Cited by 891Balance, Gait, and Falls PreventionStroke Rehabilitation and RecoveryDiversity and Impact of Dance

Tai chi and postural stability in patients with Parkinson's disease

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Li, Fuzhong, Harmer, Peter, Fitzgerald, Kathleen, Eckstrom, Elizabeth, Stock, Ronald, Galver, Johnny, Maddalozzo, Gianni, Batya, Sara S.·2012·New England Journal of Medicine

Abstract

BACKGROUND: Patients with Parkinson's disease have substantially impaired balance, leading to diminished functional ability and an increased risk of falling. Although exercise is routinely encouraged by health care providers, few programs have been proven effective. METHODS: We conducted a randomized, controlled trial to determine whether a tailored tai chi program could improve postural control in patients with idiopathic Parkinson's disease. We randomly assigned 195 patients with stage 1 to 4 disease on the Hoehn and Yahr staging scale (which ranges from 1 to 5, with higher stages indicating more severe disease) to one of three groups: tai chi, resistance training, or stretching. The patients participated in 60-minute exercise sessions twice weekly for 24 weeks. The primary outcomes were changes from baseline in the limits-of-stability test (maximum excursion and directional control; range, 0 to 100%). Secondary outcomes included measures of gait and strength, scores on functional-reach and timed up-and-go tests, motor scores on the Unified Parkinson's Disease Rating Scale, and number of falls. RESULTS: The tai chi group performed consistently better than the resistance-training and stretching groups in maximum excursion (between-group difference in the change from baseline, 5.55 percentage points; 95% confidence interval [CI], 1.12 to 9.97; and 11.98 percentage points; 95% CI, 7.21 to 16.74, respectively) and in directional control (10.45 percentage points; 95% CI, 3.89 to 17.00; and 11.38 percentage points; 95% CI, 5.50 to 17.27, respectively). The tai chi group also performed better than the stretching group in all secondary outcomes and outperformed the resistance-training group in stride length and functional reach. Tai chi lowered the incidence of falls as compared with stretching but not as compared with resistance training. The effects of tai chi training were maintained at 3 months after the intervention. No serious adverse events were observed. CONCLUSIONS: Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson's disease, with additional benefits of improved functional capacity and reduced falls. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00611481.).

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Authors
Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Stock, R., Galver, J., Maddalozzo, G., & Batya, S. S.
Affiliations
  • Oregon Research Institute (US)
  • Willamette University (US)
  • Oregon Health & Science University (US)
  • Oregon State University (US)
Venue
New England Journal of Medicine
Published
2012-02-09
Volume
366
Issue
6
Pages
511-519
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2150072209
Cited by
890
References
39
Citations by year
2026: 42 · 2025: 54 · 2024: 47 · 2023: 53 · 2022: 63 · 2021: 69 · 2020: 52 · 2019: 67 · 2018: 50 · 2017: 58 · 2016: 62 · 2015: 75 · 2014: 79 · 2013: 81 · 2012: 37
FWCI
216.62
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Neurological Disorders and Stroke (NS047130, R01NS047130)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Diversity and Impact of Dance
Keywords
Tai Chi, Parkinson's disease, postural stability, balance disorders, falls, exercise intervention, resistance training, stretching, limits of stability test, gait, functional reach test, fall prevention
MeSH terms
Aged, Postural Balance, Female, Gait, Humans, Male, Parkinson Disease, Outcome Assessment, Health Care, Tai Ji, Muscle Stretching Exercises, Resistance Training

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