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Evaluating Exercise Prescription and Instructional Methods Used in Tai Chi Studies Aimed at Improving Balance in Older Adults: A Systematic Review
Author(s) -
Wu Yin,
MacDonald Hayley V.,
Pescatello Linda S.
Publication year - 2016
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/jgs.14242
Subject(s) - medicine , psychological intervention , randomized controlled trial , medical prescription , physical therapy , cinahl , balance (ability) , medline , exercise prescription , gerontology , nursing , political science , law
Objectives To develop an evaluation instrument to determine to what extent Tai Chi interventions aimed at improving the balance of older adults disclosed their exercise prescription (Ex R x ) and instructional methods and met best‐practice exercise recommendations for balance improvement. Design Review. Setting PubMed, Scopus, and CINAHL databases were searched from their inception until August 22, 2014. Participants Adults aged 60 and older without debilitating disease. Measurements Three electronic databases were searched to identify randomized controlled trials ( RCT s) of Tai Chi interventions aimed at improving balance in older adults without severe debilitating diseases. Three Ex R x (frequency, time, intervention length) and 10 instructional (e.g., style, number of forms) methods of the included RCT s were evaluated. Results Twenty‐seven interventions were identified from 26 RCT s. On average, Tai Chi was performed for a mean 56.5 ± 14.4 minutes per session for 2.8 ± 1.4 sessions per week for 19.7 ± 12.7 weeks. Most interventions reported all three Ex R x methods items, with a mean reporting rate of 92.6 ± 19.2%. For the 10 instructional methods items, the mean reporting rate was 41.1 ± 18.0%, significantly lower than for the Ex R x methods items ( P < .001). Fewer than half of the interventions reported unsupervised practice (15%), progression (22%), or the use of breathing (30%) and relaxation (15%) techniques. The instructional methods items most important for targeting Tai Chi practice to improve balance were not routinely disclosed, with only 15% reporting names of forms and 52% reporting movement principles. Conclusion Most Tai Chi interventions disclosed their Ex R x methods yet routinely failed to report instructional methods. To increase the effectiveness of Tai Chi to improve balance in older adults, future RCT s should disclose their Ex R x and instructional methods, especially methods that target balance.