The effect of Tai Chi exercise on gait initiation and gait performance in persons with Parkinson's disease

Abstract

Gait dysfunction and postural instability are two debilitating symptoms in persons with Parkinson’s disease (PD). Tai Chi exercise has recently gained attention as an attractive intervention for persons with PD because of its known potential to reduce falls and improve postural control, walking abilities, and safety at a low cost. The purpose of this report is to investigate the effect of Tai Chi exercise on dynamic postural control during gait initiation and gait performance in persons with idiopathic PD, and to determine whether these benefits could be replicated in two different environments, as complementary projects. In these two separate projects, a total of 45 participants with PD were randomly assigned to either a Tai Chi group or a control group. The Tai Chi groups in both projects completed a 16-week Tai Chi exercise session, while the control groups consisted of either a placebo (i.e., Qi-Gong) or non-exercise group. Tai Chi did not significantly improve Unified Parkinson’s Disease Rating Scale Part III score, selected gait initiation parameters or gait performance in either project. Combined results from both projects suggest that 16 weeks of class-based Tai Chi were ineffective in improving either gait initiation, gait performance, or reducing parkinsonian disability in this subset of persons with PD. Thus the use of short-term Tai Chi exercise should require further study before being considered a valuable therapeutic intervention for these domains in PD.

Tai Chi for Improvement of Motor Function, Balance and Gait in Parkinson's Disease: A Systematic Review and Meta-Analysis

“…Tai Chi did not show beneficial performance in gait velocity (SMD, −0.02; 95% CI −0.58 to 0.54; p = 0.94, Figure 6) [10], [12] or step length (SMD, −0.00; 95% CI −0.57 to 0.56; p = 0.99, Figure 6) [10], [12]. Compared with active therapies, Tai Chi did not either outperform other active therapies in gait velocity (SMD, 0.27; 95% CI −0.01 to 0.55; p = 0.06, Figure 5) [9], [10] nor step length (SMD, 0.28; 95% CI −0.21 to 0.77; p = 0.27, Figure 5) [9], [10]. Gait endurance was assessed by 6-MWD.…”

Aerobic Exercise for Parkinson's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…The aggregated result showed a statistically significant benefit in favor of aerobic exercise for PD in UPDRS III (SMD, −0.57; 95% CI −0.94 to −0.19; p = 0.003; Figure 2) [7]–[9], [15], [16], [20]–[23], [25], [26], [28]. But it was not associated with significant improvements in UPDRS I (SMD, −0.33; 95% CI −0.87 to 0.22; p = 0.24; Figure 2) [15], [16], [20], UPDRS II (SMD, −0.31; 95% CI −0.97 to 0.35; p = 0.36; Figure 2) [15], [16], [20], [26], UPDRS IV (SMD, −0.56; 95% CI −1.26 to 0.13; p = 0.11; Figure 2) [15], [16], nor UPDRS tot (SMD, −0.28; 95% CI −0.73 to 0.18; p = 0.23; Figure 2) [15], [16], [20], [26].…”

Taijiquan in the prevention of symptoms of Parkinson’s disease – A comparative analysis of research results

“…By contrast, Amano et al [27] believe that Taijiquan is ineffective in improving the initiation of walking or in reducing disability on the UPDRS scale. According to Li et al [26], the group did not reduce the frequency of falls compared to the group practicing only strength training.…”

“…In 2013, Amano et al [27] conducted two randomized studies on 45 people with control groups. In the first project, the Taijiquan group consisted of 12 people who practiced the first 8 movements of the shortened form of the Yang style.…”

“…Although Taijiquan training is recommended for people suffering from Parkinson's disease [27,28,29,30,31,32,33,34], the studies described above have shown conflicting results of the effectiveness of this training for Parkinson patients. Despite the fact that the majority of the discussed results [20,21,22,23,25,26] confirm the effectiveness of Taijiquan, only two of these studies had a stronger methodological quality with the Jadad scale score 3.…”