Modified tai chi program reduced fall rate in high-risk older adults

Reference

Li F, Harmer P, Fitzgerald K, et al. Effectiveness of a therapeutic tai ji quan intervention vs a multimodal exercise intervention to prevent falls among older adults at high risk of falling. A randomized clinical trial. JAMA Intern Med 2018;178(10):1301-1310.

Synopsis

These investigators enrolled 670 patients with an average age of 77.7 years. The enrollees were all living independently, had fallen at least once in the previous 12 months, were thought to be at risk for future falls, and were ambulatory but had limited mobility. More than half of the participants (65%) were women and most (92.1%) were white. The participants were assigned, allocation concealment uncertain, to one of three 60-minute exercise programs conducted twice weekly for 6 months: stretching; a multimodal exercise program comprising aerobic conditioning, strength, balance, and flexibility activities; or a tai chi program called Tai Ji Quan: Moving for Better Balance, which is specifically tailored for older patients with the goal of improving balance. Over 6 months, 48.4% of the paticipants reported a fall. Using intention-to-treat analysis, the likelihood of falling was significantly lower in the tai chi group than in the exercise group (P = .04), and both groups experienced significantly fewer falls than the those in the stretching group (P < .001). There were significantly fewer falls resulting in serious injury in the tai chi group as compared with the stretching group (8 vs 25; P = .008), though there was no difference in serious injuries between the exercise and tai chi groups.