title: The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults.
abstract: BACKGROUND
  Few data exist to evaluate whether Tai Chi (TC) training improves physical performance and hemodynamic outcomes more than a wellness education (WE) program does among older fallers transitioning to frailty.
  
  
  METHODS
  This 48-week randomized clinical trial was provided at 10 matched pairs of congregate living facilities in the Atlanta metropolitan area to 291 women and 20 men, who were transitionally frail, >or=70 years old, and had fallen at least once within the past year. Pairs of facilities were randomized to either TC exercise (n = 158) or WE (control) interventions (n = 153) over 48 weeks. Physical performance (freely chosen gait speed, reach, chair-rises, 360 degrees turn, picking up an object from the floor, and single limb support) and hemodynamic outcomes (heart rate and blood pressure) were obtained at baseline and after 4, 8, and 12 months.
  
  
  RESULTS
  Mean percent change (baseline to 1 year) for gait speed increased similarly in both cohorts (TC: 9.1% and WE: 8.2%; p =.78). However, time to complete three chair-rises decreased 12.3% for TC and increased 13.7% for WE (p =.006). Baseline to 1 year mean percent change decreased among TC and increased within WE cohorts for: body mass index (-2.3% vs 1.8%; p <.0001), systolic blood pressure (-3.4% vs 1.7%; p =.02), and resting heart rate (-5.9% vs 4.6%; p <.0001).
  
  
  CONCLUSIONS
  TC significantly improved chair-rise and cardiovascular performance. Because TC training reduced fall occurrences in this cohort, factors influencing functional and cardiovascular improvements may also favorably impact fall events.
authors.affiliation: Department of Rehabilitation Medicine, Emory University School of Medicine, 212 C Rehabilitation Center, 1441 Clifton Rd. NE, Atlanta, GA 30322, USA. swolf@emory.edu
authors.forename: Steven L
authors.initials: SL
authors.lastname: Wolf
authors.forename: Michael
authors.initials: M
authors.lastname: O'Grady
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Easley
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.forename: Reto W
authors.initials: RW
authors.lastname: Kressig
authors.forename: Michael
authors.initials: M
authors.lastname: Kutner
mesh_terms: D000368:Aged; D005260:Female; D016330:Frail Elderly; D006293:Health Promotion; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D009043:Motor Activity; D026302:Tai Ji