title: Impact of tai-chi on falls among preclinically disabled older people. A randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effectiveness of tai-chi in preventing falls among community-dwelling older people.
  
  
  METHODS
  Multisite parallel group individually randomized controlled trial.
  
  
  METHODS
  Melbourne, Australia.
  
  
  METHODS
  Preclinically disabled community-dwelling people 70 + years (n = 503), without major medical conditions or moderate to severe cognitive impairment.
  
  
  METHODS
  Sixty-minute modified Sun style tai-chi group-based exercise program twice weekly for 48 weeks; control intervention was a seated group-based flexibility exercise program of the same dose.
  
  
  METHODS
  All falls, self-reported using a monthly calendar, analyzed at 24 weeks and 48 weeks. Injurious falls reported in follow-up telephone interviews for each reported fall.
  
  
  RESULTS
  The adjusted fall incidence rate ratios at 24 and 48 weeks were 1.08 [(95% confidence interval (CI) 0.64-1.81)], and 1.12 (95% CI 0.75-1.67), respectively. A higher proportion of intervention participants ceased attendance in the first 24 weeks (difference 17.9%, 95% CI 9.6-25.8), and the second 24 weeks (2.7%, 95% CI -5.0 to 10.4). Intervention participants who ceased attendance had lower left quadriceps strength (difference 3.3 kg 95% CI 0.15-6.36) and required longer to complete the timed up and go test (difference 1.7 seconds 95% CI 0.22-3.17) at baseline.
  
  
  CONCLUSIONS
  This study does not support modified Sun style tai-chi as a falls prevention measure among relatively well community-dwelling older people with modified mobility and at increased risk of disability. Insufficient intervention intensity, or low exercise class attendance may have contributed to the lack of effect, as may have attrition bias among the intervention group.
authors.affiliation: Falls Prevention Research Unit, Monash Injury Research Institute, Monash University, Melbourne, Australia. Electronic address: lesley.day@monash.edu.
authors.forename: Lesley
authors.initials: L
authors.lastname: Day
authors.affiliation: Faculty of Health Sciences, School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia. Electronic address: keith.hill@curtin.edu.au.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Hill
authors.affiliation: Falls Prevention Research Unit, Monash Injury Research Institute, Monash University, Melbourne, Australia.
authors.forename: Voula Z
authors.initials: VZ
authors.lastname: Stathakis
authors.affiliation: Center for Medical Research, University of Western Australia, Perth, Australia.
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.affiliation: Division of Health Sciences, School of Population Health, University of South Australia, Adelaide, Australia.
authors.forename: Leonie
authors.initials: L
authors.lastname: Segal
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Flavia
authors.initials: F
authors.lastname: Cicuttini
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Damien
authors.initials: D
authors.lastname: Jolley
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance; D011788:Quality of Life; D026302:Tai Ji / Q000379:methods*; D016896:Treatment Outcome
keywords: Falls; older people; tai-chi