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A seated form of a traditional martial art may help stroke survivors regain strength and balance and help relieve symptoms of depression as well or better than standard post-stroke exercise programs, new research suggests Chinese.

The study authors said it was the first randomized controlled trial to analyze the ability of a modified tai chi program to help stroke survivors recover. The research was published Thursday in the journal American Heart Association Stroke.

Tai chi combines deep breathing with a series of slow, careful movements of the hands, arms, neck, legs and trunk. A scientific statement from 2014 on activity and exercise for stroke survivors highlights tai chi and yoga as flexibility and muscle strength training programs that can improve balance, quality of life and mental health while reducing fear of falling.

“Tai chi has a long history as a form of exercise in China,” said the study’s lead author, Jie Zhao, in a press release. Zhao is a lecturer at Yunnan University of Traditional Chinese Medicine in Yunnan Province, southwest China. “We have revised tai chi movements for people with weakness or partial paralysis of the limbs. It is adapted so that participants can move one arm with the help of the healthy arm.”

It can be done in a chair or wheelchair at home, Zhao said. “The program costs next to nothing to practice, and it requires no special equipment or travel time.”

AHA guidelines released in 2019 for stroke management recommend starting a rehab program within the first week and sticking with it for up to six months. Many people don’t because they lack physical stability or are unable to move their arms.

In this study, conducted at two hospitals in Kunming, China, 160 adult stroke survivors were assigned to a seated tai chi or standard rehabilitation exercise program within six months of their first stroke. The standard program included a series of upper extremity movements recommended by the hospital. Participants in both groups, whose average age was 63, had at least one arm.

The seated tai chi group received a week of individualized training with an instructor and a self-guided video to use at home three times a week for 11 weeks. Participants in the standard exercise program received the self-guided video to use at home for 12 weeks. In both groups, family members and caregivers supervised the exercises at home.

After three months, people in the seated tai chi group had better hand and arm function and better seated balance control, significant reductions in symptoms of depression, and better shoulder range of motion per compared to people in the standard exercise group. They also showed greater improvements in activities of daily living and quality of life. More than half of people who practiced seated tai chi continued doing it after 12 weeks and continued to see improvements for up to four more weeks.

“My follow-up study will measure the long-term effects of seated tai chi,” Zhao said. “People will most likely need to adhere to seated tai chi exercise beyond 12 weeks to achieve the long-term beneficial effects.”

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