Balance and strength training in older adults: Intervention gains and Tai Chi maintenance

OBJECTIVE: To determine the effect on balance and strength of 3 months of intensive balance and/or weight training followed by 6 months of low intensity Tai Chi training for maintenance of gains. DESIGN: Randomized control intervention. Four groups in 2 x 2 design: Control, Balance, Strength, Balance + Strength, using blinded testers. SETTING: Exercise and balance laboratory at University of Connecticut Health Center. PARTICIPANTS: Subjects were 110 healthy community dwellers (mean age 80) who were free of dementia, neurological disease, and serious cardiovascular or musculoskeletal conditions. INTERVENTIONS: Short-term training (3 months) occurred 3 times/week (45 minutes Balance and Strength, 90 minutes Balance + Strength). Balance training included equilibrium control exercises on firm and foam surfaces and center-of-pressure biofeedback. Strengthening consisted of lower extremity weight-lifting. All subjects then received long-term group Tai Chi instruction (6 months, 1 hour, 1 time/week). MEASUREMENTS: Losses of balance during Sensory Organization Testing (LOB), single stance time (SST), voluntary limits of stability (FBOS), summed isokinetic torque of eight lower extremity movements (ISOK), and usual gait velocity (GVU). RESULTS AND CONCLUSIONS: Balance training meaningfully improved all balance measures by restoring performance to a level analogous to an individual 3 to 10 years younger: LOB = -2.0 ± 0.3 (adjusted paired differences, P < .005 ANOVA); SST = 7.0 ± 1.2 sec; and FBOS = 9.0 ± 2.0% of foot length (P < .05). Strengthening increased ISOK by 1.1 ± 0.1 Nm kg^-1 (P < .005). There was no interaction between balance and strength training. Significant gains persisted after 6 months of Tai Chi, although there was some decrement.