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Part 1 of a Series on Tai Chi-Qigong for Rehabilitation
Jeff and Maria had strokes many years ago, and were attending my Tai Chi-Qigong (Chi Kung) class during the summer to see if they could restore some lost function. Others in the class had Parkinson's, MS, spinal cord injury, and other conditions. That summer we all learned a lot about putting the power of Tai Chi & Qigong (Chi Kung) to work to make us stronger and more functional.
Jeff and Maria have one weak side, including a shoulder and arm that are paralyzed, and at the beginning of the summer each had a hand that was drawn up into a tight fist. Each has his or her own unique strengths and weaknesses. Before the end of the summer, Jeff and Maria and others in the class were making significant progress. (You can meet Jeff in our new video. He is in the pic on the back left.)
In this first blog I will focus on four key principles of Tai Chi-Qigong that I employed in helping these people--and people with many other types of disabilities--restore function from neurological damage. Later blogs will detail applications for each principle.
Whole person approach: The first key to my strategy was to view each person’s disability in the larger context of the whole person. For example, we would not just focus on the hand, but would see the hand and its function as an integral part of the function of the arm, shoulder and upper body. We would continue to do foundational movements that engage the whole body. That is the Qigong approach—we are whole persons and all the parts work together.
Brain plasticity: I was also primed with research on the plasticity of the brain by such people as Edward Taub, Paul Bach y Rita, Michael Merzenich and other neuroscientists, all of whom have made breakthrough contributions in understanding how the brain can regenerate itself after traumatic events such as a stroke. I was hoping to apply their insights to my own work.
Neurons that fire together wire together: One of their findings I was keeping in mind is that “neurons that fire together wire together.” Adjacent parts of the body, such as shoulder and arm, are wired into adjacent parts of the brain. Moving the shoulder stimulates neurons in the brain that are also closely connected with the arm neurons. The practical application of this principle was that I would work the parts of the body that are next to the dysfunctional areas and expect that they would stimulate their neighbors both in the body and the brain. Tai Chi-Qigong is especially good for this because the slow, mindful movements raise awareness of the body and help the practitioner isolate and focus on very specific muscles and sensations. I would employ movements to target not just the weak areas, such as a tight hand, but also the more functional areas that were nearby, including arm and shoulders.
Shaping: Another key idea, from Edward Taub’s research, is the principle he calls “shaping.” Shaping occurs in rehabilitation therapy when very small movements are repeated many times and are increased in small increments, a strategy that can significantly boost restoration of lost function. Once again, Qigong is especially good for implementing this strategy, because we repeat small movements many times and gradually extend them out, challenging the body and mind to go farther than before.
Pay attention: Michael Merzenich discovered that paying close attention is essential to long-term changes in the brain. When actions are performed automatically, without paying attention, changes do occur in the brain, but they do not last long and the benefits to the body are not robust. Playing music, reading, talking on the phone and watching TV will probably water down the effects of exercise and rehab work. If you want to get the deeper brain benefits of a workout, better pay attention! Qigong is great for implementing this principle because in Qigong the mind is as important as the body. Attention and visualization are powerful components of all movement, breathing and energy work and are at the core of our work in Tai Chi-Qigong class.
Mental practice: Alvaro Pascual-Leone of Harvard Medical School proved that doing mental practice of a skill, such as playing the piano, produces the same changes in the brain map as actually doing the physical practice. Although their improvement was not as rapid, those who “imagined” playing a certain sequence of notes on the piano had the same changes in the motor signals to their muscles as those who did physical practice.
This is great news for people who have disabilities and whose energy does not allow them to do as much physical practice as they would like or as is necessary to regain and maintain function. Mentally practicing new skills and reviewing old skills can support an overall program of physical exercise and therapy.
Energy work: A key element of Tai Chi-Qigong is the energy work. “Chi” means energy, and “kung” or "gong" means discipline or practice. Thus, at its heart Qigong is about developing, maintaining and increasing the body’s energy through consistent, disciplined practice. This is accomplished through certain breathing techniques, through physical movements and through specific energy exercises that include breathing and visualization. Besides cleansing toxins and improving energy and stamina, this work also stimulates production of endorphins and other hormones that lift mood and support a positive attitude that is so necessary for doing rehab.
Pascual-Leone and other neuroscientists are confirming what Tai Chi and Qigong practitioners have known for thousands of years. Mental practice is a core aspect of these ancient arts and helps account for their powerful healing effects throughout the ages.
These are some basic principles I find effective in doing Chi Kung with people who have disabilities resulting from stroke and from other neurological conditions. Stay tuned! I will be building these out in succeeding excerpts.
Copyright by Anna York, 2010
Preview new DVD:
There are now many articles and books describing recent research on the plasticity of the brain. Here are a couple of good overviews.
Norman Doidge M.D., The Brain that Changes Itself. Viking, New York, 2007.
Sharon Begley, Train Your Mind, Change Your Brain: How a New Science Reveals Our Extraordinary Potential to Transform Ourselves. Forward by the Dalai Lama. Ballantine Books, New York, 2007.