Tai Chi, Qigong (Chi Kung)


Schmitz-Hubsch et al. of Germany published their study in a
recent issue of Movement Disorders: Qigong exercise helps
reducing the motor and non-motor symptoms of Parkinson's disease:
A randomized controlled pilot study.

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Members with Parkinson's rated Tai Chi "9.7" out of a possible "10" in effectiveness as Parkinson's therapy.

Why aren't our health media informing other Parkinson's patients of this fact, more effectively ??

Parkinson's Publications, Books and Magazines:

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Tai Chi, Qigong (Chi Kung)

Below are excerpts from articles dealing with
Tai Chi & Parkinson's Disease. Links to the
full articles are provided below.

Contributed by Kevin Chen:

Schmitz-Hubsch et al. of Germany published their study in a recent issue of

Movement Disorders: Qigong exercise helps reducing the motor and non-motor

symptoms of Parkinson's disease: A randomized controlled pilot study.

ABSTRACT: Irrespective of limited evidence, not only traditional

physiotherapy, but also a wide array of complementary methods are applied

by patients with Parkinson's disease (PD). We evaluated the immediate and

sustained effects of Qigong on motor and nonmotor symptoms of PD, using an

add-on design. Fifty-six patients with different levels of disease severity

(mean age/standard deviation [SD], 63.8/7.5 years; disease duration 5.8/4.2

years; 43 men [76%]) were recruited from the outpatient movement disorder

clinic of the Department of Neurology, University of Bonn. We compared the

progression of motor symptoms assessed by Unified Parkinson's Disease

Rating Scale motor part (UPDRS-III) in the Qigong treatment group (n = 32)

and a control group receiving no additional intervention (n = 24). Qigong

exercises were applied as 90-minute weekly group instructions for 2 months,

followed by a 2 months pause and a second 2-month treatment period.

Assessments were carried out at baseline, 3, 6, and 12 months. More

patients improved in the Qigong group than in the control group at 3 and 6

months (P = 0.0080 at 3 months and P = 0.0503 at 6 months; Fisher's exact

test). At 12 months, there was a sustained difference between groups only

when changes in UPDRS-III were related to baseline. Depression scores

decreased in both groups, whereas the incidence of several nonmotor

symptoms decreased in the treatment group only. (Movement Disorders, 2005

Oct 14).



Diseases and Conditions - June 10, 2004

Parkinson's disease - From MayoClinic.com

Special to CNN.com [for entire article visit cnn.com]


Parkinson's disease is a disorder that affects nerve cells (neurons) in the part of the brain
controlling muscle movement. People with Parkinson's often experience trembling, muscle
rigidity, difficulty walking, and problems with balance and coordination. These symptoms
generally develop after age 50, although the disease affects a small percentage of younger
people as well.

Parkinson's disease is progressive, meaning the signs and symptoms become worse over time. But although Parkinson's may eventually be disabling, the disease often progresses gradually, and most people have many years of productive living after a diagnosis.

Furthermore, unlike other serious neurologic diseases, Parkinson's disease is treatable. For decades, the drug levodopa, commonly known as L-dopa, has been the mainstay of Parkinson's disease treatment. But L-dopa can cause side effects, and it may become less effective as the disease worsens, especially as new symptoms develop. In addition, responses to the drug may become more erratic over time. For that reason newer drugs are now also used, either alone or in combination with levodopa.

Another treatment that has had encouraging results is deep brain stimulation (DBS). DBS
involves implanting a brain stimulator, similar to a heart pacemaker, in certain areas of the brain. For some people, DBS may control symptoms so well that medications can be greatly reduced. Meanwhile, research into other treatments continues.
. . .

Avoiding falls

In the later stages of the disease, you may fall more easily. That's because Parkinson's disease affects the balance and coordination centers in the brain. In fact, you may be thrown off balance by just a small push or bump. The following suggestions may help:

Ask your doctor or physical therapist about exercises that improve balance, especially tai chi. Originally developed in China more than 1,000 years ago, tai chi uses slow, graceful movements to relax and strengthen muscles
and joints.

Remove all area rugs from your home and make sure carpeting is secured firmly to the floor.

Install handrails, especially along stairways.

Keep electrical and telephone cords out of the way.

Install grab bars around your tub and beside the toilet.

Make sure you can reach the telephone from your bed and carry a cordless phone
with you during the day.


Complementary Therapies and Parkinson's Disease

Read entire article at: http://www.parkinson.org/site/pp.asp?c=9dJFJLPwB&b=238635

Melanie M. Brandabur, MD - NPF Center of Excellence, University of Illinois at Chicago

Jill Marjama-Lyons, MD - NPF Center of Excellence, Shands Jacksonville


As in many areas of medicine, patients, physicians and other practitioners are looking
outside traditional therapies to find ways to treat various aspects of PD and
side effects of treatment.

Most patients derive a great deal of benefit from today's medications and surgical
therapies for Parkinson's Disease. These treatments have improved the quality of life,
sometimes even the duration of life, for many thousands of patients and continue to
provide the foundation of therapy. However, benefits of these therapies can be limited.
As time goes by, the medications may not seem as effective as they once were. Side
effects or unpredictable response may develop. Surgical therapies are not curative and
often treat only selected aspects of Parkinson's Disease. For these reasons, patients
may decide to explore other modalities, such as massage therapy, Tai Chi, yoga, or
herbal preparations to augment their Parkinson's medication.

In the medical literature on Parkinson's disease, there is a paucity of information related
to alternative and complementary therapies, although this is beginning to change. One
Parkinson's specialist, Dr Bala Manyam, a neurologist at the NPF center at Texas A. and M.
University, has been studying and writing about alternative approaches for much of his career.
Dr Manyam recently co-authored a chapter with DR Jose Sanchez-Ramos entitled Traditional
and Complementary Therapies in Parkinson's Disease, which provides a thorough overview of
available therapies. The authors suggest that the term "cosmopolitan medicine" might be more
accurate than "traditional" or "western" medicine because it reflects the fact that today's
medical treatments are actually derived from a wide array of cultural practices
which may date back for many centuries.
. . .

The National Center for Complementary and Alternative Medicine has been established by the
National Institutes of Health for the purpose of facilitating and conducting research into
complementary modalities. Many research centers and Universities have
also developed such programs.


Most Parkinson patients have become very sophisticated about their condition and are very
knowledgeable about the medications and other traditional therapies available. It is just as
important to become educated about complementary therapies. Unfortunately, a few
unscrupulous practitioners will make unsubstantiated claims about miraculous, and often very
costly treatments. It is wise to remember the old saying: "If it sounds too good to be true, it
probably is." For most of these therapies, it is important to find a well-trained practitioner who
either understands Parkinson's disease or is willing to learn about it, is concerned about safety
and is willing to adapt their practice to fit the limitations of the participants.


This is not an exhaustive review nor a recommendation for treatment, but a brief discussion
of some of the complementary therapies that have been explored recently by Parkinson patients.
Many of these treatments are derived from ancient medical traditions such as Oriental or Chinese
medicine. True expertise in these modalities requires years of training and discipline. What is
presented here is a brief survey viewed through the lens of a modern practitioner of
"cosmopolitan medicine" and is meant to be informative only.


Ruth Villalobos, Chiyo Sasaki
under the guidance of
Kurland will be starting a
Parkinsons and
Impaired T'ai-chi group at Calvary
Presbyterian Church in Riverside
CA. www.dotaichi.com


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Traditional Chinese Medicine (TCM)

The Chinese concept of disease considers normal functioning of the body to be a matter of
internal balance between yin and yang. Yin and Yang represent co-creative opposites in the
Chinese philosophy about harmony within nature. When this balance is disturbed, disease
results. Parkinson's disease is thought to result from a defective Liver (yin) function and the
invasion of Wind (yang), which is believed to cause tremor. Liver in TCM refers not only to the
organ proper, but to its associated meridian (energy channel) and sphere of influence. For
example, Liver is thought to rule coordination and smooth body movement. According to the
"Principles of Medicine", written in 1565, "Wind tremors are (caused by) Wind entering the Liver
and the Qi of the channels rebelling upward, (causing) tics of the face and tremors of the limb."
"Qi"(pronounced "chee") refers to the quality of the vital energy which flows through meridians
within the body. Much of the aim of traditional Chinese medicine is to direct Qi appropriately to
preserve or restore health. This is often done by using a combination of modalities
such as herbal therapy and acupuncture.
. . .


Acupuncture is a technique developed over 2,500 years ago in China and is part of the holistic
system of traditional Chinese medicine. It involves the insertion of hair-like needles into certain
points on the body for the purpose of correcting imbalances in the flow of Qi within the body. The
points of insertion of the needles are called acupoints and each is thought to be associated with
specific body organs or organ systems. There are only a few published studies of the benefits of
this therapy in PD. However some studies have established that certain physiologic changes do
occur in response to acupuncture therapy. Parkinson's patients who are interested in exploring
acupuncture as a complementary therapy should find a practitioner who is trained and licensed in
acupuncture and recommended by either their own physician or by a national acupuncture
organization such as the National Certification Commission for Acupuncture and Oriental Medicine
(NCCAOM). This is especially true given the risk of infection or other complications that could
result from improper procedures or patient selection.

Massage Therapy

The benefits of massage therapy have long been recognized by many patients with Parkinson's
Disease. In addition to alleviating some degree of joint and muscle stiffness, patients may also
experience significant stress reduction. As with other complementary therapies, third-party payers
have been slow to reimburse for massage therapy but this may change as the many benefits are
demonstrated through research studies. There are a number of different types of massage therapy.
The choice from the patient perspective is a matter of personal comfort as well as interest in a
particular philosophy. For example, Shiatsu and acupressure are associated with Oriental medicine.
Swedish massage emphasizes soothing strokes while deep tissue therapies may produce some
discomfort during the actual treatment, but can greatly benefit areas of muscle tension. In choosing
a practitioner, it is important to find someone trained by an accredited school of massage therapy.
. . .

Tai Chi Chuan (TCC) or Tai Chi

Tai Chi is a form of exercise and self-defense which developed from Taoism, an ancient Chinese
belief system, in which the movements of the body are coordinated with the mind and breathing.
With it's emphasis on tranquility of the mind and agility of the body, Tai Chi has become popular
primarily as a way to improve physical and psychological well-being. At the Struther's Parkinson's
Center in Minnesota, Parkinson's patients have been participating in Tai Chi classes for many
years. A study comparing male Tai Chi practitioners with sedentary controls (non-practitioners)
found improved balance, flexibility and cardiovascular fitness in the Tai Chi practitioners. Similar
studies have demonstrated positive effects on balance in older Tai Chi practitioners. Studies of
Tai Chi in Parkinson's patients are a natural outgrowth of this research. One such study is
planned at Shands Jacksonville Parkinson Center, under the direction of Dr Marjama-Lyons.


Many patients with Parkinson's Disease have become interested in complementary therapies
to supplement medications and other traditional PD treatments. As the benefits of various
modalities are demonstrated in clinical research studies, physicians will advocate their use
more widely, thus incorporating them into "cosmopolitan" medical practice.

Read entire article at: http://www.parkinson.org/site/pp.asp?c=9dJFJLPwB&b=238635



For entire article visit: http://www.neurologychannel.com/parkinsonsdisease/surgery.shtml


Surgery is another method of controlling symptoms and improving quality of life when
medication ceases to be effective or when medication side effects, such as jerking and
dyskinesias, become intolerable.

Not everyone is a good candidate for surgery. For example, if a patient never responded to,
or responded poorly to levodopa/carbidopa, surgery may not be of any help. Only about
10% of Parkinson’s patients are estimated to be suitable candidates.
A related procedure,
cryothalamotomy, uses a supercooled probe that is inserted into the thalamus to freeze
and destroy areas that produce tremors.
. . .

Deep Brain Stimulation (DBS)

DBS targets the subthalamic nucleus, which is located below the thalamus and is difficult
to reach, the globus pallidus, or the thalamus. In DBS, the targeted region is inactivated,
not destroyed, by an implanted electrode.
. . .

Transplantation or Restorative Surgery

In transplantation, or restorative, surgery dopamine-producing cells are implanted into the
striatum. The cells used for transplantation may come from one of several sources: the
patient’s body, human embryos, pig embryos.

Complementary Treatments

A number of modalities and nutritional supplements can help relieve symptoms and improve
quality of life.
. . .

The slow flowing movements of Tai Chi help maintain flexibility, balance, and relaxation. The
Struthers Parkinson’s Center in Minneapolis, which teaches a modified form of Tai Chi,
consistently reports benefits achieved by patients in all stages of Parkinson’s. . . .

For entire article visit: http://www.neurologychannel.com/parkinsonsdisease/surgery.shtml



For entire article visit: http://www.what-is-cancer.com/papers/newmedicine/parkinson1.html

Medicine tells us that Parkinson's disease (PD) is a neurological syndrome resulting from
a damage (necrosis) of the basal ganglia (substantia nigra) in the brain, initiating a deficiency
of the neurotransmitter dopamine. PD is initiated by a shortage of dopamine, and ought
therefore be treated by dopamine replacement, with an analog called levodopa.

Medicine has only one therapeutic objective, dopamine replacement. Otherwise she has
little to offer . A simplistic approach to an intricate disease. Medicine ignores the main
therapeutic objective, which is to slow down disease progression! It will be illustrated here
with the aid of a simple model. . . .

Quality of life

What WOB regards as an optimal solution, may not meet the patient’s expectation. He
(mind) demands a good life, and gets from his doctor the desired pill. However levodopa has
a disadvantage which cannot be ignored. Since suppressing internal dopamine production
internal dopamine reserve declines. On the other hand levodopa effectiveness depends on
internal dopamine reserves. As they dwindle so does levodopa effect. In other words,
levodopa speeds PD progression and should be taken with a great care. Physician’s
task is to work out a compromise between WOB solution and mind demand for a better life.

WOB-PD and Mind-PD

We have to distinguish between two aspects of PD. A declining production which is handled
by WOB, and called WOB-PD, and a demand for a better life, called Mind-PD. Physician can
do little to assist WOB which knows best how to handle declining resource. His main task is
to assist the mind. Social and cultural pressure on the patient increases her misery, which
has nothing to do with the chronic injury from which she suffers. Her misery is product of the
mind , or Mind-PD, which ought to be the main concern of the physician.


First he ought to turn his attention to patients whose PD progresses slowly. They know how
to live with PD in good health, and are called here PD-yogis. What is their secret and how to
apply it to other patients? It is striking that during sleep tremor vanishes, which indicates that
WOB manages well without assistance. One wonders what other conditions may enable the
patient (WOB) to reduce tremor?


A meditating patient may attain a sleep like condition while maintaining his full consciousness.
His muscles relax, heart beats slower, and so is breathing. Dopamine demand declines, and
tremor vanishes. Meditation has yet another advantage. Patient learns how to ignore his mind
with all this noise generated by society and culture. Meditation reduces the demand for
dopamine. It introduces the patient to a new life. From now on his mission is to be a PD-Yogi. . . .

Cerebral blood flow

PD is first of all a pathology of the brain. Dopamine is required by neurons which control
muscle activity. As it become less and less available, it might be therapeutically redistributed
so that some neurons receive more and other less. For instance, by supplying more
dopamine to neurons which control facial muscles, tremor and rigidity
of the face might be reduced.

When a muscle is activated, brain neurons controlling it get more blood. When I laugh neurons
controlling my laughter get more blood . One wonders whether it might be possible to divert
blood to neurons controlling facial muscles by activating other muscles? This
might be achieved with Tai Chi and Chi Gong.

Chinese Mind-Body Exercises.

Ancient Chinese martial arts, Tai Chi, and Chi Gong help improve balance, strength and
body awareness. Tai Chi is described as meditation in movement using controlled
breathing combined with a slow and precise flow of body postures. Chi Gong, is
described as meditation in stillness during which participants learn to better control
their movements through directed visualization (imagery), meditation and controlled breathing.

Like sport these exercises are risky and the patient has to be closely monitored. They
may be applied to bolster a 'Slow is chic' attitude. Thai Chi is like in a slow dance. It
gradually activates different muscles. One wonders what might be the choreography
which enhances blood flow in neurons controlling facial muscles, enabling
the patient to laugh again.

Terra incognita

These examples illustrate the vast treatment potential of the so called alternative
medicine, which ought to be examined scientifically. How to evaluate effectiveness
of these treatments? Two indicators might suffice: Whether they reduce tremor or
rigidity, and whether patient feels better. . . .

For entire article visit: http://www.what-is-cancer.com/papers/newmedicine/parkinson1.html



Parkinson's Disease meeting its match in tai chi

Apr 13, 2005

For entire article visit:

Lauren Gilchrist

In a tranquil sunny room overlooking George Street, Betty Stirling practices the slow
and graceful movements of tai chi.

With soft music playing in the background, she and a dozen others are performing the
meditative routine to condition their bodies and minds.

Mrs. Stirling has been attending Peterborough Tai Chi Association classes for the past
decade. After being diagnosed with Parkinson's in 1992, she refused to let the disease
change the active lifestyle she led. She admits being diagnosed with Parkinson's as a
healthy 55-year-old was a jolt but she knew right away she
was going to deal with it head-on.

"We can feel embarrassed and disappear from society or be proud and thankful that
another day is dawning," assesses Mrs. Stirling.

"I am not embarrassed by my Parkinson's or its ramifications."

Two years after her diagnosis, she began performing the ancient Chinese exercise
because she thought it would be a great way to stay active. She recalls having
read literature supporting the idea that exercise can help control
some of the symptoms of Parkinson's.
. . .

Dr. Mark Guttman, director of the Centre for Movement Disorders in Markham,
Ontario, recommends people with Parkinson's do exercises that involve a lot of
stretching, similar to the movements of tai chi.

"Tai chi is wonderful; it can help people with disabilities as well as people with
Parkinson's," he says.
. . .

She believes strongly that exercise is important for people with Parkinson's to
help control the symptoms.

Mrs. Stirling practices tai chi because the exercises strengthen her leg muscles,
improve her balance, and relaxes rigid and stiff muscles.

"Overall, it's just great," says Lillian Embree.

Ms Embree has been an instructor with the Peterborough Tai Chi Association for
nine years. She sees students in her class who have fibromyalgia, multiple sclerosis,
cystic fibrosis and Parkinson's.

"We have a lot of fun and laugh together in this group...everyone has something
to gain from this exercise," says Mrs. Stirling.

"Doctors are now sending people here," adds Ms Embree. . . .

For entire article visit: http://www.mykawartha.com/ka/news/peterborough/story/2705429p-3134176c.html