The Neurophysiological Effects of Wheelchair Tai Chi Training in Individuals With Cervical Cord Lesion
Date Issued
2007
Date
2007
Author(s)
Chen, Ying-Chen
DOI
en-US
Abstract
Background: Tai Chi or Tai Chi Chuan (TCC) is a traditional Chinese martial art and TCC in standing posture proved its benefits for the elderly and the individuals with neurological diseases. However, the disabled and deconditioned people are unable to do the traditional exercise in stance. Therefore, in 1997 Dong-Sing Yang, an experienced coach of Tai Chi, developed Wheelchair Tai Chi (WCTC) which is the modified TCC in sitting posture for them, but the training effects of WCTC are still unknown.
Purpose: The purposes of this study were: (1) to investigate whether eight-week WCTC training would improve the neurophysiological function on upper extremity in subjects with chronic, incomplete cervical cord lesion, and (2) to quantify the intensity of WCTC during training.
Methods: Sixteen individuals with chronic, incomplete cervical cord lesion (C2~C6, ASIA C~D) were recruited and assigned to WCTC group and control group. The WCTC training was conducted about 60 min per session, 3 sessions per week for eight weeks. Control group did not receive any training and kept their original lives. The neurophysiological assessments were executed before, during, and after WCTC training, including the measurement of the alpha motoneuron (MN) excitability (i.e. max H/M ratio, Hslp/Mslp ratio), maximal voluntary contraction (MVC), muscle voluntary activation, and fatigue test of flexor carpi radialis (FCR) muscles. Moreover, the Spinal Cord Independence Measure (SCIM, version II) was used to evaluate the clinical functional status. Furthermore, one WCTC coach and one chronic, incomplete SCL were selected to measure the heart rate and oxygen consumption during WCTC exercise.
Results: Eight participants of WCTC group (mean age=42.6±9.4 yrs, mean height=164.4±5.2 cm, mean weight=65.1±11.2 kg) and 8 of control group (mean age=38.5±13.2 yrs, mean height=166.1±9.9 cm, mean weight=61.5±12.7 kg) were recruited. There were no significant differences in age, height, weight, injury level, injury duration and SCIM sores between two groups. After training, WCTC group increased significantly in MVC (from 3.53±1.8 kg to 5.09±2.6 kg，p=0.017), and muscle voluntary activation level (from 47.35±17.35% to 59.15±16.74%, p=0.012). In control group, no significant differences were found in MVC and muscle voluntary activation following eight weeks. However, there were no significant differences between WCTC and control groups in max H/M ratio and Hslp/Mslp ratio before and after training. Increased in fatigue index and central fatigue index were observed in WCTC group, whereas in control group. In terms of cardiopulmonary function, the results indicated that the training intensity was low with heart rate being about 70.5 bpm, and the METs being about 1.6.
Conclusions: The eight-week WCTC training could improve muscle strength, muscle voluntary activation, and endurance in chronic, incomplete cervical cord lesion. The possible mechanism might be related to the enhancement of central neural drive in descending corticospinal tract. Since the MN excitability at spinal level did not change significantly, the change might be mainly due to cortical reorganization. Further study is suggested to investigate if cortical reorganization happens after training.
Subjects
太極拳
電刺激
H反射
肌肉疲勞
橈側屈腕肌
Tai Chi Chuan
Electric Stimulation
H-reflex
Muscle Fatigue
Flexor Carpi Radialis
Type
other
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