TAI CHI INTERVENTION FOR FALL RISK PREVENTION IN GERIATRIC PATIENTS WITH PARKINSON'S DISEASE. A SYSTEMATIC REVIEW

L.I. Brand Sánchez¹, E.H. Arriaga Díaz¹, M.P. Aboytes Reyes¹, D. Yepez Quiroz¹, M.C. Arenas Arrocena²

¹ENES León, Physiotherapy, Leon, Mexico, ²ENES León, Nanostructures & Biomaterials, Leon, Mexico

Background: Parkinson's disease is a progressive neurodegenerative disease characterized by the progressive loss of dopaminergic neurons of the substantia nigra. Approximately five million people over 50 suffer from this disease, reporting decreased muscle strength, aerobic capacity, functionality, and balance. This disease is manifested mainly in older adults, leads to physical disability, and increases the risk of falling. Regular practice of Tai Chi can improve functional capacity, balance, muscle strength, and endurance in older people; therefore, it can be a complementary treatment strategy to reduce the risk of a fall in patients with Parkinson's disease.

Purpose: To conduct a systematic review of randomized controlled trials on Tai Chi intervention in decreasing the risk of falls in patients with Parkinson's disease.

Methods: A systematic review was carried out using the PRISMA methodology. Related publications were obtained from PubMed and Cochrane databases from the date of their inception until July 2022, using the keywords: "Parkinson's disease," "Tai Chi," "Balance," "Falls," and "Gait." The review included studies that explored the effect of Tai Chi on balance, functionality, and mobility in patients with primary or idiopathic parkinsonism measuring, Unified Parkinson Disease Rating Scale II (UPDRS II) and III (UPDRS III) scales, Time Up and Go Test (TUG) or the Berg Balance Scale. The PEDro scale was used to assess the methodological quality of the included studies.

Results: A total of eight studies were included in the systematic review involving 211 patients. The duration of the intervention ranged from 2 to 12 months. The characteristics of each study were collected, such as type of intervention, duration of treatment, and population characteristics. In all the articles where the UPDRS scale was implemented, there was an average reduction of four points. Likewise, there was a reduction in time in the TUG scale by an average of 3.31 seconds, and finally, in the Berg scale, there was an increase of ten points on average. Therefore, the eight articles reported an improvement in the scales used, indicating an improvement in functionality, balance, and mobility in patients with Parkinson's disease. No study reported adverse effects, demonstrating that Tai Chi practice is a safe intervention.

Conclusions: The results show an improvement in the balance, functionality, and mobility of Parkinson's patients, so it is deduced that the risk of falls in patients decreases with results that favor a low risk of falls. It is important to note that the positive results were only in a population with primary Parkinson's disease. However, there is a need to study the long-term effects and incidence of falls in patients after the interventions.

Implications: Tai Chi is an exercise with a positive effect on balance, mobility, and functionality, reducing the risk of falling in patients with Parkinson's disease, making the physiotherapist a key player in the medical team, both in rehabilitation and prevention. Tai Chi is a safe and suitable exercise to complement the patient's physical activity.

Funding acknowledgements: This review was not funded by any institution or person.

Keywords:
Parkinson´s disease
Tai Chi
Fall

Topics:
Neurology: Parkinson's disease
Older people
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? No

Reason: Not applicable because it is a systematic review.