Dr. Li Li [lli3@lsu.edu]

Dr. Li graduated from the department of exercise science, university of Massachusetts at Amherst in 1999. He is an associate professor with the department of kinesiology of Louisiana state university. Dr. Li is member of the following professional organization: North American Society for the Psychology of Sport and Physical Activity, American College of Sports Medicine, American Alliance for Health, Physical Education, Recreation and Dance, and International Society of Biomechanics. Dr. Li is a Fellow of American College of Sports Medicine and a Research Consortium Fellow of American Alliance for Health, Physical Education, Recreation and Dance Dr. Li has served on the editorial board of Journal of Electromyography and Kinesiology since 2001. He reviews for European Journal of Applied Physiology, Journal of Applied Biomechanics, Journal of Applied Physiology, Journal of Biomechanics, Journal of Electromyography and Kinesiology, Journal of Gerontology, Journal of Motor Behavior, Medicine and Science in Sports and Exercise, Research Quarterly Exercise and Sport, and Sport Biomechanics Dr. Li presented 16 invited presentations at institutions from US to Asia, to Latin America, and also different national and international conferences. He has 29 papers published in peer reviewed scientific journals. He has also published three book chapters. He had 91 scientific presentations at different regional, national and international conferences.

Selected research project

Project website http://pn.lsu.edu/

An estimated 20 million Americans suffer from peripheral neuropathy, a neurological disorder that causes debilitating pain, weakness in the arms and legs, and difficulty walking.

----------108th Congress report

Dr. Li has been conducting an intervention study that focus on peripheral neuropathy since the summer of 2004. The project objectives are to identify interventions that can help in managing the disease, to investigate what interventions are more beneficial, and to help peripheral neuropathy patients manage their symptoms through continuous participation. Anyone with peripheral neuropathy who can walk around (even with assistance device, walking stick or walker) is welcomed to participate in the study. Normally our participants need to come to LSU three times a week for one hour at a time. Currently we have an intervention program that compares the effects of two different kinds of interventions - Tai Chi or Light Therapy. We will monitor the progress of the participants through sensory, balance, mobility and vascular function tests.

Pilot data shown that the intervention employed can recover balance, improve mobility, reduce pain, and a small percentage of our participants have regained sensation at the bottom of their feet.

1. What is Peripheral Neuropathy?

Peripheral neuropathy describes damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body.

More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis. Impaired function and symptoms depend on the type of nerves -- motor, sensory, or autonomic -- that are damaged. Some people may experience temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness. Others may suffer more extreme symptoms, including burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction. Peripheral neuropathy may be either inherited or acquired. Causes of acquired peripheral neuropathy include physical injury (trauma) to a nerve, tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, and vascular and metabolic disorders. Acquired peripheral neuropathies are caused by systemic disease, trauma from external agents, or infections or autoimmune disorders affecting nerve tissue. Inherited forms of peripheral neuropathy are caused by inborn mistakes in the genetic code or by new genetic mutations.

Is there any treatment?

No medical treatments exist that can cure inherited peripheral neuropathy. However, there are therapies for many other forms. In general, adopting healthy habits -- such as maintaining optimal weight, avoiding exposure to toxins, following a physician-supervised exercise program, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption -- can reduce the physical and emotional effects of peripheral neuropathy. Systemic diseases frequently require more complex treatments.

What is the prognosis?

In acute neuropathies, such as Guillain-Barré syndrome, symptoms appear suddenly, progress rapidly, and resolve slowly as damaged nerves heal. In chronic forms, symptoms begin subtly and progress slowly. Some people may have periods of relief followed by relapse. Others may reach a plateau stage where symptoms stay the same for many months or years. Some chronic neuropathies worsen over time, but very few forms prove fatal unless complicated by other diseases. Occasionally the neuropathy is a symptom of another disorder.

2. Mobility is the key to whole-body coordination in humans with peripheral neuropathy
Jan M. Hondzinski, Yongqin Cui, Li Li, Michael Welsch, Robert H. Wood

People with peripheral neuropathy (PN) have distal nerve damage commonly associated with impairments in function, balance and mobility. Movements of people with and without PN performing functional tasks were studied to determine the influence of the disease on whole-body control in this population. Effect of exercise training, which has improved balance and mobility in older disease-free adults, was also studied. Fifteen subjects with PN were tested before and after six weeks of training exercises and compared to four normal controls of similar mean age. In goal-directed functional tests subjects anchored their gaze on a target before reaching to its real or remembered spatial location. Body movements were recorded as subjects reached with and without a step. Measures of mobility and balance were also collected. Results exhibited lower endpoint errors after training, lower variable errors for control subjects compared to PN subjects pre-test and for many subjects greater movement coupling of the hand and foot during the step and reach task. Significant correlations were observed between movement coupling and measures of mobility and balance, but not between movement coupling and endpoint accuracy. These data provide evidence that improvements in mobility and balance are important for movement coordination during rehabilitation efforts in people with peripheral neuropathy.

3. Peripheral neuropathy patients benefit more from Tai Chi than traditional exercise
Brad Manor, M.S. Alison Doherty, and Li Li, Ph.D., FACSM
Louisiana State University, Baton Rouge

Peripheral neuropathy is a severely debilitating disease marked by lower extremity sensory loss and an increased risk of suffering a fall. Richardson et al (Arch Phys Med Rehabil. 2001, 82:205-9) reported improved postural stability in response to a focused exercise (FE) specifically designed for peripheral neuropathy patients. At the mean time, the traditional Chinese martial arts - Tai Chi (TC) has increasingly been employed to improve balance with the elderly population (Wolf et al., J Am Geriatr Soc. 2003, 51:1794-803). The purpose of this experiment was to determine whether TC training would increase balance, strength, and physical function in individuals with peripheral neuropathy over and above FE training. Ten subjects with peripheral neuropathy were recruited. The following testings were conducted before and after a six week (~18 times) exercise intervention for either TC or FE. Standing balance was evaluated by the average velocity (VEL) of the body center of pressure (COP) and the area inclosing 95% of the COP (A95) with the subject's eyes closed. Isokinetic knee extensor (KE) and flexor (KF) peak torque was measured at an angular velocity of 60 deg/s. The distance walked in the six minute walk test (6MWT) and the time needed to complete the timed up-and-go (TUG) test were also recorded. Following pre-testing, subjects underwent six weeks (~18, one hour sessions) of progressive, group-based TC or FE training. The TC group had 3 women, 3 men (mean age = 69.8 ± 9.6 years)and the FE group had 3 women, 1 man (mean age = 67.7 ± 17.0 years). The TC group demonstrated significantly greater percent increases in the 6MWT (TC = 13.6%, FE = 3.7%, t10 = 4.3, p < 0.01), TUG (TC = 16.7%, FE = 6.23% t10 = 2.6, p = 0.03), VEL (TC = 23.4%, FE = -2.5%, t10 = 2.9, p = 0.01), and KE (TC = 11.3%, FE = 2.1%, t10 = 2.78, p = 0.02) and KF (TC = 19.1%, FE = 1.4%, t10 = 3.3, p = 0.01) peak torque. It was concluded that TC led to significantly greater improvements in function, balance, and strength than did the FE group, suggesting that this form of exercise may be better suited for individuals presenting with peripheral neuropathy.

4. Tai chi therapy: Martial arts class proves beneficial for people with peripheral neuropathy -The Advocate (May 21, 2006) By LAURIE SMITH ANDERSON
Advocate staff writer
Published: May 21, 2006

Juanita Guillot feels certain she would be in a wheelchair today were it not for a special tai chi class she takes at LSU to improve her balance and walking skills.

In 1995, Guillot was diagnosed with peripheral neuropathy, which is damage to nerve endings that causes weakness, numbness, tingling, burning and pain in the hands, arms, feet and legs. Balance problems and loss of sensation can make it difficult to walk, drive and grip.

In Guillot, the disease progressed to the point where she was staggering, holding on to people and objects as she moved about, and she even fell a couple of times.

“I’m 62 years old, not an old lady,” she said. “Three years ago, I thought about getting a cane and was afraid I was headed for the wheelchair, but not now. No way!”

As a member of the Baton Rouge Peripheral Neuropathy Support Group, Guillot heard about the tai chi class, which was initiated by Li Li, an LSU kinesiologist who was interested in helping people afflicted with peripheral neuropathy.

“I’m a biomechanist, which means I study balance and gait,” Li said. “About four years ago, I met a man who could walk well but had to hold on to something in order to stand. That suggested to me that the control mechanisms of balance and walking are different, and I found that very interesting.

“About two years ago, I started going to the support group meetings for people with peripheral neuropathy, and they were seeking help. So, I started a six-week study in the summer of 2004 comparing two forms of exercise, walking and tai chi, to see what impact they might have on balance and gait.”

Both groups saw improvements, he said, but the tai chi group was more motivated to continue the program.

Preliminary data from testing showed most participants had recovered balance, improved mobility and suffered less pain. A small percentage even recovered some sensation in their feet.

“I believe there is a link between tai chi and nerve regrowth,” Li said. Many of the participants have been able to give up their canes and walkers. Falling and fear of falling are major concerns for peripheral neuropathy patients. Several of the class members reported falling less and walking with greater confidence.

Participants started with a modified beginner’s class, many of them holding onto chairs to keep their balance. “Now, there are no more chairs,” Li said.

Now, almost two years after the pilot study began, more than 30 people are still meeting for classes behind the LSU Fieldhouse two to three times a week for either 60- or 90-minute sessions.

Instructor Thomas Yajun leads the group in the Chinese martial arts form believed to promote health and longevity and improve internal circulation. It has also been called a “moving meditation.” Participants employ slow, graceful, repetitive movements in a natural range of motion over their center of gravity.

In addition, some of the LSU study participants are undergoing a special infrared light therapy to determine whether it might show some of the same benefits.

Local neurologist Allen Proctor works with Li to review the study procedures. One other faculty member, a doctoral student, three undergraduate students and Yajun are also involved.

Thus far, the program has been conducted with the support of the college, but with little in the way of direct funding and at no cost to the participants. Li said he hopes to apply for funds to support the program and offer services to more peripheral neuropathy patients.

Guillot, a retired licensed practical nurse who lives in Baker, says her condition has improved though she still has some numbness.

“I’m not staggering as much. I’m better able to control my balance. I don’t have to grab on to people, and I haven’t fallen since I started tai chi. I have more confidence about going out in public again. It (the class) has been a Godsend to me.”

Eighty-one-year-old Pat Dimeceli of Amite and her son, Darryl, travel three hours round-trip three times a week to participate in the class. She has some numbness in her feet, and her son, who was electrocuted, was diagnosed with peripheral neuropathy.

“My son had to use a cane before but he doesn’t now. He’s doing much better. So am I. I saw my cardiologist last week, and he said, ‘You look great. Whatever you’re doing, keep it up. It’s given me such a positive outlook. I wouldn’t give it (the class) up for the world,” Dimeceli said.

Dennis Edmon was diagnosed with peripheral neuropathy in 1998. “I heard about the tai chi class through Dr. Li and the support group. I didn’t think it would help, but I was willing to try anything.

“In a few weeks, I saw improvements in my balance. I still have some numbness, but I feel more sure of myself. I don’t stumble as much or fall anymore. Now, I schedule everything around tai chi. I attend classes religiously and only miss if I go out of town.”

There are many known causes of peripheral neuropathy, according to The Neuropathy Association. Treating the underlying condition can, in some cases, slow, stop or reverse the condition. Vitamin deficiencies can be corrected with supplements, and infections are treated with antibiotics. Toxic or drug-induced neuropathies are treated by removing the offending agent, and in diabetes (the most common known cause of neuropathy), close control of blood sugar helps slow the development of neuropathy.

In one-third of cases, there is no known cause and no cure, though treatment can help.

In some cases, treatment means relief of symptoms, such as pain, but what works for one patient may not work for another, and some of the medications can have undesirable side effects.

The LSU program has a continuous open enrollment. For more information on Li’s studies and the tai chi group, visit the LSU Web site http://www.pn.lsu.edu or call (225) 578-2036.

For more information about peripheral neuropathy, the Neuropathy Association maintains a Web site at http://www.neuropathy.org.

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[Edited by Zan Gao]