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Second Article in a Series on Tai Chi-Qigong for Rehabilitation
Ralph and Maria, two people in my Chi Kung class, both had strokes many years ago, and when they came to my class, they had not had therapy for some decades. It often happens that once progress “plateaus,” therapy is suspended. There is an assumption that the patient has made all possible recovery and there will not be enough benefit to spend further time, energy and money. Nevertheless, Ralph and Maria both made significant progress in their range of motion and their ability to use their hands and arms for activities of daily living. Here are some reasons why this improvement might have occurred.
Brain plasticity: Paul Bach y Rita, a famous neuroscientist who began his work in the 1960’s, became interested in late rehabilitation of strokes after his father recovered from a disabling stroke. Bach y Rita became an advocate of brain “plasticity,” which includes the idea that the brain is able to reorganize and change itself throughout life—even into old age. He argued that learning plateaus such as those in stroke recovery are temporary, that they are part of a learning cycle. Stages of learning are followed by periods of consolidation, during which it seems there is no progress being made. Nevertheless, there are internal changes that help new skills become more automatic and refined. Thus, after a “plateau,” there is a new opportunity for increased progress and recovery of function.
Ralph and Maria had a very long plateau, possibly because their strokes occurred before the recent research on brain plasticity and they did not know they could continue to progress. When they came to Tai Chi-Qigong class, we did exercises that helped them go to a new level. Ralph began to use his weak hand in tandem with his right hand for all kinds of activities of daily living that he previously did one-handed. Maria’s rehabilitation doctor noticed her progress and suggested new therapy sessions for her. Ralph and Maria are examples of the power of our brains to renew themselves and reorganize to overcome old stroke symptoms.
Tai Chi-Qigong and stroke recovery
Whole person approach: Tai Chi-Qigong has several inherent qualities that are highly supportive of stroke recovery, even after many years. The whole body approach described in a previous blog is very important because every part of the body has to be recruited to assist the weak parts. The more body parts that are recruited, the greater the brain stimulation and the more robust the supporting neurological connections will be in the brain.
Stimulates new brain connections: Tai Chi-Qigong moves parts of the body that are not usually moved, stimulating the brain to create new, fresh connections.
Repetition reinforces connections: Repetition many times during a single session and over several weeks reinforces the new connections. The more practice participants do between classes, the more reinforcement and the more stable the neurological connections and functions become.
Practical movement: One of Paul Bach y Rita’s principles of recovery was that exercises should be as close to normal, everyday activities as possible. Unlike weight lifting and using various types of gym machines, Qigong movements are required to perform basic functions of everyday life. Thus, each exercise contributes directly to better practical performance of walking, reaching, grasping, turning, balance, coordination and much more.
Qigong is accessible: Long-term rehabilitation exercises need to be easily accessible so they can be done several times a week and throughout the day. While gym work, swimming and aerobic workouts are good, they require going to an outside facility and often spending money that disabled people cannot afford. After learning Qigong movements, anyone can do them in the home in a small space, at any time of day, seated or standing or lying down. It is an immediately available, very practical, ongoing, life supporting practice that can continue fruitfully throughout one’s life.
Tai Chi-Qigong is a great component of an overall program of rehabilitation and long term maintenance for stroke and many other chronic disabling conditions.
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Copyright by Anna York, 2010
Reference: Norman Doidge M.D., The Brain that Changes Itself. Viking, New York, 2007, pp. 24-25.
[This is part of a series on Chi Kung and Restoring Function after Stroke. Principles also apply to many other conditions. See Archive for other articles on this topic and on exercise and rehabilitation.]