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Table 1 Characteristics of studies exploring the association between Physical Activity and Balance in community dwelling healthy older adults (50 years and over)

From: The association between balance and free-living physical activity in an older community-dwelling adult population: a systematic review and meta-analysis

Study Author Study Design Study Population Physical Activity measure (type, level) Outcome measures of balance Main Finding
N, Age (mean & range) % female, race, ethnicity, height (m), weight (kg), BMI, education, country, setting, consent More active (MA)
V less active (LA)
Measure, Duration, Intensity Neuromuscular
(Gait (G); Strength (S); Functionality (FU); Flexibility (FL)
Cognitive Sensory Other
Observational Studies:
Aoyagi et al., 2009 [47] Prospective cohort
1 year
Recruitment: Nakanojo study
Conflict of Interest:
N/k
Source of funding: declared
N: 170
Age: 72.6 ± 4.6 yrs
(65-84 yrs)
55% women
Height(m): 1.53 ± 0.08
Weight(kg): 54.3 ± 8.6
BMI: 23.3 ± 3.3
Japan
Community setting
Written informed consent
MA group: 65-74 yr group
LA group: 75-84 yr group
Accelerometer
MA group: 7190 ± 2491
steps per day
LA group: 5482 ± 2829
steps per day
Indirect measure
- (G) Walking speed (preferred &
maximal) (5 m) (velocity - m/s)
- (S) Handgrip test (dynamometer)
(force - n)
- (S) Isometric knee extension
(dynamometer) (torque –
N*m/kg)
- (FL) Functional reach test
(distance - m)
Direct measure
Static balance test:
Total body stability (eyes open/closed) (sway distance - m)
n/a n/a n/a Measures of physical fitness except handgrip and total body sway were greater for MA group (65-74 yr).
Brooke-Wavell & Cooling, 2008 [50] Cross sectional
1 time point
Recruitment: local bowls clubs; media & friends & family)
Conflict of Interest:
N/k
Source of funding: N/k
N: 74
Age: 68.3 ± 4.65 yrs
(60-75 yrs)
100% women
Weight(kg): 69.2 ± 10.1
BMI(kg/m2): 26.95 ± 3.9
Community setting
Written informed consent
MA group: Bowlers
LA group: non-bowlers
MA group:
2–3+ hours of PA per week
LA group: less than 3 h PA per week
Indirect measure
(S) Isometric knee & hip extension (scat & force meter) (force - n)
(S) BUA of the calcaneus (Osteometer) (dB/MHz)
(FL) TUG (3 m) (time - s)
(FL) Range of Motion: shoulder & ankle (goniometer) (degrees°)
Direct measure
Static balance test
Total body stability (eyes open/closed (distance - mm)
Reaction time (s) n/a Falls MA group had significantly better postural stability, muscle strength, and flexibility.
Buatois et al., 2007 [51] Cross sectional
1 time point
Recruitment: cohort from a larger study on fall prevention
Conflict of Interest:
N/k
Source of funding: declared
N: 130
Age: 70.3 ± 4.3 yrs
41% women
BMI(kg/m2): 26.28 ± 3.75
Community setting
Written informed consent
MA group: PA -walking, cycling, swimming, gymnastics;
PA experience: 28 ± 9.5 yrs
LA group: no PA
MA group: 1–2 h per week
LA group: no PA
Direct measure
Sensory Organisation Test (equilibrium scores and composite score)
n/a n/a n/a Sensory conflicting conditions were more challenging for LA group who swayed more and frequently lost balance than MA group.
Dewhurst et al., 2014 [69] Cross sectional
1 time point
Recruitment: n/k
Conflict of Interest:
N/k
Source of funding: N/k
N: 60
Mean age: 69.36 ± 2.9 yrs
(60-80 yrs)
100% women
Height(m): 1.58 ± 0.07
Weight(kg): 64.05 ± 8.15
BMI(kg/m2): 25.95 ± 3.9
Waist(cm):82.45 ± 9.08
Hip (cm): 102.6 ± 7.62
Waist/hip ratio: 0.80 ± 0.2
Scotland
Community setting
Written informed consent
MA group: Dancers
LA group: Non-dancers
RAPA
MA group: 2.5 h hours of PA per week
10 yrs Scottish dance experience
LA group:
2.5 h PA per week (no dancing)
Indirect measure
(G) Walking speed (preferred/maximum) (6 m) (speed - s)
(FL) Timed Up & Go (2.44 m) (time to complete - s)
(FL) Range of motion: Chair sit & reach test (distance - cm)
(FL) Range of motion: Back scratch test (left/right shoulder) (distance - cm)
Direct measure
Static balance test
Total body stability (sway area -cm2)
n/a n/a n/a No differences in measures of flexibility between groups. Better results for MA group on measures of TUG, walking and sway.
Fong & Ng, 2006 [52] Cross sectional
1 time point
Recruitment: n/k
Conflict of Interest:
N/k
Source of funding: N/k
N: 48
Age: 55.4 ± 11.5 yrs
50% women
Community setting
Written informed consent
MA group: tai chi
LA group: no tai chi
MA group: 3-6 h per week
1-3 yrs tai chi experience
LA group: no tai chi
Indirect measure
(FL) Knee repositioning (electrogoniometer) (°degrees; absolute error)
Direct measure
Tilt board (balance time - s)
Reaction time (electromyography) (ms) Knee angle repositioning n/a MA group had better reaction times, knee joint positioning, and dynamic standing balance measures than LA group.
Fong et al., 2014 [53] Cross sectional
1 time point
Recruitment: martial arts and elderly centres
Conflict of Interest:
N/k
Source of funding: N/k
N: 84
Age: 64.39 ± 11.9 yrs
44% women
Weight(Kg): 63.2 ± 11.8
Height(m): 1.60 ± 0.09
BMI(kg/m2): 49.3 ± 3.65
Falls: 0.1 ± 0.35
Community setting
Written informed consent
MA group: martial arts
LA group: no martial arts
MA group: 2 h per week of martial arts
Experience: 8 ± 9.9 yrs
LA group: no martial arts
Direct measure
(S) Bone ultrasound: arm (SOS T & Z scores)
Indirect measure
(FU) Five times sit to stand (time to complete s)
(FU) Berg Balance Scale (14 items) (max score 56)
ABC (16 items) n/a n/a MA had better bone strength, lower limb muscular strength and better functional balance than LA group.
Gao et al., 2011 [48] Cross sectional
1 time point
Recruitment: local golf clubs, community centres
Authors declare no conflict of interest
Source of funding: declared
N: 23
Age: 68.75 ± 6.7 yrs
(60-80 yrs)
0% women
Height(m): 1.6 ± 0.06
China
Community setting
Written informed consent
MA group: Golfers
LA group: Non-golfers
MLTPAQ
MA group:
Light =6
Mod. =4
Heavy =1
LA group:
Light =10
Mod. = 2
Heavy =0
Indirect measure
(FL) Functional reach test (forward) (functional reach normalised with body height - %)
Direct measure
Sensory Organisation Test (somatosensory, visual and vestibular ratios)
MMSE (30 items)
ABC (mod.)(16 items)
n/a n/a MA group had better balance control, reach, postural control, visual & vestibular inputs. No significant difference between somatosensory ratios between groups.
Gauchard et al., 1999 [54] Cross sectional
1 time point
Recruitment: cohort involved in a study of ageing
Conflict of Interest:
N/k
Source of funding: N/k
N: 40
Age: 72.7 ± 6.5 yrs
70% women
Community setting
Informed consent
MA group: yoga & soft gymnastics
LA group: walking
MA group: 90mins per week
LA group: 5 km per week
Indirect measure
(S) Knee & ankle extension/flexion, dynamometer (power - Nm/s; strength - Nm)
Direct measure
Dynamic balance test
AP stability (eyes open/closed) (foot displacement - FFT; strategy type - Type 1, 2, & 3)
n/a n/a n/a Regular PA improves measures of strength and postural control.
Gauchard et al., 2001 [55] Cross sectional
1 time point
Recruitment: cohort involved in a study of ageing
Conflict of Interest:
N/k
Source of funding: N/k
N: 36
Age: 72.9 ± 6.5 yrs
72% women
Community setting
Informed consent
MA group: yoga & soft gymnastics
LA group: walking
MA group: 90mins per week and 5 km walking per week
LA group: 5 km per week
Direct measure
Static balance test
AP (eyes open/closed) (EC/EO ratio)
Dynamic balance test
AP stability (eyes open/closed) (component velocities of nystagmus -left, right, total R-MSCV; L-MSCV; T-MSCV; strategy type Type 1, 2, 3)
n/a Vestibular tests (caloric/rotational-vestibular reflectivity) n/a Inactivity causes poor balance, vestibular hypo excitability and dependency on visual afferent. PA such as yoga improves dynamic postural control.
Gauchard et al., 2003 [56] Cross sectional
1 time point
Recruitment: cohort study of age-related physiology
Conflict of Interest:
N/k
Source of funding: N/k
N: 44
Median age: 73.33 yrs
(63-85 yrs)
100% women
Community setting
Written informed consent
MA group: yoga & soft gymnastics
LA group: no PA: walking
MA group: 90 mins per week
LA group: n/k
Direct measures
Static balance test
Total body stability (sway distance - m; sway area -cm2)
AP & ML stability (eyes open/closed) (sway distance - m; sway area - cm°; ratio - EO/EC)
n/a n/a n/a Regular PA increases postural control in older adults. Proprioceptive PA like yoga is more successful in improving static balance.
Gaudagnin et al., 2015 [71] Cross sectional
1 time point
Recruitment: n/k
Authors declare no conflict of interest
Source of funding declared
N: 24
Age: 67.5 ± 5.5 yrs
100% women
Height(m): 1.54 ± 0.06
Weight(Kg): 65.5 ± 10.5
Brazil
Community setting
Written informed consent
MA group: PA
LA group: no regular PA
MA group: at least 150mins per week
LA group: no PA
Indirect measure
(G) Walking speed (preferred) (8 m) (velocity - m/s)
n/a n/a n/a Active lifestyle improves gait speed.
Gyllensten et al., 2010 [64] Cross sectional
1 timepoint
Recruitment: community centres
Authors declare no conflict of interest
Source of funding: N/k
N: 44
Age: 69.9 ± 6.85 yrs
82% women
Weight(k) 154.8 ± 6.95
Height(m): 1.55 ± 6.95
Hong Kong, China
Community setting
Written informed consent
MA group: Tai chi
LA group: Non-tai chi
MLTPAQ
MA group:
Light =4
Mod. =17
Heavy =3
LA group:
Light =7
Mod. =12
Heavy =1
Indirect measure
(FU) Body Awareness Scale- Healthy (BAS-H) (25 items)
(FU) Single Leg Jump Test (yes/no; s)
Direct measure
Dynamic balance test
Limits of Stability (movement velocity - °/sec; endpoint excursion - %; maximum excursion - %; directional control - %)
MMSE (mod.) (30 items) n/a n/a MA group had better stability limits, increased ability to perform a single leg stance, more stability on landing on one leg, and better body awareness.
Hakim et al., 2004 [70] Cross sectional
1 time point
Recruitment: local tai chi clubs/senior centres
Conflict of Interest:
N/k
Source of funding: N/k
N: 94
Age: 75.2 ± 7.5 yrs
(60-96 yrs)
84% women
87% 1 or more chronic conditions
88% independent ambulation
Pennsylvania; US
Community setting
Written informed consent
MA group: Tai chi
LA group:
No exercise
MA group: 62.5% walk regularly and 100% take a tai chi class 1 or more times per week
tai chi experience: mean 5.6 yrs
LA group: no tai chi and no walking
Indirect measure
(FU) Timed Up & Go (3 m) (time to complete - s)
(FU) Chair stand test (30s) (number of full stands)
(FL): Multidirectional reach test (distance - inches)
ABC (16 items) n/a n/a MA group have better balance performance, confidence, and multidirectional reach results
Hakim et al., 2010 [57] Cross sectional
1 time point
Recruitment: local tai chi/senior centres
Authors declare no conflict of interest
Source of funding: N/k
N: 52
Age: 74.46 ± 5.09 yrs
87% women
Marital status:
Single = 17%; Married = 30%; Divorced = 11%
Widowed = 42%
17% comorbidities
37% fall history
Community setting
Informed consent
MA group: Tai chi
LA group: No exercise
MA: 11.66 ± 5.15 (days/month)
LA group: 10.73 ± 9.52 (days/month)
Indirect measure
(FU) Fullerton Advanced Balance Scale (FAB) (10 items)
(FU) Time Floor Transfer test (time to complete - s)
(FU) Single leg stance (30s) (balance time - s)
(FL) Multidirectional reach test (distance - inches)
ABC (16 items) n/a n/a MA group have better balance performance scores on FAB and multidirectional reach test. No significant differences found on ABC, single leg stance, and Timed floor transfer test between groups
Lu et al., 2013 [65] Cross sectional
1 timepoint
Recruitment: local tai chi clubs/ elderly centres
Authors declare no conflict of interest
Source of funding declared
N: 58
Age: 73.5 ± 5.15 yrs
72% women
Height(m): 1.54 ± 0.80
Weight(kg): 56.95 ± 9.1
Hong Kong, China
Community setting
Written informed consent
MA group: Tai chi
LA group: Non-tai chi
MA group: Light = 4
Mod. =23
Heavy = 1
Minimum of 1.5 h per week tai chi
Tai chi experience: 6.7 ± 4.6 yrs
LA group: No tai chi:
Light = 5
Mod. =25
Heavy = 0
Direct measures
Static balance test
Total body sway (dual and single task) (sway distance - mm; sway area - cm2)
MMSE(30 items)
Auditory Stroop test (reaction time (s); error rate (%)
  n/a MA group performed better in both stepping down and Stroop tests and so have better postural control and cognitive performance whether there is a single or dual task situation.
Perrin et al., 1999 [72] Cross sectional
1 time point
Recruitment: cohort study of ageing
Authors declare no conflict of interest
Source of funding: N/k
N: 65
Age: 71.8 s ± 0.8 yrs
66% women
France
Community setting
MA group: either walking, swimming, cycling, tennis
LA group: no PA
MA group: n/k
LA group: no PA
Direct measure
Static balance test:
Total body stability (eyes open/closed) (sway velocity - cm/s; sway area - cm2)
AP/ML stability (eyes open/closed) (sway velocity -cm/s; sway area - cm2)
Dynamic balance test:
Tilt board (Short, medium, and long latency responses)
n/a n/a n/a Balance in EO or EC conditions is significantly improved in MA group.
Rahal et al., 2015 [58] Cross sectional
1 time point
Recruitment: geriatrician by anamnesis
Conflict of Interest:
N/k
Source of funding: N/k
N: 76
Age: 73.55 yrs
(60-80 yrs)
74% women
Community setting
Written informed consent
MA group: Tai chi group
LA group: Dance group
Measure: n/k
MA group: up to 3 h tai chi per week
LA group: up to 3 h dance per week
Direct measure
Static balance test:
Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) (sway velocity - °/s)
Unilateral stance (sway velocity - °/s)
Dynamic balance test:
Walk across test: (sway speed - cm/s; step width - cm; sway velocity - °/s)
Sit to stand test: (sway velocity - - °/s; weight transfer - s)
n/a n/a n/a MA group had reduced postural sway and thus improved static and dynamic balance.
Tsang & Hui-Chan, 2004 [59] Cross sectional
1 time point
Recruitment: tai chi clubs
Authors declare no conflict of interest
Source of funding declared
N: 47
Age:
69.03 ± 6.37 yrs
0% women
Height(m): 1.61 ± 6.45
Weight(kg): 62.65 ± 7.75
Community setting
Written informed consent
MA group: Tai chi group
Tai chi experience: 8.4 yrs
LA group: No exercise group
MLTPAQ
MA group:
Light =7
Mod. =4
Heavy = 1
PA - Up to 1.5 h p/w
LA group: Light = 10
Mod. =2
Heavy =0
Walked/ stretching exercise daily
Direct measure
Dynamic balance test
Limits of stability test (reaction time (s); maximum excursion (%); directional control (%))
MMSE (30 items) Passive knee joint repositioning test (dynamometer); (absolute angle error - °) n/a MA group had better knee joint proprioception and greater limits of stability (dynamic balance).
Tsang & Hui-Chan, 2005 [60] Cross sectional
1 timepoint
Convenience sampling: tai chi clubs and community centres
Authors declare no conflict of interest
Source of funding declared
N: 48
Age: 70.45 ± 5.55 yrs
50% women
Height(m): 1.55 ± 0.07
Weight(kg): 58.1 ± 9.05
Community setting
Written informed consent
MA group:
Tai chi
LA group: No tai chi
MLTPAQ
MA group:
Light =17
Mod. =5
Heavy = 2
PA Up to 1.5 h per week
LA group:
Light =21
Mod. =3
Heavy =0
Walked/ stretching exercise daily
Indirect measure
(S) Isokinetic knee strength test (dynamometer) (peak torque to body weight ratio)
Direct measure
Static balance test
AP & ML body stability (body sway angle °)
Dynamic balance test
AP & ML body stability (body sway angle °)
ABC (16 items) n/a n/a MA group showed better knee muscle strength, less body sway in static standing and perturbed single leg stance and greater balance confidence.
Tsang & Hui-Chan, 2006 [61] Cross sectional
1 timepoint
Recruitment: tai chi clubs/ community centres
Conflict of interest: N/k
Source of funding: N/k
N: 48
Age: 70.45 ± 5.55 yrs
50% women
Height(m): 1.55 ± 0.09
Weight(kg): 58.1 ± 17.5
Community setting
Written informed consent
MA group: tai chi group
Tai chi experience: mean 8.5 yrs
LA group: No tai chi group
MLTPAQ
MA group:
Light =17
Mod. =5
Heavy =2
PA Up to 1.5 h per week
LA group:
Light =21
Mod. =3
Heavy =0
Walked/ stretching exercise daily
Direct measure
Static balance test
Total body stability pre-& post vestibular stimulation (eyes open/closed) (sway distance - cm)
AP & ML stability pre-& post vestibular stimulation (eyes open/closed) (velocity -cm/s; amplitude°)
n/a n/a n/a MA group have better control of body sway along AP direction.
Tsang & Hui-Chan, 2010 [62] Cross sectional
1 time point
Recruitment: golf clubs/community centres
Authors declare no conflict of interest
Source of funding declared
N: 23
Age: 68.75 ± 6.7 yrs
0% women
Height(m): 1.62 ± 6.95
Weight(kg): 64.05 ± 8.15
Community setting
Written informed consent
Ma group:
Golfers
Golf experience: 15.2 yrs
LA group: Non-golfers
MLTPAQ
MA group:
Light =6
Mod. =4
Heavy =1
PA Up to 1.5 h per week
LA group:
Light =10
Mod. =2
Heavy =0
Walked/ stretching exercise daily
Indirect measure
(FU) Single leg stance (balance time -s)
(FL) forward lunge test (average distance of lunge as % of height)
Direct measure
Dynamic balance test
AP body stability (body sway angle °)
N/a n/a n/a MA group achieved significantly longer stance duration during single-leg stance, better results on perturbed single leg stance, smaller sway, larger lunge distance onto both legs.
Tsang et al., 2004 [66] Cross sectional
1 timepoint
Recruitment: centres for elderly
Conflict of interest: N/k
Source of funding: N/k
N: 60
Age: 53.33 ± 3.73 yrs
50% women
Height(m): 1.57 ± 0.09
Weight(kg): 58.7 ± 9.7
Hong Kong, China
Community setting
Informed consent
MA group:
Tai chi group
Tai chi experience: 7.2 yrs
LA group: No tai chi group
MLTPAQ
MA group:
Light =1
Mod. =15
Heavy =4
PA Up to 3 h per week
LA group:
Light =0
Mod. =15
Heavy = 5
Walked/or stretching exercise daily
Indirect measure
(S) Handgrip test (dynamometer) (strength (Kg))
Direct measure
Sensory Organisation Test (somatosensory, visual, vestibular ratios)
MMSE(mod.)(30 items) n/a n/a MA group had better postural control under reduced or conflicting sensory conditions (increased reliance on vestibular and visual systems).
Wayne et al., 2014 [49] Cross sectional
1 time point
Recruitment: N/k
Conflict of interest: N/k
Source of funding: N/k
N: 87
Age: 63.48 ± 7.63 yrs
(50-79 yrs)
66% women
White: 86%
Non-Hispanic: 98%
Education: 18 ± 3.3 yrs
BMI(kg/m2) 25 ± 3.9
Boston, US
Community setting
MA group: Tai chi expert
LA group: Tai chi naïve
PASS
MA group:
6.0 ± 2.0 (intensity/mins per week)
LA group: 4.4 ± 2.2
(intensity/mins per week
Indirect measure
(FU) Timed Up & Go (time to complete - s)
(FU) Single leg stance (balance time - s)
Direct measure
Static balance test
Total body stability (eyes open/close) (sway velocity (mm/s); sway area (mm2))
Dynamic balance test
AP & ML stability (eyes open/closed) (sway velocity (mm/s)
MMSE (30 items) n/a n/a Complexity based measures of sway, single leg stance and TUG are better for MA group.
Wong et al., 2001 [67] Cross sectional
1 time point
Recruitment: tai chi clubs; volunteer group
Conflict of interest: N/k
Source of funding declared
N: 39
Age: 68.47 ± 5.53 yrs
69% women
Weight(kg): 64.73 ± 8.03
Height(m): 1.57 ± 0.08
Taiwan
Community setting
Informed consent
MA group: tai chi
LA group: no tai chi
MA group: tai chi
Experience: 15.6 ± 10.5 yrs
LA group: no tai chi
Direct measure
Static balance test
Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s)
Dynamic balance test
Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s)
n/a n/a n/a MA group had better postural control than LA group.
Wong et al., 2011 [68] Cross sectional
1 time point
Recruitment: local tai chi clubs
Authors declare no conflict of interest
Source of funding declared
N: 86
Age: 66.93 ± 5.63 yrs
62% women
Weight(Kg): 58.65 ± 8
Height(m): 1.57 ± 0.07
Taiwan
Community setting
Written informed consent
MA group: tai chi
LA group: no PA
MA group: 162mins per week
LA group: no PA
Direct measure
Static balance test
Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s; ankle strategy - %)
Dynamic balance test
Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s; ankle strategy - %)
Reaction time (eye/hand) speed - ms)   n/a MA group showed significantly greater maximal stability, smaller COP velocity, and greater use of ankle strategy, therefore overall better postural control.
Zhang et al., 2011 [63] Cross sectional
1 timepoint
Recruitment: local tai chi/ walking groups
Authors declare no conflict of interest
Source of funding declared
N: 30
Age: 65.7 ± 4.9 yrs
100% women
Community setting
Written informed consent
MA group: Tai chi group
LA group: Walking group
MA group: 7 h per week of tai chi
8.2 yrs tai chi experience
LA group: 7 h per week of walking
8.8 yrs walking experience
Indirect measure
- (FU) Single leg stance (time spent on one leg during walking (s))
- (G) Walking speed (preferred) (velocity (m/s)
n/a n/a n/a MA group have better movement control but LA group have better results on single leg stance measures.
RCT studies:
Paillard et al., 2004 [73] RCT
Baseline & post 12 weeks
Randomised but not specified
Conflict of interest: N/k
Source of funding: N/k
N: 21
Age: 66.15 ± 2 yrs
(63-72 yrs)
0% women
Weight(kg): 74.8 ± 6.7
Height(m): 1.71 ± 0.05
Community setting
Written informed consent
Intervention group: 3 months walking programme
Control: no walking programme
Baseline measure: n/k
MA group: up to 5 h of walking per week for 3 months
LA group: up to 3 h per week no walking programme
Indirect measure
(G) Walking speed (preferred) (velocity - m/min)
Direct measure
Static balance test
Total body stability (eyes open/closed) (sway distance -- mm; sway area -mm2; speed variation; ratio - EO/EC*100)
AP & ML stability (eyes open/closed) (distance - mm; sway area - mm2)
Dynamic balance test
ML stability (eyes open/closed) (position°; amplitude°; spectral energy- %)
n/a n/a n/a 12 week walking programme can improve postural control whilst moving but not when static.
Santos Mendeset al., 2011 [74] RCT
Baseline & post 4 months
stratified by sex & randomised
Conflict of interest: N/k
Source of funding: N/k
N: 30
Age 68.7 ± 3.5 yrs
60% women
Weight(kg): 66.9
Height(m): 1.69
Community setting
Intervention group: 4 months walking programme
Control: no PA
MA group: 1 h per week for 4 months
LA group: no PA
Direct measure
Static balance test
Total body stability (8 positions) (Static Balance Index)
Dynamic balance test
Total body stability (2 tests - hurdle obstacle; sit down and stand up from chair) (Dynamic Balance Index)
n/a n/a n/a Walking is beneficial to both dynamic and static balance.
Wayne et al., 2014 [49] RCT
3 time points: Baseline, 3 months, 6 months
Recruitment: N/k
Conflict of interest: N/k
Source of funding: N/k
N: 60
Age: 64.19 ± 7.72 yrs
(50-79 yrs)
67% women
White: 92%
Non-Hispanic: 98%
Education: 17 ± 3 yrs
BMI(kg/m2): 26.5 ± 5.5
Boston, US
Community setting
MA group;
Tai chi expert
6 months tai chi
LA group: Tai chi naïve
PASS
MA group: 4.0 ± 2.0 (intensity/mins per week)
LA group: 4.0 ± 2.0
(intensity/mins per week
Indirect measure
(FU) Timed Up & Go (time to complete -s)
(FU) Single leg stance (balance time - s)
Direct measure
Static balance test
Total body stability (eyes open/close) (sway velocity - mm/s; sway area - mm2)
Dynamic balance test
AP & ML stability (eyes open/closed) (sway velocity - mm/s)
MMSE (30 items) n/a n/a MA group had no significant short term effects from being more active based on traditional COP measures, but some increases in body sway in complexity COP measures (AP and ML eyes closed) correlated to practice hours.
Yang et al., 2007 [75] RCT
Baseline, 2 month, 6 month
Randomisation program for 4 locations
Conflict of interest: N/k
Source of funding: N/k
N: 49
Age: 80.55 ± 8.49 yrs
(60-97 yrs)
80% women
Retirement home (76%)
MA group: 2 months Tai chi
LA group: no tai chi
Measure: n/k
MA group: 3 h tai chi per week for 2 months
LA group: usual activity 3.67 ± 2.38 h per week
Indirect measure
(FU) Berg Balance (baseline only)
Direct measure
Sensory Organisation Test (somatosensory, visual & vestibular ratios)
Base of support (area - cm2; feet opening angle °)
n/a n/a n/a MA group have better SOT vestibular results and greater Base of Support measures but no differences for SOT visual ratios or feet opening angle between groups.