Abstract
Background: This single-blinded, randomized controlled study investigated the effects of practicing Tai Chi on the postural control and cognitive performance of older women while dual tasking.
Methods: Community-dwelling older women (n=31) were recruited from community centers. They were randomized to Tai Chi group (n=15, 12-form Yang style Tai Chi training) or a control group (n=16, general interest classes) for 16 weeks. Balance was tested in single leg stance after stepping down from a step, with and without a concurrent auditory response task (auditory Stroop test). Balance was measured by total sway path and sway area of subject’s center of pressure (COP). The reaction time and the correctness of the auditory Stroop test were also measured.
Results: Tai Chi subjects made fewer errors in auditory Stroop test under dual-task condition after Tai Chi training (p=0.01). They also showed significant decreases in the COP path (p<0.05) and the COP area (p<0.05) in their postural control after training in both single- and dual-task conditions. The subjects in the control group did not show any significant improvement in dual-task condition after the intervention.
Conclusions: Tai Chi training improves the cognitive and postural control performance of older women when dual tasking.
Acknowledgments
The study material is original and has not been presented previously. The authors thank the Hong Kong Polytechnic University, the institution where the study was performed, for financial support of this study, 07901517R. Thanks are also owed to the subjects and to the elderly centers for permission to recruit their members. The authors also thank Mr Bill Purves for his English editorial advice.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: The Hong Kong Polytechnic University; 07901517R.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Carter ND, Kannus P, Khan KM. Exercise in the prevention of falls in older people: A systematic literature review examining the rationale and the evidence. Sports Med 2001;31:427–38.10.2165/00007256-200131060-00003Search in Google Scholar
2. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006;35:ii37–41.10.1093/ageing/afl084Search in Google Scholar
3. Zijlstra A, Ufkes T, Skelton DA, Lundin-Olsson L, Zijlstra W. Do dual tasks have an added value over single tasks for balance assessment in fall prevention programs? A mini-review. Gerontology 2008;54:40–9.10.1159/000117808Search in Google Scholar
4. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701–7.10.1056/NEJM198812293192604Search in Google Scholar
5. Anstey KJ, von Sanden C, Luszcz MA. An 8-year prospective study of the relationship between cognitive performance and falling in very old adults. J Am Geriatr Soc 2006;54:1169–76.10.1111/j.1532-5415.2006.00813.xSearch in Google Scholar
6. Startzell JK, Owens DA, Mulfinger LM, Cavanagh PR. Stair negotiation in older people: a review. J Am Geriatr Soc 2000;48:567–80.10.1111/j.1532-5415.2000.tb05006.xSearch in Google Scholar
7. Ojha HA, Kern RW, Lin CH, Winstein CJ. Age affects the attentional demands of stair ambulation: evidence from a dual-task approach. Phys Ther 2009;89:1080–8.10.2522/ptj.20080187Search in Google Scholar
8. Hortobágyi T, DeVita P. Muscle pre- and coactivity during downward stepping are associated with leg stiffness in aging. J Electromyogr Kinesiol 2000;10:117–26.10.1016/S1050-6411(99)00026-7Search in Google Scholar
9. Faulkner KA, Redfern MS, Cauley JA, Landsittel DP, Studenski SA, Rosano C, et al. Health, Aging, and Body Composition Study. Multitasking: association between poorer performance and a history of recurrent falls. J Am Geriatr Soc 2007;55:570–6.10.1111/j.1532-5415.2007.01147.xSearch in Google Scholar PubMed
10. Tsang WW, Hui- Chan CW. Effects of exercise on joint sense and balance in elderly men: Tai Chi versus golf. Med Sci Sports Exerc 2004;36:658–67.10.1249/01.MSS.0000122077.87090.2ESearch in Google Scholar PubMed
11. Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, et al. Tai Chi and fall reduction in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2005;60:187–94.10.1093/gerona/60.2.187Search in Google Scholar
12. Chen EW, Fu AS, Chan KM, Tsang WW. The effects of Tai Chi on the balance control of elderly persons with visual impairment: a randomized clinical trial. Age Ageing 2012;41:254–9.10.1093/ageing/afr146Search in Google Scholar
13. Tsang WW, Hui-Chan CW. Sensorimotor control of balance: a Tai Chi solution for balance disorders in older subjects. Med Sport Sci 2008;52:104–14.10.1159/000134290Search in Google Scholar
14. Tsang WW, Hui-Chan CW. Effects of Tai Chi on joint proprioception and stability limits in elderly subjects. Med Sci Sports Exerc 2003;35:1962–71.10.1249/01.MSS.0000099110.17311.A2Search in Google Scholar
15. Li JX, Xu DQ, Hong Y. Effects of 16-week Tai Chi intervention on postural stability and proprioception of knee and ankle in older people. Age Ageing 2008;37:575–8.10.1093/ageing/afn109Search in Google Scholar
16. Tsang WW, Fu AS, Lui F, Hui-Chan CW. Trunk position sense in older Tai Chi sword practitioners. Hong Kong Physiother J 2009;27:55–60.10.1016/S1013-7025(10)70009-9Search in Google Scholar
17. Tsang WW, Hui-Chan CW. Comparison of muscle torque, balance, and confidence in older Tai Chi and healthy adults. Med Sci Sports Exerc 2005;37:280–9.10.1249/01.MSS.0000152735.06282.58Search in Google Scholar PubMed
18. Tsang WW, Wong VS, Fu SN, Hui-Chan CW. Tai Chi improves standing balance control under reduced or conflicting sensory conditions. Arch Phys Med Rehabil 2004;85:129–37.10.1016/j.apmr.2003.02.002Search in Google Scholar PubMed
19. Wong AM, Lin YC, Chou SW, Tang FT, Wong PY. Coordination exercise and postural stability in elderly people: effect of Tai Chi Chuan. Arch Phys Med Rehabil 2001;82:608–12.10.1053/apmr.2001.22615Search in Google Scholar PubMed
20. Tsao SW. An in-depth analysis of Taijiquan. Hong Kong: The Chinese University Press, 1995.Search in Google Scholar
21. Li JX, Hong Y, Chan KM. Tai Chi: physiological characteristics and beneficial effects on health. Br J Sports Med 2001;35:148–56.10.1136/bjsm.35.3.148Search in Google Scholar PubMed PubMed Central
22. Lu X, Siu KC, Fu SN, Hui-Chan CW, Tsang WW. Tai Chi practitioners have better postural control and cognitive performance in stepping down with and without a concurrent auditory response task. Eur J Appl Physiol 2013;113:1939–45.10.1007/s00421-013-2624-9Search in Google Scholar PubMed
23. Chiu HF, Lee HC, Chung WS, Kwong PK. Reliability and validity of the Cantonese version of Mini-Mental Status Examination: a preliminary study. J HK Coll Psychiatr 1994;4:25–8.Search in Google Scholar
24. Van Heuvelen MJ, Kempen GI, Ormel J, Rispens P. Physical fitness related to age and physical activity in older persons. Med Sci Sports Exerc 1998;30:434–41.10.1097/00005768-199803000-00015Search in Google Scholar PubMed
25. Wayne PM, Kaptchuk TJ. Challenges inherent to T’ai Chi research Part I: T’ai Chi as a complex multicomponent intervention. J Altern Complement Med 2008;14:95–102.10.1089/acm.2007.7170ASearch in Google Scholar PubMed
26. Gyllensten AL, Hui-Chan CW, Tsang WW. Stability limits, single-leg jump, and body awareness in older Tai Chi practitioners. Arch Phys Med Rehabil 2010;91:215–20.10.1016/j.apmr.2009.10.009Search in Google Scholar PubMed
27. 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;36:648–57.10.1249/01.MSS.0000121941.57669.BFSearch in Google Scholar PubMed
28. Lu X, Hui-Chan CW, Tsang WW. Effects of Tai Chi training on arterial compliance and muscle strength in female older seniors: a randomized clinical trial. Eur J Prev Cardiol 2013;20:238–45.10.1177/2047487311434233Search in Google Scholar PubMed
29. Condron JE, Hill KD. Reliability and validity of a dual-task force platform assessment of balance performance: effect of age, balance impairment, and cognitive task. J Am Geriatr Soc 2002;50:157–62.10.1046/j.1532-5415.2002.50022.xSearch in Google Scholar PubMed
30. Verghese J, Buschke H, Viola L, Katz M, Hall C, Kuslansky G, et al. Validity of divided attention tasks in predicting falls in older individuals: a preliminary study. J Am Geriatr Soc 2002;50:1572–6.10.1046/j.1532-5415.2002.50415.xSearch in Google Scholar PubMed
31. Bergland A, Jarnlo GB, Laake K. Predictors of falls in the elderly by location. Aging Clin Exp Res 2003;15:43–50.10.1007/BF03324479Search in Google Scholar PubMed
32. Silsupadol P, Lugade V, Shumway-Cook A, van Donkelaar P, Chou LS, Mayr U, et al. Training-related changes in dual-task walking performance of elderly persons with balance impairment: a double-blind, randomized controlled trial. Gait Posture 2009;29:634–9.10.1016/j.gaitpost.2009.01.006Search in Google Scholar PubMed PubMed Central
33. Hall CD, Miszko T, Wolf SL. Effects of Tai Chi intervention on dual-task ability in older adults: a pilot study. Arch Phys Med Rehabil 2009;90:525–9.10.1016/j.apmr.2008.09.566Search in Google Scholar PubMed
34. Silsupadol P, Shumway-Cook A, Lugade V, van Donkelaar P, Chou LS, Mayr U, et al. Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial. Arch Phys Med Rehabil 2009;90:381–7.10.1016/j.apmr.2008.09.559Search in Google Scholar PubMed PubMed Central
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