Improve Balance in the Elderly by Uncoupling Posture and Respiration with Tai Chi

Improve Balance in the Elderly by Uncoupling Posture and Respiration with Tai Chi


By John M. de Castro, Ph.D.

“Practising the ancient martial art of Tai Chi is so beneficial to elderly people’s health that it should be “the preferred mode of training”, according to scientists.” – The Telegraph


The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly. Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of fall in the elderly.


An interesting contributor to imbalance is the synchronization of respiration with postural sway. When a person stands erect, with eyes closed, there is a normal sway in the posture. When respiration occurs the expansion of the abdomen and chest produces a slight shift in the center of gravity and the body sways to compensate. When the normal sway becomes synchronized with the sway produced by respiration, it results in an exaggeration of the sway. This produces a greater imbalance. This is usually minor and of very little consequence. But, in the elderly, with compromised balance and muscular control, the small extra imbalance may be a contributor to falls.


Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the likelihood of falls in the elderly. One possible way that Tai Chi training may contribute to the decrease in falls is by decreasing posturo-respiratory synchronization. This interesting speculation has not been previously investigated.


In today’s Research News article “Tai Chi training reduced coupling between respiration and postural control.” See summary below or view the full text of the study at:

Holmes and colleagues investigate the effect of Tai Chi training on posturo-respiratory synchronization. They recruited healthy males and females over 70 years of age and randomly assigned them to receive either Tai Chi training or education. Tai Chi training consisted of 12 weeks of instructor led group training for one hour, twice a week. The education condition involved health related lectures on the same schedule as the Tai Chi training. Before and after training the elderly were measured for postural sway, respiration and posturo-respiratory synchronization.


They found that after training neither group showed a change in postural sway or in respiration. Although the two groups did not differ in posturo-respiratory synchronization before training, after training the Tai Chi had significantly smaller posturo-respiratory synchronization than they did during baseline and in comparison to the education group. Hence, Tai Chi training reduced the contribution of posturo-respiratory synchronization to imbalance in the elderly. This may be one of the mechanisms by which Tai Chi training improves balance and reduces falls in the elderly.


Falls become more and more likely with age and the consequences of falls to the elderly can be devastating. So, a practice that can lower the risk of falls is important for the health and well-being of the elderly. Tai Chi is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects. So, it is well suited as an exercise for an elderly population. In addition, once learned it can be practiced at home or in groups, making it a flexible very low cost solution. Hence, it appears that Tai Chi should be recommended to the elderly to improve balance and reduce falls and thereby improve the health and well-being of the elderly.


So, improve balance in the elderly by uncoupling posture and respiration with tai chi.


“One of the greatest benefits of Tai Chi for the elderly is that even individuals who have physical limitations can practice this ancient healing art. Because it is comprised of a series of slow, relaxed movements, Tai chi is a non-strenuous activity that will not put added strain on weakened muscles. Tai Chi movements help encourage proper posture and rely on constant gentle movements that force the individual to concentrate and breathe deeply, two important techniques that are often overlooked in the elderly community.” – Delialah Falcon


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+ and on Twitter @MindfulResearch


Study Summary

Holmes, M. L., Manor, B., Hsieh, W., Hu, K., Lipsitz, L. A., & Li, L. (2016). Tai Chi training reduced coupling between respiration and postural control. Neuroscience Letters, 610, 60–65.



  • Tai Chi training did not affect average sway speed& magnitude or respiratory rate
  • Yet tai Chi training reduced the impact of respiration on postural sway
  • The effects of Tai Chi on postural control could be optimized system interaction


In order to maintain stable upright stance, the postural control system must account for the continuous perturbations to the body’s center-of-mass including those caused by spontaneous respiration. Both aging and disease increase “posturo-respiratory synchronization;” which reflects the degree to which respiration affects postural sway fluctuations over time. Tai Chi training emphasizes the coordination of respiration and bodily movements and may therefore optimize the functional interaction between these two systems. The purpose of the project was to examine the effect of Tai Chi training on the interaction between respiration and postural control in older adults. We hypothesized that Tai Chi training would improve the ability of the postural control system to compensate for respiratory perturbations and thus, reduce posturo-respiratory synchronization. Participants were recruited from supportive housing facilities and randomized to a 12-week Tai Chi intervention (n=28; 86±5yrs) or educational-control program (n=34, 85±6yrs). Standing postural sway and respiration were simultaneously recorded with a force plate and respiratory belt under eyes-open and eyes-closed conditions. Posturo-respiratory synchronization was determined by quantifying the variation of the phase relationship between the dominant oscillatory mode of respiration and corresponding oscillations within postural sway. Groups were similar in age, gender distribution, height, body mass, and intervention compliance. Neither intervention altered average sway speed, sway magnitude or respiratory rate. As compared to the education-control group, however, Tai Chi training reduced posturo-respiratory synchronization when standing with eyes open or closed (p<0.001). Tai Chi training did not affect traditional parameters of standing postural control or respiration, yet reduced the coupling between respiration and postural control. The beneficial effects of Tai Chi training may therefore stem in part from optimization of this multi-system interaction.


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