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Harvard Medical School Studies Tai Chi for Cardiac Rehabilitation and Fall Risk Mitigation

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July 20, 2015

The Gentle Cardiac Rehabilitation Study for Patients Not Attending Cardiac Rehabilitation

In this new study, Harvard Medical School is teaming up with the Warren Alpert Medical School of Brown University.

Cardiac rehabilitation (CR) programs reduce overall and cardiovascular mortality in patients with a history of acute coronary events or revascularization procedures, but only 30% of patients enroll in CR and attrition rates reach up to 60%. Tai Chi, a mind-body practice based on light/moderate aerobic exercise accompanied by meditative components could be a possible exercise option for patients who do not attend CR.

Sixty patients will be randomized to a "LITE" condition (one tai chi session twice weekly for 12weeks) or to a "PLUS" condition (one tai chi session 3 times weekly for 12weeks, followed by maintenance classes 1-2 times weekly for an additional 12 weeks). Measurements will be conducted at baseline, 3-, 6-, and 9months after enrollment. The primary outcome is to determine the feasibility, acceptability and safety of each dose.

Findings from this pilot study will provide preliminary indications about the usefulness of Tai Chi as an exercise option for patients not attending traditional CR programs. Results will also shed light on the possible mechanisms by which Tai Chi practice may improve overall physical activity among patients with atherosclerotic coronary heart disease.

Tai Chi May Reduce Dual Task Gait Variability, a Potential Mediator of Fall Risk, in Healthy Older Adults

The June 2015 issue of the journal Frontiers in human neuroscience published a research jointly performed by Harvard Medical School, Tel Aviv University and National Central University of Taiwan. It compared differences in usual and dual-task gait between long-term Tai Chi-expert practitioners and Tai Chi-naive adults, and to determine the effects of short-term TC training on gait in healthy, non-sedentary older adults.

Tai Chi exercise improves balance and reduces falls in older, health-impaired adults. Tai Chi's impact on dual task gait parameters predictive of falls, especially in healthy active older adults, however, is unknown.

The cross-sectional study compared gait in healthy TC-naive and TC-expert older adults. The experts have 13 to 37 years of experience. TC-naive adults then completed a 6-month, two-arm, wait-list randomized clinical trial of TC training.

During dual tasks, gait speed decreased and stride time variability increased in all groups. Cross-sectional comparisons indicated that stride time variability was lower in the TC-expert vs. TC-naive group, significantly so during dual tasks; by contrast, gait speed during both undisturbed and DT conditions did not differ between groups. Longitudinal analyses of TC-naive adults randomized to 6 months of Tai Chi training or usual care identified improvement in DT gait speed in both groups.

In conclusion: In healthy active older adults, positive effects of short- and long-term Tai Chi were observed only under cognitively challenging dual-task conditions and only for stride time variability. Dual-task stride time variability offers a potentially sensitive metric for monitoring TC's impact on fall risk with healthy older adults.


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