Tai Chi and fall reductions in older adults: a randomized controlled trial

Background. The authors' objective was to evaluate the efficacy of a 6-month Tai Chi intervention for decreasing the number of falls and the risk for falling in older persons. Methods. This randomized controlled trial involved a sample of 256 physically inactive, community-dwelling adults aged 70 to 92 (mean age, 77.48 years; standard deviation, 4.95 years) who were recruited through a patient database in Portland, Oregon. Participants were randomized to participate in a three-times-per-week Tai Chi group or to a stretching control group for 6 months. The primary outcome measure was the number of fails; the secondary outcome measures included functional balance (Berg Balance Scale, Dynamic Gait Index, Functional Reach, and single-leg standing), physical performance (50-foot speed walk, Up&Go), and fear of falling, assessed at baseline, 3 months, 6 months (intervention termination), and at a 6-month postintervention follow-up. Results. At the end of the 6-month intervention, significantly fewer falls (n = 38 vs 73; p = .007), lower proportions of fallers (28% vs 46%; p = .01), and fewer injurious falls (7% vs 18%; p = .03) were observed in the Tai Chi group compared with the stretching control group. After adjusting for baseline covariates, the risk for multiple fails in the Tai Chi group was 55% lower than that of the stretching control group (risk ratio, .45; 95% confidence interval, 0.30 to 0.70). Compared with the stretching control participants, the Tai Chi participants showed significant improvements (p < .001) in all measures of functional balance, physical performance, and reduced fear of failing. Intervention gains in these measures were maintained at a 6-month postintervention follow-up in the Tai Chi group. Conclusions. A three-times-per-week, 6-month Tai Chi program is effective in decreasing the number of falls, the risk for falling, and the fear of falling, and it improves functional balance and physical performance in physically inactive persons aged 70 years or older.