Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial

Objectives: To examine the effects of Tai Chi on balance and functional mobility in people with Parkinson’s disease, and determine whether fall incidence could be reduced by the Tai Chi exercise. Design: Single blinded randomized control trial with 6 months’ follow-up. Setting: A hospital and general community. Participants: Patients (n=76) diagnosed with idiopathic Parkinson’s disease, over 40 years old, able to walk independently and fell at least one time during the past 12 months. Interventions: The Tai Chi group (n=37) received 24-form Yang style Tai Chi exercise for 60 minutes each time, three times a week and lasted for 12 weeks. The control group (n=39) received no intervention. Main outcome measures: Berg Balance Scale (BBS), Unified Parkinson’s Disease Rating Scale (UPDRS) III, Timed Up&Go (TUG) and occurrences of falls. Results: The Tai Chi group improved more than the control group on the BBS (p<0.05), but there was no difference on UPDRS III scores and Timed Up&Go (p>0.05). During the 6-month follow-up, only 8 (21.6%) out of 37 patients in the Tai Chi group had experience of falls comparing to 19 (48.7%) out of 39 patients in the control group (p<0.05). The average times of falls were 0.30±0.62 in the Tai Chi group compared with 0.64±0.74 in the control group (p<0.05). Conclusions: Our findings suggested that Tai Chi exercise could improve the balance and decrease the fall risks in patients with Parkinson’s disease.

[1]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[2]  S. Wood-Dauphinée,et al.  The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. , 1995, Scandinavian journal of rehabilitation medicine.

[3]  M. Morris,et al.  Reliability of measurements obtained with the Timed "Up & Go" test in people with Parkinson disease. , 2001, Physical therapy.

[4]  S. Gabriel,et al.  Mortality, Disability, and Nursing Home Use for Persons with and without Hip Fracture: A Population‐Based Study , 2002, Journal of the American Geriatrics Society.

[5]  The Unified Parkinson's Disease Rating Scale (UPDRS): Status and recommendations , 2003, Movement disorders : official journal of the Movement Disorder Society.

[6]  J. Smit,et al.  Consequences of falling in older men and women and risk factors for health service use and functional decline. , 2004, Age and ageing.

[7]  P. Harmer,et al.  Tai Chi and Self‐Rated Quality of Sleep and Daytime Sleepiness in Older Adults: A Randomized Controlled Trial , 2004, Journal of the American Geriatrics Society.

[8]  Zhenxin Zhang,et al.  Parkinson's disease in China: prevalence in Beijing, Xian, and Shanghai , 2005, The Lancet.

[9]  C. Hui-Chan,et al.  Comparison of muscle torque, balance, and confidence in older tai chi and healthy adults. , 2005, Medicine and science in sports and exercise.

[10]  P. Thompson,et al.  Reasons for admission to hospital for Parkinson’s disease , 2006, Internal medicine journal.

[11]  G. Ng,et al.  The effects on sensorimotor performance and balance with Tai Chi training. , 2006, Archives of physical medicine and rehabilitation.

[12]  K Bo Foreman,et al.  Collections Tests and Measurements Parkinson Disease and Parkinsonian Disorders Diagnosis / Prognosis : Other in the following collection , 2008 .

[13]  H. Williams,et al.  Can Tai chi enhance cognitive vitality? A preliminary study of cognitive executive control in older adults after A Tai chi intervention. , 2008, Journal of the South Carolina Medical Association.

[14]  Y. Pei,et al.  Eye-hand coordination of elderly people who practice Tai Chi Chuan. , 2008, Journal of the Formosan Medical Association = Taiwan yi zhi.

[15]  Gammon M Earhart,et al.  Tai Chi improves balance and mobility in people with Parkinson disease. , 2008, Gait & posture.

[16]  E. Ernst,et al.  Effectiveness of tai chi for Parkinson's disease: a critical review. , 2008, Parkinsonism & related disorders.

[17]  S. Fetzer,et al.  The effects of tai chi exercise on elders with osteoarthritis: a longitudinal study. , 2008, Asian nursing research.

[18]  Youlian Hong,et al.  Changes in muscle strength, endurance, and reaction of the lower extremities with Tai Chi intervention. , 2009, Journal of biomechanics.

[19]  M. Fernández-Del-Olmo,et al.  Mechanisms involved in treadmill walking improvements in Parkinson's disease. , 2010, Gait & posture.

[20]  C. Hui-Chan,et al.  Stability limits, single-leg jump, and body awareness in older Tai Chi practitioners. , 2010, Archives of physical medicine and rehabilitation.

[21]  S. Yasumura,et al.  The development of a Tai Chi exercise regimen for the prevention of conditions requiring long-term care in Japan. , 2011, Archives of gerontology and geriatrics.

[22]  Yin-Tsen Huang,et al.  Adhering to a Tai Chi Chuan Exercise Program Improves Vascular Resistance and Cardiac Function , 2011 .

[23]  Mollie Venglar Tai chi improves balance in people with Parkinson's disease , 2012, Evidence-Based Medicine.

[24]  Vanisha Parekh Parkinson disease: Tai chi improves balance in Parkinson disease , 2012, Nature Reviews Neurology.

[25]  Bridget Farham,et al.  Tai Chi and postural stability in patients with Parkinson’s disease , 2012 .

[26]  L. Lao,et al.  Tai chi for patients with Parkinson's disease. , 2012, The New England journal of medicine.

[27]  Natalie E. Allen,et al.  Recurrent Falls in Parkinson's Disease: A Systematic Review , 2013, Parkinson's disease.

[28]  W. Tsang Tai Chi training is effective in reducing balance impairments and falls in patients with Parkinson's disease. , 2013, Journal of physiotherapy.