Tai Chi as a Treatment for Balance Impairment
Chris A McGibbon,1,3 David E
Krebs,2,3,4 Stephen W Parker,4,5 Donna M Scarborough,2,3
Peter M Wayne,3,6 and Steven L Wolf7
1Institute of Biomedical Engineering,
University of New
Brunswick, Fredericton, NB
2Biomotion Laboratory, Massachusetts General Hospital,
of Health Professions, Boston, MA
School, Boston, MA 02115, USA
5Dept of Neurology, Massachusetts General Hospital,
School of Acupuncture,
Watertown, MA, 02472, USA
7Dept of Rehabilitation Medicine, Emory University
School of Medicine, Atlanta,
2005; 5: 3.
rehabilitation (VR) is a well-accepted exercise program intended to remedy
balance impairment caused by damage to the peripheral vestibular system.
Alternative therapies, such as Tai Chi (TC), have recently gained popularity as
a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may
be related to neuromuscular adaptations of the lower extremities for the two
different therapies are unknown.
the relationship between lower extremity neuromuscular function and trunk
control in 36 older adults with vestibulopathy,
randomized to 10 weeks of either VR or TC exercise. Time-distance measures
(gait speed, step length, stance duration and step width), lower extremity sagittal plane mechanical energy expenditures (MEE), and
trunk sagittal and frontal plane kinematics (peak and
range of linear and angular velocity), were measured.
gait time-distance measures were improved in both groups following treatment,
no significant between-groups differences were observed for the MEE and trunk
kinematic measures. Significant within groups changes, however, were observed.
The TC group significantly increased ankle MEE contribution and decreased hip
MEE contribution to total leg MEE, while no significant changes were found
within the VR group. The TC group exhibited a positive relationship between
change in leg MEE and change in trunk velocity peak and range, while the VR
group exhibited a negative relationship.
function improved in both groups consistent with expectations of the
interventions. Differences in each group's response to therapy appear to
suggest that improved gait function may be due to different neuromuscular
adaptations resulting from the different interventions. The TC group's
improvements were associated with reorganized lower extremity neuromuscular
patterns, which appear to promote a faster gait and reduced excessive hip
compensation. The VR group's improvements, however, were not the result of
lower extremity neuromuscular pattern changes. Lower-extremity MEE increases
corresponded to attenuated forward trunk linear and angular movement in the VR
group, suggesting better control of upper body motion to minimize loss of
balance. These data support a growing body of evidence that Tai Chi may be a
valuable complementary treatment for vestibular disorders.