Scientific Research

The first clinical study on poi, health, and older adults

Summary

As our lifespan lengthens and our aging population rapidly grows, simple and effective strategies for maintaining quality of life in old age are urgently needed. Dr. Kate Riegle van West, founder of SpinPoi, conducted the first scientific study in the world to evaluate if poi may be one such strategy. Seventy-nine healthy older adults participated in the double-blind randomized controlled trial, and after one month of poi practice, there were statistically significant improvements in grip strength, balance, and sustained attention.

1. Aim and Methods

The aim of this study was to investigate the effects of International Poi (the style of poi practiced worldwide), as compared to Tai Chi, on physical, cognitive, and emotional health in healthy older adults. Seventy-nine participants (60–86 years old) were randomly allocated to the International Poi or Tai Chi group. Physical and cognitive function were measured one month before, immediately before, immediately after, and one month after the intervention (2 lessons a week for 4 weeks). Follow-up questionnaires were administered after each lesson, immediately after the intervention, and one month after the intervention.

2. Tests

Participants were tested across 3 domains:

  • Physical (balance, bimanual coordination, blood pressure, heart rate, grip strength, lower body strength, manual dexterity, upper limb range of motion)
  • Cognitive (simple and complex attention, cognitive flexibility, motor speed, processing speed, psychomotor speed, reaction time, working memory, composite memory)
  • Emotional (psychological well-being). These domains were measured a total of 4 times (twice before and twice after the poi or Tai Chi lessons).

All tests were safe, non-invasive, and standard means of measuring physical, cognitive, and emotional function.

3. Lessons

Tai Chi lessons were taught by Bruno Rubini, a full time Auckland area instructor with over 30 years of Tai Chi Chuan experience.

A typical lesson had 3 phases: Energising Joints (strengthening the joints and tendons through a specific set of movements), Silk Reeling, Chen Style (basic warm up movements to connect the upper and lower body) and Tai Chi Qigong Shibashi (using movements from the Yang style Tai Chi Chaun, with an emphasis on synchronizing 18 movements with proper breathing techniques).

International Poi lessons were taught by Kate Riegle van West, the principal investigator for this study.

The lessons focused on exploring and controlling the timing, plane, and direction of the poi with an awareness of ones body in relation to the poi. This was done through specific movements, such as the figure 8, butterfly, chasing the sun, flowers, and pendulums. Each lesson began with a warm up stretch, and concluded with a cool down stretch.

4. Results

Questionnaires

After the lessons, participants were asked to explain any positive or negative effects which seemed to caused by learning poi or Tai Chi. Their answers were analyzed thematically and visual representations were created.

Word Clouds

Participants were asked “What 3 words best describe how you are feeling?” after each of their lessons. Their answers are displayed here in word clouds (the more times a word was said, the bigger it is!). There is a word cloud for all of the poi responses (collected over 1 month), all of the Tai Chi responses (collected over 1 month) and then word clouds broken down by week which display the poi group and Tai Chi group next to each other for comparison.

What 3 words best describe how you are feeling?

Words collected after International Poi lessons, twice a week for one month, from 37 participants.
Words collected after Tai Chi lessons, twice a week for one month, from 44 participants

Clinical Tests

Immediately post intervention both groups improved balance, upper limb strength, and simple attention. Tai Chi also improved systolic blood pressure. One month post intervention, compared to immediately post intervention, both groups improved upper limb strength, upper limb range of motion, and memory. Poi also improved systolic blood pressure. 

This shows that the means of measuring were sensitive to the expected effects, because the findings are consistent with previous research on Tai Chi. It also shows that poi improved right alongside Tai Chi, meaning poi is as good as an activity which is considered a gold standard of exercise for older adults.

In addition, the results cover the hallmarks of frailty: balance, cardiovascular function, strength, and memory. This is particularly exciting for thinking about poi as a tool for maintaining or improving quality of life in old age.

Some hard data for those that want it…

For both groups, three physical measures and one cognitive measure improved immediately post intervention: 4-Stage Balance Test (F1,39 = 9.9, = 0.003), Functional Reach Test (F1,76 = 7.5, = 0.008), hand grip (F1,76 =11.6, = 0.001), and simple attention (F1,38 = 4.6, P = 0.038). For both groups, two cognitive measures declined: composite memory (F1,76 = 7.8, = 0.007) and visual memory (F1,76 = 8.8, P = 0.004). There was an interaction between time and group for systolic blood pressure (F1,76 = 4.3, P = 0.041). The interaction arose because systolic blood pressure decreased for the Tai Chi group (M = -5.1 mm Hg, SD = 12.7 mm Hg, T77 = 2.25), but not the poi group (M = 2.2 mm Hg, SD = 16.3 mm Hg).  

One month post intervention, two physical measures and three cognitive measures improved: hand grip (F1,75 =4.9, = 0.029), shoulder ROM (F1,75 = 10.6, = 0.002), composite memory (F1,73 = 10.3, = 0.002), visual memory (F1,73 = 6.3, P = 0.014) and verbal memory (F1,75 = 4.2, P = 0.043). There was an interaction between time and group for systolic blood pressure (F1,75 = 7.4, P = 0.008). The interaction arose because systolic blood pressure decreased for the poi group (M = -5.05 mm Hg, SD = 14.4 mm Hg, T76 = -2.47), but not the Tai Chi group (M = 3.71 mm Hg, SD = 13.75 mm Hg).

5. Conclusion

This study investigated the effects of poi, compared with Tai Chi, on physical and cognitive function in healthy older adults. Immediately post intervention, both groups improved balance, grip strength, and attention. Tai Chi also improved systolic blood pressure. These are exciting results, especially when thinking about maintaining quality of life as we age.

6. Learn More

Articles

You can read the full dissertation on Academia.edu , Research Gate, or the University of Auckland thesis database.

You can also read this article published in the peer-reviewed Journal of Aging and Physical Activity.

Documentary

A Spin On Health gives you a behind the scenes look at the study, following participants before, during, and after taking part.

Press

TVNZ One News interviews poi study participant Marlene Stratton along with Kate Riegle van West to discuss the health benefits of poi for older adults.

Radio New Zealand article weaves together scientific data and interviews with kapa haka performer Puti Mackey, poi research participant Jocelyn Fausett, and researcher Kate Riegle van West.

Te Kāea, Māori Television nightly news interviews Kate and her participants about the first research study on poi, and opportunities to continue poi / health research in the future.

Hania Douglas from Te Karere, a New Zealand news and current affairs programme broadcast in the Māori language, interviews Kate and study participant Marlene.

Tim Wilson from TV ONE’s Seven Sharp gives poi a go and speaks with Kate about International Poi’s potential to keep older adults physically and cognitively fit.

“The exercise every over-60 should be doing.” Tracy Adshead interviews Kate Riegle van West about the health benefits of poi for older adults in this article on www.oversixty.com.

Kathryn Ryan from Radio New Zealand’s Nine to Noon program interviews Kate about the poi clinical trial, what she’s found out so far, and implications for the future.

Kate speaks about how learning new things (like poi!) can be fun and good for your health on 95bFM’s Ready Steady Learn.

8. Frequently Asked Questions

    Poi contains a unique set of characteristics which have been proven, individually, to have a positive impact health. Poi is a physical activity which draws upon the key components of fitness and is highly customizable. Physically active lifestyles have been proven to reduce risk factors and improve functioning and quality of life in the elderly (Daley, 2000). Poi is intrinsically playful, and play is proven to have a vital role in keeping the mind and body young by presenting novel situations which foster cognitive innovation, adaptability, and flexibility; which in turn improves reflexes, memory, processing speeds, etc. (Brown, 2009).

    Poi is rhythmic, and active music therapy has a multitude of physical, mental, and emotional benefits (Drake, 2010). The rhythmic nature of poi can potentially tap into the same benefits as rhythmic, active, music therapy such as drumming. And activities such as juggling (Boyke, 2008) and Tai Chi (“The Health Benefits”, 2008), which share many characteristics with poi (e.g. ambidexterity, rhythm, and meditative movement) are proven to have a positive effect on maintaining both physical and cognitive ability in older adults.

    Seeing as there is no known research on poi and health, we cannot compare a poi treatment group to a poi control group. Thus, I wanted to compare a poi treatment group to a control group which was participating in an activity closely related to poi, which also:

    • has both physical and cognitive dimensions,
    • is appropriate for older adults, and
    • has a substantial amount of scientific research proving its efficacy.

    Many activities were considered (such as juggling, ballroom dancing, and yoga) but ultimately Tai Chi was the best fit based on the methodology above.

    The focus of my research is to determine if the fundamental act of a weight orbiting on the end of a string has an impact on health. To do that, I believe it’s important to peel away as many layers as possible and start with the very basics: swinging a weight on a cord in circles.

    One of the things that make Maori poi unique is their inextricable link to Maori culture. I believe this depth is extremely valuable (and it’s the reason I moved to New Zealand to do the research!), and I would like to conduct future research on Maori poi. But for the first study, International poi is a better fit for my research question and it is also where my own expertise lies. If you would like to learn more about the different styles of poi, feel free to check out my about page.

    As the young-old balance shifts throughout the world, so does the prevalence of chronic disease, making elderly health and well-being an extremely important area of interest. I could have chosen many other populations to work with (people recovering from stroke, people with dementia), and I would like to conduct research on other populations in the future, but healthy older adults is a very relevant and timely place to start with the boom in our aging population. I am particularly interested if International Poi can contribute to prolonging quality of life and possibly delaying the onset of diseases that strike in old age.

Boyke J., Driemeyer J., Gaser C., Büchel C., and May A. (2008). Training-induced Brain Structure Changes in the Elderly. Journal of Neuroscience. 28: 7031–7035.

Brown, S. (2009). Play: How It Shapes the Brain, Opens the Imagination, and Invigorates the Soul. New York, NY: Penguin Group.

Daley, M. & Spinks, W. (2000). Exercise, Mobility and Ageing. Sports Medicine. 29: 1-12.

Drake, M. (2010). The Therapeutic Effects of Drumming. Retrieved from: http://shamanicdrumming.com/drumtherapy.html

The Health Benefits of Tai Chi (2014). Harvard Medical School. Retrieved from: http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2009/May/The-health-benefits-of-tai-chi