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Effect of home-based Tai Chi, yoga or conventional balance exercise on functional balance and mobility among persons with idiopathic Parkinson's disease: an experimental study
Khuzema A, Brammatha A, Arul Selvan V
Hong Kong Physiotherapy Journal 2020 Jun;40(1):39-49
clinical trial
5/10 [Eligibility criteria: No; Random allocation: No; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Individuals with Parkinson's disease (PD) invariably experience functional decline in a number of motor and non-motor domains affecting posture, balance and gait. Numerous clinical studies have examined effects of various types of exercise on motor and non-motor problems. But still much gap remains in our understanding of various therapies and their effect on delaying or slowing the dopamine neuron degeneration. Recently, Tai Chi and yoga both have gained popularity as complementary therapies, since both have components for mind and body control. OBJECTIVE(S): The aim of this study was to determine whether eight weeks of home-based Tai Chi or yoga was more effective than regular balance exercises on functional balance and mobility. METHOD(S): Twenty-seven individuals with Idiopathic PD (Modified Hoehn and Yahr stages 2.5 to 3) were randomly assigned to either Tai Chi, yoga or conventional exercise group. All the participants were evaluated for Functional Balance and Mobility using Berg Balance Scale, Timed 10 m Walk test and Timed Up and Go test before and after eight weeks of training. RESULT(S): The results were analyzed using two-way mixed ANOVA which showed that there was a significant main effect for time as F[1,24] = 74.18, p = 0.000, partial eta-squared = 0.76 for overall balance in Berg Balance Scale. There was also significant main effect of time on mobility overall as F[1,24] = 77.78, p = 0.000, partial eta-squared = 0.76 in Timed up and Go test and F[1,24] = 48.24, p = 0.000, partial eta-squared = 0.67 for 10 m Walk test. There was a significant interaction effect for time x group with F[2,24] = 8.67, p = 0.001, partial eta-squared = 0.420 for balance. With respect to mobility, the values F[2,24] = 5.92, p = 0.008, partial eta-squared = 0.330 in Timed Up and Go test and F[2,24] = 10.40, p = 0.001, partial eta-squared = 0.464 in 10 m Walk test showed a significant interaction. But there was no significant main effect between the groups for both balance and mobility. CONCLUSION(S): The findings of this study suggest that Tai Chi as well as yoga are well adhered and are attractive options for a home-based setting. As any form of physical activity is considered beneficial for individuals with PD either Tai Chi, yoga or conventional balance exercises could be used as therapeutic intervention to optimize balance and mobility. Further studies are necessary to understand the mind-body benefits of Tai Chi and yoga either as multicomponent physical activities or as individual therapies in various stages of PD.

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