Can Tai Chi training impact fractal stride time dynamics, an index of gait health, in older adults? Cross-sectional and randomized trial studies

Brian J Gow, Jeffrey M Hausdorff, Brad Manor, Lewis A Lipsitz, Eric A Macklin, Paolo Bonato, Vera Novak, Chung-Kang Peng, Andrew C Ahn, Peter M Wayne, Brian J Gow, Jeffrey M Hausdorff, Brad Manor, Lewis A Lipsitz, Eric A Macklin, Paolo Bonato, Vera Novak, Chung-Kang Peng, Andrew C Ahn, Peter M Wayne

Abstract

Purpose: To determine if Tai Chi (TC) has an impact on long-range correlations and fractal-like scaling in gait stride time dynamics, previously shown to be associated with aging, neurodegenerative disease, and fall risk.

Methods: Using Detrended Fluctuation Analysis (DFA), this study evaluated the impact of TC mind-body exercise training on stride time dynamics assessed during 10 minute bouts of overground walking. A hybrid study design investigated long-term effects of TC via a cross-sectional comparison of 27 TC experts (24.5 ± 11.8 yrs experience) and 60 age- and gender matched TC-naïve older adults (50-70 yrs). Shorter-term effects of TC were assessed by randomly allocating TC-naïve participants to either 6 months of TC training or to a waitlist control. The alpha (α) long-range scaling coefficient derived from DFA and gait speed were evaluated as outcomes.

Results: Cross-sectional comparisons using confounder adjusted linear models suggest that TC experts exhibited significantly greater long-range scaling of gait stride time dynamics compared with TC-naïve adults. Longitudinal random-slopes with shared baseline models accounting for multiple confounders suggest that the effects of shorter-term TC training on gait dynamics were not statistically significant, but trended in the same direction as longer-term effects although effect sizes were very small. In contrast, gait speed was unaffected in both cross-sectional and longitudinal comparisons.

Conclusion: These preliminary findings suggest that fractal-like measures of gait health may be sufficiently precise to capture the positive effects of exercise in the form of Tai Chi, thus warranting further investigation. These results motivate larger and longer-duration trials, in both healthy and health-challenged populations, to further evaluate the potential of Tai Chi to restore age-related declines in gait dynamics.

Trial registration: The randomized trial component of this study was registered at ClinicalTrials.gov (NCT01340365).

Conflict of interest statement

Competing Interests: Peter M Wayne is the founder and sole owner of the Tree of Life Tai Chi Center. Peter M Wayne’s interests were reviewed and are managed by the Brigham and Women’s Hospital and Partners HealthCare in accordance with their conflict of interest policies. Remaining authors declare that they have no competing interests. We confirm that this does not alter our adherence to the PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Participant flow through the randomized…
Fig 1. Participant flow through the randomized trial sub-study.
Fig 2. Example plots of a high…
Fig 2. Example plots of a high (expert with α = 0.95) and low (naïve with α = 0.78) DFA alpha (α) result.
The slope of the linear best-fit line on the log F(n) versus log n plot represents alpha.

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