Sensorimotor control of balance: A Tai Chi solution for balance disorders in older subjects

Background/Aims: In addition to environmental factors, deteriorating sensorimotor control of balance will predispose older adults to falls. Understanding the aging effects on sensorimotor control of balance performance is important for designing fall prevention programs for older adults. How repeated practice of Tai Chi can improve limb joint proprioception, integration of neural signals in the central nervous system for balance control, and motor output at the level of knee muscles is discussed in this chapter. Results: Our previous studies showed that elderly Tai Chi practitioners performed significantly better than elderly nonpractitioners in (1) knee joint proprioception, (2) reduced or conflicting sensory situations that demand more visual or vestibular contributions, (3) standing balance control after vestibular stimulation without visual input, (4) voluntary weight shifting in different directions within the base of support, (5) single-leg stance during perturbations of the support surface, and (6) knee extensor and flexor muscle strength. In a prospective study, we further showed that 4 weeks of daily Tai Chi practice but not general education produced significant improvement in balance performance. Conclusion: The requirements of Tai Chi for accurate joint positioning and weight transfer involving smooth coordination of neck, trunk, upper and lower limb movements, make it particularly useful for improving the sensorimotor control of balance in the elderly. Because Tai Chi can be practiced any time and anywhere, and is well accepted by older people in both the East and now the West, it is especially suited to be a key component of a low-costing community-based fall prevention program alongside with education about environmental factors.