AGE

, 31:163 | Cite as

Is Tai Chi Chuan effective in improving lower limb response time to prevent backward falls in the elderly?

  • Alice M. K. Wong
  • Yu-Cheng Pei
  • Ching Lan
  • Shu-Chun Huang
  • Yin-Chou Lin
  • Shih-Wei Chou
Article

Abstract

To evaluate the training effect of Tai Chi Chuan (TCC) in postural control and backward fall prevention in the elderly, balance assessment and visually guided lower limb response time were analyzed in a case-control study conducted in a community setting. Thirty-one elderly subjects (mean age: 68.2 ± 6.8 years) participated in the TCC group, 30 community-dwelling elderly subjects with matched age and body composition served as the elderly control group, with 13 young adults (mean age: 27.5 ± 3.8 years) serving as young controls. The TCC group had practiced TCC regularly five times per week, for over 30 min per day for at least 4 years. Lower limb response time were measured using a computerized dance machine that we developed, which contains two blocks during testing: single and dual feet. The motor planning of the latter is more complex than the former. Postural control was assessed by computerized posturography (Smart Balance Master). Compared to the elderly controls, the TCC group demonstrated significantly better balance performance in sway-referenced support, which is more challenging. Moreover, the TCC group had better dual feet response than the elderly controls in the forward–backward, forward–right and forward–left directions. Practicing TCC may improve motor responses and postural control in the elderly, particularly in more challenging situations. Subjects showed better postural responses to unexpected perturbation in the forward–backward and forward–sideways direction than sideways or backward–sideways directions, which may have clinical relevance.

Keywords

Elderly Tai Chi Chuan Lower limb response time Backward fall Tai Chi 

Notes

Acknowledgments

The authors would like to thank the National Science Council of Taiwan, R.O.C. for financially supporting this research under NSC92-2314-B-182A-029. We are grateful to have the enthusiastic participation of the participants. Katie P. Wu is appreciated for her editorial assistance.

References

  1. Chiu KW, Mao DW (2006) The characteristics of foot movements in Tai Chi Chuan. Res Sports Med 14:19–28. doi: 10.1080/15438620500528216 CrossRefGoogle Scholar
  2. Girardi M, Konard HR, Amin M et al (2001) Predicting fall risks in an elderly population: computer dynamic posturography versus electronystagmography test results. Laryngoscope 111:1528–1532. doi: 10.1097/00005537-200109000-00008 PubMedCrossRefGoogle Scholar
  3. Hong YL, Li JX, Robinson PD (2000) Balance control, flexibility, and cardiopulmonary fitness among older Tai Chi practitioners. Br J Sports Med 34:29–34. doi: 10.1136/bjsm.34.1.29 PubMedCrossRefGoogle Scholar
  4. Horak FB, Shupert CL, Mirka A (1989) Components of postural dyscontrol in the elderly: a review. Neurobiol Aging 10:727–738. doi: 10.1016/0197-4580(89)90010-9 PubMedCrossRefGoogle Scholar
  5. Jacobson BH, Chen HC, Cashel C et al (1997) The effect of T’ai Chi Chuan training on balance, kinesthetic sense, and strength. Percept Mot Skills 84:27–33PubMedCrossRefGoogle Scholar
  6. Klein PJ, Adams WD (2004) Comprehensive therapeutic benefits of Taiji: a critical review. Am J Phys Med Rehabil 83:735–745. doi: 10.1097/01.PHM.0000137317.98890.74 PubMedCrossRefGoogle Scholar
  7. Lan C, Lai JS, Chen SY (2002) Tai Chi Chuan. An ancient wisdom on exercise and health promotion. Sports Med 32:217–224. doi: 10.2165/00007256-200232040-00001 Google Scholar
  8. Nnodim JO, Strasburg D, Nabozny M et al (2006) Dynamic balance and stepping versus tai chi training to improve balance and stepping in at-risk older adults. J Am Geriatr Soc 54:1825–1831. doi: 10.1111/j.1532-5415.2006.00971.x PubMedCrossRefGoogle Scholar
  9. Patla A, Frank J, Winter D (1990) Assessment of balance control in the elderly: major issues. Physiother Can 42:89–97CrossRefGoogle Scholar
  10. Pei YC, Chou SW, Lin PS et al (2008) Eye-hand coordination of elderly people who practice Tai Chi Chuan. J Formos Med Assoc 107:103–110. doi: 10.1016/S0929-6646(08)60123-0 PubMedCrossRefGoogle Scholar
  11. Rikli RE, Jones CE (1997) Assessing physical performance in independent older adults: issues and guidelines. J Aging Phys Act 5:244–261Google Scholar
  12. Sandler R, Robinovitch S (2001) An analysis of the effect of lower extremity strength on impact severity during a backward fall. J Biomech Eng 123:590–598. doi: 10.1115/1.1408940 PubMedCrossRefGoogle Scholar
  13. Schaller KJ (1996) Tai Chi Chih: an exercise option for older adults. J Gerontol Nurs 22:12–17PubMedGoogle Scholar
  14. Topp R, Mikesky A, Thompson K (1998) Determinants of four functional tasks among older adults: an exploratory regression analysis. J Orthop Sports Phys Ther 27:144–153PubMedGoogle Scholar
  15. Tsang WW, Hui-Chan CW (2003) Effects of Tai Chi on joint proprioception and stability limits in elderly subjects. Med Sci Sports Exerc 35:1962–1971. doi: 10.1249/01.MSS.0000099110.17311.A2 PubMedCrossRefGoogle Scholar
  16. Tsang WW, Hui-Chan CW (2006) Standing balance after vestibular stimulation in Tai Chi practicing and nonpracticing healthy older adults. Arch Phys Med Rehabil 87:546–553. doi: 10.1016/j.apmr.2005.12.040 PubMedCrossRefGoogle Scholar
  17. Tsang WW, Wong VS, Fu SN et al (2004) Tai Chi improues standing control under reduced or conflicting sensory conditions. Arch Phys Med Rehabil 85:129–137. doi: 10.1016/j.apmr.2003.02.002 PubMedCrossRefGoogle Scholar
  18. Tse SK, Bailey DM (1992) Tai Chi and postural control in the well elderly. Am J Occup Ther 46:295–300PubMedGoogle Scholar
  19. Wolf SL, Barnhart HX, Kutner NG et al (1996) Reducing frailty and falls in old persons: an investigation of Tai Chi and computerized balance training. J Am Geriatr Soc 44:599–600Google Scholar
  20. Wolf SL, Coogler CE, Xu T (1997a) Exploring the basis for Tai Chi Chuan as a therapeutic exercise approach. Arch Phys Med Rehabil 78:886–892. doi: 10.1016/S0003-9993(97)90206-9 PubMedCrossRefGoogle Scholar
  21. Wolf SL, Barnhart HX, Ellison GL et al (1997b) The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Atlanta FICSIT Group. Frailty and injuries: cooperative studies on intervention techniques. Phys Ther 77:371–378PubMedGoogle Scholar
  22. Wolfson L, Whipple R, Derby C et al (1996) Balance and strength training in older adults: intervention gains and Tai chi maintenance. J Am Geriatr Soc 44:498–506PubMedGoogle Scholar
  23. Wolter LL, Studenski SA (1996) A clinical synthesis of falls intervention trials. Top Geriatr Rehabil 11:9–19Google Scholar
  24. Wong AM, Lin YC, Chou SW et al (2001) Coordination exercise and postural stability in elderly people: effect of Tai chi Chuan. Arch Phys Med Rehabil 82:608–612. doi: 10.1053/apmr.2001.22615 PubMedCrossRefGoogle Scholar

Copyright information

© American Aging Association, Media, PA, USA 2009

Authors and Affiliations

  • Alice M. K. Wong
    • 1
    • 2
  • Yu-Cheng Pei
    • 1
  • Ching Lan
    • 3
  • Shu-Chun Huang
    • 1
  • Yin-Chou Lin
    • 1
  • Shih-Wei Chou
    • 1
    • 2
  1. 1.Department of Physical Medicine and RehabilitationChang Gung Memorial HospitalTaipeiTaiwan
  2. 2.Center for Gerontological ResearchChang Gung UniversityTaipeiTaiwan
  3. 3.Department of Physical Medicine and RehabilitationNational Taiwan University HospitalTaipeiTaiwan

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