Tai-Chi Significantly Improves Functional Balance and Lower-Limb Strength in Older Adults

by | Oct 14, 2019 | 2019, Aging, Fitness and Exercise

Written by Angeline A. De Leon, Staff Writer. Personalized Tai-Chi training designed based on an objective measurement and conducted according to graded intensity and complexity significantly benefited participants after an eight-week intervention.

tai chiTai-Chi is an ancient internal form of Chinese martial arts, practiced as part of defense training as well as for meditative effects and various health benefits. Its focus on gentle, fluid, low-impact movements is well-suited for older adults 1 and is accompanied by a host of other general health benefits, including enhanced cardiopulmonary fitness, lower blood pressure, and increased muscle strength and balance 2,3. Studies also suggest that the postural adaptation associated with Tai-Chi may help reduce risk of falling in the elderly 4,5 and that the concentric and eccentric muscle contractions involved in the practice can improve lower-limb strength, including functionality of the knee, hips, and ankle muscles 6-8. Despite the multitude of health benefits Tai-Chi is thought to offer older adults, traditional Tai-Chi sequences can sometimes pose a challenge for older individuals due to the complexity, intensity, and duration of certain sequences 9. In addition, the majority of programs lack a personalized component which takes into account individual capacity for balance and coordination 10. Thus, in a research study 11 published in BMC Geriatrics (2019), researchers in Taiwan designed a simplified and personalized Tai-Chi (individualized Tai-Chi, iTC) program for older adults, evaluating the potential benefits of an iTC regimen on functional balance and lower-extremity muscle strength in older adults.

A total of 50 community-dwelling older adults (aged 65 years and older) were enrolled in a prospective, quasi-experimental, single-blind, controlled trial. Participants who were unwilling to practice Tai-Chi were assigned to a control group (n = 15) receiving an exercise and nutrition education program, and the remaining were assigned either to a traditional Tai-Chi program (n = 15) or iTC (n = 20), both consisting of three 30-minute sessions per week for 8 weeks. iTC involved a computerized evaluation of each participant’s center of pressure displacement and tests of individual endurance and progressively more complex movement sequences based on individual adaptation. At baseline and post-intervention, participants completed functional balance tests (Berg Balance Scale, BBS; timed up-and-go test, TUG; and a functional-reach test), and lower-extremity muscle strength was measured using an isometric dynamometer.

Researchers found a significant improvement for the iTC group, compared to the control group, on all functional balance tests (p < 0.001 for all) and in strength assessments for 16 major lower-limb muscle groups (p < 0.001-0.007). In the traditional Tai-Chi group vs. control, only BBS score was significantly improved (p = 0.005), and strength improvement was seen only in the hips and ankles (bilateral hip flexors, right hip extensor, left hip abductor, right hip adductor, and bilateral ankle dorsiflexor) (p < 0.001-0.033). Relative to participants in the traditional Tai-Chi program, the iTC group demonstrated better performance on the BBS (p < 0.001) and greater strength improvement in two major muscles (right hip flexor, right hip extensor, left hip abductor, left and right hip adductor, right knee flexor, left and right ankle dorsi-flexor) (p < 0.001-0.039).

Results of the study highlight the benefits of a simplified, personalized approach to Tai-Chi exercise for older adults. Over a period of 8 weeks, an iTC program using graded intensity and complexity appeared to improve not only functional balance (across all objective measures), but also muscle strength in the lower body. By tailoring the duration and complexity of movement sequences to each individual, the benefits of a traditional Tai-Chi program for older adults appear to be significantly amplified. It is of note that the clinical gains observed over the course of the 8-week treatment period in the current study are comparable to those seen in Tai-Chi interventions of a longer duration (12 to 48 weeks) 12. Primary limitations of the study include the exploratory nature of its design (quasi-experimental and single-blind) and its relatively limited sample size. For future studies, it would be interesting to examine the benefits of a personalized Tai-Chi regimen for other populations, including rehabilitation patients and those with impaired motor function.

Source: Penn I, Sung W, Lin C, et al. Effects of individualized Tai-Chi on balance and lower-limb strength in older adults. BMC Geriatrics. 2019; 19: 235. DOI: 10.1186/s12877-019-1250-8.

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)  (http://creativecommons.org/publicdomain/zero/1.0/)

Click here to read the full text study.

Posted October 14, 2019.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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