PT Critically Appraised Topics

Document Type

Critically Appraised Topic

Publication Date


Clinical Scenario

The patient who led us to pursue this question is a 61 y/o female with a diagnosis of Parkinson’s disease who was seen in an outpatient orthopedic clinic. Problems identified include balance, initiation of gait and bradykinesia. Due to the clinical instructor not being a specialist in Parkinson’s disease, more research was needed to find the most beneficial treatments.

Clinical Question

Is Tai Chi effective at improving gait and balance in patients with Parkinson’s disease?

Clinical Bottom Line

Based on the results of the outcomes from Li et al., 2007, Li et al., 2012, and Hackney and Earhart, Tai Chi is effective at improving gait and balance in patients with mild to moderate Parkinson’s disease. Of the three articles, the greatest improvement for Functional Reach was 4.9 cm, for the Timed Up and Go was 1.36 seconds, and for the Berg Balance Scale was 3.3 points. Improvements were also seen in maximum excursion of 11.98%, stride length of 12.3 cm, gait velocity of 14.9 cm/s, and 50-ft speed walk of 2.3 seconds. Participants in all three studies had similar characteristics to patients that would be seen in an outpatient clinic. Elements of the Tai Chi interventions could easily be incorporated into a physical therapy treatment session. Due to minimal threats to internal validity, the results from the Li et al., 2012 article and the Hackney and Earhart article can be extrapolated to a larger patient population. However, the results from the Li et al., 2007 article should not be used for future clinical intervention due to many major threats to internal validity that significantly compromise the methodological quality of this study.