Comparison of telecommunication, community, and home-based Tai Chi exercise programs on compliance and effectiveness in elders at risk for falls.
OBJECTIVE
To compare the adherence to and effectiveness of Tai Chi exercise program through a live, interactive, telecommunication-based exercise (Tele-ex) with that of a similar program through a community center-based exercise (Comm-ex) and a home video-based exercise (Home-ex) among community-dwelling elders who are at risk for falls.


METHODS
Three groups randomized controlled trial with pretests and posttests.


METHODS
Exercise programs were community-based, and the outcome measures were laboratory-based.


METHODS
Adults (N=64) age 65+ years with positive fall history in the previous year and/or significant fear of falling.


METHODS
A 24-form, Yang-style Tai Chi for 15 weeks, 3 hours a week.


METHODS
Exercise compliance, number of falls, fear of falling (Activities-specific Balance Confidence [ABC] score), self-perceived health (Medical Outcomes Study 36-Item Short Form Health Survey [SF-36]), Timed Up & Go (TUG), single leg stance (SLS), and body sway during quiet stance (medial-lateral foot center of pressure [ML-COP]).


RESULTS
Tele-ex and Comm-ex groups demonstrated significantly higher exercise attendance and in-class practice time than the Home-ex group (P<.01) and significant reductions in the mean number of falls and injurious falls (P<.01). There were significant improvements posttraining in SLS, ABC, ML-COP, and Physical Health subscore of the SF-36 (P<.05). Both Tele-ex and Comm-ex groups demonstrated larger improvements than the Home-ex group in TUG, ML-COP, and the Social Function, Mental Health, and Physical Health subscores of the MOS SF-36.


CONCLUSIONS
Compared with the Home-ex, the Tele-ex and Comm-ex groups are better in exercise compliance, fall reduction and balance and health improvements. Tele-ex is an effective, affordable, and acceptable choice of exercise for elders.
Wu
Ge
G
Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05405, USA. ge.wu@uvm.edu
Keyes
Lawrence
L
Callas
Peter
P
Ren
Xiaolin
X
Bookchin
Bea
B
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000704:Analysis of Variance; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D004856:Postural Balance; D026302:Tai Ji; D016896:Treatment Outcome; D014741:Video Recording; D049269:Videoconferencing