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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

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The effectiveness of Tai Chi as a fall prevention intervention for older adults: a systematic review

and .

Review published: .

CRD summary

The review concluded that Tai Chi for older adults may be beneficial in reducing fall occurrences, but only in a more robust older population. Restricted reporting of study results coupled with the possibility that the review was subject to language and publication biases mean the authors' conclusions should be interpreted with a degree of caution.

Authors' objectives

To assess the effectiveness of Tai Chi for preventing falls in older adults.

Searching

MEDLINE, EMBASE, CINAHL, SPORTDiscus, AMED, Web of Knowledge, British Nursing Index, and Cochrane Central Register of Controlled Trials were searched from inception (latest date not provided); search terms were reported. Reference lists of obtained articles were searched.

Study selection

Randomised controlled trials (RCTs) of Tai Chi in adults over 60 years of age (frail and pre-frail), and that reported incidence of falls were eligible for inclusion. Interventions where Tai Chi was a component were eligible, as were exercise interventions derived from the principles of Tai Chi. In all included studies a large majority of participants were female. Mean ages ranged from 69 to 85 years. Duration of treatment ranged from 15 weeks to 24 months. Types of Tai Chi used were reported by the authors as being varied. The control/other treatments included education, computerised balance training and strength or stretching exercises.

The authors did not state how many reviewers selected studies for inclusion.

Assessment of study quality

Two reviewers independently assessed study quality according to Scottish Intercollegiate Guidelines Network with randomisation process, allocation concealment, blinding and completeness of follow-up among 10 criteria assessed. Studies were categorised into three groups based on whether all or most, some, or few or no criteria were fulfilled. Disagreements were resolved by discussion, or by a third reviewer.

Data extraction

Two reviewers independently extracted data.

Methods of synthesis

A narrative synthesis was presented.

Results of the review

Six studies (n=1,857) were included in the review. Sample sizes ranged from 110 to 702 participants. One study fulfilled all or most criteria, four fulfilled some criteria and one fulfilled few or no criteria. Only two studies used blinded outcome assessors. Drop-out rates ranged from 3% to 29%.

Three studies reported a statistically significant reduction in risk of falling for the Tai Chi group compared to control/other treatments, in relatively healthy populations living in the community. Three studies of more frail dependent patient populations reported no significant differences, although there were some differences for subpopulations including an increased risk of falling with Tai Chi in frail patients (one study).

Authors' conclusions

Tai Chi for older adults may be beneficial in reducing fall occurrences, but only in a more robust older population.

CRD commentary

The review had a clear aim and was supported by appropriate inclusion criteria. Although numerous databases were searched, the authors acknowledged that the review was prone to possible language bias (only English-language papers were selected and Chinese databases were not searched); publication bias may also have affected the results. The authors adopted methods to reduce risks of reviewer error and bias when extracting data and assessing study quality. Methods used for selecting studies were not reported. The use of a narrative synthesis appeared appropriate. Study quality was adequately assessed and presented. However, effectiveness results were reported only as being significant or not (no actual numbers provided). In light of this restricted reporting, and the possibility that the review was subject to language and publication biases, the authors' conclusions should be interpreted with a degree of caution.

Implications of the review for practice and research

Practice: The authors stated that Tai Chi practice should be promoted as a fall prevention intervention among more robust elderly, but organisers of Tai Chi schemes should be aware of potential increased risk of falling in more frail participants.

Research: The authors stated a need for research into Tai Chi in an elderly male population, modified Tai Chi for the frail elderly (or research on whether other preventative strategies were needed) and more generally for studies in a UK population.

Funding

Not stated.

Bibliographic details

Gregory H, Watson MC. The effectiveness of Tai Chi as a fall prevention intervention for older adults: a systematic review. International Journal of Health Promotion and Education 2009; 47(3): 94-100.

Indexing Status

Subject indexing assigned by CRD

MeSH

Accidental Falls; Aged; Aged, 80 and over; Humans; Tai Ji

AccessionNumber

12009109363

Database entry date

21/04/2010

Record Status

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.

Copyright © 2014 University of York.
Bookshelf ID: NBK78280

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