Effectiveness of a therapeutic Tai Ji Quan intervention vs a multimodal exercise intervention to prevent falls among older adults at high risk of falling: A randomized clinical trial

JAMA Internal Medicine Sep 14, 2018

Li F, et al. - Researchers conducted a single-blind, three-arm, parallel-design, randomized clinical trial to ascertain the effectiveness of a therapeutically tailored tai ji quan intervention, Tai Ji Quan: Moving for Better Balance (TJQMBB), and a multimodal exercise (MME) program relative to stretching exercise in reducing falls among older adults at high risk of falling. Results showed that, compared with conventional exercise approaches, a therapeutically tailored tai ji quan intervention was more effective in reducing the incidence of falls in this study population.

Methods

  • This trial was conducted in seven urban and suburban cities in Oregon from February 20, 2015, to January 30, 2018.
  • Researchers screened 1,147 community-dwelling adults aged ≥70 years for eligibility; of these, 670 who had fallen in the preceding year or had impaired mobility consented and were enrolled.
  • Intention-to-treat assignment was used in all analyses.
  • Interventions included 1 of 3 exercise interventions: two 60-minute classes weekly for 24 weeks of TJQMBB, entailing modified forms and therapeutic movement exercises; MME, integrating balance, aerobics, strength, and flexibility activities; or stretching exercises.
  • Incidence of falls at 6 months was the primary measure.

Results

  • Researchers randomized 670 adults (mean [standard deviation] age: 77.7 [5.6] years), of whom 436 (65%) were women, 617 (92.1%) were white, and 31 (4.6%) were African American.
  • During the trial, the TJQMBB group had 152 falls (85 individuals), the MME group had 218 falls (112 individuals), and the stretching-exercise group had 363 falls (127 individuals).
  • At 6 months, significantly lower incidence rate ratio (IRR) was observed in the TJQMBB (IRR, 0.42; 95% confidence interval [CI]: 0.31-0.56; P < 0 .001) and MME groups (IRR, 0.60; 95% CI: 0.45-0.80; P=0.001) vs the stretching group.
  • Falls were reduced by 31% for the TJQMBB group vs the MME group (IRR, 0.69; 95% CI: 0.52-0.94; P=0.01).
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