Abstract
PurposeTo determine if Tai Chi (TC) has an impact on long-range correlations and fractal-like scaling in gait stride time dynamics, previously shown to be associated with aging, neurodegenerative disease, and fall risk.MethodsUsing Detrended Fluctuation Analysis (DFA), this study evaluated the impact of TC mind-body exercise training on stride time dynamics assessed during 10 minute bouts of overground walking. A hybrid study design investigated long-term effects of TC via a cross-sectional comparison of 27 TC experts (24.5 ± 11.8 yrs experience) and 60 age- and gender matched TC-naïve older adults (50–70 yrs). Shorter-term effects of TC were assessed by randomly allocating TC-naïve participants to either 6 months of TC training or to a waitlist control. The alpha (α) long-range scaling coefficient derived from DFA and gait speed were evaluated as outcomes.ResultsCross-sectional comparisons using confounder adjusted linear models suggest that TC experts exhibited significantly greater long-range scaling of gait stride time dynamics compared with TC-naïve adults. Longitudinal random-slopes with shared baseline models accounting for multiple confounders suggest that the effects of shorter-term TC training on gait dynamics were not statistically significant, but trended in the same direction as longer-term effects although effect sizes were very small. In contrast, gait speed was unaffected in both cross-sectional and longitudinal comparisons.ConclusionThese preliminary findings suggest that fractal-like measures of gait health may be sufficiently precise to capture the positive effects of exercise in the form of Tai Chi, thus warranting further investigation. These results motivate larger and longer-duration trials, in both healthy and health-challenged populations, to further evaluate the potential of Tai Chi to restore age-related declines in gait dynamics.Trial registrationThe randomized trial component of this study was registered at ClinicalTrials.gov (NCT01340365).
Highlights
Gait is a fundamental, yet complex activity of daily living that requires the functional integration of skeletal, muscular, nervous, circulatory, and respiratory systems
Cross-sectional comparisons using confounder adjusted linear models suggest that Tai Chi (TC) experts exhibited significantly greater long-range scaling of gait stride time dynamics
Tai Chi experts and naïve subjects were generally well matched with respect to average age and global cognitive status
Summary
Gait is a fundamental, yet complex activity of daily living that requires the functional integration of skeletal, muscular, nervous, circulatory, and respiratory systems. Gait performance can be characterized in a number of ways including, for example, speed, variability, and dynamics, each capturing distinct aspects of gait. Gait speed has received the most attention: reduced average walking velocity has been associated with lower overall quality of life, increased risk of falls and all-cause mortality, and accelerated progression of chronic diseases including diabetes, chronic heart failure, and dementia [3,4,5]. Metrics characterizing long-range gait dynamics have received less attention, even though they show promise in uniquely informing the physiology of gait, in quantifying age-related and pathological alterations in locomotor control systems, and in augmenting objective measurement of mobility and functional status [9,10,11,12,13]
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