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Intense Tai Chi Exercise Training and Fall Occurrences in Older, Transitionally Frail Adults: A Randomized, Controlled Trial

Authors

  • Steven L. Wolf PhD, FAPTA,

    1. From the *Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GeorgiaCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GeorgiaDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia§Center for Human Movement Studies, School of Applied Physiology, Georgia Institute of Technology, Atlanta, Georgia.
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  • Richard W. Sattin MD,

    1. From the *Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GeorgiaCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GeorgiaDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia§Center for Human Movement Studies, School of Applied Physiology, Georgia Institute of Technology, Atlanta, Georgia.
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  • Michael Kutner PhD,

    1. From the *Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GeorgiaCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GeorgiaDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia§Center for Human Movement Studies, School of Applied Physiology, Georgia Institute of Technology, Atlanta, Georgia.
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  • Michael O'Grady MD,

    1. From the *Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GeorgiaCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GeorgiaDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia§Center for Human Movement Studies, School of Applied Physiology, Georgia Institute of Technology, Atlanta, Georgia.
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  • Arlene I. Greenspan Dr PH,

    1. From the *Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GeorgiaCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GeorgiaDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia§Center for Human Movement Studies, School of Applied Physiology, Georgia Institute of Technology, Atlanta, Georgia.
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  • Robert J. Gregor PhD

    1. From the *Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GeorgiaCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GeorgiaDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia§Center for Human Movement Studies, School of Applied Physiology, Georgia Institute of Technology, Atlanta, Georgia.
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  • This research was supported by National Institutes of Health Grant AG 14767 from the National Institute on Aging and coupons for redeemable products from the Kroger Corporation and CVS Pharmacies for each participant upon completion of participation.

Address correspondence to Steven L. Wolf, PhD, FAPTA, Center for Rehabilitation Medicine, Room 206, Department of Rehabilitation Medicine, 1441 Clifton Road NE, Atlanta, GA 30322. E-mail: swolf@emory.edu

Abstract

Objectives: To determine whether an intense tai chi (TC) exercise program could reduce the risk of falls more than a wellness education (WE) program in older adults meeting criteria for transitioning to frailty.

Design: Randomized, controlled trial of 48 weeks duration.

Setting: Twenty congregate living facilities in the greater Atlanta area.

Participants: Sample of 291 women and 20 men aged 70 to 97.

Measurements: Demographics, time to first fall and all subsequent falls, functional measures, Sickness Impact Profile, Centers for Epidemiologic Studies—Depression Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scales, and adherence to interventions.

Results: The risk ratio (RR) of falling was not statistically different in the TC group and the WE group (RR=0.75, 95% confidence interval (CI)=0.52–1.08), P=.13). Over the 48 weeks of intervention, 46% (n=132) of the participants did not fall; the percentage of participants that fell at least once was 47.6% for the TC group and 60.3% for the WE group.

Conclusion: TC did not reduce the RR of falling in transitionally frail, older adults, but the direction of effect observed in this study, together with positive findings seen previously in more-robust older adults, suggests that TC may be clinically important and should be evaluated further in this high-risk population.

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