George stopped having physiotherapy ever since starting his Qigong training. By the third week of July 2010, after twenty sessions of Qigong practice, Great Grand Master Kellen Chia decided to teach George and Hannah five minutes of Tai Chi practice in addition to the Qigong.

George had played tennis for seventy years, four times a week, two hours per session, up until he had a stroke. If he had taken up Qigong or Tai Chi six months prior, perhaps the stroke may not have happened. There are ten risk factors that are associated with 90% of the risk of stroke: high blood pressure, smoking, poor diet, abdominal obesity, physical inactivity, above-normal lipids or fats, type-2 diabetes, alcohol intake, stress and depression, and heart disorders. George had only one of these, being depression, and Qigong and Tai chi are effective in helping people with depression. Nevertheless, the fact is that the doctors do not know what caused George’s stroke.

Qigong works well in treating stroke survivors and those with other medical conditions primarily because the movements are slow and relaxed; it is not just the deliberate rhythmic breathing, as many people are led to believe. If one only does deliberate rhythmic breathing in static postures, whether it be standing, sitting or lying down, then there is almost no beneficial effect for medical problems. The key to medical benefits is in Qigong’s slow movements accompanied by a relaxed state. With hundreds of styles of Qigong and over two thousand exercises, they can be categorized as healing ( sometimes called medical ), meditative and martial Qigong. The medical benefits of healing Qigong vary considerably, so for a stroke survivor there is little point in practising some of them. Examples include the exercise that resembles drawing a bow and arrow to the left and to the right while in a shoulder-width stance, the static horse stance while intermittently slowly punching the fists forward, and thirdly the exercise with all of the body’s weight on the back foot while repeatedly bending forward touching the front toes and returning to the upright position. These exercises will not work for stroke survivors, doing nothing to improve balance or to alleviate other medical conditions such as stiffness in hips and legs, needles of pain around the eye, swallowing difficulties, etc.

The movements of Qigong are effective in improving both intrinsic motor control and functional status. They increase aerobic capacity and sensorimotor function, and improve the timing of muscle activation and strength, cardio respiratory fitness, mobility, coordination, balance and importantly one’s circulation. They also calm the mind. Qigong has a favourable effect on the prevention of recurrent stroke and cardiovascular events.

Qigong training offers four distinct advantages in the rehabilitation of stroke survivors. Firstly, it involves the performance of movements that are required for everyday living, such as walking and reaching. The movements in Twelve Wonders Qigong and Nine Heavens Qigong involve shifting weight, leaning in different directions and reaching. Secondly, they are easy to perform, so almost anyone can do them. Thirdly, Qigong exercises elicit no cardiovascular stress. And fourthly, they consume a minimal amount of energy which is ideal given that post-stroke subjects expend considerably more energy than their healthy counterparts for even the most common household tasks such as vacuuming and making one’s bed.

Each year there are about 60,000 Australians who suffer a stroke, and it is the second most common cause of death after coronary heart disease. Statistics show that following their first-ever stroke, one in five people die within one month and one in three people die within a year. 150,000 people in America die each year from stroke, out of 700,000 people who suffer a stroke, making it the number three cause of death after heart disease and cancer. Furthermore, stroke occurs in people of all age groups; nearly 20% of all strokes occur in people under 55 years old, and more than half of the men and women aged under 65 who have a stroke die within 8 years. It can occur before birth, when the foetus is still in the womb. About 87% of stroke survivors are confined to their home, most with a disability. And close to 40% of stroke survivors have a second stroke within five years, the highest risk period being the first few months; a repeat stroke is more devastating than the first.

These are frightening statistics*, but according to medical studies 90% of stroke risk factors are preventable through lifestyle changes. Quitting smoking and eating more fish and fruit are linked to the greatest reduction in the risk of stroke. High blood pressure is the most significant risk factor, and Tai Chi and Qigong have been shown to be effective in treating this. Tai Chi and Qigong are also effective for type-2 diabetes and stress, and are beneficial in treating heart disorder such as irregular heart beat, all of which are risk factors for stroke. Abdominal obesity can be reduced within two years of Tai chi and Qigong practice. The Twelve Wonders Qigong and Nine Heavens Qigong learnt by George are suitable for people of all ages and fitness levels: the infirm become healthy and the strong become stronger.

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[* The mortality statistics referred to in this paper are taken from medical studies conducted in Australia and America.]