Effects of home-based Tai Chi training on balance in older adults with mild cognitive impairment
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Abstract
Objectives: The objective of this study was to examine effects of home-based Tai Chi training on balance in older adults with mild cognitive impairment (MCI).
Methods: Thirty-four older adults with MCI were randomly assigned to the Tai Chi group (n=17; mean age 68.8±5.56 years) and control group (n=17; mean age 65.29±5.49 years). Both groups were age and gender matched. Participants in Tai Chi group practiced Tai Chi at home for 50 minutes per session, 3 times a week for 12 consecutive weeks. Postural sway was evaluated under 4 conditions (stand with eyes open on floor, eyes closed on floor, eyes open on foam, eyes closed on foam). Trunk coordination stability was evaluated using Lord sway meter. All evaluations were performed before and after 12-week period. Student’s t-tests were conducted to compare differences of each outcome measure between and within groups. Significance level was set at p≤0.05.
Results: After 12-week Tai Chi training, the Tai Chi group demonstrated significant improvement from baseline in all outcome variables (p<0.05). In contrast, the control group showed no significant differences in all outcome variables when compared between baseline and at 12-week period (p>0.05). Due to baseline differences between groups, outcome measures were normalized to their baseline values for between-group comparisons at 12-week period. Results showed that postural sway tested while standing on floor under both eyes open and eyes closed conditions as well as trunk coordination stability significantly improved for the Tai Chi group as compared to controls (p<0.05). There were no significant differences in postural sway between two groups for foam conditions both under eyes open and eyes closed (p>0.05). Specifically, there was a trend for participants in Tai Chi group to decrease postural sway from baseline more than those in control group when tested with eyes open on foam (p=0.061) while there was no significant difference in postural sway with eyes closed on foam conditions between groups (p=0.242).
Conclusion: Home-based Tai Chi training for 50 minutes per session, 3 times per week for 12 consecutive weeks could improve balance in older adults with MCI.
Bull Chiang Mai Assoc Med Sci 2016; 49(1): 123-133. Doi: 10.14456/jams.2016.6
Article Details
Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
References
2. Montero-Odasso M, Muir SW, Speechley M. Dual-task complexity affects gait in people with mild cognitive impairment: the interplay between gait variability, dual tasking, and risk of falls. Arch Phys Med Rehabil 2012; 93: 293-9.
3. Buracchio TJ, Mattek NC, Dodge HH, Hayes TL, Pavel M, Howieson DB, et al. Executive function predicts risk of falls in older adults without balance impairment. BMC Geriatr 2011, 11: 74.
4. Allan LM, Ballard CG, Rowan EN, Kenny RA. Incidence and prediction of falls in dementia: A prospective study in older people. PLoS ONE 2009; 4: 1-8.
5. Grundman M, Petersen RC, Ferris SH, Thomas RG, Aisen PS, Bennett DA, et al. Mild cognitive impairment can be distinguished from Alzheimer disease and normal aging for clinical trials. Arch Neurol 2004; 61: 59-66.
6. Leandri M, Cammisuli S, Cammarata S, Baratto L, Campbell J, Simonini M, et al. Balance features in Alzheimer’s disease and amnestic mild cognitive impairment. J Alzheimers Dis 2009; 16: 113-20.
7. Liu-Ambrose TY, Ashe MC, Graf P, Beattie BL, Khan KM. Increased risk of falling in older community-dwelling women with mild cognitive impairment. Phys Ther 2008; 88: 1482-591.
8. Shin BM, Han SJ, Jung JH, Kim JE, Fregni F. Effect of mild cognitive impairment on balance. J Neurol Sci 2011; 305: 121-5.
9. Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, et al. Current concepts in mild cognitive impairment. Arch Neurol 2001; 58: 1985-92.
10. Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, et al. Prevalence of cognitive impairment without dementia in the United States. Ann Intern Med 2008; 148: 427-34.
11. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairment–beyond controversies, towards a consensus: Report of the international working group on mild cognitive impairment. J Intern Med 2004; 256: 240-6.
12. Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, et al. Tai Chi and fall reductions in older adults: A randomized controlled trial. J Gerontol A Biol Sci Med Sci 2005; 60: 187-94.
13. Audette JF, Jin YS, Newcomer R, Stein L, Duncan G, Frontera WR. Tai Chi versus brisk walking in elderly women. Age Ageing 2006; 35: 388-93.
14. Wu G, Keyes LM. Group tele-exercise for improving balance in elders. Telemed J E Health 2006; 12: 561-70.
15. Voukelatos A, Cumming RG, Lord SR, Rissel C. A randomized, controlled trail of Tai Chi for the prevention of falls: the central Sydney Tai Chi trial. JAGS 2007; 55: 1185-91.
16. Pereira MM, Oliveira RJ, Silva MAF, Souza LHR, Vianna LG. Effects of Tai Chi Chuan on knee extensor muscle strength and balance in elderly women. Ther Rev Bras Fisioter 2008; 12(2): 121-6.
17. Wolf SL, Coogler C, Xu T. Exploring the basis for Tai Chi Chuan as a therapeutic exercise approach. Arch Phys Med Rehabil 1997; 78: 886-92.
18. Thai Cognitive Test Development Committee 1999. Mini-Mental State Examination-Thai 2002. Bangkok: Institute of Geriatric Medicine, Department of Medical Services, Ministry of Public Health, Thailand; 2002.
19. Nasreddine ZS, Phillip NA, Bedirian V, Charbonneau S, Whitehead V. The Montreal Cognitive Assessment MoCA: a brief screening tool for mild cognitive impairment. JAGS 2005; 53: 695-9.
20. Wongpakaran N, Wongpakaran T. Prevalence of major depressive disorders and suicide in long-term care facilities: A report from northern Thailand. Psychogeriatrics 2012; 12: 11-7.
21. Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther 2003; 83: 237-52.
22. Sturnieks DL, Arnold R, Lord SR. Validity and reliability of the Swaymeter device for measuring postural sway. BMC Geriatr 2011; 11:63.
23. Lord SR, Ward JA, Williams P. Exercise effect on dynamic stability in older women: A randomized controlled trial. Arch Phys Med Rehabil 1996; 77: 232-6.
24. Tsang WW, Hui-Chan CW. Effect of 4- and 8-wk Intensive Tai Chi Training on Balance Control in the Elderly. Med Sci Sports Exerc 2004; 36(4): 648-57.
25. Yang Y, Verkuilen JV, Rosengren KS, Grubisich SA, Reed MR, Hsiao-Wecksler ET. Effect of combined Taiji and Qigong training on balance mechanisms: a randomized controlled trial of older adults. Med Sci Monit. 2007; 13(8): 339–348.
26. Lelard T, Doutrellot PL, 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. Arch Phys Med Rehabil 2010; 91(1): 9-14.
27. Ross MC, Bohannon AS, Davis DC, Gurchiek L. The effects of a short-term exercise program on movement, pain, and mood in the elderly. Results of a pilot study. J Holist Nurs 1999; 17: 139-47.
28. Liu H, Frank A. Tai chi as a balance improvement exercise for older adults: a systematic review. J Geriatr Phys Ther 2010; 33(3): 103-9.
29. Tsang WW, Hui-Chan CW. Effects of tai chi on joint proprioception and stability limits in elderly subjects. Med Sci Sports Exerc 2003; 35: 1962-71.
30. Chan SP, Luk TC, Hong Y. Kinematic and electromyographic analysis of the push movement in Tai Chi. Br J Sports Med 2003; 37: 339-44.
31. Wu G. Muscle action pattern and knee extensor strength of older Tai Chi exercisers. Med Sport Sci 2008; 52: 30-9.
32. Xu DQ, Li JX, Hong Y. Effects of long term Tai Chi practice and jogging exercise on muscle strength and endurance in older people. Br J Sports Med 2006; 40: 50-4.
33. Lam LW. Chau RM, Wong BL. Interim follow-up of a randomized controlled trial comparing Chinese style mind body (Tai Chi) and stretching exercises on cognitive function in subjects at risk of progressive cognitive decline. Int J Geriatr Psychiatry 2010; 26: 733-40.
34. Kasai JYT, Busse AL, Magaldi RM, Soci MA, Moraes RP, Curiati JA, et al. Effects of Tai Chi Chuan on cognition of elderly women with mild cognitive impairment. Einstein 2010; 44: 40-5.
35. Cheng ST, Chow PK, Song YQ, et al. Mental and physical activities delay cognitive decline in older persons with dementia. Am J Geriatr Psychiatry 2012; 22(1): 63-74.
36. Zhang JG, Ishikawa TK, Yamazaki H, Morita T, Ohta T. The effects of Tai Chi Chuan on physiological function and fear of falling in the less robust elderly: An intervention study for preventing falls. Arch Gerontol Geriatr 2006; 42: 107-16.