The effectiveness of selected Tai Chi exercises in a program of strategic rehabilitation aimed at improving the self-care skills of patients aroused from prolonged coma after severe TBI

Abstract

BackgroundDifficulties in self-care constitute a very common problem for patients recovering from prolonged coma after a severe TBI, and a major factor reducing their quality of life. Effective new rehabilitation programs that would help solve this problem are urgently needed. The purpose of our experiment was to evaluate improvement in this respect in a group of patients aroused from prolonged coma who participated in a goal-oriented rehabilitation program (Rehab-3), enhanced with selected elements of Tai-Chi.Material/MethodsWe examined 40 patients aroused from prolonged coma after a severe TBI, undergoing long-term rehabilitation according to a standard phased rehabilitation program. These patients were divided into two numerically even groups: a control group treated according to the standard program, and an experimental group, who received an additional goal oriented program enhanced with selected Tai-Chi exercises. The research methods included analysis of documentation (MRI, CT), a structured clinical interview, and the Standard Self-Care Scale.ResultsThe experimental group achieved significant improvement of self-care skills, whereas in the control group the improvement was slight and not statistically significant. The value of co-efficient j (0.64) indicates a very strong association between the rehabilitation procedure and improved self-care in the experimental group, but not in the control group.ConclusionsOur results confirmed that a goal-oriented rehabilitation program enhanced with elements of Tai-Chi was more effective than the standard program in improving the performance of activities of daily living.

The Impact of Complementary and Integrative Medicine Following Traumatic Brain Injury: A Scoping Review

“…Another RCT compared a weekly 1-hour seated tai chi/qigong session to nonexercise social/leisure activities and reported improvements in mood in the tai chi/qigong group 78. A 2-group comparison study that compared a goal-oriented program enhanced with biweekly tai chi exercises with standard rehabilitation showed improvement in self-care in the tai chi group 82. In a case series of 3 individuals with severe TBI who practiced tai chi over 2 to 4 years postintervention, all participants ambulated without assistance and had a decrease in falls 86…”

“…Yoga and tai chi are considered forms of therapeutic exercise, delineated as a skilled service. 77 Of the 10 yoga and tai chi studies that met inclusion criteria, 3 studies were RCTs [78][79][80] ; the others were quasiexperimental studies, [81][82][83] mixed-methods studies, 20,84 or case reports. 85,86 Yoga is an ancient Vedic practice incorporating breath, meditation, and body postures for promoting health.…”

Therapeutic Potentials of Synapses after Traumatic Brain Injury: A Comprehensive Review

“…Notably, aerobic exercises such as tai chi and yoga have been popularly promoted for its potential advantages in healthy and ill-attacked populations [62–67]; however, the frequency and burden of exercise after TBI differ from one to another and remain to be further elucidated [68]. …”

“…Exercises are believed to be effective in improving TBI prognosis; the underlying mechanisms include changing the brain structural integrity by enhancing neurogenesis and angiogenesis with more secretions of growth factors promoting synaptic plasticity [ 59 – 61 ]. Notably, aerobic exercises such as tai chi and yoga have been popularly promoted for its potential advantages in healthy and ill-attacked populations [ 62 – 67 ]; however, the frequency and burden of exercise after TBI differ from one to another and remain to be further elucidated [ 68 ].…”

Effect of Pregabalin in Preventing Secondary Damage in Traumatic Brain Injury: An Experimental Study

“…A wide array of pharmaceuticals has been used in experimental and clinical trials to alter the events during the course of TBI, although none have shown much promise [ 8 ]. These include anticholinergics, excitatory amino acid antagonists, endogenous opioid antagonists, catecholamines, serotonin antagonists, modulators of arachidonic acid, antioxidants and free radical scavengers, steroid and lipid peroxidation inhibitors, platelet activating factor antagonists, anion exchange inhibitors, magnesium, gangliosides, calcium channel antagonists, growth factors, antihistamine agents, and stem cells [ 9 – 11 ].…”