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Effectiveness of Tai Chi as a Community‐Based Falls Prevention Intervention: A Randomized Controlled Trial
Author(s) -
Taylor Denise,
Hale Leigh,
Schluter Philip,
Waters Debra L.,
Binns Elizabeth E.,
McCracken Hamish,
McPherson Kathryn,
Wolf Steven L.
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.03928.x
Subject(s) - medicine , randomized controlled trial , fall prevention , poison control , intervention (counseling) , physical therapy , suicide prevention , injury prevention , human factors and ergonomics , occupational safety and health , gerontology , medical emergency , nursing , surgery , pathology
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 N ew Z ealand. 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 ( TC 1) (n = 233); tai chi twice a week ( TC 2) (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 ( T imed‐ U p‐and‐ G o T est), 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 TC 1 and LLE groups ( IRR = 1.05, 95% confidence interval ( CI ) = 0.83–1.33, P = .70) or between the TC 2 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.