Effect of health Baduanjin Qigong for mild to moderate Parkinson's disease. Tai Chi improves balance and mobility in people with Parkinson disease. Does pain-catastrophising mediate the effect of tai chi on treatment outcomes for people with low back pain? A randomised controlled cross-over trial of aerobic training versus Qigong in advanced Parkinson's disease. Tai Chi Training may Reduce Dual Task Gait Variability, a Potential Mediator of Fall Risk, in Healthy Older Adults: Cross-Sectional and Randomized Trial Studies A systems biology approach to studying Tai Chi, physiological complexity and healthy aging: design and rationale of a pragmatic randomized controlled trial. Breathing frequency-independent effect of Tai Chi Chuan on autonomic modulation Effects of therapeutic Tai chi on functional fitness and activities of daily living in patients with Parkinson disease Improvement of isokinetic knee extensor strength and reduction of postural sway in the elderly from long-term Tai Chi exercise. Combined Cognitive-Psychological-Physical Intervention Induces Reorganization of Intrinsic Functional Brain Architecture in Older Adults A randomized, double-blind, controlled trial of add-on therapy in moderate-to-severe Parkinson's disease. Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults. The effect of Tai Chi exercise on gait initiation and gait performance in persons with Parkinson's disease. The influence of Tai Chi training on the center of pressure trajectory during gait initiation in older adults. Dementia and survival in Parkinson disease Health-related quality of life and alternative forms of exercise in Parkinson disease. Qigong exercise for the symptoms of Parkinson's disease: a randomized, controlled pilot study. Enhancing both motor and cognitive functioning in Parkinson’s disease: Aerobic exercise as a rehabilitative intervention Taiji for Individuals with Parkinson Disease and their Support Partners: Program Evaluation Changes in muscle strength, endurance, and reaction of the lower extremities with Tai Chi intervention. Effects of Tai Chi and Multimodal Exercise Training on Movement and Balance Function in Mild to Moderate Idiopathic Parkinson Disease Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report
AIM The present study investigated the effectiveness of Baduanjin Qigong on symptoms related to gait , functional mobility and sleep in Parkinson disease ( PD ) patients . METHODS A total of 100 patients ( age 67.53 ± 8.56 years , range 55 - 80 years ) with mild to moderate PD were r and omly assigned to two groups . Participants in the Baduanjin Qigong group ( BQG ) received a Baduanjin Qigong program , consisting of four 45-min sessions each week and daily walking 30 min for 6 months . Participants in the control group were carried out daily walking for 30 min . Pre- and post-intervention testing was carried out to assess sleep quality , fatigue , functional mobility and gait performance in these participants . RESULTS After the 6-month Baduanjin Qigong intervention , the BQG showed sleep quality improvements in the Unified Parkinson 's Disease Rating Scale score ( P = 0.049 ) , Parkinson 's Disease Sleep Scale-2 ( PDSS-2 ) total score ( P = 0.039 ) , Motor Symptoms at Night ( PDSS-2 ) score ( P = 0.039 ) , PD Symptoms at Night ( PDSS-2 ) score ( P = 0.029 ) , Disturbed Sleep ( PDSS-2 ) score ( P = 0.037 ) . The BQG showing functional mobility capacity greater improvements in the Berg Balance Scale ( P = 0.041 ) and 6-minute walk test ( P = 0.042 ) , and greater decrease in the Timed Up & Go ( s ; P = 0.046 ) . The BQG showing gait function increased in the gait speed ( m/s ; P = 0.011 ) . However , this was not the case for the control group , which remained at the same level as pretest performance . CONCLUSIONS BQG improved the gait performance , functional mobility and sleep quality in older adults with PD at the 6-month follow up . It is as an alternative home exercise program for older adults in rehabilitation for PD . Geriatr Gerontol Int 2016 ; 16 : 911 - 919 This pilot study examines the effects of Tai Chi on balance , gait and mobility in people with Parkinson disease ( PD ) . Thirty-three people with PD were r and omly assigned to either a Tai Chi group or a control group . The Tai Chi group participated in 20 1-h long training sessions completed within 10 - 13 weeks ; whereas , the control group had two testing sessions between 10 and 13 weeks apart without interposed training . The Tai Chi group improved more than the control group on the Berg Balance Scale , UPDRS , Timed Up and Go , t and em stance test , six-minute walk , and backward walking . Neither group improved in forward walking or the one leg stance test . All Tai Chi participants reported satisfaction with the program and improvements in well-being .  Tai Chi appears to be an appropriate , safe and effective form of exercise for some individuals with mild-moderately severe PD OBJECTIVES There is evidence to support the effectiveness of tai chi for reducing pain-related symptoms across multiple musculoskeletal conditions , however , the mechanism(s ) are unclear . This study explores the role of pain-catastrophising as a possible mediator in the relationship between practising tai chi and back pain symptoms . DESIGN Exploratory mediation analyses using a Baron and Kenny approach and bootstrapping methods were employed as a secondary analysis of data from a previously published r and omised controlled trial . SETTING Adults with persistent low back pain were recruited via community advertisement in Sydney , NSW , Australia . INTERVENTIONS A 10-week tai chi intervention and a wait-list control . MAIN OUTCOME MEASURES Patients completed self- assessment s of pain intensity and bothersomeness using 0 - 10 numerical rating scales , disability using the Rol and Morris Disability Question naire and pain catastrophising using the Pain Coping Strategies Question naire pre and post intervention . RESULTS The results suggest partial mediation , by which a reduction in catastrophising explained approximately 1/3 of the effect on pain intensity and bothersomeness and 2/3 of the effect on disability . CONCLUSION As the first known mediation analysis of tai chi for reducing low back pain-symptoms , it provides initial evidence that it may do so by having an effect on cognitive appraisal outcomes such as pain-catastrophising and information for choosing appropriate process measures for future studies . As tai chi is growing in popularity as an alternative treatment for patients with chronic musculoskeletal conditions , it is important to gain a better underst and ing of how it might work using confirmatory mediation analysis alongside future RCTs AIM To investigate the effects of an aerobic training in subjects with Parkinson 's disease ( PD ) as compared to a medical Chinese exercise ( Qigong ) . METHODS DESIGN r and omized controlled trial with a cross over design . SETTING PD out- patients referred to a Neurorehabilitation facility for the management of motor disability . SUBJECTS 26 PD patients in Hoehn and Yahr stage II to III under stable medication were r and omly allocated to either Group AT1+QG2 ( receiving 20 aerobic training sessions followed by 20 ' ' Qigong ' ' group sessions with 2 month interval between the interventions ) , or Group QG1+AT2 ( performing the same treatments with an inverted sequence ) . MAIN OUTCOME MEASURES clinical effects of treatment were sought through the Unified Parkinson 's Disease Rating Scale ( UPDRS ) , Brown 's Disability Scale ( B'DS ) , six-Minute Walking Test ( 6MWT ) , Borg scale for breathlessness , Beck Depression Inventory ( BDI ) and Parkinson 's Disease Question naire-39 items ( PDQ-39 ) . A spirometry test and maximum cardiopulmonary exercise test ( CPET ) were also performed to determine the pulmonary function , the metabolic and cardio-respiratory requests at rest and under exercise . All measures were taken immediately before and at the completion of each treatment phase . RESULTS The statistical analysis focusing on the evolution of motor disability and quality of life revealed a significant interaction effect between group and time for the 6MWT ( time x group effect : F : 5.4 P=0.002 ) and the Borg scale ( time x group effect : F : 4.2 P=0.009 ) . Post hoc analysis showed a significant increase in 6MWT and a larger decrease in Borg score after aerobic training within each subgroup , whereas no significant changes were observed during Qigong . No significant changes over time were detected through the analysis of UPDRS , B'DS , BDI and PDQ-39 scores . The analysis of cardiorespiratory parameters showed significant interaction effects between group and time for the Double Productpeak ( time x group effect : F : 7.7 P=0.0003 ) , the VO(2peak ) ( time x group effect : F : 4.8 P=0.007 ) , and the VO(2)/kg ratio ( time x group effect : F : 4.3 P=0.009 ) , owing to their decrease after aerobic training to an extent that was never observed after Qigong treatment . CONCLUSIONS Aerobic training exerts a significant impact on the ability of moderately disabled PD patients to cope with exercise , although it does not improve their self-sufficiency and quality of life Background Tai Chi ( TC ) exercise improves balance and reduces falls in older , health-impaired adults .  TC ’s impact on dual task ( DT ) gait parameters predictive of falls , especially in healthy active older adults , however , is unknown . Purpose To compare differences in usual and DT gait between long-term TC-expert practitioners and age-/gender-matched TC-naïve adults , and to determine the effects of short-term TC training on gait in healthy , non-sedentary older adults . Methods A cross-sectional study compared gait in healthy TC-naïve and TC-expert ( 24.5 ± 12 years experience ) older adults . TC-naïve adults then completed a 6-month , two-arm , wait-list r and omized clinical trial of TC training . Gait speed and stride time variability ( Coefficient of Variation % ) were assessed during 90 s trials of undisturbed and cognitive DT ( serial subtractions ) conditions . Results During DT , gait speed decreased ( p < 0.003 ) and stride time variability increased ( p < 0.004 ) in all groups . Cross-sectional comparisons indicated that stride time variability was lower in the TC-expert vs. TC-naïve group , significantly so during DT ( 2.11 vs. 2.55 % ; p = 0.027 ) ; by contrast , gait speed during both undisturbed and DT conditions did not differ between groups . Longitudinal analyses of TC-naïve adults r and omized to 6 months of TC training or usual care identified improvement in DT gait speed in both groups . A small improvement in DT stride time variability ( effect size = 0.2 ) was estimated with TC training , but no significant differences between groups were observed . Potentially important improvements after TC training could not be excluded in this small study . Conclusion In healthy active older adults , positive effects of short- and long-term TC were observed only under cognitively challenging DT conditions and only for stride time variability . DT stride time variability offers a potentially sensitive metric for monitoring TC ’s impact on fall risk with healthy older adults INTRODUCTION Aging is typically associated with progressive multi-system impairment that leads to decreased physical and cognitive function and reduced adaptability to stress . Due to its capacity to characterize complex dynamics within and between physiological systems , the emerging field of complex systems biology and its array of quantitative tools show great promise for improving our underst and ing of aging , monitoring senescence , and providing biomarkers for evaluating novel interventions , including promising mind-body exercises , that treat age-related disease and promote healthy aging . MATERIAL AND METHODS An ongoing , two-arm r and omized clinical trial is evaluating the potential of Tai Chi mind-body exercise to attenuate age-related loss of complexity . A total of 60 Tai Chi-naïve healthy older adults ( aged 50 - 79 ) are being r and omized to either six months of Tai Chi training ( n=30 ) , or to a waitlist control receiving unaltered usual medical care ( n=30 ) . Our primary outcomes are complexity-based measures of heart rate , st and ing postural sway and gait stride interval dynamics assessed at 3 and 6months . Multiscale entropy and detrended fluctuation analysis are used as entropy- and fractal-based measures of complexity , respectively . Secondary outcomes include measures of physical and psychological function and tests of physiological adaptability also assessed at 3 and 6months . DISCUSSION Results of this study may lead to novel biomarkers that help us monitor and underst and the physiological processes of aging and explore the potential benefits of Tai Chi and related mind-body exercises for healthy aging Objective This study investigates the breathing frequency (BF)-independent effect of Tai Chi Chuan ( TCC ) on autonomic nervous modulation in  TCC practitioners . Methods Twenty-five TCC practitioners and 25 sedentary normal controls were recruited . The stationary heart rate variability ( HRV ) measures of TCC practitioners and controls were compared . The same HRV measures in TCC practitioners and among the controls , TCC practitioners before TCC and TCC practitioners 30 min after TCC were compared . Results In TCC practitioners , the BF , normalized high-frequency power ( nHFP ) , and normalized very low-frequency power were significantly increased , while the normalized low-frequency power ( nLFP ) was significantly decreased 30 min after TCC . The BF correlated significantly and negatively with heart rate ( HR ) , nHFP and nLFP , and correlated significantly and positively with mean RR interval ( MnRR ) before TCC in TCC practitioners . A slower BF is associated with a higher HR , a greater vagal modulation , and a greater combined sympatho-vagal modulation before TCC . To remove the effect of BF on HRV measures , new indices such as HR*BF , nHFP*BF , nLFP*BF , and MnRR/BF were introduced for comparison among the controls , TCC practitioners before TCC , and TCC practitioners 30 min after TCC . Thirty minutes after TCC , the MnRR/BF of TCC practitioner was smaller whereas HR*BF and nHFP*BF were greater than those before TCC.InterpretationThe BF-independent effects of TCC on the autonomic nervous modulation of TCC practitioners are an increase in vagal modulation and HR , and a decrease in mean RR interval . The mechanism underlying the parallel increase in HR and vagal modulation in TCC practitioners is not understood yet at present The purpose of the study is to investigate the effects of therapeutic Tai chi ( TTC ) on the functional fitness status and activities of daily living ( ADL ) of patients with Parkinson disease ( PD ) . The participants were clinical ly stable PDs in Hoehn and Yahr stage 1–2 . These patients were r and omly assigned to either the TTC group ( n=11 ) or the control ( CON ) group ( n=9 ) . The TTC exercised at the clinic 2 times a week and performed home-based activity 1 time per week for 12 weeks . All the PDs were evaluated for functional fitness test and ADL screen before and after the 12-week trial . There was a significant Time × group interaction effect on the arm curl ( P<0.01 ) , functional reach ( P<0.05 ) , and st and on foot with eyes opened ( P<0.05 ) of the functional fitness as compared to the CON . The results of the functional reach test in the CON worsened significantly during the 12-week intervention in comparison with those of the TTC ( P<0.01 ) . Also ADL showed significant changed in TCC ( P<0.05 ) . Tai chi training showed good effects on the functional fitness in PDs . This study suggests that further research into the based such as Tai chi intervention must be developed PD ’s quality of life in the future OBJECTIVES To compare isokinetic strength of leg muscles and foot center of pressure ( COP ) as a measure of sway between long-term Tai Chi practitioners and controls . DESIGN Cross-sectional study . SETTING Community setting . PARTICIPANTS Twenty subjects in the Tai Chi group and 19 subjects in the control group ( age , > 55 y ) . INTERVENTION Subjects in Tai Chi  group had practice d Tai Chi for a minimum of 3 years . MAIN OUTCOME MEASURES Concentric and eccentric strength of knee extensors and flexors at 60 degrees/s and 120 degrees/s , and foot COP displacement during quiet stance with eyes open or closed . RESULTS People in the  Tai Chi group had significantly higher knee extensor strength at all speeds tested ( P<.013 ) , and smaller foot COP excursions for both eyes open and eyes closed conditions ( P<.05 ) than people in control group . No significant difference existed in knee flexors between the 2 groups ( P<.713 ) . The COP excursions correlated significantly with the eccentric strength of knee extensors ( P<.07 ) but not with the concentric strength of knee extensors ( P<.14 ) or with the isokinetic strength of knee flexors at most of the speeds ( P<.27 ) . CONCLUSION These findings support the hypothesis that the maintenance of eccentric strength of postural muscles in the lower extremities , which is beneficial for maintaining good postural stability , is helped through the long-term practice of Tai Chi Mounting evidence suggests that enriched mental , physical , and socially stimulating activities are beneficial for counteracting age-related decreases in brain function and cognition in older adults . Here , we used functional magnetic resonance imaging ( fMRI ) to demonstrate the functional plasticity of brain activity in response to a combined cognitive-psychological-physical intervention and investigated the contribution of the intervention-related brain changes to individual performance in healthy older adults . The intervention was composed of a 6-week program of combined activities including cognitive training , Tai Chi exercise , and group counseling . The results showed improved cognitive performance and reorganized regional homogeneity of spontaneous fluctuations in the blood oxygen level-dependent ( BOLD ) signals in the superior and middle temporal gyri , and the posterior lobe of the cerebellum , in the participants who attended the intervention . Intriguingly , the intervention-induced changes in the coherence of local spontaneous activity correlated with the improvements in individual cognitive performance . Taken together with our previous findings of enhanced resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe regions following a combined intervention program in older adults , we conclude that the functional plasticity of the aging brain is a rather complex process , and an effective cognitive-psychological-physical intervention is helpful for maintaining a healthy brain and comprehensive cognition during old age OBJECTIVE The primary objective was to evaluate the efficacy and safety of droxidopa as add-on therapy in improving stiffness , tremors and other motor functions and activities of daily living for moderate-to-severe Parkinson 's disease ( PD ) . METHODS PD patients , above Hoehn-Yahr III ( including Hoehn-Yahr III ) , were r and omly assigned to drug therapy ( droxidopa 600 mg/day for 8 weeks ) or placebo . Efficacy indicators were the Unified Parkinson 's Disease Rating Scale ( UPDRS ) part I , II , III subscale , Clinical Global Impression ( CGI ) rating score , and individual symptom scores ( e.g. stiffness , tremors ) , to evaluate motor function and activities of daily life . RESULTS There are 109 patients in the droxidopa group , and 110 in the placebo group , at baseline , there were no differences between the two groups for age , body weight , disease severity and previous drugs therapy . At days 14 and 57 of droxidopa add on treatment , UPDRS-II scores reflecting activities of daily life and UPDRS-III scores reflecting motor functions were significantly different compared to the pre-treatment baseline scores ( P < 0.01 ) , UPDRS- II and UPDRS-III scores at day 14 and day 57 were also significantly different ( P < 0.01 ) between the two groups . Individual motor symptoms such as stiffness , resting tremor , and alternate h and motion were also significantly improved with droxidopa on days 14 and 57 of treatment ( P < 0.01 vs placebo ) , showing that droxidopa is effective in improving rigidity , tremor and alternate motion of h and . CONCLUSIONS Droxidopa was effective as symptomatic adjunct therapy , improved significantly motor function and activities of daily living , benefited patients with signs of tremor and Stiffness OBJECTIVES To determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education ( WE ) program in older adults who had fallen previously and meet criteria for transitioning to frailty . DESIGN Cluster-r and omized , controlled trial of 48 weeks ' duration . SETTING Ten matched pairs of congregate living facilities in the greater Atlanta area . PARTICIPANTS Sample of 291 women and 20 men , aged 70 to 97 . MEASUREMENTS Activity-related fear of falling using the Activities-Specific Balance Confidence Scale ( ABC ) and the Fall Efficacy Scale at baseline and every 4 months for 1 year . Demographics , time to first fall and all subsequent falls , functional measures , Centers for Epidemiologic Studies Depression Scale , medication use , level of physical activity , comorbidities , and adherence to interventions . RESULTS Mean ABC was similar in both cohort groups at the time of r and omization but became significantly higher ( decreased fear ) in the tai chi cohort at 8 months ( 57.9 vs 49.0 , P<.001 ) and at study end ( 59.2 vs 47.9 , P<.001 ) . After adjusting for covariates , the mean ABC after 12 months of intervention was significantly greater in the tai chi group than in the WE group , with the differences increasing with time ( mean difference at 12 months=9.5 points , 95 % confidence interval=4.8 - 14.2 , P<.001 ) . CONCLUSION Tai chi led to a significantly greater reduction in fear of falling than a WE program in transitionally frail older adults . The mean percentage change in ABC scores widened between tai chi and WE participants over the trial period . Tai chi should be considered in any program design ed to reduce falling and fear of falling in transitionally frail older adults Gait dysfunction and postural instability are two debilitating symptoms in persons with Parkinson 's disease ( PD ) .  Tai Chi exercise has recently gained attention as an attractive intervention for persons with PD because of its known potential to reduce falls and improve postural control , walking abilities , and safety at a low cost . The purpose of this report is to investigate the effect of Tai Chi exercise on dynamic postural control during gait initiation and gait performance in persons with idiopathic PD , and to determine whether these benefits could be replicated in two different environments , as complementary projects . In these two separate projects , a total of 45 participants with PD were r and omly assigned to either a Tai Chi group or a control group . The Tai Chi groups in both projects completed a 16-week Tai Chi exercise session , while the control groups consisted of either a placebo ( i.e. , Qi-Gong ) or non-exercise group . Tai Chi did not significantly improve Unified Parkinson 's Disease Rating Scale Part III score , selected gait initiation parameters or gait performance in either project . Combined results from both projects suggest that 16 weeks of class-based Tai Chi were ineffective in improving either gait initiation , gait performance , or reducing parkinsonian disability in this subset of persons with PD . Thus the use of short-term Tai Chi exercise should require further study before being considered a valuable therapeutic intervention for these domains in PD OBJECTIVE To determine if a program of intense Tai Chi exercise that has been shown to reduce the risk of falling in older adults improves postural control by altering the center of pressure ( COP ) trajectory during gait initiation . DESIGN Before-after trial . SETTING Biomechanics research laboratory . PARTICIPANTS Twenty-eight older adults transitioning to frailty who participated in either a 48-week intervention of intense Tai Chi training or a wellness education ( WE ) program .  INTERVENTIONS Eight Tai Chi forms emphasizing trunk rotation , weight shifting , coordination , and narrowing of lower-extremity stance were taught twice weekly . WE program participants met once a week and received lectures focused on health . Main outcome measures The COP was recorded during gait initiation both before and after the 48-week intervention by using a forceplate sampling at 300 Hz . The COP trajectory was divided into 3 periods ( S1 , S2 , S3 ) by identifying 2 l and mark events . Displacement and average velocity of the COP trace in the anteroposterior ( x ) and mediolateral ( y ) directions , as well as smoothness , were calculated . RESULTS Tai Chi training increased the posterior displacement of the COP during S1 and improved the smoothness of the COP during S2 . CONCLUSIONS Tai Chi improved the mechanism by which forward momentum is generated and improved coordination during gait initiation , suggesting improvements in postural control Background : The risk for dementia in Parkinson disease ( PD ) is high , with important clinical consequences for patients with PD . However , the absolute risk of dementia and how it affects survival in PD are not known . Such questions are important for patients , their families , and service providers but require long-term studies . Methods : This study is a prospect i ve longitudinal cohort study with patients from a prevalence study of PD in Norway . Patients were reassessed 4 , 8 , 9 , 10 , 11 , and 12 years after prevalence day . A dementia diagnosis according to Diagnostic and Statistical Manual of Mental Disorders , Third Edition , Revised , criteria was based on a semistructured caregiver interview , cognitive rating scales , and neuropsychological tests . Progression from PD to PD with dementia and death was modeled using a continuous-time three-state irreversible Markov model . Results : A total of 233 PD patients were included , and 140 patients ( 60 % , 95 % CI 54 % to 66 % ) had developed dementia by the end of the study period . The cumulative incidence of dementia steadily increases with age and duration of PD and , conditional on survival , increases to 80 % to 90 % by age 90 years . Women live with PD longer than men and spend more years with dementia . At age 70 years , a man with PD but no dementia has a life expectancy of 8 years , of which 5 years would be expected to be dementia free and 3 years would be expected to be with dementia . Conclusion : Dementia is a key part of survival in Parkinson disease and must be planned for in services for this condition Parkinson disease ( PD ) reduces health-related quality of life ( HRQoL ) , but exercise may improve HRQoL. This pilot study compared the effects of Tango , Waltz/Foxtrot , Tai Chi and No Intervention on HRQoL in individuals with PD . Seventy-five persons with PD ( Hoehn and Yahr I-III ) were assigned to 20 lessons of Tango , Waltz/Foxtrot , Tai Chi , or an untreated No Intervention group . Participants completed the PDQ-39 before and after participation in 20 classes or within 13 weeks in the case of the No Intervention group . Two-way repeated measures ANOVAs determined differences between interventions . Tango significantly improved on mobility ( p=0.03 ) , social support ( p=0.05 ) and the PDQ-39 SI ( p<0.01 ) at post-testing . No significant changes in HRQoL were noted in the Waltz/Foxtrot , Tai Chi or No Intervention . Tango may be helpful for improving HRQoL in PD because it addresses balance and gait deficits in the context of a social interaction that requires working closely with a partner Irrespective of limited evidence , not only traditional physiotherapy , but also a wide array of complementary methods are applied by patients with Parkinson 's disease ( PD ) . We evaluated the immediate and sustained effects of Qigong on motor and nonmotor symptoms of PD , using an add-on design . Fifty-six patients with different levels of disease severity ( mean age/st and ard deviation [ SD ] , 63.8/7.5 years ; disease duration 5.8/4.2 years ; 43 men [ 76 % ] ) were recruited from the outpatient movement disorder clinic of the Department of Neurology , University of Bonn . We compared the progression of motor symptoms assessed by Unified Parkinson 's Disease Rating Scale motor part ( UPDRS-III ) in the Qigong treatment group ( n = 32 ) and a control group receiving no additional intervention ( n = 24 ) . Qigong exercises were applied as 90-minute weekly group instructions for 2 months , followed by a 2 months pause and a second 2-month treatment period . Assessment s were carried out at baseline , 3 , 6 , and 12 months . More patients improved in the Qigong group than in the control group at 3 and 6 months ( P = 0.0080 at 3 months and P = 0.0503 at 6 months ; Fisher 's exact test ) . At 12 months , there was a sustained difference between groups only when changes in UPDRS-III were related to baseline . Depression scores decreased in both groups , whereas the incidence of several nonmotor symptoms decreased in the treatment group only BACKGROUND Aerobic exercise training ( AET ) has been shown to provide health benefits in individuals with Parkinson 's disease ( PD ) . However , it is yet unknown to what extent AET also improves cognitive and procedural learning capacities , which ensure an optimal daily functioning . OBJECTIVE In the current study , we assessed the effects of a 3-month AET program on executive functions ( EF ) , implicit motor sequence learning ( MSL ) capacity , as well as on different health-related outcome indicators . METHODS Twenty healthy controls ( HC ) and 19 early PD individuals participated in a supervised , high-intensity , stationary recumbent bike-training program ( 3 times/week for 12 weeks ) . Exercise prescription started at 20 min ( + 5 min/week up to 40 min ) based on participant 's maximal aerobic power . Before and after AET , EF tests assessed participants ' inhibition and flexibility functions , whereas implicit MSL capacity was evaluated using a version of the Serial Reaction Time Task . RESULTS The AET program was effective as indicated by significant improvement in aerobic capacity in all participants . Most importantly , AET improved inhibition but not flexibility , and motor learning skill , in both groups . CONCLUSION Our results suggest that AET can be a valuable non-pharmacological intervention to promote physical fitness in early PD , but also better cognitive and procedural functioning Background and Purpose Exercise is advocated in the management of Parkinson disease ( PD ) , however , little is known regarding the potential benefits of complementary mind/body exercise for this clinical population . The purpose of this pilot program evaluation was to gain insight into participant and instructor perceptions of the perceived benefits and potential utility of a taiji exercise program . Program Evaluation Program participants ( N= 15 ) included 8 individuals with PD and 7 support partners with no history of PD .  Group taiji instruction was offered in 45-minute weekly sessions , for 12 weeks at a community facility . Postprogram evaluation included administration of a survey question naire , thematic analysis of a focus group discussion , instructor reflections , and review of attendance records . Results Benefits were perceived by participants in physical , psychological , and social domains . Thirteen of the survey respondents , including 6 of the 8 respondents with PD reported perceiving a physical benefit attributed to taiji practice . Improved balance was reported most frequently . Instructor observations and participant testimony suggest movement capability for individuals with Parkinsons may also be improved by performing taiji . Conclusion This preliminary research provides support for further Taiji Buddy program examination and application This study examines the effects of a 16-week Tai Chi ( TC ) training program on the muscle strength , endurance , and reaction time of the lower extremities of elderly people . A total of 40 elderly individuals ( aged 60 years ) completed the study . They were divided into two groups : the TC group ( 11 men and 11 women ) underwent a supervised TC exercise program for 16 weeks , while the control group ( 9 men and 9 women ) received general education for a comparable time period . Pre- and post-intervention measurements were conducted . An isokinetic dynamometer was used to measure the maximum concentric strength and dynamic endurance of the knee flexors and the extensors , and the maximum concentric strength of the ankle plantarflexors and dorsiflexors . The neuromuscular response of the rectus femoris , semitendinosus , gastrocnemius , and anterior tibialis muscles was measured by the onset latency to sudden perturbations using an electromyography system . After 16 weeks , the TC group showed a 19.9 % increase in muscle strength of the knee flexors ( p<.000 ) that was significantly greater than that in the control group ( p=.046 ) . There was also a significant decrease in semitendinosus muscle latency ( 6.6 % , p=.014 ) that was significantly shorter than that in the control group ( p=.042 ) . No significant training effects were found in other measures . These results suggest that improving biomechanical characteristics of lower extremity muscles may need longer TC intervention for elderly people Objective The primary aim of this study was to investigate the effects of two different patterns of rehabilitation training on movement and balance function in patients with idiopathic Parkinson disease . Design Forty patients with Parkinson disease were r and omized into the tai chi group ( n = 20 ) or the multimodal exercise training group ( n = 20 ) . Outcome measures were assessed at baseline and after 12 wks of exercise .  Balance was assessed using the Berg Balance Scale , and movement was assessed by the Unified Parkinson ’s Disease Rating Scale — Motor Examination , stride length , gait velocity , and Timed Up and Go Test . Results The multimodal exercise training group improved significantly in movement from baseline , and a reduction in balance impairment was observed for the multimodal exercise training group . The question naire results after training showed that the multimodal exercise training is easy to learn and adhere to . No major adverse events were noted in both groups . Conclusions This multimodal exercise training could improve motion function and benefit balance function in patients with Parkinson disease . The multimodal exercise training is easy to learn and practice Background Vestibular rehabilitation ( VR ) is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system . Alternative therapies , such as Tai Chi ( TC ) , have recently gained popularity as a treatment for balance impairment . Although VR and TC can benefit people with vestibulopathy , the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown . Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy , r and omized to 10 weeks of either VR or TC exercise .  Time-distance measures ( gait speed , step length , stance duration and step width ) , lower extremity sagittal plane mechanical energy expenditures ( MEE ) , and trunk sagittal and frontal plane kinematics ( peak and range of linear and angular velocity ) , were measured . Results Although gait time-distance measures were improved in both groups following treatment , no significant between-groups differences were observed for the MEE and trunk kinematic measures . Significant within groups changes , however , were observed . The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE , while no significant changes were found within the VR group . The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range , while the VR group exhibited a negative relationship . Conclusion Gait function improved in both groups consistent with expectations of the interventions . Differences in each group 's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations result ing from the different interventions . The TC group 's improvements were associated with reorganized lower extremity neuromuscular patterns , which appear to promote a faster gait and reduced excessive hip compensation . The VR group 's improvements , however , were not the result of lower extremity neuromuscular pattern changes . Lower-extremity MEE increases corresponded to attenuated forward trunk linear and angular movement in the VR group , suggesting better control of upper body motion to minimize loss of balance . These data support a growing body of evidence that Tai Chi may be a valuable complementary treatment for vestibular disorders
PURPOSE To systematic ally evaluate and quantify the effects of Tai Chi/Qigong ( TCQ ) on motor ( UPDRS III , balance , falls , Timed-Up- and -Go , and 6-Minute Walk ) and non-motor ( depression and cognition ) function , and quality of life ( QOL ) in patients with Parkinson 's disease ( PD ) .