The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial

Abstract

Purpose: To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. Methods: The participants (152 older adults over 65 who were admitted to a geriatric day hospital program) were randomly assigned to either a supervised Tai Chi group or the usual physiotherapy. The presence of the clinical variables related to falls was evaluated before the intervention (T1), immediately after (T2), and 12 months after the end of the intervention (T3). Results: Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. However, self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001). Conclusions: The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program.

Implications for Rehabilitation

• Each participant received a multidisciplinary intervention with either Tai Chi or physical therapy.

• Both interventions were associated with improved balance, gait, less fear of falling, improved functional autonomy and greater self actualisation.

• Only Tai Chi decreased the incidence of falls which appeared to be related to self-efficacy.

• Tai Chi seems to be a good alternative to physical therapy exercises to prevent falls in frail older people.

Keywords::

• Balance exercise
• fall prevention
• older people
• physical therapy
• self-efficacy
• Tai Chi

Acknowledgements

We thank all the patients who participated in this trial, the research staff at the Research Center on Aging, and the Tai Chi instructor, Raymond C. Benoit, for their involvement in the project.

Declaration of interest: This research was supported in part by a grant received from the Canadian Institutes of Health Research [grant number mct-58344].