Effects of individualized Tai-Chi on balance and lower-limb strength in older adults

I-Wen Penn, Wen-Hsu Sung, Chien-Hui Lin, Eric Chuang, Tien-Yow Chuang, Pei-Hsin Lin, I-Wen Penn, Wen-Hsu Sung, Chien-Hui Lin, Eric Chuang, Tien-Yow Chuang, Pei-Hsin Lin

Abstract

Background: To investigate whether a simplified and personalized Tai-Chi program could be beneficial for practitioners. A prospective quasi-experimental observer-blinded controlled trial was done in Beitou District of Taipei City.

Methods: Community-dwelling adults aged 65 and older without debilitating disease (N = 50) participated the study. Those who were willing to participate in exercise program were assigned to individualized Tai-Chi (iTC) group (n = 20), receiving iTC training for 8 weeks, and traditional Tai-Chi (tTC) group (n = 15), receiving tTC training for 8 weeks. Those who were not willing to participate in exercise training were included in the control group (n = 15). Functional balance tests, the Berg Balance Scale (BBS), timed up-and-go (TUG) test, functional-reach test, and measurement of lower-extremity muscle strength were conducted before and 8 weeks after the intervention.

Results: Significant improvements were noted in all functional balance tests and strength assessments of 16 major lower-limb muscle groups in participants of the iTC group compared to the control group, whereas only BBS and muscle strength of hips and ankles were improved in the tTC group. Practitioners of iTC outperformed tTC in BBS and strength of two major muscles.

Conclusions: Personalized Tai-Chi training designed based on an objective measurement and conducted according to graded intensity and complexity benefitted practitioners after a short period.

Trial registration: Trial registration number: ClinicalTrials.gov ID: NCT03659396 , Unique Protocol ID: 1000087 Date of registration: 03/28/2017 The trial was registered retrospectively.

Keywords: Exercise; Functional balance; Muscle strength; Tai-chi.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart explaining assignment of the participants to the study and control groups

References

    1. Rdejlgm M. Exercise prescription for healthy populations with special consideration. In: Medicine” ACoS, editor. ACSMs guidelins for exercise testing and prescription. 10th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2018. p. 180–202.
    1. Lan C, Lai JS, Chen SY, Wong MK. 12-month tai chi training in the elderly: its effect on health fitness. Med Sci Sports Exerc. 1998;30:345–351. doi: 10.1097/00005768-199803000-00003.
    1. Smith LL, Wherry SJ, Larkey LK, Ainsworth BE, Swan PD. Energy expenditure and cardiovascular responses to tai chi easy. Complement Ther Med. 2015;23:802–805. doi: 10.1016/j.ctim.2015.09.004.
    1. Young DR, Appel LJ, Jee S, Miller ER., 3rd The effects of aerobic exercise and T'ai chi on blood pressure in older people: results of a randomized trial. J Am Geriatr Soc. 1999;47:277–284. doi: 10.1111/j.1532-5415.1999.tb02989.x.
    1. Lee YM. The effects of tai chi on waist circumference and blood pressure in the elderly. J Phys Ther Sci. 2017;29:172–175. doi: 10.1589/jpts.29.172.
    1. Tsang WW, Hui-Chan CW. Effect of 4- and 8-wk intensive tai chi training on balance control in the elderly. Med Sci Sports Exerc. 2004;36:648–657. doi: 10.1249/.
    1. Song QH, Zhang QH, Xu RM, Ma M, Zhao XP, Shen GQ, et al. Effect of tai-chi exercise on lower limb muscle strength, bone mineral density and balance function of elderly women. Int J Clin Exp Med. 2014;7:1569–1576.
    1. Huang ZG, Feng YH, Li YH, Lv CS. Systematic review and meta-analysis: tai chi for preventing falls in older adults. BMJ Open. 2017;7:e013661. doi: 10.1136/bmjopen-2016-013661.
    1. Jain A, Taylor J, Sanzo P, Zerpa C. The effect of tai chi on functional lower extremity mobility and strength, ankle proprioception, and postural adaptation in older adults. Am J Med Med Sci. 2017;7:229–237.
    1. Zaleski AL, Taylor BA, Panza GA, Wu Y, Pescatello LS, Thompson PD, et al. Coming of age: considerations in the prescription of exercise for older adults. Methodist Debakey Cardiovasc J. 2016;12:98–104. doi: 10.14797/mdcj-12-2-98.
    1. Li F, Fisher KJ, Harmer P, Shirai M. A simpler eight-form easy tai chi for elderly adults. J Aging Phys Act. 2003;11:206–218. doi: 10.1123/japa.11.2.206.
    1. Wang H, Wei A, Lu Y, Yu B, Chen W, Lu Y, et al. Simplified tai chi program training versus traditional tai chi on the functional movement screening in older adults. Evid Based Complement Alternat Med. 2016;2016:5867810.
    1. Chen KM, Chen WT, Huang MF. Development of the simplified tai chi exercise program (STEP) for frail older adults. Complement Ther Med. 2006;14:200–206. doi: 10.1016/j.ctim.2006.05.002.
    1. Tousignant M, Corriveau H, Roy PM, Desrosiers J, Dubuc N, Hebert R. Efficacy of supervised tai chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial. Disabil Rehabil. 2013;35:1429–1435. doi: 10.3109/09638288.2012.737084.
    1. Sung WH, Liu CC, Wei SH, Chuang LR, Chuang E, Wang KA, et al. Feasibility and outcome of an individualized tai chi program for improving balance and strength in the elderly: apilot study. NeuroRehabilitation. 2018;43:509–518. doi: 10.3233/NRE-162061.
    1. Kim HD. Effects of tai chi exercise on the center of pressure trace during obstacle crossing in older adults who are at a risk of falling. J Phys Ther Sci. 2009;21:49–54. doi: 10.1589/jpts.21.49.
    1. Juras G, Slomka K, Fredyk A, Sobota G, Bacik B. Evaluation of the limits of stability (LOS) balance test. J Hum Kinet. 2008;19:39–52. doi: 10.2478/v10078-008-0003-0.
    1. Zou Y. History of the 24 forms simplified Tai Chi routine/movements of 24 forms simplified Tai Chi routine. . Accessed 24 Aug 2019.
    1. Berg K, Wood-Dauphinee S, Williams JI. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med. 1995;27:27–36.
    1. Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–148. doi: 10.1111/j.1532-5415.1991.tb01616.x.
    1. Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45:M192–M197. doi: 10.1093/geronj/45.6.M192.
    1. Lan C, Lai JS, Chen SY, Wong MK. Tai chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study. Arch Phys Med Rehabil. 2000;81:604–607. doi: 10.1016/S0003-9993(00)90042-X.
    1. Pereira MM, Oliveiria RJ, Silva MAF, Souza LHR, Vianna LG. Effects of tai chi Chuan on knee extensor muscle strength and balance in elderly women. Res Bras Fisioter. 2008;12:121–126. doi: 10.1590/S1413-35552008000200008.
    1. Ye J, Cai S, Zhong W, Cai S, Zheng Q. Effects of tai chi for patients with knee osteoarthritis: a systematic review. J Phys Ther Sci. 2014;26:1133–1137. doi: 10.1589/jpts.26.1133.
    1. Xu D, Hong Y, Li J, Chan K. Effect of tai chi exercise on proprioception of ankle and knee joints in old people. Br J Sports Med. 2004;38:50–54. doi: 10.1136/bjsm.2002.003335.
    1. Li JX, Xu DQ, Hong Y. Effects of 16-week tai chi intervention on postural stability and proprioception of knee and ankle in older people. Age Ageing. 2008;37:575–578. doi: 10.1093/ageing/afn109.
    1. Liu B, Liu ZH, Zhu HE, Mo JC, Cheng DH. Effects of tai chi on lower-limb myodynamia in the elderly people: a meta-analysis. J Tradit Chin Med. 2011;31:141–146. doi: 10.1016/S0254-6272(11)60029-0.
    1. Hong Y, Li JX. Biomechanics of tai chi: a review. Sports Biomech. 2007;6:453–464. doi: 10.1080/14763140701491674.
    1. Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, et al. Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med. 2012;366:511–519. doi: 10.1056/NEJMoa1107911.
    1. Taylor-Piliae RE, Hoke TM, Hepworth JT, Latt LD, Najafi B, Coull BM. Effect of tai chi on physical function, fall rates and quality of life among older stroke survivors. Arch Phys Med Rehabil. 2014;95:816–824. doi: 10.1016/j.apmr.2014.01.001.
    1. Day L, Hill KD, Stathakis VZ, Flicker L, Segal L, Cicuttini F, et al. Impact of tai-chi on falls among preclinically disabled older people: a randomized controlled trial. J Am Med Dir Assoc. 2015;16:420–426. doi: 10.1016/j.jamda.2015.01.089.
    1. Leung ES, Tsang WW. Comparison of the kinetic characteristics of standing and sitting tai chi forms. Disabil Rehabil. 2008;30:1891–1900. doi: 10.1080/09638280802358563.
    1. Lemay JF, Gagnon DH, Nadeau S, Grangeon M, Gauthier C, Duclos C. Center-of-pressure total trajectory length is a complementary measure to maximum excursion to better differentiate multidirectional standing limits of stability between individuals with incomplete spinal cord injury and able-bodied individuals. J Neuroeng Rehabil. 2014;11:8. doi: 10.1186/1743-0003-11-8.
    1. Szturm T, Fallang B. Effects of varying acceleration of platform translation and toes-up rotations on the pattern and magnitude of balance reactions in humans. J Vestib Res. 1998;8:381–397. doi: 10.1016/S0957-4271(97)00087-6.
    1. Nakamura H, Tsuchida T, Mano Y. The assessment of posture control in the elderly using the displacement of the center of pressure after forward platform translation. J Electromyogr Kinesiol. 2001;11:395–403. doi: 10.1016/S1050-6411(01)00016-5.
    1. Woo J, Hong A, Lau E, Lynn H. A randomised controlled trial of tai chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing. 2007;36:262–268. doi: 10.1093/ageing/afm005.
    1. Wayne PM, Walsh JN, Taylor-Piliae RE, Wells RE, Papp KV, Donovan NJ, et al. Effect of tai chi on cognitive performance in older adults: systematic review and meta-analysis. J Am Geriatr Soc. 2014;62:25–39. doi: 10.1111/jgs.12611.
    1. Zheng G, Liu F, Li S, Huang M, Tao J, Chen L. Tai chi and the protection of cognitive ability: a systematic review of prospective studies in healthy adults. Am J Prev Med. 2015;49:89–97. doi: 10.1016/j.amepre.2015.01.002.
    1. Miller SM, Taylor-Piliae RE. Effects of tai chi on cognitive function in community-dwelling older adults: a review. Geriatr Nurs. 2014;35:9–19. doi: 10.1016/j.gerinurse.2013.10.013.

Source: PubMed

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