ABSTRACT
Parkinson's disease (PD) affects gait and postural stability. Tai Chi (TC) is recommended for PD for management of the condition, however biomechanical understanding to its effects on gait and postural stability is limited. This study aimed to examine the effects of an online 12-week biomechanical-based TC intervention on gait and posture in people with PD. Fifteen individuals in early-stage PD were recruited (Hoehn & Yahr stages 1-2). The TC intervention program was 60 âmin session, three times weekly for 12 weeks. The pre- and post-intervention test in obstacle crossing, timed-up-and-go (TUG) test, and single leg standing (SLS) with eyes open (EO) and closed (EC) were conducted. Gait speed, crossing stride length, clearance height of the heel and toe, anterior-posterior (AP) and medial-lateral (ML) displacement and velocity of the center of mass (COM) and separation of the COM-center of pressure (COP) were analyzed. The participants significantly improved their pre-vs. post-TC intervention performance on TUG test (p â= â0.002). During obstacle crossing, the participants significantly increased crossing stride length of the trailing foot, increased AP COM displacement and decreased ML COM-COP separation (p â< â0.05); the maximal dorsiflexion angle of the leading limb significantly increased and maximal plantarflexion angle of the trailing limb significantly decreased (p â< â0.05). A 12-week biomechanical-based online TC training was effective towards improvement of gait and postural stability among people in the early-stage of PD. The TC program and online training could be applied for management of PD.
ABSTRACT
BACKGROUND: Parkinson's disease (PD) is associated with changes in gait and posture, which increases the rate of falls and injuries in this population. Tai Chi (TC) training enhances the movement capacity of patients with PD. However, the understanding of the effect of TC training on gait and postural stability in PD is lacking. This study aims to examine the effect of biomechanical-based TC training on dynamic postural stability and its relationship with walking performance. METHODS/DESIGN: A single-blind, randomized control trial of 40 individuals with early-stage PD was conducted (Hoehn and Yahr stages 1 to 3). Patients with PD will be randomly assigned to either the TC or control group. The TC group will participate in a biomechanical-based TC training program that is formed based on the movement analysis of TC and will be practiced thrice a week for 12 weeks. The control group will be required to engage in at least 60 min of regular physical activity (PA) on their own for three times per week for 12 weeks. The primary and secondary outcomes will be assessed at baseline and at 6 and 12 weeks after commencing the study protocol. The primary outcome measures will include dynamic postural stability indicated by the center of mass and center of pressure separation distance and clearance distance of the heel and toe measured during fixed-obstacle crossing. The secondary measures are gait speed, cadence, step length during level surface walking (simple task), and fixed-obstacle crossing (challenging task). The Unified Parkinson's Disease Rating Scale, single leg-stance test with eyes open and closed, and three cognitive scores (Stroop Test, Trail Making Test Part B, and the Wisconsin Card Sorting Test) were also employed. DISCUSSION: This protocol could lead to the development of a biomechanics TC training program for the improvement of gait and postural stability among individuals with PD. The program could enhance the understanding of the effect of TC training on gait and postural stability and could help improve or preserve the postural stability, self-confidence, and active participation in social activities of the participants, thus enhancing their overall quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT04644367. Registered on 25 November 2020.
Subject(s)
Parkinson Disease , Tai Ji , Humans , Parkinson Disease/diagnosis , Parkinson Disease/therapy , Quality of Life , Single-Blind Method , Posture , Gait , Randomized Controlled Trials as TopicABSTRACT
This study examined the maximum joint angles and moments, and electromyography (EMG) activity of the lower limbs in an experienced Tai Chi (TC) practitioner in performing four dynamic (Repulse Monkey, Wave-hand in Clouds, Brush Knee Twist Step, and Lateral Forward Step) and three static TC movements (Starting Form, Hero Touch Sky, and Push Hand Back) and compared them with the measures from walking. Integrated EMG (iEMG) and peak EMG of the rectus femoris, adductor longus, tibialis anterior, semitendinosus, erector spinae, gluteus medius, tensor fasciae latae, medial and lateral gastrocnemius muscles were analyzed. One-way analysis of variance showed that compared with walking, TC presented 1) significantly larger hip flexion (71.4° vs. 42.2°) and abduction angles (11.9° vs. 5.3°), smaller knee flexion (45.2° vs. 71.1°) and abduction angles (13.0° vs. 27.7°), larger ankle dorsiflexion (41.4° vs. 11.3°) and abduction angles (8.8° vs. 7.2°); 2) hip flexion moment and knee flexion and abduction moment were significantly larger. Ankle dorsiflexion moment were significantly smaller, whereas ankle abduction moment was significantly larger in two TC movements; and 3) the EMG activity of the muscles in TC varied from 10% to 610% of walking. The knee extensors, hip adductors and abductors had significantly higher peak EMG (430% â± â40%, 240% â± â30%, and 320% â± â90%) and iEMG values (610% â± â30%, 311% â± â30%, and 1.4% â± â20%), respectively. The findings suggested that these TC movements could be a good option for the improvement of muscle strength and range of motion of the lower limbs.
ABSTRACT
The effects of body mass and sex on lower limb biomechanics during ascent and descent were examined in participants aged 50 to 75 with normal weight (n â= â19), overweight (n â= â18), and obese (n â= â8). Peak joint angles and joint moment of the lower limb were analyzed with the VICON motion analysis system. Results from multivariate analysis of variance showed that during descent, the overweight participants had significantly higher knee extensor moment (0.98 â± â0.30 âNâm/kg-1) than the normal-weight participants (0.70 â± â0.29 âNâm/kg-1). The obese group had significantly higher ankle abductor moment (0.21 â± â0.11 âNâm/kg-1) than the normal weight (0.12 â± â0.08 âNâm/kg-1) and overweight groups (0.09 â± â0.06 âNâm/kg-1). During ascent, the obese participants had significant higher hip flexor moment (0.42 â± â0.20 âNâm/kg-1) than overweight participants (0.22 â± â0.17 âNâm/kg-1). Significant sex differences were found in knee extension angles (4.2 â± â3.4° vs 7.0 â± â3.3°) during descent, plantar flexion angles during ascent (23.7 â± â5.3° vs 15.6 â± â3.7°) and descent (29.9 â± â5.0° vs 22.1 â± â7.9°), and ankle adduction angles (6.8 â± â4.8° vs 2.5 â± â2.5°) during ascent. It is concluded that body mass has significant impact on joint loading of lower limbs during stair walking. Being overweight and obese increased hip joint loading during ascent, and knee and ankle joint loading during descent in older adults. Sex difference in joint kinematics was presented during stair walking regardless of the body mass.
ABSTRACT
Tai Chi (TC) is a recommended exercise for elderly people; however, its loading on the joints of the lower limbs is unknown. This study examined the 3D kinetics of the lower limbs during two typical TC movements and walking in the elderly. Fifteen experienced TC practitioners participated. Ground reaction forces, joint moments and time-to-peak joint moment generation were analysed. Compared with walking, both TC movements generated significantly (1) smaller peak ground reaction forces in all directions, except the anterior; (2) larger hip extension, adduction and internal rotational moments, knee adduction/abduction and internal rotation moments and eversion/inversion and external/internal moments of ankle-foot; and (3) longer peak moment generation time for hip extension, adduction and internal rotation, knee extension and ankle dorsiflexion and inversion. The TC loading patterns are consistent with the mechanical behaviour of biological tissues, which could help to strengthen the lower extremities and prevent falls in the elderly.
Subject(s)
Movement/physiology , Tai Ji , Walking/physiology , Aged , Ankle Joint , Biomechanical Phenomena , Hip Joint , Humans , Knee Joint , Male , RotationABSTRACT
Tai Chi movements share many similar biomechanical features with normal walking. The purpose of the study was to examine and to compare the temporospatial and kinematic features of two typical Tai Chi movements with forward walking. Experienced male Tai Chi practitioners (n = 15) between the ages of 65 to 75, performed 'Repulse Monkey (RM)', 'Wave-hand in Cloud (WHIC)', and forward walking. The results showed that stride width was larger for WHIC compared with walking; double-support time was longer for RM while both Tai Chi movements spent less time in single-support. The Tai Chi movements elicit larger vertical and mediolateral displacement of the centre of mass compared with walking. During RM and WHIC, the knees remained flexed while RM had notably larger abduction and adduction of the knee joint. The gentle and fluid Tai Chi movements have unique biomechanical features that may result in special training to postural control capacity.
