Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial

Abstract

Purpose: To compare the effectiveness of supervised Tai Chi exercises versus the conventional physical therapy exercises in a personalized rehabilitation program in terms of the incidence and severity of falls in a frail older population. Method: The participants were frail older adults living in the community, admitted to the day hospital program in Sherbrooke, Quebec, Canada (n = 152). They were randomized to receive a 15-week intervention, either by supervised Tai Chi exercises (n = 76) or conventional physical therapy (n = 76). Fall incidence and severity were assessed using both the calendar technique and phone interviews once a month during 12 months following the end of the intervention. Other variables were collected at baseline to compare the two groups: age, comorbidity, balance, sensory interaction on balance, and self-rated health. Results: Both interventions demonstrated a protective effect on falls but Tai Chi showed a greater one (RR = 0.74; 95% CI = 0.56–0.98) as compared to conventional physical therapy exercises. Conclusions: Supervised Tai Chi exercises as part of a rehabilitation program seem to be a more effective alternative to the conventional physical therapy exercises for this specific population.

Implications for Rehabilitation

• Seniors who have fallen have a 50% chance of falling again during the following year, leading them to reduce their outings and thus decrease their social activities.

• Frail older people could benefit more from an individualized intervention than the regular group program generally used in a Tai Chi intervention.

• Tai Chi exercises seems to be a good alternative to regular physiotherapy exercises as a part of a multidisciplinary intervention in preventing a subsequent fall over a 12-month period.

Keywords::

• Accidental falls
• elderly
• Tai Chi

Acknowledgements

We thank all the patients who participated in this trial and the research staff at the Research Centre on Aging.

Declaration of Interest: This study was supported exclusively by funding from the Canadian Institutes of Health Research [grant number mct-58344]. The authors report no conflicts of interest.