Clinical Health Updates

Once-weekly tai chi decreases rate of falls in the elderly

Clinical Question:
Does once-weekly tai chi prevent falls in the elderly?

Bottom Line:
One hour of tai chi a week for 16 weeks modestly decreases the rate of falls in community-dwelling elderly patients.

Reference:
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. J Am Geriatr Soc 2007;55:1185-1191.

Study Design:
Randomized controlled trial (nonblinded)

Synopsis:
Prior studies have found that twice-weekly tai chi prevents falls in community-dwelling elders. In this study, the researchers evaluated a 16-week program of tai chi. The sessions lasted 1 hour and were led by instructors with at least 5 years’ experience or who completed an accredited trainer’s course. The patients had to be at least 60 years of age and living in the community.The patients were recruited via newspaper adds and randomized to the intervention group (n=353) or to the control group (n=349). The control patients were able to participate in the tai chi program at the conclusion of the study. The researchers excluded anyone with degenerative neurological conditions (such as Parkinson?s disease), dementia, a severely debilitating stroke, severe arthritis, marked vision impairment, if they had done tai chi during the previous year, or if they were unable to walk across a room unaided. Approximately 85% of the patients in both groups rated themselves as generally healthy and the mean age was 69 years (considered young elderly). The participants and control patients were followed up for 8 weeks after completing the program to see how many falls occurred by the end of the program and 8 weeks later. At the end of the study, only 18 patients dropped out (6 from the intervention group, 12 from the control group). At the end of the 16-week program, there was no difference in the rate of falls; however, 8 weeks after completing the program, the rate of falls in the intervention group was 33% lower than in the control group (P=.02). Although the number of patients with multiple falls was quite small, tai chi was most effective in preventing these types of falls.