Thursday, March 20, 2014

Tai Chi for Falls Prevention


According to the US Center for Disease Control (CDC), more than 1 in 3 US adults over 65 fall each year. The treatment cost for falls in the US is about $20 Billion each year. Scary, isn't it.

The CDC issues what are called "evidence-based practice" recommendations. This is the highest level of recognition in the medical community because there is evidence that the practice works. The Tai Chi for Arthritis program developed by Dr. Paul Lam is evidence-based practice for reducing falls.

"…the fall rate among Tai Chi participants was one-third lower and the rate of multiple falls was 46 percent lower than the rates for participants who did not take Tai Chi."

Voukelatos A, Cumming RG, Lord SR, Rissel C. A randomized, controlled trial of Tai Chi for the prevention of falls: The Central Sydney Tai Chi trial. Journal of the American Geriatrics Society.2007 Aug;55(8):1185-91.


That's a jaw-dropping result! The fall rate dropped dramatically for the people learning tai chi. There are no guarantees for individuals, but this is an official endorsement. Tai chi is a method proven to help empower people to take control of their health.

"Tai chi is especially useful for improving balance and preventing falls—a major concern for older adults. Studies have shown tai chi to reduce falls in seniors by up to 45%, Dr. Wayne says. It can also improve balance in people with neurological problems. Tai chi helps improve balance because it targets all the physical components needed to stay upright—leg strength, flexibility, range of motion, and reflexes—all of which tend to decline with age."
 
There are three main tai chi practices that are helpful in reducing falls.

1) The practice of being aware of full (substantial) and empty (insubstantial). A substantial foot means that all (or most) of your weight is in that foot. For instance, if the whole body's weight is on the right foot, the right foot is substantial and the left foot is insubstantial, and vice versa. Read more here.

Most often, people fall laterally (to the side). The side stepping of Waving Hands Like Clouds develops improved strength and balance. When we place our foot empty and then shift our weight, we are moving with muscles instead of using momentum to move us. This strengthens the muscles and joints in the legs and helps with balance. In addition, stepping this way is a mind-body practice that builds awareness of posture and balance.

A bent knee stance and movement works to strengthen lower limb muscle, particularly the quads. However, don't overdo it. Always work within your comfort zone. If a bent knee stance is too difficult, then do the movement without bent knees.

Tai Chi addresses gait problems by teaching correct movement of the lower limbs. This is done by lifting lower limbs from the knee rather than the foot and lifting lower limbs without misaligning the pelvis. Tai chi also teaches to place heel down first when moving forward and toes first when moving back.

2. Moving as if against a gentle resistance. Visualize doing your tai chi in water and lower your center of gravity. This increases the load on lower limbs and over time increases sensation and awareness of lower limb movement. It develops a mind-body connection and builds strength. Body awareness means that you are more aware of what your body is doing and helps keep you out of unstable postures where falls can occur.

3. Coordinate the movements of the upper and lower body. Be aware of your posture. Keep your shoulders over your hips and move from the hips (center of the body) to remain vertical. Read more here.

The whole body should act as a unified whole. Motion is rooted in the feet, released through the legs, controlled by the waist, and manifested by the hands through the shoulders and arms. From legs to waist, there needs to be unison of movement. Thus when your hands move, your waist and feet as well as the focus of the eyes must move accordingly.

© 2014 by Eric Borreson