“The population that is age above 60 years old is expected to rise from 10% in 2000 to 21.8% in 2025” (2016). As the age increase, elderly health problems are expected to increase. The common chronic diseases afflicting the elderly are diabetes, visual problems, musculoskeletal disease, and neurological disorders. The authors addressed the problem is older adults are having difficulty maintaining balance which could increase the frequency of falls. The rate and severity of falls increase gradually due to aged and the function of organs in the body are declining. The author’s hypothesis is Tai Chi can use for improving balance and other neuromuscular functions in older adults. Tai Chi is a traditional Chinese martial art and often used as exercises. Tai Chi consists of slow, flexible, and continuous movement that focuses on connecting the body and the mind. Hence, the purpose of the study is to prove the effectiveness of Tai Chi on balance in elderly. The introduction was effective because it explains the reasons for the authors to conduct this research. It also showed how aging affects the body and how Tai Chi improves health conditions.
The study participants were elderly who have been recruited from community elderly centers in Pune and India. To participate in the study, subjects must be able to perform a different range of motion exercises. The age limit for the study is 65 to 80. The exclusion criteria were subjects cannot have an illness such as cardiovascular disease, hypertension, musculoskeletal disease, stroke, neurological disorder, and Parkinson’s disease. To demonstrate that Tai Chi is effective on balance in elderly, the participates required to have no previous experience in Tai Chi and physical inactivity. The study recruited 40 individuals to participate, but 10 of them were ineligible. All subjects were asked to complete a questionnaire contained questions about personal health status, occupation, and demographic data. The assessment test consisted of ankle joint position passive matching and time up and go test. The ankle joint position passive matching test is a subject sit on a testing chair with both legs are at a forty-five-degree angle, then the investigator moves the subject’s foot to the maximal inversion or eversion. The two reference degrees are ankle at 10- and 20-degree inversion. The subject needs to maintain the position for ten seconds. The subject was instructed to stop when he or she thought the position had been reached. This test was repeated three times to find the average of the absolute angle error. The time up and go test is a subject sit on the chair and lean against the back of the chair. When the investigator gives a signal, a subject gets up, walks for three meters at a comfortable pace, then turn, walks back to the chair and sit down. The investigator will write down the time it took a subject to complete the test. Each subject must do an assessment test at the beginning week of the study, week-2, and week-4. The group needs to perform the assigned exercises three times a week for 4 weeks. The class was taught by a certified Tai Chi trainer. Each class is 45 minutes which included 5 minutes of warm-up, 30 minutes of Tai Chi movement, 5 minutes breathing technique, and 5 minutes cool down to end the class. “The program consisted of 7 forms such as preparation and holding the ball, turning the wheel, brush the knee and twist step, step back to the repulse monkey, walking circle, kick heel out to left and right, and the partition of the wild horse’s name” (2016). There are two tables and graphs to show the results over the four consecutive weeks. The first table and graph are the absolute angle error of the right and left ankle test. The second table and graph are the time up and go test. The Tai Chi intervention showed significant improvement in the assessment test. The results support the author’s hypothesis because the statistical analysis proved that Tai Chi can improve balance and other neuromuscular functions in the elderly.
The authors discuss several limitations. They targeted elderly people and stated that the population of the elderly are increasing, but the sample size was small. They stated that this study does not fit for elderly who are living in nursing homes or hospital settings because of the limited mobility and pre-established exercise program. The authors could recruit the elderly from different communities and cities in India. Another limitation was the subject had not learned Tai Chi before and it is hard for the subject to perform those movements correctly under four-weeks. Although there are Tai Chi trainers to assist the elderly, older adults take more times to memorize the movements and perform it accurately. The study program can increase from four weeks to twelve consecutive weeks. Learning a martial art is hard because it takes dedication and motivation to persistent regularly practice over months and years. A limitation not listed by the authors was the assessment of body composition and dietary which are another critical component that can affect the improvement of balance and other neuromuscular functions. A strength of the study was the program was taught by a certified Tai Chi trainer because they explained the procedures, principles, theory, and general choreography of the forms to subjects. It is good to have an instructor to guide the elderly to practice a new form of exercises correctly because it will reduce the risk of injuries in the elder. A weakness of the study was the form of exercises because instructors did not design forms to meet specific physical needs. It is better to include self-paced and subjects can move at their own speed.
The authors concluded that the intervention was effective for the elderly. In other words, practicing Tai Chi helped improve balance and other neuromuscular functions. This study can introduce to elderly who are searching for a way to reduce the fear of falling and looking for an exercise to improve health conditions. Not only does Tai Chi improve balance and other neuromuscular functions, but it may also increase endurance and mental focus. More research needs to be done to determine Tai Chi can influence older adults functioning and well-being. Based on this study, future research can focus on the long-term effect of practicing Tai Chi daily. Moreover, future research can include Tai Chi for rehabilitation.
References
Ujwal, D., Yeole, U., Gharote, M.G., Bardgujar, S., Pawar, A.P., Panse, R., & Kulkarni, A.S. (2016). Effectiveness of tai-chi on balance in elderly. Journal Of Medical Science And Clinical Research, 04, 14848-54.
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