Tai Chi Improves Foot Sole Sensation, Balance and Functional Mobility for People with Peripheral Neuropathy

Abstract

People with peripheral neuropathy (PN) suffer reduced physical function among other symptoms. Tai Chi (TC) training has been shown to maintain and restore physical function in the elderly population. The PURPOSE of this study was to examine the effect of a 6-week (3 one hour sessions / week) TC training program on the physical function of PN. METHODS: 6 people with PN were recruited and gave informed consent after the project was approved by the university's IRB. The mean (SD) age, height, body mass and duration of PN were 71.5 (9.6) yr, 166.8 (11.8) cm, 85.2 (29.2) kg and 6.5 (4.6) yr. Physical functions were examined at week one, eight and fifteen. There was no intervention during the first 6-week control period (wks 2-7), while modified TC instructions were provided for the second 6-week training period (wks 9-14). Sensation (SEN) of 5 foot sole locations was tested by using a 5.07 gauge monofilament. Peak torques during maximum isokinetic (60 deg/s) knee extension (KE) and flexion (KF) on a dynamometer were used to examine knee joint strength. Postural balance was examined using average velocity (VEL) and 95% area (AREA) of the center of pressure movement during 5-sec of eyes-closed quiet standing. 6-minute walk (6MW) distance and Timed Up-and-Go (TUG) time were used to examine functional mobility. Changes during the two 6-week periods were compared statistically (one tailed paired T-Test). RESULTS: TC led to improved SEN (53±64%) compared to control (0±0, p=.0489). No significant KE change was observed during the experiment (p=.3468) although KF exhibited an interesting trend (42±81% increase followed by a 16±54% decrease, p=.0428). Balance deteriorated during the control period (increased AREA 69±58% and VEL 44±49%) but improved with TC (decreased AREA 16±21% and VEL 31±37%, p=.0039 and .0010 for the AREA and VEL changes, respectively). 6MW distance increased slightly following TC (4±3%) but no change was observed during the control period (0±3%, p=.0629). There was no change in perceived exertion among all three 6MW tests (p=.4413). TC effectively reduced TUG time (+5±12%-control,−18±9%-TC, p=0.0061). CONCLUSIONS: PN may lead to functional deterioration, especially to standing balance, in as little as 6 wks. Modified Tai Chi training can improve foot sole sensation, balance and functional mobility in this population.