Comparison of Treadmill Trip-Like Training Versus Tai Chi to Improve Reactive Balance Among Independent Older Adult Residents of Senior Housing: A Pilot Controlled Trial

Abstract

Background: There is growing interest in using perturbation-based balance training to improve the reactive response to common perturbations (eg, tripping and slipping). The goal of this study was to compare the efficacy of treadmill-based reactive balance training versus Tai Chi performed at, and among independent residents of, older adult senior housing.

Methods: Thirty-five residents from five senior housing facilities were allocated to either treadmill-based reactive balance training or Tai Chi training. Both interventions were performed three times per week for 4 weeks, with each session lasting approximately 30 minutes. A battery of balance tests was performed at baseline, and again 1 week, 1 month, 3 months, and 6 months post-training. The battery included six standard clinical tests of balance and mobility, and a test of reactive balance performance.

Results: At baseline, no significant between-group differences were found for any balance tests. After training, reactive balance training participants had better reactive balance than Tai Chi participants. Maximum trunk angle was 13.5° smaller among reactive balance training participants 1 week after training (p = .01), and a reactive balance rating was 24%-31% higher among reactive balance training participants 1 week to 6 months after training (p < .03). Clinical tests showed minimal differences between groups at any time point after training.

Conclusion: Trip-like reactive balance training performed at senior housing facilities resulted in better rapid balance responses compared with Tai Chi training.

Keywords: Balance-biomechanics; Exercise; Falls; Gait-biomechanics.

Figure 1.

Study flow diagram. For each stage, n indicates the number of participants who completed that part of the protocol.

Figure 2.

Maximum trunk angle, step length, and reactive balance rating at baseline (base) before the 4-week intervention, Week 5 (w5), Week 8 (w8), Week 16 (w16), and Week 28 (w28). Reactive balance rating ranges from 0 to 12 (best). Values illustrated are least square means, errors bars are standard errors, and asterisk indicates a significant difference (p ≤ .05) between training groups at a given time point. Sample size at each time point was the number of participants who completed at least 9 of 12 training sessions. For RBT participants, this was n = 16 for all time points. For Tai Chi participants, this was n = 16 for time points of baseline through Week 8, and n = 15 for time points of Week 16 and Week 28.