Tai Chi for the Prevention of Falls Among Older Adults: A Critical Analysis of the Evidence

Nyman, Samuel R.

doi:10.1123/japa.2020-0155

Cited by 11 publications

(6 citation statements)

References 64 publications

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“…However, although the efficacy of TC is clear in studies that a TC protocol compares to a control group [11,12,14] , in cases where its efficacy is compared to another method, its superiority over the other method is unclear [17,18] . The findings of this review are consistent with those of Nyman [19] , who also found in his review the lack of evidence about the efficacy of TC against other similar interventions in reducing falls in older adults.…”

Section: Discussionsupporting

confidence: 90%

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The effect of tai chi on balance, fear, and reduction of falls in older adults: A narrative review

Makri¹,

Iakovidis²,

Lytras³

et al. 2023

Int. J. Orthop. Sci.

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Falls are considered one of the most serious problems faced by older adults due to their injuries and socio-economic implications. The aim of this review is to investigate the effect of Tai Chi training on geriatric patients in terms of balance and falls based on recent research data. Method: The PubMed, Google Scholar, and PEDro databases were searched with the following keywords: Tai-chi AND falls AND elderly OR older adults. The search was filtered for articles that were clinical studies or cross-over studies published in the last 10 years. Results: Eight studies were used in this review with a total sample of 1,110 older adults with or without a risk of falling. The findings of the studies included converge on the fact that Tai Chi has a positive effect on reducing falls and the fear of an impending fall while also improving balance. In six of the eight studies included the Tai Chi program seemed more effective than a control group, while in two studies it seemed equally effective as other means such as conventional physiotherapy and yoga. Discussion -Conclusions: The results show that Tai Chi training is accessible to older adults and seems to have a positive effect on fall risk and balance. However, the percentage of studies that support it is not sufficient nor do the results of this review prove the superiority of the Tai Chi method over other therapies. More thorough research is needed to confirm its efficacy.

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Section: Discussionsupporting

confidence: 90%

“…However, it is not clear whether personalized TC programs can improve adherence to exercise. According to Nyman [19] , 71-81% of community-dwelling older adults are adherent to class-based Tai Chi interventions. More research is therefore needed to provide more evidence on the efficacy between individualized or group programs.…”

Section: Discussionmentioning

confidence: 99%

The effect of tai chi on balance, fear, and reduction of falls in older adults: A narrative review

Makri¹,

Iakovidis²,

Lytras³

et al. 2023

Int. J. Orthop. Sci.

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“…On the other hand, transfer to gait stability from solely standing balance training [ 4 – 6 ] is suggested by improved clinical balance scores, gait parameters, and performance on the timed up and go, and other tests. In addition, studies that trained standing balance found reduced falls [ 7 ]. Consequently, the existence of transfer from standing balance training to gait, as well as the mechanisms underlying such a transfer, if present, are insufficiently clear.…”

Section: Introductionmentioning

confidence: 99%

Improvement in gait stability in older adults after ten sessions of standing balance training

et al. 2022

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Balance training aims to improve balance and transfer acquired skills to real-life tasks. How older adults adapt gait to different conditions, and whether these adaptations are altered by balance training, remains unclear. We hypothesized that reorganization of modular control of muscle activity is a mechanism underlying adaptation of gait to training and environmental constraints. We investigated the transfer of standing balance training, shown to enhance unipedal balance control, to gait and adaptations in neuromuscular control of gait between normal and narrow-base walking in twenty-two older adults (72.6 ± 4.2 years). At baseline, after one, and after ten training sessions, kinematics and EMG of normal and narrow-base treadmill walking were measured. Gait parameters and temporal activation profiles of five muscle synergies were compared between time-points and gait conditions. Effects of balance training and an interaction between training and gait condition on step width were found, but not on synergies. After ten training sessions step width decreased in narrow-base walking, while step width variability decreased in both conditions. Trunk center of mass displacement and velocity, and the local divergence exponent, were lower in narrow-base compared to normal walking. Activation duration in narrow-base compared to normal walking was shorter for synergies associated with dominant leg weight acceptance and non-dominant leg stance, and longer for the synergy associated with non-dominant heel-strike. Time of peak activation associated with dominant leg stance occurred earlier in narrow-base compared to normal walking, while it was delayed in synergies associated with heel-strikes and non-dominant leg stance. The adaptations of synergies to narrow-base walking may be interpreted as related to more cautious weight transfer to the new stance leg and enhanced control over center of mass movement in the stance phase. The improvement of gait stability due to standing balance training is promising for less mobile older adults.

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“…Song et al 's finding indicated that Tai Chi practice improved physical stability during the performance of dual tasks in older adults (Song et al, 2018). In comparison with other exercise interventions, Tai Chi might be a superior strategy for fall reduction through benefitting the cognitive function (Nyman, 2021) and neuromuscular function improvements (Hu et al, 2021). Yuan Yang et al randomly assigned 26 healthy older women to the Tai Chi group and Control group, with Tai Chi group performing Tai Chi exercise for 8 weeks and Control group engaging in daily activities, and after Tai Chi intervention, the Tai Chi group demonstrated elevated HbO 2 concentration in the PFC (Yang et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Tai Chi practice enables prefrontal cortex bilateral activation and gait performance prioritization during dual-task negotiating obstacle in older adults

Chen

Mao

Sun

et al. 2022

Front. Aging Neurosci.

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BackgroundWith aging, the cognitive function of the prefrontal cortex (PFC) declined, postural control weakened, and fall risk increased. As a mind–body exercise, regular Tai Chi practice could improve postural control and effectively prevent falls; however, underlying brain mechanisms remained unclear, which were shed light on by analyzing the effect of Tai Chi on the PFC in older adults by means of functional near-infrared spectroscopy (fNIRS).Methods36 healthy older adults without Tai Chi experience were divided randomly into Tai Chi group and Control group. The experiment was conducted four times per week for 16 weeks; 27 participants remained and completed the experiment. Negotiating obstacle task (NOT) and negotiating obstacle with cognitive task (NOCT) were performed pre- and post-intervention, and Brodmann area 10 (BA10) was detected using fNIRS for hemodynamic response. A three-dimensional motion capture system measured walking speed.ResultsAfter intervention in the Tai Chi group under NOCT, the HbO2 concentration change value (ΔHbO2) in BA10 was significantly greater (right BA10: p = 0.002, left BA10: p = 0.001), walking speed was significantly faster (p = 0.040), and dual-task cost was significantly lower than pre-intervention (p = 0.047). ΔHbO2 in BA10 under NOCT was negatively correlated with dual-task cost (right BA10: r = −0.443, p = 0.021, left BA10: r = −0.448, p = 0.019). There were strong negative correlations between ΔHbO2 and ΔHbR under NOCT either pre-intervention (left PFC r = −0.841, p < 0.001; right PFC r = −0.795, p < 0.001) or post-intervention (left PFC r = −0.842, p < 0.001; right PFC r = −0.744, p < 0.001).ConclusionTai Chi practice might increase the cognitive resources in older adults through the PFC bilateral activation to prioritize gait performance during negotiating obstacles under a dual-task condition.

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Tai Chi for the Prevention of Falls Among Older Adults: A Critical Analysis of the Evidence

Cited by 11 publications

References 64 publications

The effect of tai chi on balance, fear, and reduction of falls in older adults: A narrative review

The effect of tai chi on balance, fear, and reduction of falls in older adults: A narrative review

Improvement in gait stability in older adults after ten sessions of standing balance training

Tai Chi practice enables prefrontal cortex bilateral activation and gait performance prioritization during dual-task negotiating obstacle in older adults

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