title: Reducing the fear of falling among community-dwelling elderly adults through cognitive-behavioural strategies and intense Tai Chi exercise: a randomized controlled trial.
abstract: OBJECTIVE
  To examine the effectiveness of cognitive-behavioural strategies with/without intense Tai Chi exercise in reducing fear of falling among community-dwelling elderly adults. Background.  Fear of falling is a major health problem among community-dwelling older persons. The prevalence of this fear ranges from 29% to 77%, indicating the importance of developing effective strategies to reduce fear of falling among elderly adults.
  
  
  METHODS
  Data were collected from January to December 2007. A randomized controlled trial with three groups (control, cognitive-behavioural and cognitive-behavioural with Tai Chi). Participants were assessed at baseline for demographic data, falls-related history, and fear of falling. Data on these variables plus falls, mobility, social support behaviour and satisfaction, and quality of life were also collected at 2 and 5 months after interventions.
  
  
  RESULTS
  Participants in the three groups differed significantly in both measures of fear of falling (F = 20·89, P < 0·001; F = 6·09, P < 0·001) and mobility (F = 30·33, P < 0·001), social support behaviour and satisfaction (F = 3·32, P < 0·05 and F = 6·35, P < 0·001, respectively), and quality of life (F = 16·66, P< 0·001). In addition, participants who received the cognitive-behavioural intervention with Tai Chi had significantly lower fear of falling scores (P < 0·001) and higher mobility (P < 0·001), social support satisfaction (P < 0·01) and quality of life (P < 0·001) than the cognitive-behavioural alone and control groups at 5 months. The three groups did not differ significantly in falls.
  
  
  CONCLUSIONS
  The results of this trial suggest that the cognitive-behavioural intervention with Tai Chi exercise helped community-dwelling elderly adults to enhance their mobility, to manage their fear of falling and to increase their quality of life.
authors.affiliation: School of Nursing, Chang-Gung University, Taoyuan, Taiwan. thuang@mail.cgu.edu.tw
authors.forename: Tzu-Ting
authors.initials: TT
authors.lastname: Huang
authors.forename: Lin-Hui
authors.initials: LH
authors.lastname: Yang
authors.forename: Chia-Yih
authors.initials: CY
authors.lastname: Liu
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged / Q000523:psychology*; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005239:Fear / Q000523:psychology*; D005260:Female; D005684:Gait / Q000502:physiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D004856:Postural Balance / Q000502:physiology; D015995:Prevalence; D011788:Quality of Life; D012424:Rural Population; D012944:Social Support; D026302:Tai Ji; D013624:Taiwan / Q000453:epidemiology