title: Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the effectiveness of tai chi and low-level exercise in reducing falls in older adults; to determine whether mobility, balance, and lower limb strength improved and whether higher doses of tai chi resulted in greater effect.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Eleven sites throughout New Zealand.
  
  
  METHODS
  Six hundred eighty-four community-residing older adults (mean age 74.5; 73% female) with at least one falls risk factor.
  
  
  METHODS
  Tai chi once a week (TC1) (n = 233); tai chi twice a week (TC2) (n = 220), or a low-level exercise program control group (LLE) (n = 231) for 20 wks.
  
  
  METHODS
  Number of falls was ascertained according to monthly falls calendars. Mobility (Timed-Up-and-Go Test), balance (step test), and lower limb strength (chair stand test) were assessed.
  
  
  RESULTS
  The adjusted incident rate ratio (IRR) for falls was not significantly different between the TC1 and LLE groups (IRR = 1.05, 95% confidence interval (CI) = 0.83-1.33, P = .70) or between the TC2 and LLE groups (IRR = 0.88, 95% CI = 0.68-1.16, P = .37). Adjusted multilevel mixed-effects Poisson regression showed a significant reduction in logarithmic mean fall rate of -0.050 (95% CI = -0.064 to -0.037, P < .001) per month for all groups. Multilevel fixed-effects analyses indicated improvements in balance (P < .001 right and left leg) and lower limb strength (P < .001) but not mobility (P = .54) in all groups over time, with no differences between the groups (P = .37 (right leg), P = .66 (left leg), P = .21, and P = .44, respectively).
  
  
  CONCLUSIONS
  There was no difference in falls rates between the groups, with falls reducing similarly (mean falls rate reduction of 58%) over the 17-month follow-up period. Strength and balance improved similarly in all groups over time.
authors.affiliation: Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand. denise.taylor@aut.ac.nz
authors.forename: Denise
authors.initials: D
authors.lastname: Taylor
authors.forename: Leigh
authors.initials: L
authors.lastname: Hale
authors.forename: Philip
authors.initials: P
authors.lastname: Schluter
authors.forename: Debra L
authors.initials: DL
authors.lastname: Waters
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Binns
authors.forename: Hamish
authors.initials: H
authors.lastname: McCracken
authors.forename: Kathryn
authors.initials: K
authors.lastname: McPherson
authors.forename: Steven L
authors.initials: SL
authors.lastname: Wolf
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D003153:Community Health Services; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D016037:Single-Blind Method; D026302:Tai Ji