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J Am Med Dir Assoc. 2015 May 1;16(5):420-6. doi: 10.1016/j.jamda.2015.01.089. Epub 2015 Mar 10.

Impact of tai-chi on falls among preclinically disabled older people. A randomized controlled trial.

Author information

1
Falls Prevention Research Unit, Monash Injury Research Institute, Monash University, Melbourne, Australia. Electronic address: lesley.day@monash.edu.
2
Faculty of Health Sciences, School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia. Electronic address: keith.hill@curtin.edu.au.
3
Falls Prevention Research Unit, Monash Injury Research Institute, Monash University, Melbourne, Australia.
4
Center for Medical Research, University of Western Australia, Perth, Australia.
5
Division of Health Sciences, School of Population Health, University of South Australia, Adelaide, Australia.
6
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Abstract

OBJECTIVE:

To investigate the effectiveness of tai-chi in preventing falls among community-dwelling older people.

DESIGN:

Multisite parallel group individually randomized controlled trial.

SETTING:

Melbourne, Australia.

PARTICIPANTS:

Preclinically disabled community-dwelling people 70 + years (n = 503), without major medical conditions or moderate to severe cognitive impairment.

INTERVENTION:

Sixty-minute modified Sun style tai-chi group-based exercise program twice weekly for 48 weeks; control intervention was a seated group-based flexibility exercise program of the same dose.

MEASUREMENTS:

All falls, self-reported using a monthly calendar, analyzed at 24 weeks and 48 weeks. Injurious falls reported in follow-up telephone interviews for each reported fall.

RESULTS:

The adjusted fall incidence rate ratios at 24 and 48 weeks were 1.08 [(95% confidence interval (CI) 0.64-1.81)], and 1.12 (95% CI 0.75-1.67), respectively. A higher proportion of intervention participants ceased attendance in the first 24 weeks (difference 17.9%, 95% CI 9.6-25.8), and the second 24 weeks (2.7%, 95% CI -5.0 to 10.4). Intervention participants who ceased attendance had lower left quadriceps strength (difference 3.3 kg 95% CI 0.15-6.36) and required longer to complete the timed up and go test (difference 1.7 seconds 95% CI 0.22-3.17) at baseline.

CONCLUSIONS:

This study does not support modified Sun style tai-chi as a falls prevention measure among relatively well community-dwelling older people with modified mobility and at increased risk of disability. Insufficient intervention intensity, or low exercise class attendance may have contributed to the lack of effect, as may have attrition bias among the intervention group.

KEYWORDS:

Falls; older people; tai-chi

PMID:
25769960
DOI:
10.1016/j.jamda.2015.01.089
[Indexed for MEDLINE]

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