Going With the Flow

Tai Chi classes tailored to Parkinson’s patients and their caregivers

Robbie Miles, certified Tai Chi instructor, leads the North Tampa class offered by the USF Parkinson’s Disease and Movement Disorders Center.

An ancient Chinese exercise is being put to new therapeutic use by the USF Health Parkinson’s Disease and Movement Disorders Center.

The Center in partnership with the National Parkinson’s Foundation (NPF) offers free Tai Chi classes across the greater Tampa Bay area especially designed for patients with Parkinson’s and their caregivers. The gentle movements and controlled breathing of Tai Chi are performed in a slow, relaxed manner intended to create a sense of relaxation, improve balance and posture, and boost the flow of energy (or chi) in the body.

The first class started in a gymnasium in New Port Richey with 20 participants in 2005. Now more than 200 patients and caregivers are taking Tai chi weekly at seven sites, said Eden Feldman, MSW, a social worker and outreach coordinator for the Movement Disorders Center.

Eden Feldman, MSW, outreach coordinator for the USF PD and Movement Disorders Center, coordinates the free weekly Tai Chi classes for patients with PD and their caregivers across the greater Tampa Bay area.

Because it is practiced slowly, Tai Chi doesn’t tax patients as much as some other exercises that rely on strength, force, speed or even holding one posture for an extended time, Feldman said. “It helps with slowness, stiffness, tremor and balance problems – symptoms that are all components of Parkinson’s disease…. And we figured our male patients would rather do Tai Chi than yoga, since Tai chi is a martial art as well as an exercise.”

Tai Chi for Parkinson’s is increasingly recommended by support groups and mentioned as a complementary therapy on the Mayo and Cleveland Clinics websites. While some smaller studies suggests that Tai Chi improves mobility and balance for those with Parkinson’s, more rigorous randomized trials are need to validate the specific benefits of Tai Chi for this patient population.

“An emerging body of scientific evidence indicates that exercise, including Tai Chi, not only improves symptoms and helps keep patients functioning at their best, but may also be useful in slowing disease progression,” said Robert Hauser, MD, director of the USF Parkinson’s Disease and Movement Disorders Center. “This is an exciting possibility that is now a major research focus.”

Above: Miles, says she has seen improvements in students’ posture and balance after even a few Tai Chi sessions. Below: Arms floating upward, caregiver Mary Olson practices a basic movement.

Robbie Miles, a certified personal trainer also certified in Tai Chi instruction, has taught the class out of the North Tampa Gold’s Gym since November. Miles, 54, learned Tai Chi to help her cope with the draining effects of another chronic disease, ulcerative colitis, which she has lived with for 20 years.

“Some days I felt 70 years old, other days 90, so I can relate to how my students with Parkinson’s sometimes feel,” Miles said. “I got into Tai Chi to help heal my body and it has helped greatly with pain control and increasing my energy level.”

At a recent Monday afternoon class, as the Miles warms up the group with some flexes as they sit in chairs, and follows with meditative deep breathing combined with simple hand movements. After a brief break, the class transitions into the Tai Chi movements requiring shifting of body weight and coordination of upper and lower body — exercises that can challenge concentration and balance.

While the exercise regimen is to tailored to particpants’ limitations, Miles challenges them to stretch themselves.

“I will modify the routine, and break things into smaller steps, if it gets too difficult for anyone to keep up,” said Miles, who encourages her students with humor and gentle prodding. “I want to make sure they’re getting all the benefits of the exercise with minimal risk.”

Miles has seen improvements in many participants, even after a few sessions. “People come into class with much better posture, walking straighter. They move more easily and have better body awareness,” she said. “And the balance training is really helpful … I even had one patent say ‘I can stand on one foot and put on my underwear, and I couldn’t do that a year ago!’”

Harold Stein, a regular at the weekly classes, says Tai Chi is an ideal exercise for everyone.

Harold Stein, 78, who practiced judo before moving from Michigan to Florida five years ago, is an enthusiastic regular at the weekly Tai Chi classes. He was diagnosed with Parkinson’s about a year ago after a fall resulting in a shoulder injury. A neurologist noticed a slight tremor in his hand.

“The main thing is you have to keep moving; if not, the stiffness sets in. If I practice this religiously, it may help decrease the dosage of medication needed,” said Stein, who takes Sinemet, a first-line medication that replaces dopamine, the brain chemical depleted in Parkinson’s disease. “Tai Chi is ideal exercise therapy for anyone, really, because you don’t need equipment, certain clothes or a special room.”

Maria Swanson, 59, diagnosed with early-onset Parkinson’s at age 45, admits it’s sometimes hard to get to class, but she’s always glad when she makes the effort. “The breathing aspect of the Tai Chi movements really helps me to calm down, and I sleep better at night,” she said.

Maria Swason, who has lived with Parkinson’s more than 14 years, says the deep breathing and relaxation of Tai Chi have helped her.

It’s not only Parkinson’s patients who report benefit from the Tai Chi classes. Nearly 40 percent of those attending are caregivers. Sometimes they come with the patients; other times on their own.

“I always leave Tai Chi feeling better. It’s such a great stress reliever,” said Mary Olson, who has cared for a husband with Parkinson’s disease for the last 26 years and finds social support sharing experiences with other caregivers in the class.

While many Parkinson’s patients tend to shy away from group classes, Feldman said, they feel more comfortable in a class where the person next to them either has Parkinson’s or understands the symptoms because their spouse or family member lives with the progressive neurological disease. Most patients have mild to moderate Parkinson’s, but some come to class with walkers and wheelchairs, joining in the deep breathing exercises and upper body movements.

The Tai Chi classes are part of the comprehensive package of education and support services for patients and caregivers offered by the USF Health Parkinson’s Disease and Movement Disorders Center, designated as one of only 29 NPF Centers of Excellence worldwide. Other services include lectures about treatments, disease management, diet and exercise, and a mentor program that matches newly diagnosed patients with those who have had Parkinson’s several years.

The USF Center is also one of the country’s leading sites for testing new medications to combat movement disorders, and is working on new surgeries and innovative cell-based therapies that may offer hope to patients who no longer benefit from drug therapy.

For more information about the Tai Chi classes and other outreach services, contact Feldman at efeldman@health.usf.edu or (813) 844-4547.

Feldman and Miles with the North Tampa Tai Chi class

- Story by Anne DeLotto Baier, USF Health Communications
– Photos by Eric Younghans, USF Health Communications
– Video by Eric Younghans and Klaus Herdocia, USF Health Communications