Reduce Falls in the Elderly with Tai Chi
By John M. de Castro, Ph.D.
“A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age,” – Peter Wayne
The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.
Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of fall in the elderly.
Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Because it is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for an elderly population. So, it would seem that tai chi practice would be well suited to improving balance and coordination in seniors and thereby reduce the likelihood of falls.
In today’s Research News article “Systematic review and meta-analysis: Tai Chi for preventing falls in older adults.” See summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293999/
Huang and colleagues reviewed and summarized the published research findings on the effectiveness of Tai Chi practice in preventing falls in the elderly. They identified 18 research publications describing randomized controlled trials, 16 of which were included in a meta-analysis. The studies included employed Tai Chi practice with individuals over 60 years of age and measured falls.
They found that the published research indicated that with Tai Chi training there were more elderly individuals who did not experience any falls at all and of those who did fell less often. These improvements were associated with the frequency of training with the greater the training the greater the benefits. In addition, the style of Tai Chi mattered with the Yang style being superior to the Sun style in preventing falls. The Yang style Tai Chi is characterized by big and open movements and is the most popular form of tai chi studied today. Sun Style has movements that are continuous, slow, even and with agile steps, a higher stance, and less kicking and punching. So, it would appear that the large and open movements of the Yang style are important in improving balance and thereby making falls less likely.
These are important findings. Falls become more and more likely with age and the consequences of falls to the elderly can be devastating. So, a practice that can lower the risk of falls is important for the health and well-being of the elderly. Tai Chi is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects. So, it is well suited as an exercise for an elderly population. In addition, once learned it can be practiced at home or in groups, making it a flexible very low cost solution. Hence, it appears that Tai Chi should be recommended to the elderly to improve balance and reduce falls and thereby improve the health and well-being of the elderly.
So, reduce falls in the elderly with tai chi.
“Treatment of injuries, due to falls, is one of the most expensive health conditions. Evidence has shown tai chi being one of the two effective exercises to prevent falls.” – Paul Lam
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Huang, Z.-G., Feng, Y.-H., Li, Y.-H., & Lv, C.-S. (2017). Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open, 7(2), e013661. http://doi.org/10.1136/bmjopen-2016-013661
Abstract
Objective
It remains unclear whether Tai Chi is effective for preventing falls in older adults. We undertook this systematic review to evaluate the preventive effect of Tai Chi by updating the latest trial evidence.
Design
Systematic review and meta-analysis.
Methods
The Cochrane Library, MEDLINE and EMBASE were searched up to February 2016 to identify randomised trials evaluating Tai Chi for preventing falls in older adults. We evaluated the risk of bias of included trials using the Cochrane Collaboration’s tool. Results were combined using random effects meta-analysis.
Outcome measures
Number of fallers and rate of falls.
Results
18 trials with 3824 participants were included. The Tai Chi group was associated with significantly lower chance of falling at least once (risk ratio (RR) 0.80, 95% CI 0.72 to 0.88) and rate of falls (incidence rate ratio (IRR) 0.69, 95% CI 0.60 to 0.80) than the control group. Subgroup analyses suggested that the preventive effect was likely to increase with exercise frequency (number of fallers: p=0.001; rate of falls: p=0.007) and Yang style Tai Chi was likely to be more effective than Sun style Tai Chi (number of fallers: p=0.01; rate of falls: p=0.001). The results might be influenced by publication bias as the funnel plots showed asymmetry. Sensitivity analyses by sample size, risk of bias and comorbidity showed no major influence on the primary results.
Conclusions
Tai Chi is effective for preventing falls in older adults. The preventive effect is likely to increase with exercise frequency and Yang style Tai Chi seems to be more effective than Sun style Tai Chi.
Strengths and limitations of this study:
- This study is, to date, the most comprehensive systematic review evaluating Tai Chi for preventing falls in older adults. A number of recently published trials were included, which improved the precision of the estimated effects and enabled us to investigate various influential factors such as Tai Chi style and frequency.
- Our confidence in the findings is further increased by significant dose–response effect, stable sensitivity analyses and stable analyses by adjusting for publication bias.
- The findings are likely to be influenced due to the bias in some original trials.
- The estimated preventive effect of Tai Chi may be overestimated due to publication bias.