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      Detraining effects of regular Tai Chi exercise on postural control ability in older women: A randomized controlled trial

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          Abstract

          Background/Objective

          This study aimed to investigate the training and detraining effects of Tai Chi (TC) on postural control ability in single leg stance (SLS) by conducting a single-blind randomized controlled trial.

          Method

          Forty-eight older women were randomly divided into the TC, brisk walking (BW), and control(C) groups by using computer-generated program. The participants completed a 16-week intervention training and 8-week detraining program. Postural control ability in SLS was tested at the baseline, 16 t h, 20 t h, and 24 t h weeks. The primary outcomes included single-leg stance time (Time) and secondary outcomes included maximal displacement of the center of pressure (COP) in the anterior–posterior (AP) direction (D-ap), maximal displacement of the COP in the medial–lateral (ML) direction (D-ml), total length of the COP trajectories (Lng), and 95% confidence ellipse area of the COP movements (area), mean AP total excursion velocities (V-ap), and mean ML total excursion velocities (V-ml).

          Results

          Significant within-group difference compared with the baseline and between-groups difference compared with control group were found at 16 t h, 20 t h, and 24 t h weeks in the TC group and at the 16 t h and 20 t h weeks in the BW group in all the primary and secondary outcomes. Most of secondary outcomes including Lng, D-ml, V-ml, Area increased significantly at the 24 t h week compared with that at the 16 t h week in BW group.

          Conclusions

          TC was effective in improving postural control ability and maintaining intervention gains, and was recommended as an appropriate exercise to prevent falls in the older adults.

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          Most cited references36

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          Measures of postural steadiness: differences between healthy young and elderly adults.

          Measures of postural steadiness are used to characterize the dynamics of the postural control system associated with maintaining balance during quiet standing. The objective of this study was to evaluate the relative sensitivity of center-of-pressure (COP)-based measures to changes in postural steadiness related to age. A variety of time and frequency domain measures of postural steadiness were compared between a group of twenty healthy young adults (21-35 years) and a group of twenty healthy elderly adults (66-70 years) under both eyes-open and eyes-closed conditions. The measures that identified differences between the eyes-open and eyes-closed conditions in the young adult group were different than those that identified differences between the eye conditions in the elderly adult group. Mean velocity of the COP was the only measure that identified age-related changes in both eye conditions, and differences between eye conditions in both groups. The results of this study will be useful to researchers and clinicians using COP-based measures to evaluate postural steadiness.
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            Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations.

            This systematic review update includes 54 randomised controlled trials and confirms that exercise as a single intervention can prevent falls (pooled rate ratio 0.84, 95% CI 0.77-0.91). Meta-regression revealed programs that included balance training, contained a higher dose of exercise and did not include walking training to have the greatest effect on reducing falls. We therefore recommend that exercise for falls prevention should provide a moderate or high challenge to balance and be undertaken for at least 2 hours per week on an ongoing basis. Additionally, we recommend that: falls prevention exercise should target both the general community and those at high risk for falls; exercise may be undertaken in a group or home-based setting; strength and walking training may be included in addition to balance training but high risk individuals should not be prescribed brisk walking programs; and other health-related risk factors should also be addressed.
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              Visual Risk Factors for Falls in Older People

              To determine the tests most predictive of falls in community-dwelling older people from a range of visual screening tests (high and low contrast visual acuity, edge contrast sensitivity, depth perception, and visual field size). To determine whether one or more of these visual measures, in association with measures of sensation, strength, reaction time, and balance, can accurately predict falls in this group. Prospective cohort study of 12 months duration. Falls and Balance Laboratory, Prince of Wales Medical Research Institute. 156 community-dwelling men and women age 63 to 90 (mean age 76.5, standard deviation = 5.1). Screening tests of vision, sensation, strength, reaction time and balance, falls. Of the 148 subjects available at follow-up, 64 (43.2%) reported falling, with 32 (21.7%) reporting multiple falls. Multiple fallers had decreased vision, as indicated by all visual tests, with impaired depth perception, contrast sensitivity, and low-contrast visual acuity being the strongest risk factors. Subjects with good vision in both eyes had the lowest rate of falls, whereas those with good vision in one eye and only moderate or poor vision in the other eye had elevated falling rates-equivalent to those with moderate or poor vision in both eyes. Discriminant analysis revealed that impaired depth perception, slow reaction time, and increased body sway on a compliant surface were significantly and independently associated with falls. These variables correctly classified 76% of the cases, with similar sensitivity and specificity. The study findings indicate that impaired vision is an important and independent risk factor for falls. Adequate depth perception and distant-edge-contrast sensitivity, in particular, appear to be important for maintaining balance and detecting and avoiding hazards in the environment.
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                Author and article information

                Contributors
                Journal
                J Exerc Sci Fit
                J Exerc Sci Fit
                Journal of Exercise Science and Fitness
                The Society of Chinese Scholars on Exercise Physiology and Fitness
                1728-869X
                2226-5104
                11 June 2018
                August 2018
                11 June 2018
                : 16
                : 2
                : 55-61
                Affiliations
                [a ]School of Kinesiology, Shanghai University of Sport, Shanghai, China
                [b ]Shandong Institute of Sport Science, Jinan, Shandong, China
                [c ]Shandong Sport University, Jinan, Shandong, China
                Author notes
                []Corresponding author. School of Kinesiology, Shanghai University of Sport, Shanghai, China. m_d_wei@ 123456sina.com
                Article
                S1728-869X(17)30335-0
                10.1016/j.jesf.2018.06.003
                6323166
                30662494
                0e044d1d-d762-4615-9af6-55453773c34a
                © 2018 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 4 December 2017
                : 9 February 2018
                : 4 June 2018
                Categories
                Original Article

                tai chi,aging,postural control,rct design
                tai chi, aging, postural control, rct design

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