Martials arts use in physical and rehabilitation medicine: Literature review and perspectives

Abstract

Martial arts are physical and meditative discipline available as complementary strategies able to improve functional capacity, physical performances, postural control of patients suffering from chronical diseases. They can probably slow their clinical evolution. The objective of this communication is a review of the literature about the effects of martial arts training into a said chronical disease. A literature research in PubMed and Pedro databases was performed with the following keywords: martial arts, rehabilitation, chronic disease, neurologic disorders, heart disease, chronic obstructive pulmonary disease, musculo-squelettal disorders, low back pain. Abstracts had to include an intervention being a martial arts program for a determined period with clearly defined measured criteria. Two independent reviewers did the literature research and the article analysis. Eighty-one abstracts were found, 1 meta-analysis and 3 randomized controlled studies were analyzed. Patients underwent a martial arts program controlled versus medical treatment only. Primary outcome were respectively: UPDRS, postural control and balance for Parkinson's disease; VO 2 peak for post-myocardial infarction rehabilitation; forced expiratory volume in one second for chronic obstructive pulmonary disease respiratory rehabilitation; pain and functional capacity in low back pain. It seems the only martial art studied is Tai Chi Chuan. In Parkinson's diseases, there is a significant difference compared to the control group: UPDRS –4.34, Functional Reach Test 3.89, Berg Balance scale 4.25. In post-myocardial infarction, VO 2 peak was significantly improved by 5.2 mL/kg/min. For COPD, average FEV1 after Tai Chi training was improved at 1.43 L versus 1.21 (47.6% of predicted FEV1 vs. 41.2) within the Tai Chi group and versus 1.18 L (42%) for the controlled group after Tai Chi training. Concerning lower back pain, patients reported improvements in pain and functional capacity (pain VAS 1.3 and Rolland Morris scale 2.6). All these results seem to show that Tai Chi Chuan is an effective complementary strategy associated with medical and rehabilitation care of chronic diseases and larger scale studies could confirm them. Further more, it would be interesting to study the effects of other martial arts with different intervention modalities.