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Title: Effects of sitting Tai Chi on sitting balance control and quality of life in community-dwelling persons with spinal cord injuries
Authors: Gao, Li Kelly
Degree: M.Phil.
Issue Date: 2012
Abstract: Background Context: Control of sitting balance is associated with the level of injury in people with spinal cord injury (SCI). Balance control is an important ability for functional activities, especially for wheelchair users. However, the measurement of the dynamic sitting balance is lacking. Tai Chi is a mind-body exercise which has been documented as improving balance. Traditional Tai Chi is performed in standing, which is not suitable for wheelchair users. Sitting Tai Chi may be an appropriate exercise for people with SCI. The benefits of sitting Tai Chi for people with SCI have not been demonstrated scientifically. Study 1: Purpose: Study 1 aimed to develop a reliable and valid tool for measuring the dynamic sitting balance of wheelchair users with SCI. Study Design/Setting: This was a cross-sectional study. Patient Sample: Convenience sampling from the community. Outcome Measures: Limits of stability (LOS) and sequential weight shifting (SWS) were designed in this study. The tests measured participants’ volitional weight shifting in multiple directions within their base of support. Their mobility scores on the Spinal Cord Independence Measure III (SCIM III) were correlated with the balance test results. The LOS outcome measures were reaction time, maximum excursion and directional control; for the SWS they were total time and directional control. Methods: Nine participants with chronic SCI (average of 17.2 years post-injury) between levels C6 and L1 performed the tests while sitting in their own wheelchairs and on a standardized stool (unsupported sitting) twice, seven days apart. Results: The sitting LOS results showed moderate to excellent test-retest reliability (ICC ranged from 0.673-0.990) with both the wheelchair and the unsupported sitting. The SWS results showed moderate to excellent reliability (ICC ranged from 0.688 0.952). Only the LOS results in unsupported sitting correlated significantly with the SCIM III mobility scores, but the SWS test results had significant correlation in both sitting conditions. Conclusions: The sitting LOS and SWS tests provide a reliable and valid tool for assessing the dynamic sitting balance control of subjects with SCI.
Study 2: Purpose: Study 2 aimed to investigate the effect of sitting Tai Chi exercise on handgrip strength, balance control and quality of life among people with SCI. Study Design/Setting: This was a prospective intervention study. Patient Sample: Convenience sampling from the community. Outcome Measures: Dynamic sitting balance tests were evaluated with the subjects sitting in their own wheelchairs using the LOS test and the SWS test. Handgrip strength was tested. Quality of life was self-reported using the brief form of the World Health Organization's quality of life questionnaire (WHOQOL-BREF). Methods: Nineteen subjects with SCI between injury levels C6 and L1, 2 to 48 years post-injury participated in the study. Eleven subjects participated in sitting Tai Chi training (90 minute/session, 2 times/week for 12 weeks). Eight joined education and social activities as controls. Results: Repeated measures MANCOVA showed significant group by time interaction effects on sitting balance control. Post hoc analysis demonstrated that the Tai Chi practitioners achieved significant improvements in their reaction time (p=0.042); maximum excursion (p=0.046) and directional control (p=0.025) in the LOS test. In the SWS test, they significantly improved their total time to sequentially hit 12 targets (p=0.035) and directional control (p=0.033). These improvements were significantly greater than those of the controls. Significant improvement in handgrip strength was also found among the Tai Chi practitioners (p= 0.049). Conclusions: Twelve weeks of sitting Tai Chi training can improve the dynamic sitting balance and handgrip strength of community-dwelling SCI survivors. Clinicians might use sitting Tai Chi as an exercise for people with SCI who can continue to practice the exercise even after being discharged from hospital as a means to maintain health.
Subjects: Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation.
Tai Chi.
Equilibrium (Physiology).
Hong Kong Polytechnic University -- Dissertations
Pages: xvii, 126 leaves : ill. ; 30 cm.
Appears in Collections:Thesis

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