Get access

Selected As the Best Paper in the 1990s: Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training

Authors

  • Steven L. Wolf PhD, FAPTA,

    1. From the *Department of Rehabilitation Medicine, School of Nursing, §Division of Physical Therapy Education, and Department of Biochemistry, Emory University School of MedicineDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia. **See Acknowledgment for members of the Atlanta FICSIT Group.
    Search for more papers by this author
  • Huimnan X. Barnhart PhD,

    1. From the *Department of Rehabilitation Medicine, School of Nursing, §Division of Physical Therapy Education, and Department of Biochemistry, Emory University School of MedicineDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia. **See Acknowledgment for members of the Atlanta FICSIT Group.
    Search for more papers by this author
  • Nancy G. Kutner PhD,

    1. From the *Department of Rehabilitation Medicine, School of Nursing, §Division of Physical Therapy Education, and Department of Biochemistry, Emory University School of MedicineDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia. **See Acknowledgment for members of the Atlanta FICSIT Group.
    Search for more papers by this author
  • Elizabeth Mcneely PhD,

    1. From the *Department of Rehabilitation Medicine, School of Nursing, §Division of Physical Therapy Education, and Department of Biochemistry, Emory University School of MedicineDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia. **See Acknowledgment for members of the Atlanta FICSIT Group.
    Search for more papers by this author
  • Carol Coogler ScD, PT,

    1. From the *Department of Rehabilitation Medicine, School of Nursing, §Division of Physical Therapy Education, and Department of Biochemistry, Emory University School of MedicineDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia. **See Acknowledgment for members of the Atlanta FICSIT Group.
    Search for more papers by this author
  • Tingsen Xu PhD,

    1. From the *Department of Rehabilitation Medicine, School of Nursing, §Division of Physical Therapy Education, and Department of Biochemistry, Emory University School of MedicineDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia. **See Acknowledgment for members of the Atlanta FICSIT Group.
    Search for more papers by this author
  • and the Atlanta FICSIT Group

    1. From the *Department of Rehabilitation Medicine, School of Nursing, §Division of Physical Therapy Education, and Department of Biochemistry, Emory University School of MedicineDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia. **See Acknowledgment for members of the Atlanta FICSIT Group.
    Search for more papers by this author

  • The study was supported by NIH Cooperative Grant No. U01-AG09124 from the National Institute on Aging.

Address correspondence reprint request to Steven L. Wolf, PhD, FAPTA, Center for Rehabilitation Medicine, 1441 Clifton Road, NE, Atlanta, GA 30322.

Abstract

Objectives: To evaluate the effects of two exercise approaches, tai chi (TC) and computerized balance training (BT), on specified primary outcomes (biomedical, functional, and psychosocial indicators of frailty) and secondary outcomes (occurrences of fall).

Design: The Atlanta Frailty and Injuries: Cooperative Studies and Intervention Techniques, a prospective, randomized, controlled clinical trial with three arms (TC, BT, and education (ED)). Intervention length was 15 weeks, with primary outcomes measured before and after intervention and at 4-month follow-up. Falls were monitored continuously throughout the study.

Setting: Persons aged 70 and older living in the community.

Participants: A total of 200 participants, 162 women and 38 men; mean age was 76.2.

Measurements: Biomedical (strength, flexibility, cardiovascular endurance, body composition), functional instrumental activities of daily living (IADL), and psychosocial well-being (Center for Epidemiological Studies for Depression scale, fear of falling questionnaire, self-perception of present and future health, mastery index, perceived quality of sleep, and intrusiveness) variables.

Results: Grip strength declined in all groups, and lower extremity range of motion showed limited but statistically significant changes. Lowered blood pressure before and after a 12-minute walk was seen following TC participation. Fear of falling responses and intrusiveness responses were reduced after the TC intervention compared with the ED group (P=.046 and P=.058, respectively). After adjusting for fall risk factors, TC was found to reduce the risk of multiple falls by 47.5%.

Conclusion: A moderate TC intervention can impact favorably on defined biomedical and psychosocial indices of frailty. This intervention can also have favorable effects upon the occurrence of falls. TC warrants further study as an exercise treatment to improve the health of older people.

Get access to the full text of this article

Ancillary