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Front Hum Neurosci. 2015 Jun 9;9:332. doi: 10.3389/fnhum.2015.00332. eCollection 2015.

Tai Chi Training may Reduce Dual Task Gait Variability, a Potential Mediator of Fall Risk, in Healthy Older Adults: Cross-Sectional and Randomized Trial Studies.

Author information

1
Division of Preventive Medicine, Osher Center for Integrative Medicine, Brigham and Women's Hospital , Boston, MA , USA ; Harvard Medical School , Boston, MA , USA.
2
Department of Neurology, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.
3
Institute for Aging Research, Hebrew Senior Life , Boston, MA , USA.
4
Department of Neurology, Beth Israel Deaconess Medical Center , Boston, MA , USA.
5
Harvard Medical School , Boston, MA , USA ; Biostatistics Center, Massachusetts General Hospital , Boston, MA , USA.
6
Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center , Boston, MA , USA ; Center for Dynamical Biomarkers and Translational Medicine, National Central University , Chungli , Taiwan.

Abstract

BACKGROUND:

Tai Chi (TC) exercise improves balance and reduces falls in older, health-impaired adults. TC's impact on dual task (DT) gait parameters predictive of falls, especially in healthy active older adults, however, is unknown.

PURPOSE:

To compare differences in usual and DT gait between long-term TC-expert practitioners and age-/gender-matched TC-naïve adults, and to determine the effects of short-term TC training on gait in healthy, non-sedentary older adults.

METHODS:

A cross-sectional study compared gait in healthy TC-naïve and TC-expert (24.5 ± 12 years experience) older adults. TC-naïve adults then completed a 6-month, two-arm, wait-list randomized clinical trial of TC training. Gait speed and stride time variability (Coefficient of Variation %) were assessed during 90 s trials of undisturbed and cognitive DT (serial subtractions) conditions.

RESULTS:

During DT, gait speed decreased (p < 0.003) and stride time variability increased (p < 0.004) in all groups. Cross-sectional comparisons indicated that stride time variability was lower in the TC-expert vs. TC-naïve group, significantly so during DT (2.11 vs. 2.55%; p = 0.027); by contrast, gait speed during both undisturbed and DT conditions did not differ between groups. Longitudinal analyses of TC-naïve adults randomized to 6 months of TC training or usual care identified improvement in DT gait speed in both groups. A small improvement in DT stride time variability (effect size = 0.2) was estimated with TC training, but no significant differences between groups were observed. Potentially important improvements after TC training could not be excluded in this small study.

CONCLUSION:

In healthy active older adults, positive effects of short- and long-term TC were observed only under cognitively challenging DT conditions and only for stride time variability. DT stride time variability offers a potentially sensitive metric for monitoring TC's impact on fall risk with healthy older adults.

KEYWORDS:

Tai Chi; cognition; dual task performance; falls and fall risk prevention; gait analysis

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