Thursday, October 27, 2016

What is balance?


Good balance is often taken for granted. Most people don’t find it difficult to walk across a gravel driveway, transition from walking on a sidewalk to grass, or get out of bed in the middle of the night without stumbling. However, with impaired balance such activities can be extremely fatiguing and sometimes dangerous. Symptoms that accompany the unsteadiness can include dizziness, vertigo, hearing and vision problems, and difficulty with concentration and memory.  

Balance is the ability to maintain the body’s center of mass over its base of support. A properly functioning balance system allows humans to:

  •  see clearly while moving, 
  • identify orientation with respect to gravity, 
  • determine direction and speed of movement, and 
  • make automatic postural adjustments to maintain posture and stability in various conditions and activities.



Balance is achieved and maintained by a complex set of sensorimotor control systems that include: 

  • sensory input from vision (sight), 
  • proprioception (touch), and 
  • the vestibular system (motion, equilibrium, spatial orientation); 
  • integration of that sensory input; and 
  • motor output to the eye and body muscles. 
Injury, disease, certain drugs, or the aging process can affect one or more of these components. In addition to the contribution of sensory information, there may also be psychological factors that impair our sense of balance.


SENSORY INPUT


Maintaining balance depends on information received by the brain from three peripheral sources: eyes, muscles and joints, and vestibular organs. All three of these information sources send signals to the brain in the form of nerve impulses from special nerve endings called sensory receptors. 

INPUT FROM THE EYES

Sensory receptors in the retina are called rods and cones. Rods are believed to be tuned better for vision in low light situations (e.g. at night time). Cones help with color vision, and the finer details of our world. When light strikes the rods and cones, they send impulses to the brain that provide visual cues identifying how a person is oriented relative to other objects. For example, as a pedestrian takes a walk along a city street, the surrounding buildings appear vertically aligned, and each storefront passed first moves into and then beyond the range of peripheral vision.

INPUT FROM THE MUSCLES OR JOINTS

Proprioceptive information from the skin, muscles, and joints involves sensory receptors that are sensitive to stretch or pressure in the surrounding tissues. For example, increased pressure is felt in the front part of the soles of the feet when a standing person leans forward. With any movement of the legs, arms, and other body parts, sensory receptors respond by sending impulses to the brain. Along with other information, these stretch and pressure cues help our brain determine where our body is in space.  The sensory impulses originating in the neck and ankles are especially important. Proprioceptive cues from the neck indicate the direction in which the head is turned. Cues from the ankles indicate the body’s movement or sway relative to both the standing surface (floor or ground) and the quality of that surface (for example, hard, soft, slippery, or uneven). 

INPUT FROM THE VESTIBULAR SYSTEM

Sensory information about motion, equilibrium, and spatial orientation is provided by the vestibular apparatus, which in each ear includes the utricle, saccule, and three semicircular canals. The utricle and saccule detect gravity (information in a vertical orientation) and linear movement. The semicircular canals, which detect rotational movement, are located at right angles to each other and are filled with a fluid called endolymph. When the head rotates in the direction sensed by a particular canal, the endolymphatic fluid within it lags behind because of inertia, and exerts pressure against the canal’s sensory receptor. The receptor then sends impulses to the brain about movement from the specific canal that is stimulated. When the vestibular organs on both sides of the head are functioning properly, they send symmetrical impulses to the brain. (Impulses originating from the right side are consistent with impulses originating from the left side.) 

INTEGRATION OF SENSORY INPUT

Balance information provided by the peripheral sensory organs—eyes, muscles and joints, and the two sides of the vestibular system—is sent to the brain stem. There, it is sorted out and integrated with learned information contributed by the cerebellum (the coordination center of the brain) and the cerebral cortex (the thinking and memory center). The cerebellum provides information about automatic movements that have been learned through repeated exposure to certain motions. For example, by repeatedly practicing serving a ball, a tennis player learns to optimize balance control during that movement. Contributions from the cerebral cortex include previously learned information; for example, because icy sidewalks are slippery, one is required to use a different pattern of movement in order to safely navigate them.

PROCESSING OF CONFLICTING SENSORY INPUT

A person can become disoriented if the sensory input received from his or her eyes, muscles and joints, or vestibular organs sources conflicts with one another. For example, this may occur when a person is standing next to a bus that is pulling away from the curb. The visual image of the large rolling bus may create an illusion for the pedestrian that he or she—rather than the bus—is moving. However, at the same time the proprioceptive information from his muscles and joints indicates that he is not actually moving. Sensory information provided by the vestibular organs may help override this sensory conflict. In addition, higher level thinking and memory might compel the person to glance away from the moving bus to look down in order to seek visual confirmation that his body is not moving relative to the pavement. 

MOTOR OUTPUT

As sensory integration takes place, the brain stem transmits impulses to the muscles that control movements of the eyes, head and neck, trunk, and legs, thus allowing a person to both maintain balance and have clear vision while moving.

MOTOR OUTPUT TO THE MUSCLES AND JOINTS

A baby learns to balance through practice and repetition as impulses sent from the sensory receptors to the brain stem and then out to the muscles form a new pathway. With repetition, it becomes easier for these impulses to travel along that nerve pathway—a process called facilitation—and the baby is able to maintain balance during any activity. Strong evidence exists suggesting that such synaptic reorganization occurs throughout a person’s lifetime of adjusting to changing motion environs.
This pathway facilitation is the reason dancers and athletes practice so arduously. Even very complex movements become nearly automatic over a period of time. This also means that if a problem with one sensory information input were to develop, the process of facilitation can help the balance system reset and adapt to achieve a sense of balance again.
For example, when a person is turning cartwheels in a park, impulses transmitted from the brain stem inform the cerebral cortex that this particular activity is appropriately accompanied by the sight of the park whirling in circles. With more practice, the brain learns to interpret a whirling visual field as normal during this type of body rotation. Alternatively, dancers learn that in order to maintain balance while performing a series of pirouettes, they must keep their eyes fixed on one spot in the distance as long as possible while rotating their body. 

MOTOR OUTPUT TO THE EYES

The vestibular system sends motor control signals via the nervous system to the muscles of the eyes with an automatic function called the vestibulo-ocular reflex (VOR). When the head is not moving, the number of impulses from the vestibular organs on the right side is equal to the number of impulses coming from the left side. When the head turns toward the right, the number of impulses from the right ear increases and the number from the left ear decreases. The difference in impulses sent from each side controls eye movements and stabilizes the gaze during active head movements (e.g., while running or watching a hockey game) and passive head movements (e.g., while sitting in a car that is accelerating or decelerating). 

THE COORDINATED BALANCE SYSTEM

The human balance system involves a complex set of sensorimotor-control systems. Its interlacing feedback mechanisms can be disrupted by damage to one or more components through injury, disease, or the aging process. Impaired balance can be accompanied by other symptoms such as dizziness, vertigo, vision problems, nausea, fatigue, and concentration difficulties. 

The complexity of the human balance system creates challenges in diagnosing and treating the underlying cause of imbalance. The crucial integration of information obtained through the vestibular, visual, and proprioceptive systems means that disorders affecting an individual system can markedly disrupt a person’s normal sense of balance. Vestibular dysfunction as a cause of imbalance offers a particularly intricate challenge because of the vestibular system’s interaction with cognitive functioning,and the degree of influence it has on the control of eye movements and posture. 

Authors: the Vestibular Disorders Association, with contributions by Mary Ann Watson, MA, and F. Owen Black, MD, FACS, and Matthew Crowson, MD
http://vestibular.org/understanding-vestibular-disorder/human-balance-system

Thursday, August 11, 2016

HARVARD MAGAZINE NEW ENGLAND REGIONAL

Easing Ills through Tai Chi

Researchers study the benefits of this mind-body exercise.

CATHERINE KERR has found an antidote for the hectic pace of laboratory life in the daily practice of tai chi. This centuries-old Chinese mind-body exercise, now gaining popularity in the United States, consists of slow-flowing, choreographed meditative movements with poetic names like “wave hands like clouds,” “dragons stirring up the wind,” and “swallow skimming the pond” that evoke the natural world. It also focuses on basic components of overall fitness: muscle strength, flexibility, and balance. 


“Doing tai chi makes me feel lighter on my feet,” says Kerr, a Harvard Medical School (HMS) instructor who has practiced for 15 years. “I’m stronger in my legs, more alert, more focused, and more relaxed—it just puts me in a better mood all around.” Although she also practices sitting meditation and does a lot of walking, she says that the impact of tai chi on her mood were so noticeable—even after she was diagnosed with a chronic immune system cancer—that she has devoted her professional life to studying the effects of mind-body exercise on the brain at Harvard’s Osher Research Center.


Kerr is careful to note that tai chi is “not a magic cure-all,” and that Western scientific understanding of its possible physiological benefits is still very rudimentary. Yet her own experience and exposure to research have convinced her that its benefits are very real—especially for older people too frail to engage in robust aerobic conditioning and for those suffering from impaired balance, joint stiffness, or poor kinesthetic awareness. For anyone who practices tai chi regularly, “brain plasticity arising from repeated training may be relevant, since we know that brain connections are ‘sculpted’ by daily experience and practice,” explains Kerr, who is investigating brain dynamics related to tai chi and mindfulness meditation at HMS. “Tai chi is a very interesting form of training because it combines a low-intensity aerobic exercise with a complex, learned, motor sequence. Meditation, motor learning, and attentional focus have all been shown in numerous studies to be associated with training-related changes—including, in some cases, changes in actual brain structure—in specific cortical regions.”  SCHOLARS SAY tai chi grew out of Chinese martial arts, although its exact history is not fully understood, according to one of Kerr’s colleagues, assistant professor of medicine Peter M. Wayne, who directs the tai chi and mind-body research program at the Osher Center. “Tai chi’s roots are also intertwined with traditional Chinese medicine and philosophy, especially Taoism, and with another healing mind-body exercise called qigong,” he explains. “Though these roots are thousands of years old, the formal name tai chi chuan was coined as recently as the seventeenth century as a new form of kung fu, which integrates mind-body principles into a martial art and exercise for health.”Tai chi chuan is often translated as “supreme (grand) ultimate fist”: the first part (“tai chi”) refers to the ubiquitous dialectical interaction of complementary, creative forces in the universe (yin and yang); the second, the fist, is what Wayne describes as the “manifestation or integration of these philosophical concepts into the body.” 


According to traditional Chinese medicine, when yin and yang come together they create a dynamic inner movement. “While practicing, tai chi moves the chi and the blood and the sinews in the body—purportedly correcting health imbalances,” adds Wayne, who has founded The Tree of Life Tai Chi Center, in Somerville, Massachusetts, where he also teaches. “One key principle of tai chi is analogous to the saying ‘A rolling stone gathers no moss,’—if you maintain inner mindful movement in the body, it may improve your health.” Tai chi, considered a soft or internal form of martial art, has multiple long and short forms associated with the most popular styles taught: Wu, Yang, and Chen (named for their originators). Plenty of people practice the faster, more combative forms that appear to resemble kung fu, but the slower, meditative movements are what many in the United States—where the practice has gained ground during the last 25 years—commonly think of as tai chi. 


Qigong, sometimes called the “grammar” of tai chi, comprises countless different smaller movements and breathing exercises that are often incorporated into a tai chi practice. “One reason tai chi is popular is that it is adaptable and safe for people of all ages and stages of health,” Wayne points out. “Recent tai chi forms have even been developed for individuals to practice in wheelchairs. And although few formal medical-economic analyses have been conducted, tai chi appears to be relatively cost-effective.” SURVEYS, including one by the National Center for Complementary and Integrative Health (https://nccih.nih.gov/health/taichi), have shown that between 2.3 million and 3 million people use tai chi in the United States, where a fledgling body of scientific research now exists: the center has supported studies on the effect of tai chi on cardiovascular disease, fall prevention, bone health, osteoporosis, osteoarthritis of the knee, rheumatoid arthritis, chronic heart failure, cancer survivors, depression in older people, and symptoms of fibromyalgia. One study on the immune response to varicella-zoster virus (which causes shingles) suggested in 2007 that tai chi may enhance the immune system and improve overall well-being in older adults. However, “in general, studies of tai chi have been small, or they have had design limitations that may limit their conclusions,” notes the center’s website. “The cumulative evidence suggests that additional research is warranted and needed before tai chi can be widely recommended as an effective therapy.”


Most recently, Wayne and his fellow researchers have focused on balance issues and on cardiovascular and bone health—areas where tai chi’s benefits have begun to be evaluated most rigorously. “We’ve conducted systematic reviews of the literature, and in older people there is sound evidence that suggests tai chi can improve balance and reduce risks for falls, which have significant consequences on public health, particularly given our aging population,” he reports. 

Wayne points to a study by Fuzhong Li at the Oregon Research Institute (which carries out assessments of tai chi’s impact on health conditions, including a current project with Parkinson’s patients): it looked at 256 elderly people, from 70 to 92 years old, and compared how they benefited from tai chi and seated exercise, respectively. “They reported greater than a 40 percent reduction in the number of falls in the group that received tai chi,” Wayne reports. “This is a very significant finding. Older people with thinning bones are at very high risk for fractures; a fall related to hip fracture, for example, is associated with a 20 percent increase in mortality within one year and very high medical costs.”  


Studies conducted in Asia have reported that tai chi may benefit women with thinning bones. This has led Wayne and his colleagues to pursue another current research project—a randomized controlled trial with post-menopausal women diagnosed with osteopenia that examines bone density markers as well as computerized motion analysis to quantify how tai chi affects weight-bearing in the skeleton. 


In addition, clinical trials and basic research studies on patients with heart failure “suggest tai chi may be of benefit to patients in terms of greater exercise capacity and quality of life,” Wayne continues. “More definitive studies to confirm these observations are under way, as well as pilot studies with patients with chronic pulmonary disease.” Yet from a Western scientific standpoint, it’s difficult to pinpoint why and how tai chi affects us. In typical drug trials, a well-defined chemical compound targets physiological systems, and outcomes can be measured against placebo controls. But tai chi is a multicomponent intervention, Wayne notes, with many active ingredients—movement, breathing, attention, visualization, and rich psychosocial interactions with teachers and other students. All of these can affect many physiological systems simultaneously. Moreover, many of the older study subjects also have complex chronic conditions, so identifying a logical control is challenging: it’s just not possible to have a placebo in a tai chi study. “For these reasons,” he says, “we need to be creative in designing tai chi trials, and cautious in interpreting the results.”  HMS INSTRUCTOR and pathologist Marie-Helene Jouvin, who has practiced tai chi for a decade and teaches at the Brookline Tai Chi school near Boston (http://brooklinetaichi.org), has noticed the large number of students who attend classes there for medical reasons—after surgery, or if they are suffering from chronic or autoimmune diseases. But tai chi and qigong are not limited to being done in a classroom with a teacher, she adds. “They can be done when you are sick, or lying in bed.” Indeed, Wayne, Jouvin, and Kerr all agree that the beauty and ease of tai chi offer multifold benefits as far as its daily practice: it is adaptable to numerous physical positions and requires no special equipment, expensive outfits, or specific athletic conditioning. “It’s not a high-cardio workout, it’s all about deepening the relaxation in the movement,” Kerr says. “In aerobic exercise we’re taught to tense the muscle and push hard. Tai chi is the opposite approach; it’s about the flow of the whole body in the movement.” 


Like tai chi, qigong also accomodates busy schedules because it can be done incrementally—and sometimes involves only the smallest parts of the body. Jouvin, for example, sometimes performs an ultra-slow form of twiddling the thumbs under the table at meetings; she focuses on the minutest sensations—skin, heat, joint rotation, relationships among the clasped and moving fingers—and finds this tends to calm her down, especially during heated professional debates, she says with a smile. “These are things you can easily do to help yourself and focus,” she adds. 


Perhaps because of these multiple forms and its adaptability, tai chi looks easy to do. Yet in demonstrating to a novice the most basic short form of the Wu style, Jouvin painstakingly explains 18 precisely choreographed movements that flow together in a set order and take about four minutes to complete properly. “It’s hard to assess if you are doing it correctly without having a trained teacher or practitioner helping you,” she acknowledges. “It can look like people waving their arms and legs around.” 


At the Brookline school, this same Wu short form is taught during the course of 21 weeks of classes. “Most beginners will do the moves as if they were purely aerobic exercise,” Jouvin says. “It will take a while for them to feel the exercise internally. There seems to be an internal logic to the movements. It’s a form that was built over centuries and probably reflects how the body functions.” 

Wednesday, February 24, 2016

Tai chi’s gentle, non-jarring movements support bodily functions in many ways

  • Tai chi trains the major ligaments that serve as the springs of the body. Anatomically, the human body is kept upright by ligaments, not bones, as is commonly believed. Ligaments are also critical in keeping your internal organs from impinging on each other and thereby downgrading their functions.
  • Tai chi tones the muscles.
  • Tai chi trains biomechanical alignments which enable the bones and internal organs to withstand the forces of gravity that pull on all the other parts of the body attached to them.

The movements of tai chi continuously massage your internal organs including lungs, heart, liver kidneys and spleen. Constant turnings of the waist and limbs create gentle internal pressures that twist and create beneficial compressions in your organs.  Taking care of your internal organs is important because your life and health depend on them.  The stronger they are, the better you can perform in any area of your life.


In tai chi, stretching occurs by gently letting go of the tension in your muscles, rather than by pushing or forcing muscle fibers to stretch. Relaxing the muscles in combination with slow-motion movement gradually stretches them.  What is unique about tai chi movements is that they stretch not just the large muscles, but also hundreds of smaller muscles. Although Western exercise programs are beginning to include stretches of these smaller muscles, most don’t and even when they do, they often don’t do it as effectively. 


Tai chi does a wonderful job of relieving back, neck and shoulder pain by loosening up all
the muscles of the upper body. The emphasis on flowing relaxation is especially useful for softening muscles that become stiff through repetitive daily activities.

Tai chi make a real difference to how people recover from car accidents, other forms of serious physical trauma or surgery in significantly less time than normally projected as being possible. 


Tai chi can also help increase the healing rate for damaged organs.  One of the major effects of tai chi is to improve and regulate the movement of all the body’s fluids—blood, lymph, synovial fluid (between your joints), cerebrospinal fluid (within the spinal column) and interstitial fluid (between your cells).  Physically, tai chi moves the different body fluids by creating a series of “pumps” within its specific movements. The pumps vary from large ones like the entire spine, belly, leg or arm, to tiny pumps within specific internal organs, joints and between the vertebrae.

Energetically, the stronger the flow of chi, the smoother and more powerfully your bodily fluids move. Chi is the energetic activator that tells all your bodily fluids when to move and how. As the fluids move more, the strength of your chi increases and vice versa.  

Practicing to increase your breathing capacity helps your normal breath to become significantly deeper and last longer, putting a lot more oxygen into your system.  Tai chi increases your breathing capacity, regardless of whether or not you deliberately practice its specific breathing techniques.

Tai chi trains you to feel progressively more deeply inside your body. With tai chi practice, you develop an awareness of where your body holds tension within itself, which gradually becomes integrated into your daily life. You begin to notice how your neck and shoulders tense when working long hours at your desk or computer, what happens inside your body when you are angry or sad, or how mental exertion under pressure causes your body to fatigue.  


From the perspective of stress, the techniques of tai chi are more about training your central nervous system than your muscles. It is jangled nerves that lie at the root of anxiety, particularly in our technological age with so much intellectual activity. This anxiety affects almost every population group—from babies to the elderly. 

Overloading the brain directly affects your nervous system, resulting in a fight-or-flight response that induces tension and causes the nerves to overload. Over time, this can produce a condition in the brain and nerves, where almost any thought or decision, no matter how small, causes anxiety.  The regular practice of tai chi teaches you to consciously relax your mind and body before it starts to tense, and prevents the condition from being painful or chronic. Because chi moves through the central nervous system, the process of relaxation begins by smoothing out the functioning of the nerves. Relaxing the muscles is only part of this process.

As your nervous system opens up and loses its resistance to change, tai chi helps you gain access to and let go of the nastier emotions that tear up your insides: hatred, jealousy, self-pity, greed, inappropriate anger and more. Maintaining emotional negativity requires tension that can destroy much of life’s joy.

A relaxed muscular and nervous system provides the required support base in which your new, more open and free emotions can live and thrive. Releasing the physical tensions in muscles, organs, tissues and your nervous system provides the support to relax emotionally and maintain a sense of tranquility from deep within.

Mental relaxation will help you:
  • Settle down and become calm, allowing you to focus on the task at hand.
  • Multi-task without mental tension and distraction.
  • Connect your brain to your body without strain.
  • Become awareness of single or multiple thoughts without becoming tense and feeling yourself pulled in different directions.
  • Gain deeper insight and allow ideas to emerge naturally. 

Relaxation causes chi to flow smoothly and fully. Tension causes chi to flow erratically, in a jerky, spasmodic manner and with significantly less power. When chi moves smoothly, it has a natural balancing quality that helps the body to regenerate. The smoother the chi flow, the stronger and healthier the body becomes. That is why people can be simultaneously relaxed and strong. Gradually, it becomes obvious that when your chi flows smoothly, relaxation follows it like a shadow, and vice versa.

Besides being a great whole-body workout, tai chi helps you to reduce and manage pain of all kinds, and to recover more rapidly from trauma.  Tai chi can also serve as a form of moving meditation, helping you release energetic blockages, negative emotions, churning thoughts and embark on a profound and spiritual path.

Monday, February 8, 2016

T'ai Chi/Qigong/Balance selected classes Greece NY


Area Tai Chi/Qigong/Balance Classes - Greece NY 

Greece Senior and Community Center at the Greece Town Hall
Tuesdays September-June - 9 am-9:50 am - Yang Short Form T’ai Chi/Qigong with Barbara Carder.  Also: Warm-weather practice [generally April-October] Wednesdays 9 am at Ontario Beach Park/Charlotte on boardwalk just east of bathhouse.  Check http://flyingcormorant.blogspot.com for updates. Outside practice free.

Tai Chi / Chi-Gong - Greece School District Community Education 
Experience the mind-body connection through the core principals of Chen Style Tai Chi and Chi-Gong. Focus on relaxation and flowing motion to strengthen the joints and increase flexibility. Class will meet on February 16 and 18. Instructor: Michael DeLuca. Location: Shaolin Training Academy, 425 Stone Road. Fee: $71. Senior Saver Fee: $71. (Sessions: 8)  Tues & Thurs 8:00 pm - 9:00 pm 1/26/2016 thru 2/18/2016. For information: 585-865-1010.

NW YMCA Greece/Long Pond Rd. Tai Chi and Qigong with Bob  
Mondays, Wednesdays & Fridays - 8:30-9:15am - Qigong followed at 9:15-10am - Tai Chi Yang Long Form. Contact Y for fee/membership. For information: 585-227-3900.

Beatrice Place/Episcopal Senior Life 600 Denise Rd. Greece  
Open to public – fitness classes including Balance Class - Tuesdays 10 am. This exercise class is a low impact, sit/stand program designed to increase balance, strength, endurance and flexibility in order to decrease falling incidents. May use “Silver Sneakers” – call for information 585-546-8439 ext. 4419.