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Keywords:

  • elderly;
  • falls;
  • tai chi;
  • strength;
  • balance

Objectives

To compare the effectiveness of tai chi and low-level exercise in reducing falls in older adults; to determine whether mobility, balance, and lower limb strength improved and whether higher doses of tai chi resulted in greater effect.

Design

Randomized controlled trial.

Setting

Eleven sites throughout New Zealand.

Participants

Six hundred eighty-four community-residing older adults (mean age 74.5; 73% female) with at least one falls risk factor.

Intervention

Tai chi once a week (TC1) (n = 233); tai chi twice a week (TC2) (n = 220), or a low-level exercise program control group (LLE) (n = 231) for 20 wks.

Measurements

Number of falls was ascertained according to monthly falls calendars. Mobility (Timed-Up-and-Go Test), balance (step test), and lower limb strength (chair stand test) were assessed.

Results

The adjusted incident rate ratio (IRR) for falls was not significantly different between the TC1 and LLE groups (IRR = 1.05, 95% confidence interval (CI) = 0.83–1.33, P = .70) or between the TC2 and LLE groups (IRR = 0.88, 95% CI = 0.68–1.16, P = .37). Adjusted multilevel mixed-effects Poisson regression showed a significant reduction in logarithmic mean fall rate of −0.050 (95% CI = −0.064 to −0.037, P < .001) per month for all groups. Multilevel fixed-effects analyses indicated improvements in balance (P < .001 right and left leg) and lower limb strength (P < .001) but not mobility (P = .54) in all groups over time, with no differences between the groups (P = .37 (right leg), P = .66 (left leg), P = .21, and P = .44, respectively).

Conclusion

There was no difference in falls rates between the groups, with falls reducing similarly (mean falls rate reduction of 58%) over the 17-month follow-up period. Strength and balance improved similarly in all groups over time.