Tai Chi Research » Fall Prevention

Tai Chi reduces Fear of Falling among the Elderly

David Bendall — Sun, 16 Jan 2011 17:15:42 +0000

Fear of falling is major health problem among elderly adults. Researchers at Chang-Gung University in Taiwan studied the effectiveness of cognitive-behavioral strategies with and without tai chi in reducing the fear of falling.

Participants were randomly assigned to a control group, a cognitive-behavioral group without tai chi or a cognitive-behavioral group with tai chi. Participants in the tai chi group had significant improvements in fear of falling, mobility, social support behavior and satisfaction and quality of life five months after the intervention compared to the cognitive behavior along and control groups.

Abstract

Fear of falling has been shown to be linked to future risk of falls regardless of actual risk levels and can lead to social isolation and decreased quality of life. This study adds to the growing body of evidence that tai chi is an effective intervention for fall prevention.

Reference

Tai chi found to be one of the most cost-effective fall prevention programs for older adults.

David Bendall — Sat, 17 Apr 2010 22:11:10 +0000

A study comparing the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults found that group tai chi and the medical management of psychotropic medications were the least costly and most effective methods available.

While the medical management of psychotropic medications as well as tai chi was considered one of the most cost effective programs, it should be noted that since not all older adults take psychotropic medications, this intervention only applies to a subgroup of older adults, while almost all older adults could benefit from tai chi.

Abstract

Review of controlled trials show tai chi to be effective at reducing risk of falls among seniors.

David Bendall — Mon, 31 Aug 2009 09:22:39 +0000

A systematic review of randomizes trials of interventions to reduce falls in community-dwelling seniors published in the April 2009 Cochrane Database Syst Rev. found that tai chi is effective at reducing the rate of falls. In addition to tai chi, multiple-component group exercise, individually prescribed multiple-component home-based exercise, and assessment and multifactorial intervention were also found to be effective. Of these tai chi had the greatest estimated reduction in falls. A number of other interventions were also found to be effective, however these only applied to selected situations or populations such as anti-slip shoes in icy conditions and first eye cataract surgery.

Abstract

Study fails to show 26 hours per year of tai chi enough to reduce risk of falls among seniors.

David Bendall — Fri, 28 Aug 2009 15:54:37 +0000

Researchers at Erasmus MS University in the Netherlands randomly assigned 269 older adults to a tai chi or control group. The tai chi group received two hours of tai chi training for 13 weeks. Falls were recorded in both groups during the 12 months following the start of the tai chi classes. There was no statistically significant difference in the rate of falls observed in the two groups.

Abstract

One possible reason that this study failed to demonstrate a reduction in falls is that participants did not practice tai chi enough for there to be significant benefits. Two hours of tai chi for 13 weeks only works out to an average of 0.5 hours of tai chi per week over the one year course of the study.

I identified four other studies where the rate of falls reduction between the tai chi and control groups was available. All four of the other studies showed a substantial reduction in the rate of falls in the tai chi group, but not all of these were statistically significant. All of these had a substantially greater amount of time assigned to tai chi practice over the course of the study, ranging from 33% more to 5 times as much as this study. Because of this, it is reasonably to conclude that one of the reasons that this study failed to find reductions in fall rates was simply that participants did not practice enough.

A graph of the results (see below) indicates that, as would be expected, the studies where the participants practiced tai chi more tended to have better results. Since, as this study suggests, less than an average of one hour per week of tai chi may not be enough to significantly reduce the risk of falls, at least one hour, and preferably two, a week of ongoing tai chi practice should be recommended for elderly adults wishing to reduce their risk of falls.

1 – Abstract
2 – Abstract
3 – Abstract
4 – Abstract
5 – Abstract

1: Inge H. J. Logghe, MSc, et. Al. ; Lack of Effect of Tai Chi Chuan in Preventing Falls in Elderly People Living at Home: A Randomized Clinical Trial; J Am Geriatr Soc. 2009 Jan (p 70-75)
2: Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T; Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative sudies of Intervention Techniques.; J Am Geriatr Soc. 1996 May;44(5):489-97
3: Wolf SL, Sattin RW, Kutner M, O’Grady M, Greenspan AI, Gregor RJ.; Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial.; J Am Geriatr Soc 2003-12-23 51(12) 1693-
4: Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, Wilson NL.; Tai Chi and fall reductions in older adults: a randomized controlled trial.; 1: J Gerontol A Biol Sci Med Sci. 2005 Feb;60(2):187-94.
5: Voukelatos A, Cumming RG, Lord SR, Rissel C.; A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial.; 1: J Am Geriatr Soc. 2007 Aug;55(8):1185-91.

Tai Chi for Falls Prevention Program Successfully Implemented

David Bendall — Fri, 28 Aug 2009 15:14:33 +0000

Researchers at the Oregon Research Institute demonstrated that a tai chi based falls-prevention program developed from a clinical trial could be replicated. The program was evaluated at 6 community centers. All 6 centers successfully implemented the program with an 87% reach into the target population. The participants showed significant improvements in health-related outcome measures.

Abstract

Randomized controlled trial of tai chi for the prevention of falls shows significant results.

David Bendall — Tue, 09 Jun 2009 13:35:52 +0000

Researchers in Sydney Australia designed a study to see if a one hour per week, sixteen week falls prevention program could significantly reduce falls among community-dwelling seniors aged 60 and older. Individuals with degenerative neurological disorders, severely debilitating strokes, cancer, or severe arthritis were excluded from the study. A total of 702 individuals participated were randomly assigned to a tai chi group or a control group. Falls were recorded over a 24 weeks period for both groups. The tai chi group had a significant, 35% reduction in the risk of falls. The tai chi group also had modest, statistically significant, improvements in balance.

Abstract

Intense tai chi training leads to a reduction in fear of falling in frail older adults.

David Bendall — Sat, 30 May 2009 15:39:08 +0000

Researchers at the National Center for Injury Prevention and Control in Atlanta designed a study in order to determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education program among older adults transitioning to frailty how had previously fallen. Ten matched pairs of congregate living facilities were randomly assigned to participate in either the tai chi or wellness education program. A total of 311 elderly adults participated. Fear of falling was similar in both groups at the start of the study, but after 8 months fear of falling was significantly lower in the tai chi group, with the difference growing over time. The researchers concluded, “tai chi should be considered in any program designed to reduce falling and fear of falling in transitionally frail older adults”.

Abstract

Study finds that tai chi reduces falls among older adults.

David Bendall — Wed, 27 May 2009 06:02:28 +0000

Researchers at the Oregon Research Institute in Eugene randomly assigned 256 physically inactive older adults aged 70 to 92 to a tai chi group or a stretching control group. Both groups met three times per week for six months. There were significantly fewer falls and falls with injuries among individuals in the tai chi group than among individuals in the control group. The reduction in falls was quite dramatic, with the risk of falls 55% lower among individuals in the tai chi group. Fear of falling, balance and physical performance also improved in the tai chi group compared to the control group.

Abstract

Older tai chi practitioners found to have improved balance confidence.

David Bendall — Mon, 25 May 2009 18:08:55 +0000

Researchers at Hong Kong Polytechnic University compared 24 older tai chi practitioners to 24 healthy older adults who were matched with respect to age, gender, height, weight and physical activity. The tai chi practitioners had better knee muscle strength, less body sway after single-leg, perturbations and higher balance confidence scores.

Abstract

Four weeks of intensive tai chi training improves balance control in elderly subjects.

David Bendall — Sat, 23 May 2009 17:36:21 +0000

Researchers at Hong Kong Polytechnic University studied the effects of intensive tai chi training on balance control in healthy elderly adults. 49 participants were assigned to either general education or supervised tai chi for 1.5 hours, 6 times per week for 8 weeks. Balance was tested before the start of training, after 4 and 8 weeks during training and 4 weeks after training ended. The tai chi group showed significant improvements in balance compared to the control group even after 4 weeks. Furthermore these improvements were maintained 4 weeks after the training ended.

Abstract