Brian E. Maki, PhD, PEng
Tai Chi has been shown to increase balance confidence and reduce risk of falling in elderly patients.1 Although direct effects on balance control have yet to be demonstrated, it seems likely that Tai Chi may improve the ability to control balance by training the mind and body to integrate balance-related sensory information and by helping an individual to develop a greater "awareness" of both body position and limits to stability. By requiring a series of movements that involve lateral weight transfer and narrowing of the base of support, Tai Chi may bring about specific benefits with respect to control of lateral stability and the consequent capacity to avoid lateral falls, which are the ones that are most likely to result in debilitating (and life-threatening) hip-fracture injuries. Tai Chi has a number of other positive features that may facilitate adherence to a program: it requires no special equipment, it is enjoyable to most participants, it can be performed either in social settings or at home, and it can be safely tailored to match the physical abilities of the individual.
Notwithstanding the above, it is likely that there is nothing "magical" about Tai Chi per se. It would seem that the key factor is developing an exercise program that trains balance, as opposed to strength, flexibility or endurance alone, and incorporating into the balance training a wide range of movements that allow the limits of anteroposterior and lateral stability to be challenged in a safe, enjoyable and convenient manner.
To be linked to a community program that may include Tai Chi please contact the Falls Prevention Program at Sunnybrook Hospital.
References
- Wolf SL, Barnhart HX, Ellison GL, Coogler CE. The effect of tai chi quan and computerized balance training on postural stability in older subjects. Phys Ther 1997; 77:371-381.
Typically, the practice of Tai Chi requires the performance of a series of movements (comprising one 'form') which involve the shifting of weight from one leg to another in bent knee positions, accompanied by coordinated arm movements, and which must culminate in a final, well-balanced stance maintained for a brief period of several seconds.
In 1980, a book illustrating the 88 'forms' of Taijiquan (Tai Chi) reported the findings of an investigation carried out by the Beijing Sports Medical Research Centre on 88 elderly individuals ranging from 50 to 89 years of age. Group A, comprised of 32 regular practitioners of Taichi, had scores dramatically superior to Group B, the control group, in tests designed to asses cardiovascular function, including blood pressure and rate of arteriosclerosis (cardiographs confirmed the tests), spinal deformity, osteomalacia, and flexibility and range of movement. In Tai Chi, the waist is kept relaxed, the spine erect, and the body is held straight. Consequently, regular practice strengthens the spinal column, reinforcing postural balance and preserving strength and flexibility at the waist.
Source: Taijiquan in 88 Forms (5th ed.), Hai Feng Publishing Company, Hong Kong, 1988.
