The Benefit of Tai Chi on Balance and Gait in People with Multiple Sclerosis

Background: Multiple Sclerosis (MS) is a progressive demyelinating disease of the central nervous system affecting 2,300,000 people worldwide.   Impaired balance has been identified in up to 75% of people with MS(PWMS) throughout the course of the disease. PWMS have a 50% greater risk for falls when compared to the general population.  Falls can lead to further disability in PWMS.  

Tai Chi, a form of martial arts, is classified as a type of mind body exercise that involves a moving meditation using slow controlled movements entwined with deep breathing.  The activity is non-stressful and gentle in nature designed to rebalance the body’s healing capacity. The benefits of Tai Chi include improved balance control and flexibility.

Objectives: The objectives of this study were to identify the effectiveness of Tai Chi on balance, strength, endurance, and fatigue in people with MS.

Methods: Participants were recruited from area Chapters of the National MS Society, local neurologists, and a personal training gym. Inclusion criteria for the study were: diagnosis of MS, ages 18-75, able to understand the informed consent statement, able to attend the Tai Chi class, and able to attend a 60-120 minute testing session before and at the end of the six week class. All activity was approved by the IRB at Texas Woman’s University.

Pre-testing occurred prior to the start of the Tai Chi class, and post-testing during week 6 of the Tai Chi class. Pre-testing consisted of completion of the intake form and the Timed Up and Go (TUG), the Berg Balance Scale (BBS), the Five-Times-Sit-to-Stand (5TSTS), grip strength, the Dynamic Gait Index (DGI), the Two-Minute Walk Test (2MWT), the Fatigue Severity Scale (FSS), and the Activities-specific Balance Confidence Scale (ABC). The post-testing included all of the same outcome measures.

Participants completed a 6-week, 6 form, community-based Tai Chi program.  Class was held twice a week for one hour at a personal training gym, supported in part by the National Multiple Sclerosis Society.    

Results: Twenty-five participants recruited from the NMSS, signed the consent, and completed the pre-testing.  Class attendance during the 6 week class was excellent (80% attendance), but only 15 participants returned for post-testing.   Twelve of the participants had RRMS and 3 had SPMS or PPMS.  

Data analysis using the Wilcoxon Signed Ranks Test identified significant improvement in the BBS (p=0.003), the TUG (p=0.018), the FSS (p=0.023), the 2MWT (p=0.018), and the 5TSTS (p=0.003).  

Conclusions: A community based Tai Chi program identified improvements in balance in people with MS with improvement seen in the BBS, and the TUG.  Endurance improved as evidence by improvement in the 2MWT, and strength improved with improvements seen in the 5TSTS. The perception of fatigue decreased according to significant improvement in the FSS. Many participants began the class from a chair but by the end of the 6 weeks were completing the Tai Chi exercise in standing.