Dan Keller 0:08
Welcome to this episode of Substantial Matters: Life and Science of Parkinson's. I'm your host, Dan Keller. At the Parkinson's Foundation, we want all people with Parkinson's and their families to get the care and support they need.
Part of that support is sharing resources and practices with people with PD that can enhance their lives. One of these practices is Tai Chi Chuan, or just Tai Chi, a distinctive Chinese form of exercise that aims to balance the forces of yin and yang to bring good health and balance in our lives. As a practical matter, for people with PD, tai chi can be helpful at various stages of the disease. The slow, gentle body movements present little risk for injury, generally done in a standing or somewhat squat position. Some classes for people with PD teach it in a seated position. Studies have shown many benefits of tai chi, including increased flexibility, body awareness, balance, posture, breath control, stress reduction, and quality of life.
While many people in Western countries practice Tai Chi, I asked Dr. Pei-Fang Tang of National Taiwan University about its uptake in Eastern versus Western societies. Do you think that people with Parkinson's, or just people with any condition in Taiwan, are more likely than Western patients to explore conventional Chinese exercises like tai chi?
Dr. Pei-Fang Tang 1:56
Yes, I think so, because there are two reasons. We may have more resources; we may have more tai chi instructors there and available courses there, so people are more likely to explore Tai Chi Chuan as their exercise choices. And the other thing is that because of the influence of Chinese culture, so we are more inclined to, for example, take Chinese medicine or be engaged in Chinese-style exercises, and Tai Chi Chuan is one of them.
Dan Keller 2:29
What do the parts of Tai Chi Chuan mean?
Dr. Pei-Fang Tang 2:33
Let me explain what Tai Chi means first. "Tai" means big, huge, and "Ji" means endless. So Tai Chi together means the endless, formless state of the universe, and that's the basic principle of the universe. Also, Tai Chi is based on ancient Chinese philosophy, Taoism, and it's believed that there are several principles. For example, there are yin and yang aspects of everything in the universe, and then yin and yang interchange and interact dynamically. And so in Tai Chi Chuan, we believe that there are yin and yang components you can practice.
Tai Chi Chuan is actually martial arts based on Tai Chi philosophy. So when the movements are going out or going upward, they indicate the yang aspect, meaning the fullness of the movement. And the movement coming down or coming toward ourselves is the yin aspect, meaning emptiness. And it's believed that the balance between yin and yang, the coexistence of yin and yang, helps balance our life and also helps us have good health and longevity.
When we practice tai chi, it is believed that it can bring balance in our health and our life. And so in terms of breathing, when we practice tai chi, inhalation also indicates yang, and then exhalation indicates yin, so that helps us learn the switching between yin and yang. So the breathing component of tai chi also helps us to stay focused and concentrated, and helps us become more relaxed. So practicing tai chi is like practicing the Taoism philosophy with mind and body.
Dan Keller 4:41
How often do people do tai chi? Is this a regular thing or occasional?
Dr. Pei-Fang Tang 4:45
For people who choose tai chi as their exercise, they may do it twice or three times as a group a week. And for people who are really into tai chi exercise, they may practice every day as a daily routine. And you often see older people in the park—they practice tai chi every day because they are very into it.
Dan Keller 5:12
If people do tai chi and they have Parkinson's, how does this help them in their daily life?
Dr. Pei-Fang Tang 5:21
There is evidence showing that—actually, two recent articles show that tai chi helps them have better balance, especially dynamic balance, so they can move further without falling. And also they have less, for instance, after the training, after about three months' training or six months' training, also they can feel more relaxed, and the movement speed can be faster, and so on.
Dan Keller 5:52
Are general tai chi classes for the public safe for people with Parkinson's?
Dr. Pei-Fang Tang 5:58
I would say that it's safe for people at the de novo stage, that's the very beginning stage, and stage one of Hoehn and Yahr—stage one patients with Parkinson's, because their symptoms are not so obvious yet, and so that's safe. But for people at stage two of Hoehn and Yahr, they may need to find courses specially designed for patients with movement disorders or Parkinson's.
Dan Keller 6:26
Is it only their body that's affected, or is there any effect in cognition, mood, things like that?
Dr. Pei-Fang Tang 6:34
Yes, there's more and more evidence that Parkinson's affects the mood and the cognitive performance, and tai chi helps with the mood also, and helps with cognitive function also.
Dan Keller 6:48
Can people begin at any time, or is this something that you should start young?
Dr. Pei-Fang Tang 6:54
Actually, it's never too late. And in our society, and also in a lot of studies, Tai Chi Chuan was given to older people—older people after 65, the age of 65—and they can still learn Tai Chi, Tai Chi Chuan. So I think it's never too late.
Dan Keller 7:16
How much instruction is required? Is it set kinds of movements and exercises?
Dr. Pei-Fang Tang 7:22
Yes, there are simple forms, like eight forms, that's the simplest one I saw. And I usually, in my research, I usually use the 24-form Yang-style Tai Chi Chuan. And I give our participants 12 weeks, three months, to learn 24 forms, and they learn two to three new forms each week. And the course is like three times a week, so in those three sections they learn two to three forms. And then by week 10, they probably already learn all 24 forms, and they can practice all 24 forms in sequence without the instructor's instructions. So I think that's how it operates, usually in my studies, and usually in communities it's taught this way also.
Dan Keller 8:17
I've heard that it's good for people with Parkinson's to learn new things, keep their minds stimulated. It sounds like learning 24 forms is a good way, at least for those 12 weeks, to keep learning, keep picking up stuff. Is it possible to do it from books or online instruction, or does it really need to be done in person?
Dr. Pei-Fang Tang 8:39
Personally, I would like it to be done in person. That's because Tai Chi Chuan is not difficult, but it requires some body coordination. Because people do it differently, if you do it online—well, when we do it in person, the instructor can give you feedback about your movement immediately, and they may guide you more in detail. So if you do it online, if the instructor cannot provide online feedback to your movement, then it's difficult to know whether you perform it correctly or not.
Tai chi is called a low- to moderate-intensity exercise, and it doesn't cause too many injuries. But if you perform it in an incorrect way, it can cause, for example, knee pain, because it's performed in a semi-squat position. So I think for beginners, it's better to have instructors to teach you, teach you in person. And for people who have more experience, they may try online courses.
Dan Keller 9:48
In your research, what outcomes do you measure?
Dr. Pei-Fang Tang 9:52
We measure motor functions, cognitive function, and brain activations.
Dan Keller 9:59
Quality of life?
Dr. Pei-Fang Tang 10:01
Yes, quality of life as well. Yes.
Dan Keller 10:05
I guess it also promotes social interaction if you're taking classes and getting together.
Dr. Pei-Fang Tang 10:11
Oh, yes, because we use the group format of the practicing, so people get to know each other and they encourage each other, so their social interaction becomes better also.
Dan Keller 10:23
A little peer pressure to show up every time.
Dr. Pei-Fang Tang 10:25
Yeah, good adherence. Actually, it's amazing that I have three arms in my research. It means three groups: tai chi, aerobic, and the stretching group. And the tai chi and aerobic group, the adherence is almost 100%.
Dan Keller 10:46
Is there anything interesting or important to add?
Dr. Pei-Fang Tang 10:49
Well, I think learning tai chi needs some patience and perseverance. And at the beginning, you may find it difficult to chain the movements one after the other or to remember the sequence, and it does take time. But just be patient and relax, and enjoy the learning journey, and I think practice can make perfect.
Dan Keller 11:14
Very good. Thanks a lot. Bye.
To find out more about Tai Chi, search "Tai Chi" in our PD library by visiting parkinson.org/library, where you'll find fact sheets and additional resources on exercise, posture, and stress management for Parkinson's disease. Another excellent resource is MedlinePlus from the US National Library of Medicine at medlineplus.gov. Just search on "Tai Chi" for an extensive list of validated links. You can also call our helpline to see if there are Tai Chi classes in your area, some of them modified to meet the needs of people with PD.
While people in the early stages of PD are generally as strong and physically fit as healthy people of the same age, it's always good to check with a physical therapist trained to work with people with PD to see if a specific exercise or class is right for you. For more PD-tailored fitness videos that feature a different focus every week, from balance to coordination and more, be sure to tune into our Fitness Fridays series, part of our PD Health at Home virtual program. You can visit parkinson.org/pdhealth to view previously aired at-home workouts today.
If you have any questions about the topics discussed today, or if you want to leave feedback on this podcast, you can do it at parkinson.org/feedback. If you enjoyed this podcast, be sure to subscribe, rate, and review the series on Apple Podcasts, or wherever you get your podcasts.
At the Parkinson's Foundation, our mission is to help every person diagnosed with Parkinson's live the best possible life today. To that end, we'll be bringing you a new podcast every other week, and as always, our PD information specialists are available on the helpline to answer your questions about tai chi, exercise in general, or anything else having to do with Parkinson's. Call them toll-free at 1-800-4PD-INFO, that's 1-800-473-4636. Thank you for listening.
