Falls among the elderly are associated with increased morbidity and mortality, which makes fall prevention a primary health care goal in that population. In one approach to prevention, Korean nurse researchers demonstrated that 12 weeks of instruction in Sun-style Tai Chi-a version, created more than 90 years ago, of the ancient Chinese discipline of meditative movements-improved strength, balance, and mobility in elderly nursing home residents who were at risk for falling.
Two long-term care facilities in Korea that had similar characteristics were chosen for the study. Residents 60 years of age and older who were at risk for falls (as a result of impaired gait or balance, a history of falling in the previous year, postural hypotension, or use of four or more medications that can affect balance) were identified for inclusion in the study, but Tai Chi instruction was given at only one facility; participants at the other facility constituted the control group. A certified Tai Chi instructor led residents in the intervention group in 35 minutes of exercise three times each week. Attendance at the sessions averaged 80%. At the control facility, the residents didn't engage in regular exercise.
In comparison with the control group, the intervention group-as measured by an independent team-showed increases in muscle strength in the knee flexors and extensors and the ankle dorsiflexors and plantar flexors, as well as improvements in flexibility, balance on one foot with the eyes open, and mobility. The control group experienced declines in all measures during the study period except balancing on one foot with the eyes closed.
The residents who practiced Tai Chi also felt more confident that they could prevent themselves from falling and did fall less frequently during the 12-week intervention and four-week follow-up period (nine of 29 residents [31%] in the Tai Chi group, compared with 15 of 30 residents [50%] in the control group). Although this difference in the incidence of falls did not reach statistical significance, the relative risk of falling was 0.62 among those who practiced Tai Chi, compared with those in the control group, and the follow-up period was short.
The authors suggest that Tai Chi can "safely and easily" be used to prevent falls in the elderly, but they also suggest that more research be conducted using larger sample sizes over longer periods and that different kinds of exercise programs be compared.
Choi JH, et al. J Adv Nurs 2005;51(2): 150-7.