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: Wayne PM1, Hausdorff JM2, Lough M3, Gow BJ1, Lipsitz L3, Novak V4, Macklin EA5, Peng CK6, Manor B3.
Affiliation: 1Division of Preventive Medicine, Osher Center for Integrative Medicine, Brigham and Women's Hospital , Boston, MA , USA ; Harvard Medical School , Boston, MA , USA. 2Department of Neurology, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel. 3Institute for Aging Research, Hebrew Senior Life , Boston, MA , USA. 4Department of Neurology, Beth Israel Deaconess Medical Center , Boston, MA , USA. 5Harvard Medical School , Boston, MA , USA ; Biostatistics Center, Massachusetts General Hospital , Boston, MA , USA. 6Division 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.
Conference/Journal: Front Hum Neurosci.
Date published: 2015 Jun 9
Other: Volume ID: 9 , Pages: 332 , Special Notes: doi: 10.3389/fnhum.2015.00332 , Word Count: 312



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
PMID: 26106316 [PubMed] PMCID: PMC4460804

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460804/