Does Tai Chi improve balance and reduce falls incidence in neurological disorders? A systematic review and meta-analysis

Winser, Stanley John; Tsang, Wwn; Krishnamurthy, K.; Kannan, Priya

doi:10.1177/0269215518773442

Cited by 76 publications

(46 citation statements)

References 31 publications

(80 reference statements)

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“…Tai Chi has the beneficial effect on balance and mobility in PD [42], and it is also effective in reducing falls incidence [ [43][44][45]; however, the effect of Tai Chi on FoG was not studied.…”

Section: Discussionmentioning

confidence: 99%

The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

Wróblewska

Gajos

Smyczyńska

et al. 2019

Parkinson's Disease

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Introduction. The effectiveness of the currently utilized therapies for FoG is limited. Several studies demonstrated a beneficial impact of Nordic walking (NW) on several gait parameters in Parkinson’s disease, but only one paper reported reduction of freezing. Research Question. In the present study, the question is whether NW is an effective therapeutic intervention in FoG. Methods. Twenty PD subjects trained NW for 12 weeks, with a frequency of twice per week. Each session lasted about 60 minutes. Twenty patients in the control group did not use any form of physiotherapy (no-intervention group). Freezing of Gait Questionnaire (FOGQ), the Timed Up and Go (TUG) test, and the Provocative Test for Freezing and Motor Blocks (PTFMB) were performed at baseline, immediately after the end of NW program, and three months later. Results. The results of FOGQ, TUG, and total PTFMB revealed significant improvement after completing the exercise program, and this effect persisted at follow-up. The results of the PTFMB subtests showed a different effect of NW on particular subtypes of FoG. Start hesitation, sudden transient blocks that interrupt gait, and blocks on turning improved considerably, while motor blocks, when walking through narrow space and on reaching the target, did not respond to NW training. Significance. The results show, for the first time, that FoG during turning and step initiation, two most common forms of this gait disorder, has been significantly reduced by NW training. Different responses of particular subtypes of FoG to NW probably reflect their different pathophysiologies. Conclusions. The present study showed that NW training had a beneficial effect on FOG in PD and that the achieved improvement is long-lasting. Future research should clarify whether the observed improvement limited to FoG triggered by only some circumstances reflects different pathomechanisms of FoG subtypes.

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Section: Discussionmentioning

confidence: 99%

The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

Wróblewska

Gajos

Smyczyńska

et al. 2019

Parkinson's Disease

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“…The PEDro scale is an 11-item scale that has been previously used in systematic reviews. 19 , 20 Any disagreements were resolved via discussion or consultation with the fourth author (KJS).…”

Section: Methodsmentioning

confidence: 99%

A posturographic procedure assessing balance disorders in Parkinson's disease: a systematic review

Kamieniarz¹,

Michalska²,

Brachman³

et al. 2018

CIA

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Postural instability is common in Parkinson’s disease (PD), often contributing to falls, injuries, and reduced mobility. In the clinical setting, balance disorder is commonly diagnosed using clinical tests and balance scales, but it is suggested that the most sensitive measurement is the force platform. The aim of this systematic review was to summarize the methods and various posturographic procedures used to assess the body balance and gait in PD. A systematic review was conducted of papers published from 2000 to 2017. Databases searched were PubMed and EBSCO. Studies must have involved patients with PD, used force platform or motion analysis system as a measurement tool, and described posturographic procedure. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. A total of 32 studies met the inclusion criteria. The PEDro scores ranged from 5 to 7 points. The analysis of the objective methods assessing balance disorders revealed a large discrepancy in the duration and procedures of measurements. The number of repetitions of each trial fluctuated between 1 and 8, and the duration of a single trial ranged from 10 to 60 seconds. Overall, there are many scales and tests used to assess the balance disorders and disabilities of people with PD. Although in many included studies the authors have used posturography as a method to evaluate the postural instability of PD patients, the results are contradictory. To solve this issue, it is indicated to establish a “gold standard” of procedures of measures of balance.

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“…Oriental martial arts, such as tai chi, have been successfully used in treatment of individuals with Parkinson's disease. Tai chi combines deep breathing and slow movements and studies have provided moderate evidence that tai chi improves balance and functional mobility, reducing the number of falls, but with no significant effect in gait velocity, step length, and gait endurance improvement [33,60,61]. A systematic review and meta-analysis showed that tai chi, plus medication, showed greater gains than medication alone or another therapy plus medication in motor function and balance.…”

Section: Aerobic Training: Treadmill Cycling Free Walking Dance Amentioning

confidence: 99%

Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives

Vasconcelos¹

2020

Physical Therapy Effectiveness

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Parkinson's disease has been considered one of the most important and common neurodegenerative diseases in the world. Its motor and nonmotor signs determine a huge functional loss, leading the individuals to lose their independence. Although the treatment requires a pharmacological approach, physical therapy has confirmed its importance in this process. Today, neurorehabilitation is indispensable to increase many of the cardinal signs of the disease. Using traditional or technological approaches, physical therapy has reached good results in improving motor and nonmotor functions, as well as the quality of life of Parkinsonians. However, it is important to develop and to fortify the physical therapy approach so that we can provide stronger evidence about our practice.

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Does Tai Chi improve balance and reduce falls incidence in neurological disorders? A systematic review and meta-analysis

Abstract: Tai Chi is effective in reducing falls incidence in Parkinson's disease and stroke. This systematic review did not find high-quality studies among other neurological disorders.

Cited by 76 publications

References 31 publications

The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

A posturographic procedure assessing balance disorders in Parkinson's disease: a systematic review

Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives

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Does Tai Chi improve balance and reduce falls incidence in neurological disorders? A systematic review and meta-analysis

Abstract: Tai Chi is effective in reducing falls incidence in Parkinson's disease and stroke. This systematic review did not find high-quality studies among other neurological disorders.

Cited by 76 publications

References 31 publications

The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

A posturographic procedure assessing balance disorders in Parkinson&#39;s disease: a systematic review

Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives

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A posturographic procedure assessing balance disorders in Parkinson's disease: a systematic review