Effects of Tai Chi Chuan on Postural Stability and Lower-Limb Biomechanical Characteristics in Patients With Functional Ankle Instability: A Randomized Controlled Trial.

OBJECTIVES

To evaluate the effects of a 12-week Tai Chi Chuan (TCC) program on ankle instability/function, pain, and gait/balance performance in patients with functional ankle instability (FAI).

DESIGN

Prospective, single-blind randomized controlled trial.

SETTING

Clinical gait analysis laboratory with community-based recruitment.

PARTICIPANTS

Fifty patients with FAI were randomly divided 1:1 to a TCC group (n=25; age 65.44±8.75y; 18 women/7 men) or a control group (n=25; age 67.08±4.76y; 22 women/3 men). By eligibility criteria, all participants had experienced at least 1 severe ankle sprain within the prior year and had recurrent episodes of giving way/instability in the prior year.

INTERVENTIONS: The TCC group completed supervised simplified 24-form TCC training 3 sessions/wk for 12 weeks; controls received structured health education once every 4 weeks for 12 weeks.

MAIN OUTCOME MEASURES: The primary outcome was the Cumberland Ankle Instability Tool (CAIT). Secondary outcomes included the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score, pain intensity (visual analog scale [VAS]), 3-dimensional gait spatiotemporal and sagittal kinematic parameters, and postural control (Huber360 static balance metrics and the Y-Balance Test [YBT]).

RESULTS

After 12 weeks, CAIT increased by 10.32 points in the TCC group (14.48±5.53 to 24.80±4.21) compared with 2.84 points in the control group (15.16±5.98 to 18.00±5.05), with a significant between-group difference (P<.01), exceeding the CAIT minimal clinically important difference (MCID) (≥3 points); American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score and VAS also improved more with TCC (all P<.05), with changes within/above published AOFAS MCID estimates (7.9-30.2 points) and exceeding the commonly used VAS MCID (∼1.4 cm). The TCC group also demonstrated improvements in step width, selected sagittal-plane hip/ankle kinematics, and Y-Balance Test performance compared with controls (P<.05).

CONCLUSIONS

A 12-week TCC program may provide clinically meaningful improvements in ankle stability and function, reduce pain, and enhance gait and balance performance in patients with FAI.