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A Therapeutic Tai Chi Program: Optimal Choice for Falls Prevention

Identifying optimal choices from among evidence-based fall prevention interventions is challenging as few comparative data for effectiveness are available. Oregon Research Institute led a cohort of medical research institutes to determine the effectiveness of a therapeutically tailored Tai Chi intervention, "Tai Ji Quan: Moving for Better Balance"(TJQMBB), developed on the classic concept of Tai Chi, and a multimodal exercise (MME) program relative to stretching exercise in reducing falls among older adults at high risk of falling.

The clinical trial was conducted from February 20, 2015 to January 30, 2018 in 7 urban and suburban cities in Oregon. From 1147 community-dwelling adults 70 years or older screened for eligibility, 670 who had fallen in the preceding year or had impaired mobility consented and were enrolled. All analyses used intention-to-treat assignment.

One of 3 exercise interventions: two 60-minute classes weekly for 24 weeks of TJQMBB, using modified forms and therapeutic movement exercises; MME, integrating balance, aerobics, strength, and flexibility activities; or stretching exercises. The primary measure at 6 months was incidence of falls.

Among 670 participants (ages ranging from 72 to 84) randomized, 436 (65%) were women, 617 (92.1%) were white, 31 (4.6%) were African American. During the trial, there were 152 falls (85 individuals) in the TJQMBB group, 218 (112 individuals) in the MME group, and 363 (127 individuals) in the stretching exercise group. At 6 months, the incidence rate ratio was significantly lower in the TJQMBB and MME groups compared with the stretching group. Falls were reduced by 31% for the TJQMBB group compared with the MME group. Conclusion: among community-dwelling older adults at high risk for falls, a therapeutically tailored Tai Chi balance training intervention was more effective than conventional exercise approaches for reducing the incidence of falls.

The findings are published in September, 2018 by the Journal of the American Medical Association internal medicine.

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