Building the Understanding of the Effects of Tai Chi Training on Walking in Older People

Could tai chi help address some of the walking problems, including the risk of falling, that often plague older people? This preliminary clinical trial adds to the growing evidence that the answer may be yes. The trial, funded by NCCIH and conducted by a team led by researchers at Harvard Medical School and Beth Israel Deaconess Medical Center, found that as little as 6 months of tai chi training might improve an important indicator of how well a person can walk: gait dynamics. Tai chi is a multicomponent mind and body approach that originated in China.

Declines in walking ability with age have been linked to a wide range of health issues as well as increased risks of falls and death from all causes. Gait, or the way in which one walks, has thus become a research target. Gait enlists many systems throughout the body and has them work together in complex ways. One aspect that has not been much studied is “long-range gait dynamics”—how much people’s gaits fluctuate and change over time when they walk.

This study compared gait speed and gait dynamics in 27 tai chi experts (with at least 5 years of tai chi experience) and 60 people of similar ages who had never practiced tai chi. These 60 people were then randomly assigned to two groups: one group received 6 months of tai chi training, while the other group (the control group) was placed on a waitlist. Gait was assessed at 0, 3, and 6 months. During gait testing, participants walked for 10 minutes at their preferred pace, and wireless switches on their heels and toes captured data on multiple aspects of gait. All 87 participants were very healthy adults aged 50 to 79.

The team found that the tai chi experts had gait dynamics indicative of better gait health. Six months of tai chi training led to a slight trend in the same direction, but it didn’t reach statistical significance. Tai chi was not associated with gait speed. More tai chi class attendance and home practice appeared to be of some benefit (though this did not reach statistical significance). The authors noted that tai chi may exert its effects by maintaining or improving our flexibility to respond and adapt to unpredictable changes in terrain, stimuli, and stresses when we walk.

The authors cited a need for larger and longer randomized trials to more definitely ascertain whether tai chi can beneficially affect age-related gait dynamics, especially in people with impaired gait, e.g., from Parkinson’s disease. The study’s limitations included its small sample size and the possibility that factors other than tai chi training caused differences between the experts and the other participants.