Abstract
BackgroundTai Chi training enhances physical function and may reduce falls in older adults with and without balance disorders, yet its effect on postural control as quantified by the magnitude or speed of center-of-pressure (COP) excursions beneath the feet is less clear. We hypothesized that COP metrics derived from complex systems theory may better capture the multi-component stimulus that Tai Chi has on the postural control system, as compared with traditional COP measures.MethodsWe performed a secondary analysis of a pilot, non-controlled intervention study that examined the effects of Tai Chi on standing COP dynamics, plantar sensation, and physical function in 25 older adults with peripheral neuropathy. Tai Chi training was based on the Yang style and consisted of three, one-hour group sessions per week for 24 weeks. Standing postural control was assessed with a force platform at baseline, 6, 12, 18, and 24 weeks. The degree of COP complexity, as defined by the presence of fluctuations existing over multiple timescales, was calculated using multiscale entropy analysis. Traditional measures of COP speed and area were also calculated. Foot sole sensation, six-minute walk (6MW) and timed up-and-go (TUG) were also measured at each assessment.ResultsTraditional measures of postural control did not change from baseline. The COP complexity index (mean±SD) increased from baseline (4.1±0.5) to week 6 (4.5±0.4), and from week 6 to week 24 (4.7±0.4) (p=0.02). Increases in COP complexity—from baseline to week 24—correlated with improvements in foot sole sensation (p=0.01), the 6MW (p=0.001) and TUG (p=0.01).ConclusionsSubjects of the Tai Chi program exhibited increased complexity of standing COP dynamics. These increases were associated with improved plantar sensation and physical function. Although more research is needed, results of this non-controlled pilot study suggest that complexity-based COP measures may inform the study of complex mind-body interventions, like Tai Chi, on postural control in those with peripheral neuropathy or other age-related balance disorders.
Highlights
Tai Chi training enhances physical function and may reduce falls in older adults with and without balance disorders, yet its effect on postural control as quantified by the magnitude or speed of center-of-pressure (COP) excursions beneath the feet is less clear
In a previous study we reported the impact of a 24-week Tai Chi intervention in older adults with peripheral neuropathy [15]
The effect of tai chi on foot sole sensation, leg strength and physical function As reported previously, foot sole sensation, leg strength and physical function increased from baseline to week 24.15 Briefly, subjects exhibited heightened foot sole sensation, as defined by the number of five tested foot sole sites with intact sensation, from 2.8±1.5 to 3.8±1.3 sites (p=0.003)
Summary
Tai Chi training enhances physical function and may reduce falls in older adults with and without balance disorders, yet its effect on postural control as quantified by the magnitude or speed of center-of-pressure (COP) excursions beneath the feet is less clear. We hypothesized that COP metrics derived from complex systems theory may better capture the multi-component stimulus that Tai Chi has on the postural control system, as compared with traditional COP measures. Falls due to poor balance are common and catastrophic in older adults. Tai Chi is best viewed as a multi-component exercise including detailed regimens of physical movement, breathing techniques and cognitive tools (both visualization and focused internal awareness) [4,5,6]. Systematic reviews suggest Tai Chi practice can directly reduce fall risk [7,8,9]
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