A tai chi exercise program was more effective than multimodal exercise or stretching at reducing falls among older adults in a 6-month study of 670 participants aged 70 years and older.
Although exercise can be a safe way to reduce falls in older adults, “few comparative effectiveness data are available, especially for older adults with high fall risk,” wrote, of the Oregon Research Institute in Eugene, and his colleagues.
In a study published in JAMA Internal Medicine, the researchers randomized participants to a tailored tai chi program, Tai Ji Quan: Moving for Better Balance (TJQMBB), multimodal exercise, or a control intervention of basic stretching. Each intervention consisted of a twice-weekly 60-minute session for 24 weeks.
The study population included 670 community-dwelling adults aged 70 years and older at seven urban and suburban cities in Oregon. All participants had fallen within the past year or had impaired mobility that put them at increased fall risk. The average age of the participants was 78 years, 65% were women, and 92% were white.
A total of 152 falls occurred among 85 individuals in the TJQMBB group during the study period, compared with 218 falls among 112 individuals in the multimodal exercise group and 363 falls among 127 individuals in the stretching group. Overall, the tai chi group had a 58% reduced incidence of falls, compared with stretching, and a 31% reduced risk, compared with multimodal exercise.
The tai chi program used in the study included balance and stability training, described by the researchers as “unilateral weight-bearing and weight-shifting movements, trunk and pelvic rotation, ankle sway, and eye-head-hand movements.” The multimodal exercise program included aerobic conditioning, strength, balance, and flexibility activities, and the stretching intervention included stretching, breathing, and relaxation.
The results were limited by several factors, including the use of self-reports, low representation of African American participants, and collection of data from a single state, the researchers noted.
However, the findings support the potential of tai chi programs to reduce the risk of falls in older adults. “With increasing evidence of community adoption and implementation and information from cost-benefit and cost-effectiveness analyses, the intervention program represents a promising approach to low-cost and easily implementable fall prevention programs,” the researchers explained.
The study was supported in part by the National Institute on Aging. Dr. Li reported that he is the founder and owner of a consulting company, Exercise Alternatives, and that a licensing free for TJQMBB is paid directly to that company.
SOURCE: Li F et al. JAMA Intern Med. 2018 Sep 10. doi: 10.1001/jamainternmed.2018.3915.