The effects of Ai-Chi intervention on balance and gait performance in individuals with chronic stroke

INTERVENTION: Participants will receive Ai Chi intervention. Ai Chi is an aquatic exercise containing 16 movements invented by Jun Konno in 1993. The spirit of roundness and flow is adapted from Tai Chi, one of Chinese martial arts, and Watsu, a Japanese body‐mind relaxation technique. Ai Chi emphasizes gentle, smooth, and broad movements, Participants need to stay in a semi‐squat position with shoulders underneath water surface. It is very important to start with breathing exercise followed by arm and leg movements, and finally coordinated whole body movements. Ai Chi exercise includes several components: flexibility, strength, coordination, relaxation, postural control, and balance. Ai Chi sessions will be delivered by a certificated physiotherapist with 2 year experience in aquatic therapy and Ai Chi. Training frequency will be 60 min per session, 3 sessions per week for a total of 6 weeks. It will be small group sessions taking place in a hydrotherapy pool in Cheng Hsin General Hospital. Each participant will have a check sheet and it has to be registered at every session in order to monitor adherence. CONDITION: Stroke PRIMARY OUTCOME: Functional balance performance by Berg balance scale ; Limit of stability by SMART Balance Master, NeuroCom International, Inc., USA ; Spatial‐temporal parameters of gait by GAITRite system SECONDARY OUTCOME: Motor control of lower extremities by Fugl‐Meyer Assessment‐LE Weight bearing distribution by SMART Balance Master, NeuroCom International, Inc., USA ; INCLUSION CRITERIA: 1. age 20 y/0 to 80 y/o 2. at least 6 months after the onset of first stroke 3. ability to walk independently with or without walking aids for at lease 15 m 4. MMSE > 24 5. no previous cardiovascular disease or other neurological disorder