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tai chi & health 
tai chi in medical research and

Working with Parkinson's Disease

I have now started monthly visits to a regional branch of The Parkinson Sufferers Society.

Just exactly what this last group want or hope for from me is not so easy to summarize but it has in all been by far and away the most interesting and rewarding (for myself as a teacher/instructor) encounter of the three, so I shall begin with a report on this my new professional association with The Parkinson Sufferers Society - and describe my 'approach' to providing these people what they think they need in the way of Tai Chi.

First it must be understood that what they require above all is an instructor who is sympathetic to their condition. They had that with their last instructor because he was I believe a friend or relative of one of the Societies members; so he knew a bit about the disease but, as was unfortunately proven, he did not know enough about Tai Chi or perhaps more precisely, how to teach it. He ran out of things to say after only three sessions. Nevertheless I would say that his intentions were good. I should anyway be grateful to him whoever or whatever he was for it was he that prepared the ground for me and stimulated their interest in the first place. I only came into the picture when the Chairperson of the Society had done a Google search, visited my website, read a few articles and from that decided that I just might be the sort of person that might be able to help.

The next step was for them to send me a wad of fact sheets detailing the particular difficulties that Parkinson's sufferers experience and conditions that any therapist or 'healer' [a word that I am not keen on] must be aware of and accommodate within any 'treatment'. Between the receipt of that wad of information sheets from the Parkinson's Society and my first visit with them, I had identified these below as being crucial to understand before any therapeutic Tai Chi could be effectively administered.

1. Communication:
The condition can (due to lack of muscle control in the face - see "Muscle Cramps" below) create a misleading impression, leading incorrectly to being perceived of as being difficult, deaf, disinterested, drunk or unintelligent. As a consequence many people with Parkinson's feel very isolated.

2. Speech:
Can be slurred. Monotonous with lack of variation and expression. Hoarse and tremulous. Disordered in rate or rhythm. Responses may be very slow. Leads to similar misunderstanding as those detailed above.

3. Freezing:
About 30% of people suffering from Parkinson's will at some times experience "Freezing" - which can also lead to an increased risk of falling.

4. Muscle Cramps:
A. Dystonia: Movement disorder. Involuntary contraction of the muscles, causing spasm. Muscles become hard due to contraction without relaxing (not the same as "cramp").
B. Akinesia: Reduction in or absence of movement, muscular rigidity, "cramp". Muscles become hard and less elastic. In Parkinson's, most common in the feet. Spasm in the calf muscles can cause the toes to curl into a claw like position. In other cases the big toe hyper-extends - pointing upwards.

5. Smaller Muscles:
'A. 'Blepharospasm': Intermittent or sustained eyelid closure, caused by the contraction of the eyelid muscle. Aggravated by stress, looking up or down, reading, driving or bright lights (photophobia: abnormal intolerance to light).
B. Sialorrhoea: Drooling a.k.a. dribbling. Saliva pooling and trickling from the mouth. Not because more saliva is produced but because the tendency to swallow every now and again (even when not eating) is slowed down (See "4B. Akinesia" above).
Aggregated by poor (stooped) posture and inadequate lip seal. Everyone has difficulty in swallowing if they cannot close their lips tightly. You try! Try to swallow with your mouth open.

In some cases, simply improving the posture can alleviate Sialorrhoea.
Everyone would drool if the kept their head down and shoulders haunched for any length of time. It happens to us all when we fall asleep sitting up.

An apparently small and insignificant thing like swallowing and consequential eating problems can have a tremendous negative impact upon a person's quality of life at home, and in terms of their social life. Those with the problem can become anxious about swallowing anything for the fear of choking. Many eat less than normal and loose weight. They do not enjoy eating and feel embarrassed, or experience panic or anxiety attacks at mealtimes. All of this has a demoralising effect; because eating and drinking are essential parts of life and the social aspect is as important as the practical, biological function.

Fundamental Tai Chi and Chi Kung practices
So anyway, in some cases, simply improving the posture can alleviate Sialorrhoea. So that's good! So I decided that I was willing to give it a go if they were, convinced as I am that simple and fundamental Tai Chi and Chi Kung practices can help. As for all of those other conditions that I list above is concerned, I am just as sure that a little Tai Chi or Chi Kung will do no harm at all. Obviously I will not be teaching them the Yang Long Form, not only because I do not meet them as individuals and I go to their place rather than then coming to mine, but because The Yang Long Form is not (for now) what they need. Full blown Tai Chi Form one day perhaps, but in the meantime the introduction of some simple posture, movement, limb coordination and breath exercise is a step in the right direction!

Accordingly, I paid my first visit and presented my first session to 15 or so enthusiastic participants gathered in a Community Centre in Cosham, Portsmouth, Hants UK, on Wednesday 26th of this month. I am pleased to say that it went very well and my advanced bookings have already been extended into next year. I am quick to add now that the success of the event and enthusiasm for more is due in no small part to the participation and masterly input of my Tai Chi teacher, Raymond Wood who has generously agreed to advise and assist me in this project, and attend all of the sessions with me. Furthermore, we have agree with The Parkinson's Society that we will follow up all sessions with notes and illustrations where necessary of the exercises practiced the proceeding month - along with more concise and considered text summery of relevant issues raised. In turn I intend to use all of the notes and, with Ray's expert advice and my own hands on and direct experience, devise a full and every day program of Chi Kung and Tai Chi style exercise program for the generally aged or infirmed. The Yang Long Form its not; but any one can do it and it sure won't do any harm!

For instance:
First, just nod your head to and fro (chin down and then chin up) - 6 times down, 5 up. Breathe out as you lower your chin for the first time. Breathe in, chin up; breathe out, chin down. Finish with your chin down. When finished (6 down 5 up) keep your chin lowered for two breaths (in out, in out). On the next (3rd) in breath - raise your chin up and balance your head on your shoulders like a strawberry atop a knickerbocker glory.

That above is the first notes made recording proceedings at the first PSS (Parkinson's Sufferers Society) session. Aside from this we also did two other head/neck/cervical (particularly the Axis and the Atlas) vertebrae exercises. Following this Ray led the group in some very interesting, easy to do 'stepping, pushing and breathing' exercises. These too will be documented soon and will, along with some ongoing suggestions for practice to keep the participants busy with till we next meet (we have already agreed this with the participants) go on to make up the "full and every day program of Chi Kung and Tai Chi style exercise program for the generally aged or inferred" mentioned above.


 


 
An apparently small and insignificant thing like swallowing and consequential eating problems can have a tremendous negative impact upon a person's quality of life at home, and in terms of their social life. Those with the problem can become anxious about swallowing anything for the fear of choking. Many eat less than normal and loose weight.
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