Intense Tai Chi Exercise Training and Fall Occurrences

 Abstract:  Intense Tai Chi Exercise Training and Fall Occurrences in Older, Transitionally Frail Adults: A Randomized, Controlled Trial

 Keywords:

• exercise;
• falls;
• balance;
• aging;
• tai chi

Objectives: To determine whether an intense tai chi (TC) exercise program could reduce the risk of falls more than a wellness education (WE) program in older adults meeting criteria for transitioning to frailty.

Design: Randomized, controlled trial of 48 weeks duration.

Setting: Twenty congregate living facilities in the greater Atlanta area.

Participants: Sample of 291 women and 20 men aged 70 to 97.

Measurements: Demographics, time to first fall and all subsequent falls, functional measures, Sickness Impact Profile, Centers for Epidemiologic Studies—Depression Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scales, and adherence to interventions.

Results: The risk ratio (RR) of falling was not statistically different in the TC group and the WE group (RR=0.75, 95% confidence interval (CI)=0.52–1.08), P=.13). Over the 48 weeks of intervention, 46% (n=132) of the participants did not fall; the percentage of participants that fell at least once was 47.6% for the TC group and 60.3% for the WE group.

Conclusion: TC did not reduce the RR of falling in transitionally frail, older adults, but the direction of effect observed in this study, together with positive findings seen previously in more-robust older adults, suggests that TC may be clinically important and should be evaluated further in this high-risk population.

Quelle:  http://onlinelibrary.wiley.com/doi/10.1046/j.1532-5415.2003.51552.x/abstract

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Tai Chi: Improving functional balance and predicting subsequent falls in older persons

Résumé / Abstract

Purpose: To determine whether improved functional balance through a Tai Chi intervention is related to subsequent reductions in falls among elderly persons.

Methods: Two hundred fifty-six healthy, physically inactive older adults aged 70-92 (mean age ± SD = 77.48 ± 4.95), recruited from a local health system in Portland, OR, participated in a 6-month randomized controlled trial, with allocation to Tai Chi or exercise stretching control, followed by a 6-month postintervention follow-up. Functional balance measures included Berg balance scale, dynamic gait index, and functional reach, assessed during the 6-month intervention period (baseline, 3-month, and 6-month intervention endpoint) and again at the 6-month postintervention follow-up. Fall counts were recorded during the 6-month postintervention follow-up period. Data were analyzed through intention-to-treat analysis of variance and logistic regression procedures.

Results: Tai Chi participants who showed improvements in measures of functional balance at the intervention endpoint significantly reduced their risk of falls during the 6-month postintervention period, compared with those in the control condition (odds ratio (OR), 0.27, 95% confidence interval (CI), 0.07-0.96 for Berg balance scale; OR, 0.27, 95% CI, 0.09-0.87 for dynamic gait index; OR, 0.20, 95% CI, 0.05-0.82 for functional reach).

Conclusions: Improved functional balance through Tai Chi training is associated with subsequent reductions in fall frequency in older persons.

Quelle:   http://cat.inist.fr/?aModele=afficheN&cpsidt=16330923


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