Emory researchers have found that intense training in tai chi,
the ancient Chinese martial arts form, may help reduce the risks
of falls in elderly, frail adults. But the benefit of the exercise
is somewhat less pronounced than in more active, “robust” seniors,
according to lead researcher Steven Wolf, professor of rehabilitation
medicine.
The advantages of tai chi training in a study population defined
as “transitioning
to frailty” became most apparent by the fourth month of the study, when
risks of falling were reduced by 40 percent as participants became less dependent
on walkers and wheelchairs and learned the movements of tai chi. The $1.2 million
study was funded by the National Institute of Aging, a branch of the National
Institutes of Health, and results were published recently in the Journal
of the American Geriatrics Association.
Researchers enrolled more than 300 participants from 70 to 97 years of age in
the
48-week study. All participants were residents of assisted-living facilities
in the Atlanta area and were randomly selected to learn either tai chi or be
enrolled in wellness education classes.
All participants had to be “transitioning to frailty,” and all had
to have fallen one or more times in the year prior to enrolling in the study.
“In a previous study known as the FICSIT (Frailty and Injuries: Cooperative
Studies of Intervention Techniques) study, we looked at the effects of tai chi,
balance training and wellness education in elderly people,” Wolf said. “This
study enrolled older individuals in the community who were otherwise healthy
and strong, often identified as ‘robust.’ The results showed that
tai chi had the most profound effect in fall prevention, reducing the risks of
multiple falls by 47.5 percent, when compared to balance training and wellness
education.”
Published in 1996, the FICSIT study was selected as the best paper in the 1990s
by the Journal of the American Geriatrics Association out of roughly 1,400 entries.
“With information from FICSIT, we decided to evaluate the population that
is considered to be ‘transitioning to frailty’ to determine if the
outcomes are similar,” Wolf said. “We haven’t looked at tai
chi training in less healthy individuals until now.”
In the new study, tai chi participants took classes twice a week. The martial
art consists of slow, rhythmic movements that emphasize trunk rotation, weight
shifting and coordination. Participants in the wellness education class gathered
once a week to learn about fall prevention, exercise and balance, diet and nutrition,
medication management, and other topics. The class provided printed handouts,
but there was no physical instruction in exercise.
Over the 48-week study period, 46 percent of participants did
not fall. The percentage of participants who fell at least once
in the tai chi group was 47.6, compared to 60.3 percent in the
wellness education group. The study also compared participants’ education
with fall rates; participants in the tai chi group with no high school degree
had significantly lower fall rates than those in the wellness education group.
“While we saw a 40 percent decline in falls from the fourth month on
in the tai chi group, we also saw a slight decline in the number of falls per
month in the wellness education group,” Wolf said. “Health promotion
can be an effective intervention in preventing disease or injury. The wellness
education activities may have motivated some participants to become more physically
active, adopt healthier and safer lifestyles, and thus reduce their risk factors
for falling.”
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