Effectiveness of Tai Chi as a Community-Based Falls Prevention Intervention: A Randomized Controlled Trial

Authors

  • Denise Taylor PhD,

    Corresponding author
    • Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
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  • Leigh Hale PhD,

    1. Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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  • Philip Schluter PhD,

    1. School of Public Health and Psychosocial Studies, AUT University, Auckland, New Zealand
    2. Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
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  • Debra L. Waters PhD,

    1. Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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  • Elizabeth E. Binns MHSc,

    1. Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
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  • Hamish McCracken MPH,

    1. Business Interdisciplinary Studies, Faculty of Business and Law, AUT University, Auckland, New Zealand
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  • Kathryn McPherson PhD,

    1. Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
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  • Steven L. Wolf PhD

    1. Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia
    2. Department of Medicine, Emory University, Atlanta, Georgia
    3. Department of Cell Biology, School of Medicine, Emory University, Atlanta, Georgia
    4. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
    5. Atlanta Veterans Affairs Rehabilitation Research and Development Center, Atlanta, Georgia
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  • Trial registration number: The Australia and New Zealand Clinical Trials Register number is ACTRN12607000018415.

Address correspondence to Denise Taylor, Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, AUT University, Private Bag 92006, Auckland 1142, New Zealand. E-mail: denise.taylor@aut.ac.nz

Abstract

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.

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