T'ai chi chuan is a beneficial exercise of improving health and function. Biomechanical insights of t'ai chi chuan are less understood.
Objectives:
To study t'ai chi gait (TCG), a common form of t'ai chi chuan in order to quantify external knee adduction moment (EKAM) as a key indicator of mechanical loading of the medial compartment of the knee compared with normal walking (NW).
Design:
A quantitative biomechanics approach to determine peak EKAM for NW and TCG.
Results:
There were a tri-modal pattern of EKAM during TCG and a bimodal pattern of EKAM during normal walking. In addition, subsequent analysis showed a 25%–47% reduction in peak EKAM during double support phases of TCG compared with NW; the peak EKAM of TCG during single-limb support phase showed significantly higher magnitude than the other two double-support phases.
Conclusion:
These results indicate that t'ai chi chuan might be a beneficial intervention for reducing the medial mechanical load at the knee joint, particularly during the first double-support phases of TCG, but the special consideration of higher peak EKAM of single-limb support phase is needed during regular t'ai chi chuan practice.
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References
1.
LanC, LaiJS, ChenSY, WongMK. 12-month tai chi training in the elderly: its effect on health and fitness. Med Sci Sport Exer, 1998; 30:345–351.
2.
ThorntonEW, SykesKS, TangWK. Health benefits of tai chi exercise: improved balance and blood pressure in middle-aged women. Health Promot Int, 2004; 19:33–38.
3.
LiJX, HongY, ChanKM. Tai chi: physiological characteristics and beneficial effects on health. Br J Sport Med, 2001; 35:118–156.
4.
WaynePM, KaptchukTJ. Challenges inherent to t'ai chi research: Part I- T'ai Chi as a complex multicomponent intervention. J Altern Complement Med, 2008; 14:95–102.
5.
WuG, MillonD. Joint kinetics during tai chi gait and normal walking gait in young and elderly Tai Chi Chuan practitioners. Clin Biomech, 2008; 23:787–795.
6.
WuG, LiuW, HittJ, MillonD. Spatial, temporal, and muscle action patterns of tai chi gait. J Electromyog Kines, 2004; 14:343–354.
7.
WuG, HittJ. Ground contact characteristics during tai chi gait. Gait Posture, 2005; 22:32–39.
8.
WongAM, LinYC, ChouSW, TangFT, WongPY. Coordination exercise and postural stability in elderly people: effect of tai chi chuan. Arch Phys Med Rehab, 2001; 82:608–612.
9.
JacobsenBH, ChenH, CashelC, et al.The effect of tai chi chuan training on balance, kinesthetic sense, and strength. Percept Motor Skill, 1997; 84:27–33.
10.
HainT, FullerL, WeilL, KotsiasJ. Effects of t'ai chi on balance. Arch Otolaryngol, 1999; 125:1191–1195.
11.
WuG, ZhaoF, ZhouXL, WeiL. Long-term tai chi exercise improves isokinetic strength of knee flexors and reduces postural sway in the elderly. Arch Phys Med Rehab, 2002; 83:1364–1369.
12.
WolfSL, SattinR, KutnerM, et al.Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized control trial. J Am Geriatr Soc, 2003; 51:1693–1701.
13.
WuG. Evaluation of the effectiveness of tai chi chuan for improving balance and preventing falls in the older population. J Am Geriatr Soc, 2002; 50:746–754.
14.
WuG. Age-related differences in tai chi gait kinematics and leg muscle electromyography: a pilot study. Arch Phys Med Rehab, 2008; 89:351–357.
15.
BirminghamTB, HuntMA, JonesIC, JenkynTR, GiffinJR. Test-retest reliability of the peak adduction moment during walking in patients with medial compartment knee osteoarthritis. Arthritis Rheum, 2007; 57:1012–1017.
16.
ZhaoD, BanksSA, MitchellKH, et al.Correlation between the knee adduction torque and medial contact force for a variety of gait patterns. J Orthop Res, 2007; 25:789–797.
17.
HuntMA, BirminghamTB, GiffinJR, JenkynTR. Associations among knee adduction moment, frontal plane ground reaction force, and lever arm during walking in patients with knee osteoarthritis. J Biomech, 2006; 39:2213–2220.
18.
SimicM, HinmanRS, WrigleyTV, BennellKL, HuntMA. Gait modification strategies for altering medial knee joint load: a systematic review. Arthrit Care Res, 2011; 63:405–426.
19.
AstephenJL, DeluzioKJ, CaldwellGE, DunbarMJ. Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res, 2008; 26:332–341.
20.
BaliunasAJ, HurwitzDE, RyalsAB, et al.Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarth Cartilage, 2002; 10:573–579.
21.
LulianoB, GrahnD, CaoV, ZhaoB, RoseJ. Physiologic correlates of t'ai chi chuan. J Altern Complem Med, 2011; 17:77–81.
22.
WinterDA. Biomechanics and Motor Control of Human Movement. 3rd ed. New York: John Wiley & Sons, 2005.
23.
ChangA, HayesK, DunlopD, et al.Hip abduction moment and protection against medial tibiofemoral osteoarthritis progression. Arthritis Rheum, 2005; 52:3515–3519.
24.
ChangA, HurwitzD, DunlopD, et al.The relationship between toe-out angle during gait and progression of medial tibiofemoral osteoarthritis. Anal Rheum Dis, 2007; 66:1271–1275.
25.
JenkynTR, HuntMA, JonesIC, GiffinJR, BirminghamTB. Toe-out gait in patients with knee osteoarthritis partially transforms external knee adduction moment into flexion moment during the early stance phase of gait: a tri-planar kinetic mechanism. J Biomech, 2008; 41:276–283.
26.
ChangWN, TsirikosAI, MillerF, SchuylerJ, GluttingJ. Impact of changing foot progression angle on foot pressure measurement in children with neuromuscular diseases. Gait Posture, 2004; 20:14–19.
27.
FreglyBJ, ReinboltJA, ChmielewskiTL. Evaluation of a patient-specific cost function to predict the influence of foot path on the knee adduction torque during gait. Comput Method Biomec, 2008; 11:63–71.
