Clinical Notes
Tai Chi Chuan practice as a tool for rehabilitation of severe head trauma: 3 Case reports☆,☆☆

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Abstract

Shapira MY, Chelouche M, Yanai R, Kaner C, Szold A. Tai Chi Chuan practice as a tool for rehabilitation of severe head trauma: 3 case reports. Arch Phys Med Rehabil 2001;82:1283-5. Rehabilitation after severe head trauma is a complex process that can be long and frustrating. New, more holistic methods for rehabilitation are constantly sought. We present the cases of 3 patients who had severe head injury and whose rehabilitation was facilitated by Tai Chi Chuan (TCC) therapy. TCC therapy should be taught only by a qualified TCC therapist and under close medical supervision. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Case 1

A 24-year-old man received a severe tangential head injury from shrapnel at the age of 19. The injury included open left parietal fracture, intracranial hematoma with severe brain edema, severe diffuse axonal injury, increased intracranial pressure (ICP), and brainstem herniation. The patient was treated with bleeding control and wound débridement. Eventually, because of continuously increased ICP, a lumboperitoneal shunt was inserted. The patient was in a coma for 3.5 months and then slowly

Methods

Because most persons with severe head trauma find it difficult to train while standing without assistance, the training program consisted of gradual steps: sitting, standing, and movement.

Results

After 2 to 4 years of TCC therapy, all 3 patients walk without assistance, rarely fall, and feel more secure while walking. They feel that they have greatly improved control of themselves and their surroundings, that their memory and concentration are better, and they have a decrease in hypertonicity. One patient said that TCC “gave him tools to deal with his injury and a path for improvement.” Patient 1's improvement enabled him to regain freedom in daily activities and return to driving his

Discussion

TCC is an ancient Chinese martial art, inseparable from traditional Chinese medicine. Improvement of balance by TCC practice was shown in normal elderly subjects,5, 6 and controlled studies have also shown that it improves kinesthetic sense and muscular strength in normal volunteers.7 TCC intervention is also beneficial and safe in the prevention of falls in the geriatric population.8 These studies relate to healthy subjects, but no studies have been done on TCC as a tool for rehabilitation.

Conclusion

Because this report is not a controlled study, it is impossible to demonstrate scientifically the isolated role of TCC in our patients' rehabilitation. We suggest that TCC therapy can be beneficial in any form of rehabilitation, especially in head trauma, and this form of therapy certainly warrants further studies. It is mandatory that TCC therapy be taught only by a qualified TCC therapist, and under close medical supervision, to prevent physical and mental damage.

Acknowledgements

We thank Master Nir Zaltzman-Malchi for his assistance.

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Reprint requests to Michael Y. Shapira, MD, Dept of Bone Marrow Transplantation, Hadassah University Hospital, PO Box 12000, Jerusalem 91120 Israel, E-mail: [email protected].

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Copyright © 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.