Effects of a 12-Week Tai Chi Chuan Program Versus a Balance Training Program on Postural Control and Walking Ability in Older People
Adaptations Physiologiques à l'Exercice et Réadaptation à l'Effort, Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens Cedex, France. Archives of physical medicine and rehabilitation
(Impact Factor: 2.57).
01/2010; 91(1):9-14. DOI: 10.1016/j.apmr.2009.09.014
Lelard T, Doutrellot P-L, David P, Ahmaidi S. Effects of a 12-week Tai Chi Chuan program versus a balance training program on postural control and walking ability in older people.
To compare the respective effects of 2 balance training programs: a Tai Chi (TC) program and a balance training program on static postural control and walking ability.
Randomized controlled trial.
Older subjects (N=28) participated in the study.
The TC group (n=14; mean age +/- SD, 76.8+/-5.1y) and the balance training group (n=14; 77.0+/-4.5y) were both trained for 12 weeks.
Static postural control was assessed via measurement of center of pressure sway under eyes open (EO) and eyes closed (EC) conditions. Walking speed over a 10-meter course was also assessed.
After the 12-week training period, there were no significant differences in walking speed or postural parameters in either the EO or EC conditions for the TC and balance training groups. Performance in the EC condition was lower than in the EO condition in pretest and posttest for the balance training and TC groups. The Romberg quotient (EO/EC ratio) was significantly higher after the balance training program than the TC program (P<.05).
We cannot conclude that the balance training program has better effects than the TC program on postural control or walking ability. None of the outcome measures showed significant change posttraining in either the TC or the balance training groups. However, the differences described in the Romberg quotient after the training period between the TC and the balance training groups suggest that TC should be helpful to limit the deleterious effects of eye closure on postural balance.
Available from: Pedro Jesús Jiménez-Martín
- "; Voukelatos et al. ; Wu et al. ; Yan  Posturographic platforms Gyllensten et al. ; Lelard et al. ; Li et al. ; Xu, Hong and Chan  Video cameras Gatts and Woollacott ; Ramachandran et al.  Parameters Clinical test Authors Static balance Single-leg stance test (OLS) Audette et al. ; Barnett et al. ; Hackney and Earhart ; Hartman et al. ; Li et al. ; Qin et al. ; Taylor-Piliae and Coull ; Taylor-Piliae et al. ; Wolfson et al. ; Woo et al. ; Wu et al. ; Zhang et al.  Dynamic balance 6, 8, 10 or 50 m walking speed test Hackney and Earhart ; Hartman et al. ; Lelard et al. ; Li et al. ; Li et al. ; Mark and Ling ; McGibbon et al. ; Taylor-Piliae and Coull ; Woo et al. ; Zhang et al.  Berg Balance Scale (BBS) Gatts and Woollacott ; Hackney and Earhart  Functional Reach Test (FRT) Gatts and Woollacott ; Li et al. ; Mark and Ling ; Taylor-Piliae et al. ; Thorton et al.  Single-leg jumping test Gyllensten et al. ; Hall et al.  Proprioceptive, "
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Previous systematic reviews of the literature on the effects of Tai Chi Chuan (TCC) on balance have focussed either on determining the quality of the research design or have provided just a general description of the studies. To the best of our knowledge none have approached this topic by conducting an analysis from the point of view of the factors which affect balance. It is important to present this perspective as it will help to guide future research in this field.
Seven electronic data bases were searched for publications dated between 1996 and 2012. The inclusion criteria were; randomized controlled trials (RCT) written in English.
From a total of 397 articles identified, 27 randomized controlled trials were eligible for the analysis.
Studies reviewed appear to confirm that TCC improves static and dynamic balance and in the functional factors which affect balance in persons of over 55 years of age. Only one study was identified on people affected with problems with the vestibular system. No studies on the influence of TCC on improvement in balance in individuals suffering from deteriorated brain function were identified.
Available from: Xue-Qiang Wang
- "However, a TC program may not necessarily be superior to other interventions. Lelard et al.  assessed the effects of a TC program versus a balance training program on postural control and walking ability in elderly people. The authors measured static postural control and walking speed. "
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ABSTRACT: . Tai Chi is a traditional Chinese medicine exercise used for improving neuromuscular function. This study aimed to investigate the effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people.
. Sixty elderly subjects were randomly allocated into three groups of 20 subjects per group. For 16 consecutive weeks, subjects participated in Tai Chi, proprioception exercise, or no structured exercise. Primary outcome measures included joint position sense and muscle strength of ankle. Subjects completed a satisfaction questionnaire upon study completion in Tai Chi and proprioception groups.
. (1) Both Tai Chi group and proprioception exercise group were significantly better than control group in joint position sense of ankle, and there were no significant differences in joint position sense of ankle between TC group and PE group. (2) There were no significant differences in muscle strength of ankle among groups. (3) Subjects expressed more satisfaction with Tai Chi than with proprioception exercise program.
. None of the outcome measures on neuromuscular function at the ankle showed significant change posttraining in the two structured exercise groups. However, the subjects expressed more interest in and satisfaction with Tai Chi than proprioception exercise.
Available from: Raul Oliveira
- "As lesões cápsulo-ligamentares da articulação tíbiotársica , normalmente resultantes de entorses do tornozelo, são as lesões desportivas mais frequentes e estima-se que aproximadamente 20 % a 30% dos atletas que sofram este tipo de lesão, irão apresentar sintomas residuais (Karlsson & Chan, 2005). Na população não atleta, estima-se que cerca de 40% a 75% dos indivíduos, poderão desenvolver instabilidade crónica da tíbio-társica (Wikstrom, et al., 2006). "
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ABSTRACT: Resumo Introdução/Relevância: A instabilidade crónica da tíbio-társica tem sido objecto de inúmeros estudos devido à sua elevada taxa de incidência, uma vez que se apresenta como a alteração residual mais comum após lesão cápsulo-ligamentar. Assim, torna-se relevante a análise de factores que influenciam esta condição clínica, como é o caso dos exercícios, e também a manifestação desses factores no controle postural medido através da oscilação postural. Objectivo: Analisar a influência de um programa de exercícios e da instabilidade crónica da tíbio-társica na oscilação postural Metodologia: estudo do tipo quasi-experimental, com séries temporais interrompidas, em que a amostra de doze sujeitos (sete saudáveis e cinco com instabilidade crónica da tíbio-társica) é simultaneamente o grupo de controlo e experimental. Em cada grupo, foi medida a oscilação postural antes e após a realização de um protocolo de exercícios. Resultados /Discussão: Observou-se um aumento da oscilação postural após a realização do protocolo de exercícios apenas nos sujeitos saudáveis, uma vez que nos sujeitos com instabilidade, a oscilação postural diminuiu ligeiramente em apoio unipodal sobre membro com instabilidade. Nas observações para as condições de olhos fechados, os indivíduos com instabilidade crónica da tíbio-társica apresentaram uma significativa maior oscilação postural (variabiliadade) quando comparado com olhos abertos Conclusões: A instabilidade crónica da tíbio-társica parece afectar a oscilação postural, enquanto que o efeito do exercício apenas aumentou a oscilação postural no grupo de sujeitos saudáveis. Recomenda-se para estudos futuros, uma avaliação mais dinâmica desta condição clínica (p.ex recepção após um salto) em estudos randomizados e avaliando igualmente as variáveis cinemáticas e da actividade neuromuscular. Abstract Introduction/Relevance: Chronic ankle instability, has been subject of innumerable studies due to its high incidence and also because it is the most common residual problem after ankle injury. Thus, there is some relevance in the analysis of the influence of factors that affect this clinical condition, like exercise, and also the manifestation of those factors in postural control, measurable by postural sway. Goals: analyze the influence of an exercise program and chronic ankle instability in postural sway. Methodology: quasi-experimental study, with interrupted time series design, where the sample of seven healthy subjects and five subjects with chronic ankle instability, is both the control and experimental group. In each group, we measure postural sway before and after the exercise program. Results/Discussion: An increase of the postural sway was observed after the accomplishment of the exercise protocol only in the healthy subjects because in subjects with chronic ankle instability there was a mild decrease in postural sway. Concerning the moments of evaluation, for the conditions of closed eyes, the individuals with chronic instability of the ankle present greater postural oscillation (variability) when compared with open eyes. Conclusions: Chronic Ankle Instability seems to affect postural sway while exercise only increases postural sway in the group of healthy subjects. We suggest for future investigations, a more dynamic evaluation for this type of clinical condition (e.g. landing after a jump), in a randomized studies and analyze kinematics and neuromuscular variables.
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