Effectiveness of Tai Chi in Fall Prevention and Balance Function in the Elderly: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHAO Yuan ¹ ,  WANG Yan ¹ , XU Xudong ¹ , LIU Yali ²

1. Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;2. Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China;

Corresponding?author：

WANG Yan, Email: wy620628@yahoo.com.cn

Keywords：

Tai Chi; Balance function; Elderly; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20130058

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To objectively evaluate the effectiveness of Tai Chi in fall prevention and balance function in the elderly.
Methods 　Databases such as PubMed, Web of Science, The Cochrane Library (Issue 8, 2012), EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched to collect the randomized controlled trials (RCTs) published from 2000 to 2012, and the relevant references of the included articles were also manually searched. According to the inclusion and exclusion criteria, the literature was screened, the data were extracted and the methodological quality of the included studies was assessed. Then meta-analyses were performed by using RevMan 5.1 software.
Results 　A total of 6 RCTs involving 2 796 participants were included. The results of meta-analyses showed that the Tai Chi group was superior to the control group in decrease of the incidence rate of fall (RR=0.82, 95%CI 0.73 to 0.92, P=0.000 6), Timed Up and Go Test (MD=0.71, 95%CI 0.29 to 1.12, P=0.000 9), Functional Reach Test (MD=0.78, 95%CI 0.33 to 1.23, P=0.000 7) and Berger Balance Scale (MD=2.45, 95%CI 1.47 to 3.43, P lt;0.000 01), and there were statistical differences.
Conclusion 　Tai Chi can effectively reduce the risk of fall for the elderly and improve their balance function.

Citation： ZHAO Yuan,WANG Yan,XU Xudong,LIU Yali. Effectiveness of Tai Chi in Fall Prevention and Balance Function in the Elderly: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(3): 339-345. doi: 10.7507/1672-2531.20130058 Copy

1.	Rose DJ. Preventing falls among older adults: no "one size suits all" intervention strategy. J Rehabil Res Dev, 2008, 45(8): 1153-1166.
2.	Neyens JC, Dijcks BP, Twisk J, et al. A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomisedcontrolled trial (RCT). Age Ageing, 2009, 38(2): 194-199.
3.	Greenspan AI, Wolf SL, Kelley ME, et al. Tai chi and perceived health status in older adults who are transitionally frail: a randomized controlled trial. Phys Ther, 2007, 87(5): 525-535.
4.	Brian F, Stephen S, Tatyana K, et al. Tai Chi and Low Impact Exercise: Effects on the Physical Functioning and Psychological Well-Being of Older People. J Appl Gerontol, 2007, 26(5): 433-453.
5.	Chyu MC, James CR, Sawyer SF, et al. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal womenwith osteopaenia: a randomized clinical study. Clin Rehabil, 2010, 24(12): 1080-1090.
6.	Higgins PT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
7.	Lelard T, Doutrellot PL, David P, et al. Effects of a 12-Week Tai Chi Chuan Program Versus a Balance Training Program on Postural Control and Walking Ability in Older People. Arch Phys Med Rehabil, 2010, 91(1): 9-14.
8.	Woo J, Hong A, Lau E, et al. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing, 2007, 36(3): 262-268.
9.	Maciaszek J, Osiński W, Szeklicki R, et al. Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. Am J Chin Med, 2007, 35(1): 1-9.
10.	Li F, Harmer P, Fisher KJ, et al. Tai Chi: Improving Functional Balance and Predicting Subsequent Falls in Older Persons. Med Sci Sports Exerc, 2004, 36(12): 2046-2052.
11.	Tousignant M, Corriveau H, Roy PM, et al. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial. Disabil Rehabil, 2012, 34(3): 196–201.
12.	Taylor D, Hale L, Schluter P, et al. Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial. J Am Geriatr Soc, 2012, 60(5): 841-848.
13.	Faber MJ, Bosscher RJ, Chin A Paw MJ, et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabil, 2006, 87(7): 885-896.
14.	Wolf SL, O’Grady M, Easley KA, et al. The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults. J Gerontol A Biol Sci Med Sci, 2006, 61(2): 184-189.
15.	Voukelatos A, Cumming RG, Lord SR, et al. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc, 2007, 55(8): 1185-1191.
16.	Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci, 2005, 60(2): 187-194.
17.	Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ, 2004, 328(7441): 680.
18.	Wolfson L, Whipple R, Derby C, et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc, 1996, 44(5): 498-506.
19.	Lajoie Y, Gallagher SP. Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Cofidence(ABC) scale for comparing fallers. Arch Gerontol Geriatr, 2004, 38(1): 11-26.
20.	Christou EA, Yang Y, Rosengren KS. Taiji training improves knee extensor strength and force control in older adults. J Gerontol A Biol Sci Med Sci, 2003, 58(8): 763-766.
21.	Duncan PW, Studenski S, Chandler J, et al. Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol, 1992, 47(3): M93-98.

1. Rose DJ. Preventing falls among older adults: no "one size suits all" intervention strategy. J Rehabil Res Dev, 2008, 45(8): 1153-1166.
2. Neyens JC, Dijcks BP, Twisk J, et al. A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomisedcontrolled trial (RCT). Age Ageing, 2009, 38(2): 194-199.
3. Greenspan AI, Wolf SL, Kelley ME, et al. Tai chi and perceived health status in older adults who are transitionally frail: a randomized controlled trial. Phys Ther, 2007, 87(5): 525-535.
4. Brian F, Stephen S, Tatyana K, et al. Tai Chi and Low Impact Exercise: Effects on the Physical Functioning and Psychological Well-Being of Older People. J Appl Gerontol, 2007, 26(5): 433-453.
5. Chyu MC, James CR, Sawyer SF, et al. Effects of tai chi exercise on posturography, gait, physical function and quality of life in postmenopausal womenwith osteopaenia: a randomized clinical study. Clin Rehabil, 2010, 24(12): 1080-1090.
6. Higgins PT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
7. Lelard T, Doutrellot PL, David P, et al. Effects of a 12-Week Tai Chi Chuan Program Versus a Balance Training Program on Postural Control and Walking Ability in Older People. Arch Phys Med Rehabil, 2010, 91(1): 9-14.
8. Woo J, Hong A, Lau E, et al. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing, 2007, 36(3): 262-268.
9. Maciaszek J, Osiński W, Szeklicki R, et al. Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. Am J Chin Med, 2007, 35(1): 1-9.
10. Li F, Harmer P, Fisher KJ, et al. Tai Chi: Improving Functional Balance and Predicting Subsequent Falls in Older Persons. Med Sci Sports Exerc, 2004, 36(12): 2046-2052.
11. Tousignant M, Corriveau H, Roy PM, et al. The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial. Disabil Rehabil, 2012, 34(3): 196–201.
12. Taylor D, Hale L, Schluter P, et al. Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial. J Am Geriatr Soc, 2012, 60(5): 841-848.
13. Faber MJ, Bosscher RJ, Chin A Paw MJ, et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabil, 2006, 87(7): 885-896.
14. Wolf SL, O’Grady M, Easley KA, et al. The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults. J Gerontol A Biol Sci Med Sci, 2006, 61(2): 184-189.
15. Voukelatos A, Cumming RG, Lord SR, et al. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc, 2007, 55(8): 1185-1191.
16. Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci, 2005, 60(2): 187-194.
17. Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ, 2004, 328(7441): 680.
18. Wolfson L, Whipple R, Derby C, et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc, 1996, 44(5): 498-506.
19. Lajoie Y, Gallagher SP. Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Cofidence(ABC) scale for comparing fallers. Arch Gerontol Geriatr, 2004, 38(1): 11-26.
20. Christou EA, Yang Y, Rosengren KS. Taiji training improves knee extensor strength and force control in older adults. J Gerontol A Biol Sci Med Sci, 2003, 58(8): 763-766.
21. Duncan PW, Studenski S, Chandler J, et al. Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol, 1992, 47(3): M93-98.

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Effectiveness of Tai Chi in Fall Prevention and Balance Function in the Elderly: A Meta-Analysis

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