Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson disease, with additional benefits of improved functional capacity and reduced falls, say authors of an article published this month in NEJM.
For this trial, researchers 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 1 of 3 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 Disease Rating Scale, and number of falls.
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 were 5.55 percentage points and 11.98 percentage points, respectively) and in directional control (10.45 percentage points and 11.38 percentage points, 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 more than stretching did, but not more than resistance training did. The effects of tai chi training were maintained at 3 months after the intervention. No serious adverse events were observed.
APTA member Johnny Galver, PT, coauthored the article.