March 15, 2004

Tai chi training may reduce falls in the elderly

By Janet Christenbury


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.”