Tai Chi may improve motor symptoms, physical function and quality of life in people with early to mid-stage Parkinson’s, a small trial suggests.
A 14-week programme combining resistance and stretching exercises led to similar overall improvements in motor symptoms, although the two approaches appeared to have different physical benefits.
Tai Chi appeared to have relatively greater benefits for motor control, balance and muscular endurance, while resistance and stretching showed more consistent effects on strength, mobility and functional performance.
Researchers in China conducted a prospective randomised pilot trial involving 45 adults aged 45 to 75 with early to mid-stage Parkinson’s disease.
Participants could stand and walk independently, with or without an assistive device, and had been taking a stable medication regimen for at least a month.
Parkinson’s is caused by the progressive loss of nerve cells that produce dopamine, a chemical messenger involved in controlling movement.
Motor symptoms can include slowed movement, muscle rigidity, tremor, balance difficulties and problems with walking.
Current treatments such as levodopa can ease several motor symptoms but may be less effective for balance, posture and other symptoms involving the body’s central axis.
The 45 participants were randomly assigned to three groups of 15, receiving Tai Chi, combined resistance and stretching exercises, or routine care and health education.
Both exercise programmes lasted 14 weeks, with four one-hour sessions each week.
The first 10 sessions were conducted in person so participants could learn the exercises correctly and safely. Participants then completed one supervised in-person session and three online sessions each week.
The Tai Chi group practised eight postures involving slow movements, balance, coordination and mindfulness.
The resistance and stretching programme combined static and dynamic stretches with light resistance exercises intended to improve strength, flexibility and joint stability.
The study’s main measure was Part III of the Unified Parkinson’s Disease Rating Scale, known as UPDRS-III, which assesses movement symptoms. Lower scores indicate less severe impairment.
Researchers also assessed balance, mobility, grip strength, arm and leg endurance, quality of life and freezing of gait, a symptom in which a person’s feet can temporarily feel stuck to the floor.
Assessments were carried out after participants had gone without Parkinson’s medication for at least 12 hours to reduce its immediate effects on movement.
After 14 weeks, average UPDRS-III scores fell by four points in the Tai Chi group and by 3.24 points in the resistance and stretching group.
Scores increased by 4.24 points in the control group, indicating worsening motor symptoms.
The researchers said the improvements in both exercise groups were within a previously established range of about 2.5 to five points considered potentially meaningful for people with Parkinson’s.
Exploratory analyses also suggested improvements in several specific motor areas, including rigidity and certain hand movements.
In physical-function tests, the resistance and stretching group performed better than controls on the Timed Up and Go mobility test, forward reach and grip strength.
Tai Chi participants performed better than controls on a 30-second chair-stand test, while the difference between the resistance and stretching group and controls was not significant. Both exercise groups performed better than controls on a 30-second arm-curl test.
Both programmes were also associated with better overall scores on a Parkinson’s-specific quality-of-life questionnaire. Tai Chi showed a significant benefit in its mobility section, while both groups performed better than controls in areas related to daily activities and nonmotor aspects of quality of life.
Neither form of exercise significantly changed scores for freezing of gait.
The researchers said this could be linked to the relatively low prevalence of the symptom at the start of the study, the participants’ stage of disease or limitations in using questionnaires to measure an intermittent problem.
No serious adverse events occurred. A small number of participants reported mild and temporary musculoskeletal discomfort, but none stopped the exercise programme because of it.
The researchers wrote: “These findings highlight the value of tailoring exercise interventions to individual rehabilitation needs.”
Overall, the researchers wrote: “Both Tai Chi and combined resistance-stretching effectively improved core motor symptoms.”
They added that the changes suggested potential clinical relevance alongside improvements in physical function and quality of life.
The study was limited by its small number of participants and lack of long-term follow-up, meaning it remains unclear whether the improvements persist.
Several participants also dropped out for reasons linked to the COVID-19 pandemic, which the researchers said could affect the reliability of estimates involving missing data.
The researchers concluded: “Tai Chi may be particularly beneficial for motor control and balance, whereas combined resistance-stretching exercise may better enhance muscle strength and functional performance.”
