The Effect Of Tai Chi Clouds Hands On Hemorheology And Hemodynamics Of Vertebral Artery In Patients With Cervicogenic Vertigo:a Randomized Controlled Test

Objective:The etiology and pathogenesis of cervicogenic vertigo hasn’t been consensus, clinical treatment always focuses on relieving the symptoms, improving quality of life, restoring ability to work, and reducing the relapse rate. Our previous studies have shown that Tai Chi clouds hands practice can significantly improve the clinical symptoms and enhance the range of motion in cervical region. Therefore, this study further evaluates the effects of Tai Chi Clouds Hands by assessment of clinical symptoms, general function, hemodynamic and hemorheologic changes, aims to provide clinical evidence for long term use of Clouds hands in cases with cervicogenic vertigo, as well as the basis for discussion on its therapeutic mechanism on hemodynamics and hemorheology.Method:1. Grouping:60patients met the inclusion criteria, randomized into Tai Chi Clouds hands group (treating group) and the conventional treatment group (control group),1case in control group dropped out due to Interruption of treatment,29cases in control group and30cases in treating group finished the study. In addition to the similar treatment in control group, clouds hands practice was added in treating group.2. Outcome measurement:assessment scales of cervicogenic vertigo edited by Wangchu Huai, median velocity of blood (Vm) by Transcranial Cerebral Doppler (TCD), and surrogates on blood rheology, tested by assessors who were blinded to the grouping information and at same time before and after treatment.3. Treatment protocols:conventional therapy of acupuncture and massage was provided in control group. Clouds hands practice was added in treating group in addition to conventional therapy. When severe episodes of vertigo presented, symptomatic treatment was provided when necessary. The posture and head position that may cause vertigo onset were avoided. Clouds hands was practiced when patients were free of vertigo, twice every day, lasted30minutes with5minutes of interval. A treating course consisted of1week of practice,4weeks of practice were done totally.Results:Compared with the results in control group, better effects of Clouds hands in treating group showed on symptomatic and functional scale of cervicogenic vertigo, Vm in TCD examination, indicators as whole blood viscosity and packed cell volume (PCV) in blood rheology test. The difference was statistically significant (p<0.05). The scores of scale was correlated to the results of Vm and blood rheology, especially on blood viscosity and PCV (r=0.852, r=0.745,and r=0.656,respectively).Conclusion:The research confirmed that Tai Chi clouds hands practice combined with conventional therapy of acupuncture and massage can significantly improve symptoms and function of patients with cervicogenic vertigo, Vm in TCD examination and indicators as whole blood viscosity and packed cell volume (PCV) in blood rheology test. The clinical efficacy is superior to that of conventional therapy alone. The mechanism may be correlated to its effect on correcting the disorder of hemodynamics and hemorheology in patients. Therefore, practice of Tai Chi Clouds Hands could be served as a simple, safe and effective adjuvant therapy for rehabilitation of cervogenic vertigo, and may be recommended for long term use. The prolonged follow-up and more specific therapeutic mechanism of Clouds hands warrants further studies.