Article Commentary: “Tailored Sitting Tai Chi Program for Subacute Stroke Survivors”
Farah Aleisa, MD
Zhao J, Chau JPC, Chan AWK, Meng Q, Choi KC, Xiang X, Zhao Y, He R, Li Q. Tailored Sitting Tai Chi Program for Subacute Stroke Survivors: A Randomized Controlled Trial. Stroke. 2022.
Ancient Chinese medicine suggests that Chi is aligned with our body fluids and stability of the nervous system, and it delivers functional and healing resources to all parts of the body, including the brain. It believes in the resting alert status of the body to activate circulation and facilitate oxygenation to the organs and cells. Its main outcome is harmonizing the nervous system. There are many energy channels connecting organs, glands, and cells, which are equivalent to the chemical and nervous signals. One of the modern definitions of Chi is the functionality of the chemical interactions in different body systems through enzymes, hormones, and even neurotransmitters; the methodology of Chi depends on the mind focus, breathing exercise, and specific body movements that all collaborate to enhance the efficiency of the inner chemical activities.
Dr. Zhao and his team studied the efficacy of a tailored Tai Chi rehabilitation program among stroke survivors who suffered from residual disabilities post-stroke events. The best time for rehabilitation for stroke patients is the first few days, post-stroke event, and the highest rate of recovery is up to 6 months. Beyond the 6 months period, recovery is still possible but in a much slower rate. This is the first study designed as an assessor-blind randomized controlled trial looking for the benefits of tailored Tai Chi exercises in the subacute stroke population. It enrolled patients from April 2020 to August 2020. Four separate inpatient neurology units of two tertiary A-level traditional Chinese medicine (TCM) hospitals in Kunming, China, included stroke survivors aged over 18 years, with a clinical diagnosis of ischemic stroke, with history of first-ever stroke, in the subacute stage of stroke, who can sit independently with or without cushions, use and raise at least one arm while sitting, and who are able to communicate. Few exclusion criteria were applied, like severe stroke with NIH stroke scale >16, cognitive impairment, hearing or visual disabilities, and pregnant women. Participants were randomized on a 1:1 ratio to the intervention or control groups with a block size of 8 stratified by NIHSS score (< 6 or ≥ 6) by an independent statistician according to a computer-generated randomization sequence.