Balance control is a major problem for older individuals with poor vision. The benefits of Tai Chi for balance control, muscle strength, and preventing falls have been demonstrated with sighted older people and this study sought to explore whether older people with visual difficulties could also benefit. Researchers from the Centre for East-meets-West in Rehabilitation Sciences, The Hong Kong Polytechnic University designed and conducted a 16 week trial in residential care homes involving forty people aged over 70. After intervention, the Tai Chi participants showed significant improvements in knee proprioception (awareness of the position of one’s limbs) and in their visual and vestibular ratios (ability to balance) compared to a control group.
Care home residents in the Tai Chi group were taught a modified 8-form Yang style Tai Chi routine and practiced this in 90 minute sessions, three times a week for 16 weeks. The style emphasized multi-directional weight shifting, head and trunk rotation, and awareness of body alignment. Verbal cuing and physical guidance were given. Residents in the control group participated in a music percussion activity, learning to play the Djembe, a percussion instrument.
The participants were assessed pre- and post-intervention using three tests: 1) passive knee joint repositioning to test knee proprioception; 2) concentric isokinetic strength of the knee extensors and flexors; and 3) a sensory organisation test to quantify an individual’s ability to maintain balance in a variety of complex sensory conditions.
Tai Chi practice requires conscious awareness of body position and extremity movements, which may improve joint proprioception. Repeated head movement is one of the important elements in Tai Chi, and this can help to stimulate the vestibular system to improve balance control. This study’s results agree with those of a previous study by Li, Xu, & Hong (Effects of 16-week Tai Chi intervention on postural stability and proprioception of knee and ankle in older people. Age & Ageing 2008), who reported that the knee joint proprioception of persons with normal vision could be improved with 16 weeks of Tai Chi training. This study extends those findings to visually impaired older people
Dr. Tsang said: “We know that regular exercise has positive physiological and psychological benefits for all older adults but older people who are visually impaired are less physically active than those who are sighted and this can lead to reduced physical functioning and well-being. Our study shows that Tai Chi can be a suitable form of exercise for those with visual impairment and indeed assists with improving their balance control. It would be interesting to extend this study to involve community dwelling older people, who tend to be more independent and could benefit differently from the training.”
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Notes to Editors
1. Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life. It is the official scientific journal of the British Geriatrics Society and is published by Oxford University Press.
2. The article, The effects of Tai Chi on the balance control of elderly persons with visual impairment: A randomized clinical trial, was written by Dr. Tsang and first published on 16 December 2011.
3. The authors of the study thank the S.K. Yee Medical Foundation and the Hong Kong Polytechnic University for financial support of this study.
4. The British Geriatrics Society (BGS) is a membership association of doctors, nurses, therapists, scientists and others with a particular interest in the care of the frail older person and in promoting better health in old age. The BGS strives to promote better understanding of the healthcare needs of older people and to share examples of best practice to ensure that older patients are treated with dignity and respect by all clinical staff they come into contact with.