Tai Chi Moving for Better Balance with Dr. Fuzhong Li

Fuzhong Li, Ph.d, is a leading Tai Chi researcher, based at the Oregon Research Institute.  Since 2001, he has studied the effects of exercise, especially Tai Chi, on balance and falls prevention in aging populations.

Tai Chi: Moving for Better Balance is the CDC-approved falls prevention program that Dr. Li has developed based on his research.

When I visited him in Oregon recently, he showed me the refinements he’s made to his program, we visited one of his classes and we played with some of the equipment he uses in his lab for testing different components of balance (see how I did below!).

The target population for this program are people in Medicare. They attend classes at community centers or senior centers and many are limited by chronic diseases or recovering from acute injuries.

Increasingly, Dr. Li is focusing on Parkinson’s Disease, but his driving mission comes from a concern for public health on a large scale.

Evidence-Based Tai Chi

The Moving for Better Balance protocol focuses on adapting traditional Tai Chi training to therapeutic uses by integrating skills needed for ADLs (activities of daily living) like reaching, sitting, standing, and walking.

In the lab, Dr. Li measures gait, limits of stability, and sensory integration (visual, vestibular, and sensorimotor).

Here I am on one of the machines they use for testing:

His research has led to integrating the components that challenge ankle flexibility, teach balance recovery strategies, stimulate VOR (vestibulo-ocular reflex), and refine the ability to change speeds smoothly. As a result, traditional Tai Chi movements are modified to introduce these elements. For example, participants will follow their palm with eye tracking and head rotation instead of moving the head in line with the navel during trunk rotation.

To increase their limits of stability, participants are instructed to go beyond centering their weight in the feet as traditional practice instructs.

Similar modifications are made to with extra pushing and loading, in accordance with gait analysis, to regain skills typically lost in the target population.

One driving principle is to continuously move people from stability to instability and back.

Some of Dr. Li’s newer work focuses on adding cognitive components to exercises. For example, writing “hold the ball” in the air with an imaginary ball held between the arms or spelling “hook” out loud as fingers form the beak hand or hook for Single Whip, one letter per finger.

Instructor Training and Program Development

He has trained instructors all over the country through government agencies but very few through private groups or Tai Chi schools. We were lucky to host him for a training in Boston in October 2010.

He closely monitors and upgrades his local instructors and they have extensive programs in the Eugene and Portland areas.

Based on ongoing research findings, he tweaks and upgrades the programs, for example, adding “pre-loading” to each move that mimics the loading stage of normal gait.

Dr. Li is committed to creating a functional program that is simple enough and inexpensive enough (there is no equipment used in the actual community-based program) to reach the tens of millions of Americans who are aging and want to take charge of an important dimension of their health and well-being.

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  1. Interesting post! Tai Chi is so great. I have been studying it for about a year and I really like it. I used to practice Aikido, but I think that Tai Chi is just as good or better! Fascinating stuff!

  2. Bob Hughes says:

    Great blog Dan.

    I teach taiji to seniors with Parkinson’s.
    Last February, I latched onto Dr. Li’s article,
    “Tai Chi and Postural Stability in Patients with Parkinson’s Disease,”
    in the New England Journal of Medicine
    (n engl j med 366;6 nejm.org february 9, 2012).
    You pulled off something that I was unable to do.
    I had emailed Dr. Li but received no reply.
    I asked for the protocol he used. It was generally described in his study as consisting of six tai chi movements integrated into an eight-form routine (the Appendix was not available online).
    So I’ve stuck with Dr. Lam’s “Seated Taiji for Arthritis” protocol.
    See also Susan Mathews’ work:
    You, however, went to the source and dug up some valuable info in Dr. Li’s lab.
    Way to go.
    And now I can see why Dr. Li wasn’t ready to share his protocol–he apparently is modifying it.
    For example, he is modifying the basic taiji principle of keeping the head in line with the navel during trunk rotation. This is critical. Us taiji teachers need access to these modifications. I use this principle as a basis for instruction–as well as the principles of Zhong ding and rooting.

    And I wonder what is meant by “adding “pre-loading” to each move that mimics the loading stage of normal gait.”
    Maybe you can press Dr. Li to share his techniques with the general public as soon as possible–the loss of motor skills progressively deteriorates, so timely retraining is paramount.
    Maybe he has trained instructors all over the country through government agencies,
    but this info needs to get out to the general public.
    This is what you do so well in your blogs.

  3. For over a decade, I’ve used a Fitterfirst Wobble Board daily in the hope that it would improve my ankle flexibility and balance. (Watch this 2:33 video to see the Wobble Board in action.) My impression is that the Wobble Board has significantly improved my ankle flexibility and balance, but I wonder: how would I score on the equipment that Dr. Li uses in his lab for testing the different components of balance?

  4. Jim — I actually asked him about the wobble board. We use it too in our Tai Chi Equipment training: http://dankleiman.com/2012/09/17/testing-your-internal-state-through-tai-chi-equipment-training/
    and here where Don Miller explains Equipment Training in more detail:
    Dr. Li’s answer was he wanted to avoid equipment to keep costs as low as possible so the program can get out to as many people as possible.

    Bob — Yes, I feel very lucky to have been able to work with him now on two occasions. I think this work will get out to a broader audience. He’s creating such a specific application for a very targeted audience and constantly refining the protocol to meet the function needs of this audience. He recognizes the visual and vestibular components of balance, gait and loading patterns, and can identify what happens just before a fall, so it’s all about making sure those components are included in the training people receive.