Tai Chi improves balance and mobility in people with Parkinson disease

doi:10.1016/j.gaitpost.2008.02.005

Gait & Posture

Volume 28, Issue 3, October 2008, Pages 456-460

https://doi.org/10.1016/j.gaitpost.2008.02.005 Get rights and content

Abstract

This pilot study examines the effects of Tai Chi on balance, gait and mobility in people with Parkinson disease (PD). Thirty-three people with PD were randomly assigned to either a Tai Chi group or a control group. The Tai Chi group participated in 20 1-h long training sessions completed within 10–13 weeks; whereas, the control group had two testing sessions between 10 and 13 weeks apart without interposed training. The Tai Chi group improved more than the control group on the Berg Balance Scale, UPDRS, Timed Up and Go, tandem stance test, six-minute walk, and backward walking. Neither group improved in forward walking or the one leg stance test. All Tai Chi participants reported satisfaction with the program and improvements in well-being. Tai Chi appears to be an appropriate, safe and effective form of exercise for some individuals with mild–moderately severe PD.

Introduction

Parkinson disease (PD), a progressive neurodegenerative movement disorder that affects more than 1 million people in the United States, causes falls and hip fractures costing approximately US$ 192 million annually [1], [2]. Strategies to improve balance may help reduce falls and disability from hip fractures. Tai Chi, a martial art that involves slow controlled movement and the maintenance of various postures, may be an effective means of addressing balance problems. Five days of Tai Chi training improved the 50-ft speed walk, the Timed Up and Go and the Functional Reach test [6] in 17 people with mild PD. Similarly, 12 Tai Chi sessions enhanced physical aspects of well being and balance in 8 people with PD [7]. Qigong, a martial art similar to Tai Chi, enhanced scores on the UPDRS motor subscale 3 and reduced the rate of progression across a 1-year period in PD [5]. While these studies highlight the feasibility and potential benefits of Tai Chi, none employed a control group.

The purpose of this pilot study is to quantify the effects of Tai Chi on functional mobility, gait and balance in people with mild to moderate PD compared to a matched untreated control group with PD. We hypothesized that TC would result in improvements not seen in the control group.

Section snippets

Methods

CONSORT guidelines were followed in the conduct and reporting of this study. This work was approved by the Human Research Protection Office at Washington University in St. Louis (protocol # 06-0280). All participants provided written informed consent prior to participation.

Pre- and post-testing protocol

Assessments of TC participants were conducted the week prior to initiation of training and the week following completion of 20 training sessions. Assessments of control participants were conducted at the same time interval as the TC participants. All assessments were videotaped and data files were coded for blinded ratings. During each assessment, participants were first evaluated using the Unified Parkinson's Disease Rating Scale Motor Subscale 3 (UPDRS) [11], [12]. Balance was evaluated using

Kinematics

Spatiotemporal features of walking were measured using a 5 m instrumented, computerized walkway. Subjects were asked to walk both forward and backward on the walkway at their normal pace, performing three trials in each direction. Results from the three trials of each direction were averaged. The primary variables of interest were gait velocity, stride length, and functional ambulation profile (FAP). The FAP is a single, numerical representation of gait performance [17] that is valid, reliable,

Analyses

For each individual, pre-test values were subtracted from post-test values to obtain individual change scores. Absolute change scores were compared between groups using independent t-tests when appropriate. Mann–Whitney Rank Sum tests were used when data were not normally distributed. A Bonferroni correction was applied to account for the use of multiple tests. Overall significance level was P = 0.05, and each test had a significance cutoff of P ≤ 0.004.

Results

Four participants in TC did not complete the study: one withdrew at week 4 upon being hospitalized for unrelated issues, one withdrew after week 5 citing that the exercise was not sufficiently intense, and two who had transportation issues attended sporadically over the course of the entire study but did not complete the required 20 lessons in 13 weeks. Three controls were unable to complete post-testing during the required time interval due to an ankle injury, a hospitalization, and a death in

Discussion

This pilot study compared changes in functional mobility in people with PD who participated in Tai Chi to a matched control group who received no intervention. The TC group demonstrated improvements in Berg Balance scores and TUG performance similar to those reported previously for elderly individuals with and without PD who practiced Qigong or Tai Chi [5], [6], [19], [20]. The lack of improvement in one leg stance for the TC group contrasts with a study of more than 100 seniors who

Acknowledgements

We would like to thank Jerry Wild for teaching the Tai Chi classes.

We would like to acknowledge Josh Funk, Minna Hong, Ruth Porter, Mike Falvo, Lauren Mehner, Tiffany Chung, Ba Huynh, Jeff Becket, Kyleen Albert, Laura Cohen, Patricia Engel, Callie Chen, Svetlana Kantorovich, Ryan Choi and Marghuretta Bland, for their assistance with this project. We also thank Joel Perlmutter for assistance with revision of this manuscript. A grant from the American Parkinson Disease Association funded this

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Citation Excerpt :
Some of the studies had two comparison groups and more than two outcome measures for the evaluated parameters. For this reason, data for each group were entered separately in the analysis.18,40,41,47,52,54,58 The results of the AMSTAR were summarized in Table 2.
The aim of the study was to evaluate the effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease.
A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses up to the end of October 2021. 601 studies were identified, and 16 of them were included in our study.
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Our systematic review and meta-analysis found significant effects of Tai Chi on functional mobility, balance and falls in patients with PD.
Using Martial Arts Training as Exercise Therapy Can Benefit All Ages
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Tai Chi improves balance and mobility in people with Parkinson disease

Abstract

Introduction

Section snippets

Methods

Pre- and post-testing protocol

Kinematics

Analyses

Results

Discussion

Acknowledgements

Appl Nurs Res

Arch Phys Med Rehabil

Arch Phys Med Rehabil

Arch Phys Med Rehabil

Fracture risk after the diagnosis of Parkinson's disease: influence of concomitant dementia

Mov Disord

Secular trends in hip fracture occurrence and survival rate: age and sex differences

J Aging Health

Qigong exercise for the symptoms of Parkinson's disease: a randomized, controlled pilot study

Mov Disord

Tai Chi-based exercise for older adults with Parkinson Disease

J Aging Phys Act

Taiji for individuals with Parkinson Disease and their support partners: program evaluation

J Neuro Phys Ther

Evaluation of a screening questionnaire for genetic studies of Parkinson's disease

Am J Med Genet

Criteria for diagnosing Parkinson's disease

Ann Neurol

Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases

J Neurol Neurosurg Psychiatry