Effects of Tai Chi Chuan and Brisk Walking Exercise on Balance Ability in Elderly Women: A Randomized Controlled Trial

The static balance ability on soft and hard support surfaces in older adults with mild cognitive impairment

OBJECTIVE

This study aimed to assess the static balance ability of the older adults with mild cognitive impairment (MCI) while standing on soft and hard support surfaces.

METHODS

Forty older adults participated in this study (21 in the MCI group and 19 in the control group). Participants were required to perform balance tests under four conditions of standing: standing on a hard support surface with eyes open, standing on a soft support surface with eyes open, standing on a hard support surface with eyes closed, and standing on a soft support surface with eyes closed. Each test was measured in three trials and each trial lasted 30 seconds. Participants were asked to take off their shoes and place their feet in a parallel position with a 20-centimeter distance for bipedal support. The trajectories of the center of pressure (COP) were measured using a Kistler force platform with a frequency of 1000 Hz to assess balance while standing in both groups, with larger COP trajectories indicating poorer static balance in older adults.

RESULTS

With eyes open, the displacement of COP in the anterior-posterior direction(D-ap) (hard support surface: P = 0.003) and the 95% confidence ellipse area(95%AREA-CE) (soft support surface: P = 0.001, hard support surface: P < 0.001) of the COP in the MCI group standing on hard and soft support surfaces were significantly larger than the control group. The 95%AREA-CE (P < 0.001) of the COP in the MCI group on the soft support surface was significantly larger than on the hard support surface. With eyes closed, the root mean square distance(RDIST), root mean square distance-ML(RDISTml), and 95%AREA-CE of the COP were no significant between-group differences when standing on hard support surfaces. However, the RDIST (P = 0.014), RDISTml (P = 0.014), and 95%AREA-CE (P = 0.001) of the COP in the MCI group on the soft support surfaces were significantly larger than the control group. The 95%AREA-CE (P < 0.001), RDIST (P < 0.001), and RDISTml (P < 0.001) of the COP in the MCI group on the soft support surface were significantly larger than the hard support surface.

CONCLUSION

With eyes open, the older adults with MCI showed poorer static balance ability compared to the older adults with normal cognition on soft and hard support surfaces. With eyes closed, the older adults with MCI showed poorer static balance on soft support surfaces, but no differences on hard support surfaces compared with the older adults with normal cognition. With eyes open and closed, the older adults with MCI showed poorer static balance on soft support surfaces as compared to hard support surfaces.

Effects of tai chi on postural balance and quality of life among the elderly with gait disorders: A systematic review

BACKGROUND

Tai Chi is good for improving the physical fitness of older adults. But few studies have reported the effects of Tai Chi on the postural balance and quality of life of older adults with gait disorders.

OBJECTIVE

This review aimed to assess the influence of tai chi on postural stability and quality of life in older adults with abnormal gait.

METHOD

According to the literature retrieval principles, the works published from the inception date to May 2023 were retrieved, including the following databases: PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, EBSCOhost, and Google Scholar. Subsequently, literature screening and quality assessment were performed.

RESULTS

A total of 16 randomized controlled trials were included in this study, Tai Chi intervention can affect populations with Parkinson's disease (PD), no exercise, mild cognitive impairment (MCI), chronic stroke, sedentary, fear of falling, or history of falling. Postural instability is associated with balance, gait, the Unified Parkinson's Disease Rating Scale Motor Subscale 3 (UPDRS III), mobility, lower body strength, and falls. Only two articles looked at quality of life. The Yang style is the most commonly used in the intervention. Nonetheless, most studies were performed on female participants, hence, more research on older male populations is needed.

CONCLUSION

Tai Chi intervention benefits postural balance in patients with gait disorders. 12 weeks is the most common intervention period for patients with gait disorders. The frequency of intervention is seven articles twice a week, and the intervention time is about 60 minutes. The Tai Chi intervention methods in this study involve Yang Style, Sun Style, Taoist Tai Chi, and Health Qigong Tai Chi, but the Yang Style Tai Chi intervention is the most widely used.

A comparison between effects of Square-Stepping Exercise and Tai Chi Chuan on functional fitness and fear of falling in older women

BACKGROUND

It is challenging to find exercise programs that are safe, effective, attractive, and feasible to reduce the risk of falls and fall-related injuries in older adults.

AIMS

We compared the effects of SSE (Square-Stepping Exercise) versus TCC (Tai Chi Chuan) on functional fitness and fear of falling in older women aged 60 years and above.

METHODS

It was a single blind randomized control trial. We purposefully selected 36 older women (aged 65.2 ± 3.82 years). They were then paired based on the criterion of functional reach test and randomly assigned to two groups (18 people) of TTC and SSE. The exercise program included 8 weeks of three 1-h-session training. We measured functional fitness and fear of falling. Functional fitness was assessed using the following tests: Single Leg-Stance-Eyes Open/Closed, Timed Up and Go, Functional Reach Test, Chair Stand, Arm Curl, and Back Scratch. Fear of falling was assessed using the Falls Efficacy Scale-International.

RESULTS

We analyzed the data using repeated measure ANOVA. Within-group comparisons revealed significant improvements for both groups in all nine measures of functional tests as well as fear of falling [Formula: see text]. Interaction comparisons revealed that improvements in measures of functional fitness were greater in the TTC group [Formula: see text]. Nevertheless, the groups were not significantly different in fear of falling [Formula: see text].

CONCLUSION

Our findings showed that both TCC and SSE interventions improved functional fitness and fear of falling. The TCC is more effective than SSE, though the latter is easier to learn and perform.

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

BACKGROUND

With 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).

METHODS

36 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.

RESULTS

After 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).

CONCLUSION

Tai 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.

Effects of 12 weeks of Tai Chi Chuan intervention on the postural stability and self-reported instability in subjects with functional ankle instability: Study protocol for a randomized controlled trial

Background

Tai Chi Chuan (TCC) is a physical activity modality that originated in China and is now widely popular around the world. Although there are a series of articles reporting that TCC can improve balance and other functional symptoms in a variety of populations, including the elderly, patients with stroke, and patients with Parkinson's disease, its efficiency has not been scientifically and methodically evaluated in subjects with functional ankle instability (FAI). Moreover, there is no literature directly comparing TCC and conventional balance training (CBT) interventions for FAI. The objective of this study is to investigate the comparative effects of TCC intervention and CBT protocols in improving postural balance and subjective instability feelings in patients with FAI.

Methods

This study will be a single-center, parallel group, randomized controlled trial. Sixty-eight patients with FAI will be included and randomly assigned in a 1:1 ratio to either an intervention group (n =34) or a control group (n = 34). The participants in the intervention group will complete 12 weeks of TCC intervention (40 min/time, 3 times/week for 12 weeks) on the basis of health education treatment. The control group will receive health education and 36 CBT sessions during a 12-week period. Outcome measures include postural stability and self-reported feelings of instability at baseline, after the end of the intervention, and 3-month follow-up. The postural stability assessment of patients with FAI will be detected by performing static and dynamic postural tests, which will be carried out through a specific balance platform (TecnoBody ProKin). Self-reported feelings of instability will be assessed by Cumberland Ankle Instability Tool (CAIT), American Orthopedics Foot and Ankle Society's Ankle–Hindfoot Evaluation Scale (AOFAS-AHES), and the MOS item Short Form Health Survey (SF-36).

Discussion

This trial will demonstrate whether a 12-week TCC intervention positively affects postural stability and self-reported outcomes in patients with FAI. At the same time, the superiority of its clinical efficacy will also be compared with that of CBT. This study may also help to redefine the value of traditional Chinese exercises in the treatment of chronic ankle instability.

Clinical trial registration

Chinese Clinical Trial Registry: ChiCTR2100041790. Registration date: 22 March 2021. http://www.chictr.org.cn/edit.aspx?pid=119501&htm=4.

Influence of Walking as Physiological Training to Improve Respiratory Parameters in the Elderly Population

Walking as physiological training is reported to be an effective activity in order to beneficially influence and slow the onset of aging in healthy elderly people. However, insufficient evidence exists on how walking influences lung function in seniors. In our study, we aim to evaluate the effect of different types of walking on lung function in healthy seniors. The PubMed, Web of Science, Scopus and EBSCO Essentials databases were searched, while the methodological quality was assessed by the RoB2 tool. A total of seven studies (RCTs) published between 2002-2022 that met the eligibility criteria were analysed in this review. All participants were older adults without any specific associated disease, aged 60 and above. The interventions included structured physical activity; a high/moderate exercise program; long-term regular walking; walking as a part of functional movement training; walking sideways, backward and forward as a part of aerobic training; fast walking; Stepper walking; walking on a treadmill combined with incentive spirometry; and Nordic walking. Overall, most of the mentioned types of walking led to improved lung function in healthy elderly subjects. However, the prescribed Stepper walking program did not improve lung function in healthy seniors.

Comparative Study on the Joint Biomechanics of Different Skill Level Practitioners in Chen-Style Tai Chi Punching

Purpose: “Yan Shou Hong Cui” is a representative punch in Chen-style Tai Chi. The training is an important factor in affecting the effect of Tai Chi practice. Joint angles are the most intuitive way to evaluate motion. The purpose of this study is to compare the movements of Tai Chi masters and beginners’ movements through the analysis of joint angle and punching effect, and explore the influence of training years on the power generation of Tai Chi punches. Methods: There were 14 Chinese Chen-style Tai Chi subjects recruited for this study. They were divided into the master group (n = 7, age of 38.14 ± 10.42 years, height of 1.68 ± 0.06 m, weight of 71.33 ± 8.61 kg) and the beginner group (n = 7, age of 38.00 ± 11.94 years, height of 1.69 ± 0.07 m, weight of 70.14 ± 9.79 kg). The typical movement from Chen-style Tai Chi is called Yan Shou Hong Cui. All subjects were asked to perform the action three times, and the way of force was applied each time. The kinematic and kinetic characteristics of Tai Chi were analyzed by the VICON 3D motion analysis system (100 Hz) with 16 MX13 cameras, and the punch efficiency was measured by the Chinese Kung Fu Dummy (80,000 Hz). Results: The experimental results show that the shoulder, elbow, and hand movements of the master group are more precise and the force strength is more vigorous (master group: the peak angular velocity of the shoulder joint was −324.12 ± 50.88°/s, the angular velocity of the elbow joint was −112.83 ± 56.98°/s, and the hand angular velocity was −121.69 ± 49.55°/s; beginner group: shoulder angle velocity was −281.17 ± 30.56°/s, the elbow angle speed was −263.64 ± 68.63°/s, and the hand angle speed was −36.80 ± 12.53°/s). The rotation angle and rotation speed of the hip joint in the master group were significantly higher than those in the beginner group (as for the hip rotation angle, the master group was 64°, which was significantly higher than the beginner group’s 44°, and there was a significant difference (p = 0.019 < 0.05)). In terms of rotation speed, the peak value of the master group was 370.3 ± 94.8°/s, which was significantly faster than that of the beginner group at 210.4 ± 56.1°/s, and there was a very significant difference (p = 0.003 < 0.01). The master group’s punch effect acceleration (496.39 ± 256.52 m/s2) was significantly higher than that of the beginner group (396.90 ± 116.79 m/s2). Conclusion: People who practice Tai Chi for a long time differ from the beginners in terms of joint flexibility, punching posture, and the effect of application.

Effects of Tai-Chi and Running Exercises on Cardiorespiratory Fitness and Biomarkers in Sedentary Middle-Aged Males: A 24-Week Supervised Training Study

This study examined the effectiveness of Tai-Chi and running exercises on cardiorespiratory fitness and biomarkers in sedentary middle-aged adults under 24 weeks of supervised training. Methods Thirty-six healthy middle-aged adults (55.6 ± 5.3 yr) were randomly assigned into Tai-Chi, running and control groups. During a 24-week training period, the Tai-Chi and running groups were asked to perform exercises for 60 min/day and 5 days/week, which were supervised by Tai-Chi and running instructors throughout. Resting heart rate, lean mass, blood pressure and blood lipids were measured, and cardiorespiratory fitness (VO2max, Vmax and Peak heart rate) was assessed at the baseline and the 12- and 24-week interventions. Results Compared to the no-exercise control group, both the Tai-Chi and running groups significantly decreased resting heart rate, diastolic blood pressure and cardiorespiratory fitness and increased lean mass across the training session (p < 0.05). Compared to the Tai-Chi group, the running group showed greater improvement in VO2max and Vmax (p < 0.05) and reduced triglyceride and low-density lipoprotein cholesterol (p < 0.05). Conclusion Both Tai-Chi and running exercise showed beneficial effects on cardiorespiratory fitness and enhanced health-related outcomes in middle-aged adults. Although Tai-Chi exercises were less effective in VO2max than running, Tai-Chi may be considered as a plausible alternative to running exercises that can be achieved in the indoor-based setting.

Effects of Tai Chi on the neuromuscular function of the patients with functional ankle instability: a study protocol for a randomized controlled trial

Background

Ankle instability limits physical activities and undermines a person’s quality of life. Tai Chi’s health benefits have been reported in different population groups. However, the effects of Tai Chi on neuromuscular function among young adults with functional ankle instability (FAI) remain unclear. Therefore, we aim to investigate the effect of Tai Chi on young adults with FAI.

Methods

This study will be conducted as a randomized controlled trial with blinded assessors. A total of 104 young adults with FAI will be recruited and randomly assigned to intervention and control groups. The participants in the simplified Tai Chi exercise program (STCEP) group will receive a 12-week Tai Chi training. The participants in the control group will receive a low-intensity exercise program and health education for 12 weeks. The primary and secondary outcomes will be assessed at baseline, 4th, 8th, and 12th weeks. Primary outcome measures will include the Cumberland Ankle Instability Tool (CAIT) score, kinematics/kinetics data, electromyography during single-leg landing tasks, and the modified Star Excursion Balance Test (mSEBT). Secondary outcome measures will include the total time of Dynamic Leap and Balance Test (DLBT), ankle muscle strength, and ankle proprioception.

Discussion

This study will investigate the effects of Tai Chi exercise on the neuromuscular function of patients with FAI, as indicated by ankle joint biomechanics, ankle proprioception, balance, ankle muscle strength, and ankle muscle activation. Results will demonstrate that Tai Chi can be an effective exercise for young adults with FAI.

Trial registration

Chinese Clinical Trial Registry ChiCTR2100044089. Registered on 10 March 2021

Balance, physical conditioning, and health perception in elderly women submitted to a 32-week physical exercise program

Study aim: To assess the effects of a long-term physical exercise program on balance, physical conditioning, and health perception in elderly women.

Material and methods: The sample, 143 elderly women, were randomly assigned to an experimental group (EG; n = 71; age: 71.62 ± 4.96 years) and control group (CG; n = 72; age: 72.89 ± 5.40 years). The EG was submitted to a 32-week physical exercise program (3×/week, 60 min/session). Balance and physical conditioning were assessed through the 10-step in a straight-line test, the unipedal balance test (UBT), the timed up and go (TUG) test, and the 30-second chair stand test (30s CST). Health perception was evaluated by a questionnaire.

Results: Repeated measures ANOVA (2×3) revealed significant improvements (p < 0.05) in TUG and 30s CST in the EG from the pre- to the post-test and when compared to the CG in the post-test. There were significant increases (p < 0.05) in health perception, 10-step test, and UBT in the EG, and significant improvements (p < 0.05) in these EG variables when compared to the CG in the post-test.

Conclusions: Participating in the exercise program resulted in improvements in balance, muscle strength, agility, and health perception in the elderly of the present study.

Functional Electrical Stimulation of Peroneal Muscles on Balance in Healthy Females

Balance improvement could contribute to ankle stability for the prevention of ankle sprains. Functional electrical stimulation (FES) is an effective way of augmenting muscle activity and improving balance. This study investigated the effect of FES of peroneal muscles on single-and double-leg balance. Fifteen healthy females (age = 23.1 ± 1.6 years, height = 1.63 ± 0.07 m, and weight = 63.7 ± 9.9 kg) performed single- and double-leg standing balance tests with eyes open and closed before and after 15-minute FES intervention during treadmill running at a comfortable, self-selected pace. FES of peroneal muscles was provided bilaterally, using an Odstock Dropped Foot Stimulator. The total excursion of the centre of pressure (COP) was calculated to assess the standing balance control ability. The total excursion of COP in single- and double-leg stance with eyes open reduced significantly after FES intervention by 14.7% (p < 0.001) and 5.9% (p = 0.031), respectively. The eyes-closed condition exhibited a 12.7% (p = 0.002) reduction in single-leg stance but did not significantly change in double-leg stance (p > 0.05). Limb preference did not account for balance postintervention. No significant difference in total excursion of COP was found between preferred and less preferred limbs with both visual conditions (p > 0.05). FES of peroneal muscles improved standing balance control with eyes open in double-leg and single-leg stance and with eyes closed in double-leg stance. The improvements in balance control with FES treatment did not vary concerning limb preference.

Optimal exercise parameters of tai chi for balance performance in older adults: A meta-analysis

BACKGROUND

Tai chi is considered a safe and low-cost treatment for improving balance ability among an older population. However, there is no existing evidence on the optimal exercise parameters of tai chi for improving balance in older adults.

OBJECTIVES

To investigate the optimal parameters of a tai chi intervention to improve balance performance of older adults.

DESIGN

Systematic review and meta-analysis of randomized controlled trials (RCTs).

SETTING

PubMed, Embase, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Periodical and China Biology Medicine were searched from inception until November 30, 2020.

PARTICIPANTS

Adults aged 60 years and over.

MEASUREMENTS

Two reviewers independently extracted the data and assessed the quality of the included studies according to the Physiotherapy Evidence Database (PEDro) scale. Subgroup analyses and meta-regressions were conducted to elucidate the impact of tai chi training programs on balance measures.

RESULTS

Twenty-six eligible RCTs were included in the meta-analysis. Pooled results showed that tai chi has moderate effects for improving proactive balance (weighted mean standardized mean differences [SMD_wm ] = 0.61, 95% CI 0.33-0.89) and static steady-state balance (SMD_wm  = 0.62, 95% CI 0.30-0.95) and small effects for improving dynamic steady-state balance (SMD_wm  = 0.38, 95% CI 0.03-0.73) and balance test batteries (SMD_wm  = 0.47, 95% CI 0.13-0.81) in adults over 60 years of age. The practice frequency could predict the effects of tai chi on static steady-state balance, and the 24-form simplified Yang style tai chi (45-60 min/session, more than four sessions per week and at least 8 weeks) was the most optimal.

CONCLUSIONS

Tai chi is effective at improving the balance ability of adults over 60 years of age. A medium duration and high frequency of 24-form tai chi may be the optimal program for improving balance, but this evidence should be recommended with caution due to limitations of the methodology and small sample sizes.

Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review

Objectives

This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations.

Methods

A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs.

Results

A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions.

Conclusions

We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.

The effect of Tai Chi exercise on postural time-to-contact in manual fitting task among older adults

BACKGROUND

A fall would impact elderly population's quality of life, which associate with diminished physical and psychological function, and can even be life-threatening. Tai Chi has been used to improve age-related postural instability in locomotion. However, it does not fully explain the mechanism of a lower risk of falling among the Tai Chi population compared to other healthy older adults.

RESEARCH QUESTION

The maintenance of postural stability is more complicated than minimizing postural movements. Postural time to contact is an important temporal measure of postural stability under fitting tasks, which might further clarify the benefits of long term Tai Chi exercise.

METHODS

Participants were required to fit a block (90 × 90 mm) through two different openings (130 × 130 mm and 100 × 100 mm) at two different distances (arm's length or 130 % of arm's length). Kistler forceplate and Vicon system were used to collect center of pressure and kinematic data, respectively. Postural time to contact was used to assess instantaneous perturbation for postural system.

RESULTS

Tai Chi group exhibited significant longer postural time to contact in quiet standing and shorter postural time to contact in fitting tasks, expecting for close-small condition, compared to the brisk walking and sedentary groups (p < .05). In addition, both large and small opening condition, Tai Chi group showed a shorter postural time to contact than brisk walking and sedentary groups (p < .0001).

SIGNIFICANCE

Long term Tai Chi exercise would promote the regulation of posture and decrease the postural constrain to increase the overall stability when performing fitting tasks. Therefore, Tai Chi exercise can be considered as a feasible method to enhance postural control and stability in older adult.

Effects of Tai Chi Yunshou exercise on community-based stroke patients: a cluster randomized controlled trial

Backgroud

Tai Chi Chuan was used for stroke survivors with balance impairments. However, even a short-form of Tai Chi Chuan includes forms that make the exercise challenging for the stroke survivors. Tai Chi Yunshou (wave hands in the cloud) is the “mother” form and the fundamental form of all Tai Chi Chuan styles, which is considered more suitable and feasible for stroke survivors with balance impairments. So this study was designed to evaluate the effects of Tai Chi Yunshou exercise on community-based stroke patients with balance dysfunctions.

Methods

A total of 250 participants from 10 community health centers (5 per arm) were selected and randomly allocated into Tai Chi Yunshou exercise group (TC group) or a balance rehabilitation training group (control group) in an equal ratio. Participants in the TC group were received Tai Chi Yunshou exercise training five times per week for 12 weeks and those in control group were received balance rehabilitation training five times per week for 12 weeks. Outcome assessments including Berg Balance Scale (BBS), Time up to go test (TUGT), Modified Barthel Index (MBI) were measured at baseline, 4 weeks, 8 weeks, 12 weeks and followed-up 6 weeks (18 weeks), 12 weeks (24 weeks). Intention-to-treat analysis was performed. Analysis of variance of repeated measures was used to assess between-group differences.

Results

A total of 244 participants, 120 in the TC group and 124 in the rehabilitation group, were included in final analysis. There was no siginificant difference in Tai Chi Yunshou and balance rehabilitation training on the improvement of balance ability and mobility (P = 0.531 and P = 0.839, respectively) after adjustment for baseline. However, there was significant difference between two groups on improvement of motor funtion (P = 0.022), fear of falling (P < 0.001) and depression (P = 0.035) for the post stroke patients. No adverse events were reported during the study.

Conclusion

Tai Chi Yunshou and balance rehabilitation training led to improved balance ability and functional mobility, and both are suitable community-based programs that may benefit for stroke recovery and community reintegration. Our data demonstrated that a 12-week Tai Chi Yunshou intervention was more effective in motor function, fear of falling and depression than balance rehabilitation training. Future studies examining the effectiveness of Tai Chi Yunahou as a balance ability improvement strategy for community-dwelling survivors of stroke are recommended.

Trial registration

Chinese Clinical Trail Registry: ChiCRT-TRC-13003641. Registration date: 22 August, 2013.