Aging Clinical and Experimental Research

, Volume 18, Issue 1, pp 7–19 | Cite as

Neural mechanisms underlying balance improvement with short term Tai Chi training

  • Strawberry K. Gatts
  • Marjorie Hines Woollacott
Original Article


Background and aims: Though previous research has shown that Tai Chi reduces falls risk in older adults, no studies have examined underlying neural mechanisms responsible for balance improvement. We aimed to determine the efficacy of Tai Chi training in improving neuromuscular response characteristics underlying balance control in balance-impaired older adults. Methods: Twenty-two balance-impaired older adults were randomly divided into Tai Chi (TC) or control groups. Nineteen subjects (age 68–92, BERG 44 or less) completed the study. TC training included repetitive exercises using TC motor and biomechanical strategies, techniques, and postural elements. Control training included axial mobility exercises, balance/awareness education and stress reduction. Groups trained 1.5 hours/day, 5 days/week for 3 weeks. After post-testing the control group received TC training. Subjects walked across a force plate triggered to move forward 15 cm at 40 cm/sec at heel strike. Tibialis anterior (TA) and medial gastrocnemius (GA) responses during balance recovery were measured with electromyograms (EMGs). Four clinical measures of balance were also recorded. Results: TC subjects, but not controls, significantly reduced both TA response time from 148.92±45.11 ms to 98.67±17.22 ms (p≤0.004) and occurrence of co-contraction of antagonist muscles (p≤0.003) of the perturbed leg. Clinical balance measures also significantly improved after TC. Conclusions: TC enhanced neuromuscular responses controlling the ankle pint of the perturbed leg. Fast, accurate neuromuscular activation is crucial for efficacious response to slips or trips.


Aging dynamic balance EMG posture Tai Chi 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Wolf S, Barnhart H, Kutner N, et al. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. J Am Geriatr Soc 1996; 44: 489–97.PubMedGoogle Scholar
  2. 2.
    Wolfson L, Whipple R, Derby C, et al. Balance and strength training in older adults: Intervention gains and Tai Chi maintenance. J Am Geriatr Soc 1996, 44: 498–506.PubMedGoogle Scholar
  3. 3.
    Yan J. Tai Chi practice improves senior citizens’ balance and arm movement control. J Aging Phys Act 1998; 6: 271–84.Google Scholar
  4. 4.
    Black S, Maki B, Fernie G. Aging, imbalance, and falls. In Sharpe J, Barber H, eds. The vestibular-ocular Reflex and Vertigo. New York, NY: Raven Press 1994: 1–24.Google Scholar
  5. 5.
    Tang P, Woollacott M. Inefficient postural responses to unexpected slips during walking in older adults. J Gerontol 1998; 53A: M471–80.CrossRefGoogle Scholar
  6. 6.
    Lan C, Lai J, Chen S, Wong M. 12-month Tai Chi training in the elderly: its effect on health fitness. Med Sci Sports Exerc 1998; 30: 345–51.PubMedCrossRefGoogle Scholar
  7. 7.
    Wang C, Collet J, Lau J. The effect of Tai Chi on health outcomes in patients with chronic conditions. Arch Intern Med 2004; 164: 493–501.PubMedCrossRefGoogle Scholar
  8. 8.
    Duncan P, Studenski S, Chandler J, Prescott B. Functional reach: a new clinical measure of balance. J Gerontol 1990; 45: M192–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Podsiadlo D, Richardson S. The timed “Up and Go” test: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142–8.PubMedGoogle Scholar
  10. 10.
    Woollacott M, Shumway-Cook A. Clinical and research methodology for the study of posture and balance. In Masdeu J et al, eds. Gait disorders of aging. Philadelphia: Lippincott-Raven, 1997: 107–21.Google Scholar
  11. 11.
    Mahoney R. Barthel D. Functional evaluation: The Barthel Index. Maryland Med J 1965; 14: 61–5.PubMedGoogle Scholar
  12. 12.
    Shumway-Cook A, Woollacott M. Clinical management of the patient with a postural control disorder. Motor Control. Baltimore: Lippincott Williams & Wilkins, 2001: 273.Google Scholar
  13. 13.
    Schenkman M, Morey M, Kuchibhatla M. Spinal flexibility and balance control among community-dwelling adults with and without Parkinson disease. J Gerontol 2000; 55: 441–5.CrossRefGoogle Scholar
  14. 14.
    Whipple R. Improving balance in older adults: Identifying the significant training stimuli. In Masdeu J et al. eds. Gait disorders of aging. Philadelphia: Lippincott-Raven, 1997: 355–79.Google Scholar
  15. 15.
    Wolfson L. Balance decrements in older persons: Effects of age and disease. In Masdeu J et al. eds. Gait disorders of aging. Philadelphia: Lippincott-Raven, 1997: 79–91.Google Scholar
  16. 16.
    Bogle Thorbahn L, Newton R. Use of the Berg balance test to predict falls in elderly persons. Phys Ther 1996; 76: 576–85.PubMedGoogle Scholar
  17. 17.
    Fu Z. Mastering Yang style taijiquan. (translation by Swain L). Berkeley: North Atlantic Books, 1999:12–3.Google Scholar
  18. 18.
    Ho’o M. Health benefits of the form. Tai Chi Chuan: The 27 Forms. Burbank: Ohara Publications Inc., 1986: 109–11.Google Scholar
  19. 19.
    Northwest physical therapy services. Safety and gait enhancement. Seattle, WA 98133.Google Scholar
  20. 20.
    Tideikasaar R. Environmental factors in the prevention of falls. In Masdeu J et al, eds. Gait disorders of aging. Philadelphia: Lippincott-Raven, 1997: 395–412.Google Scholar
  21. 21.
    Nashner L. Physiology of balance, with special reference to the healthy elderly. In Masdeu J et al, eds. Gait disorders of aging. Philadelphia: Lippincott-Raven, 1997: 37–53.Google Scholar
  22. 22.
    Elbe R. Changes in gait with normal aging. In: Masdeu J et al, eds. Gait disorders of aging. Philadelphia: Lippincott-Raven. 1997: 93–105.Google Scholar
  23. 23.
    Schenkman M. The Axial mobility program. In Masdeu J et al, eds. Gait disorders of aging. Philadelphia: Lippincott-Raven. 1997: 415–27.Google Scholar
  24. 24.
    Friedrich J. Tension control techniques to combat stress. In Harris R, Frankel J, eds. Guide to fitness after fifty. New York: Plenum Press, 1977: 323–36.CrossRefGoogle Scholar
  25. 25.
    Berger W, Dietz V, Quintern J. Corrective reactions to stumbling in man: neuronal co-ordination of bilateral leg muscle activity during gait. J Physiol 1984; 357: 109–25.PubMedGoogle Scholar
  26. 26.
    Strandberg L, Lanshammar H. On the biomechanics of slipping accidents. In Matsui H, Kobayashi K, eds. Biomechanics VI-II-A. (International series on biomechanics. Vol 4A). Champaign: Human Kinetics Publishers, 1981: 397–402.Google Scholar
  27. 27.
    Bonate P. Analysis of pretest-posttest designs. Chapman & Hall, Florida. 2000.CrossRefGoogle Scholar
  28. 28.
    Berg K, Wood-Dauphinee S, Williams J. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992; 83: S9–11.Google Scholar
  29. 29.
    Lin S, Woollacott M. Postural muscle responses following changing balance threats in young, stable older and unstable older adults. J Motor Behav 2002; 34: 37–44.CrossRefGoogle Scholar
  30. 30.
    Horak F, Nashner L. Central programming of postural movements: adaptation to altered support surface configurations. J Neurophysiol 1986; 55: 1369–81.PubMedGoogle Scholar
  31. 31.
    Wolf S, Sattin R, Kutner M, et al. Intense Tai Chi exercise training and fall occurrences in older, transitionally frail adults: A randomized, controlled trial. J Am Geriatr Soc 2003, 51: 1693–701.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2006

Authors and Affiliations

  • Strawberry K. Gatts
    • 1
  • Marjorie Hines Woollacott
    • 1
  1. 1.Department of Human Physiology and Institute of NeuroscienceUniversity of OregonEugeneUSA

Personalised recommendations