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  Adaptive Tai Chi
by Seana O'Callaghan
  We all know that exercise is an essential part of a healthy life--with or without MS. But it takes most of us more than the conviction that we ought to do it to get ourselves out there. Finding the right kind of exercise is one problem. Many sports and exercise programs cause the body temperature to rise, which may temporarily worsen MS symptoms. Even more daunting, fatigue, spasticity, weakness, and lack of balance make us fear exercise. Who wants to fail or look foolish in public? But, it turns out, many types of exercise can be adapted to enable people with MS to participate successfully. And although we would have guessed to the contrary, tai chi turns out to be one of them.

Tai chi is a Chinese martial art. It is not, however, a martial art in the style of Bruce Lee or Jackie Chan. Deep breathing, relaxation, and slow, gentle movements are the primary elements. Often referred to as a method of "moving meditation", tai chi is a conditioning regimen that is even gentler than most forms of yoga.

Tai chi is usually performed as an ordered set of slow, elegant motions that promote balance through thoughtful consideration of movement and heightening of body awareness. True to its Buddhist roots, tai chi seeks to relieve stress, improve focus and muscle tone, and develop balance of the mind and the body. Recent clinical studies have confirmed that tai chi produces measurable benefits in improving balance, lowering blood pressure, and improving cardiovascular health. The National Institutes of Health (NIH) has funded three current studies of tai chi as it relates to physical health, including one that focuses specifically on balance.

None of these studies involved people with MS, however, and a discussion with a physician or physical therapist who knows you and has experience with MS is essential before you begin tai chi or any exercise program. Chances are that adapted tai chi will meet strong approval. In fact, a number of National MS Society chapters sponsor programs.

The Southern New York Chapter has been offering a tai chi class for several years. Domingo Colon, the instructor, is a former physical therapist. He has been teaching tai chi for more than 25 years and has adapted the traditional forms to accommodate students at all levels of ability. Many members of his MS class rely on wheelchairs for mobility. Most have problems with balance. Colon has developed a program that begins in the seated position. If (and only if) students can balance unaided on their legs, they then move to a standing position after the sitting version of the exercise has been performed.

In his practice as a physical therapist, Colon encountered many people with neuromuscular and musculoskeletal diseases who resisted doing any exercise at all. But tai chi, modified for their levels of ability, seemed to motivate them. Generating the slow, gentle movements proved to be an attainable goal, he discovered, and the movements helped improve his patients' muscle tone. So when Colon was asked by a student in one of his regular classes if he could teach a class for people with MS, he said yes.

Improving proprioception, which is our perception of movement and spatial orientation, is a central goal of Colon's MS tai chi class. This sense of orientation can be extremely valuable to people with MS, who often face the problem of inconsistent perceptions of their sense of touch and balance. "Tai chi movements help the reintegration of mind and body on conscious and subconscious levels," Colon said.

Students in his MS class are very positive about the benefits. Susan Cambria-Pouch has been taking the class for about three years, and she's hooked. Her MS prevents her from driving or walking long distances, but it doesn't prevent her from getting to the class and participating fully.

"I was optimistic when I began, although I didn't know what to expect," she said. "I was used to really formal exercises. Tai chi was very exotic to me. I also thought that tai chi could only be done standing, and with my balance, I wondered if I could even do it. But I do the whole class standing, and I love it. The instructor tells us throughout the class, and also on the video he made, about what each exercise does for your body and your mind, and it's very inspiring and helpful."

Cambria-Pouch practices with the video at home, and both in class and at home finds that the physical benefits of tai chi go hand-in-glove with mental benefits. "There is one form that the teacher likens to drawing silk from a cocoon. It's a delicate, movement that's not hard but requires slow, deliberate motion. It helps me with relaxing. The careful attention to breathing is really good for centering. I find myself being less obsessed."

The tai chi philosophy stresses that balance is not only a physical achievement, but a mental one as well. "When we talk about balance, we're talking about many things," Colon said. "There is coordination, breathing, and also emotional balance. Some of the most important types of balance can be accessed with sitting exercises." Opening the rib cage can be very beneficial to those who sit all day, and the twisting movements that tone muscles around the ribcage are actually most easily achieved when sitting, he explained. "It's really not important whether people in the class stand or do not stand," Colon concluded.

Karen Gossard, who participates in Colon's class without standing at all, began taking tai chi on the advice of her son. He had been practicing it for a number of years. "He said it would help me with my balance," she recalled.

More than two years later, Gossard agrees, "I think it has helped." Gossard was diagnosed in 1990, and has chronic general muscle pain, from which she finds little relief. To her surprise, she said, "I felt really, really good while I was doing tai chi. And it wasn't too tough. You know there's a lot that I can't do any more, but this I can do!"

So how do you find a tai chi class? First, call your chapter. They may have referrals to programs or centers used by other people with MS. They may even sponsor their own program. Beyond that, there is a Web site, http://www.taichinetwork.org/, that lists centers and instructors nationwide, but the results from searches on this site are not always complete.

If it doesn't produce useful results for you, try typing "tai chi" along with the name of your town or county into your favorite search engine. Or simply look in the yellow pages under "Tai Chi", "Martial Arts", "Physical Fitness", or "Exercise". Local community centers, recreation departments, and many fitness clubs offer classes. The philosophy that guides tai chi disposes instructors to be willing to adapt the discipline to individual needs. But before you join or buy anything, arrange to talk with the instructor privately about your limitations.

For additional information
 Healthy Living with MS
  ASeana O'Callaghan is a free-lance writer based in Westchester County, New York.  
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Last updated February 2006