Multiple sclerosis (MS) is a demyelinating disease that disrupts communication between the central nervous system — composed of the brain, spinal cord, and optic nerves — and different parts of the body. The resulting symptoms are varied, including visual disturbances, impaired balance and coordination, weakness, loss of sensation, pain, fatigue, depression and anxiety, cognitive impairment, and problems with other bodily functions. Many of these symptoms can negatively impact normal daily activities — such as work capability, socialization with others, and personal care — which then lowers patients' quality of life.
Disease-modifying therapies (DMTs) are used to slow down the progression of the disease, while symptomatic therapies are used to reduce the effect of specific symptoms. Complementary and alternative therapies — such as exercise, vitamins or supplements, meditation, yoga, and other mind-body techniques — are frequently used to reduce the effects of the disease and improve quality of life.
Mindfulness is a concept rooted in a philosophy that focuses on the present moment while maintaining an open, nonjudgmental attitude. Mindfulness-based programs — such as meditation, yoga, and Tai Chi — have been studied in small clinical trials to determine their effect on MS symptoms and quality of life for people living with MS. The results are mixed.
What is Tai Chi?
Tai Chi, also called Tai Chi Chuan, is an ancient Chinese martial art that has evolved into a multiple-element form of exercise, featuring slow, gentle, dance-like movements that encourage deep breathing and relaxation, improve balance, and strengthen muscles and joints. I’ve heard Tai Chi referred to as “meditation in motion.” One benefit of Tai Chi is that is doesn’t require any special clothing or equipment. It is one of the mind-body therapies in complementary and alternative medicine that begins where you are and doesn’t push you beyond your abilities, but does encourage you to explore the edges of your comfort zones.
How Does Tai Chi Help MS?
Several studies have examined the effect of Tai Chi on different aspects of living with MS and its symptoms. In a systematic review of the literature, researchers found evidence that supports the effectiveness of Tai Chi on improving quality of life and functional balance in people living with MS patients. A small number of studies also reported the positive effect of Tai Chi on flexibility, leg strength, gait, and pain. The effect of Tai Chi on fatigue, however, is inconsistent across studies.
Tai Chi and Quality of Life in MS
Quality of life (QOL) is a helpful measurement in MS studies because it encompasses physical, material, social, and emotional well-being, as well as personal development and physical and social activity. Five studies examining the effect of Tai Chi on QOL in MS were included in this systematic review. In general, MS patients who engaged in Tai Chi sessions over three- to twelve-week time periods experienced significant improvements on subscales of QOL such as pain, emotional well-being, energy, vitality, social function, health distress, physical health, mental health, and overall QOL.
Tai Chi and Physical Function in MS
Impaired balance and mobility are common symptoms of MS that affect the majority of people living with MS. Balance dysfunction is associated with higher risk of falls. In five additional studies, Tai Chi demonstrated significant improvements on dynamic balance, coordination, functional mobility, walking speed, hamstring flexibility, plantar sensation, and leg strength. In these studies, participants engaged in multiple Tai Chi sessions over eight- to 24-week time periods.
Tai Chi and Fatigue in MS
Each person with MS might describe fatigue in a slightly way, but generally it is perceived as a deficient level of physical or mental energy. Fatigue is a very common symptom of MS that affects about 80 percent of people living with the disease. Fatigue can be a contributing factor to impaired balance and mobility. The results of five studies that measured the effect of Tai Chi on fatigue in MS patients were inconsistent. Tai Chi was shown to be effective against fatigue in only two of the five studies,
Tai Chi and Depression or Pain in MS
Studies included in the review demonstrated that Tai Chi significantly reduced depression and pain in people living with MS.
In conclusion, Tai Chi was found to be safe activity that didn’t lead to adverse events or new symptoms. It was noted, however, that movements that are appropriate for healthy individuals may not be “the best fit” for MS patients. Therefore, for future research studies, an appropriate individualized Tai Chi protocol should be created at the beginning of the study for each individual. With Tai Chi or any mindfulness-based program, it is best to begin the exercise program within your own abilities or limitations, and gradually expand the difficulty or complexity as you grain more experience and confidence.
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Zou L, Wang H, Xiao Z, et al. Tai chi for health benefits in patients with multiple sclerosis: A systematic review. PLoS One. 2017;12(2):e0170212. doi: 10.1371/journal.pone.0170212. eCollection 2017.