Clinical Bottom Line: There is no definitive evidence to show that Tai Chi does not improve postural balance and decrease fall risk in people over the age of 65 years. Although current evidence is inconsistent and has not eliminated doubt, it is promising. Tai Chi groups, in almost all of the articles in which it was tested, were able to improve some aspect of balance. Subjects in Tai Chi groups also had decreased fall risks in which it was tested. The question is a matter of significance and effect size. Potential for benefits is seen in healthy and frail populations. However, it is important to note the evidence for the benefits of Tai Chi in frail and transitionally frail adults is weaker than the evidence for healthy community dwelling older adults. Thus, Tai Chi should be recommended to frail elderly with extreme caution. Long-term daily practice of Tai Chi seems to be more beneficial than short-term practice. The evidence for the benefits of Tai Chi is strong when compared to educational and non-exercise controls. Further research is needed to ascertain how it compares to other exercises used to improve balance. Given the current research, it is reasonable to assume that healthy adults over the age of 65 years can improve balance and reduce their falls risk with the practice of Tai Chi. However, Tai Chi should be recommended in conjunction with other interventions designed to decrease fall risk. Falls are a multifactorial problem that requires a multifactorial solution. In addition to Tai Chi, measures should be taken to address other intrinsic and extrinsic risk factors.
The Clinical Scenario: Tai Chi is an increasingly popular form of exercise that has been used as an intervention for preventing falls and improving balance among older adults. Other interventions have included general exercise programs comprised of strengthening and flexibility. Currently, there is not a gold standard for treatment to address fall prevention and improved balance among the elderly. The purpose of this critically appraised paper (CAP) is to investigate the clinical efficacy of Tai Chi on fall prevention and balance improvement in the elderly, compared to other traditional interventions.
The Clinical PICO: Population- Elderly individuals, greater or equal to 65 years of age Intervention - Tai Chi exercise Comparison- Traditional exercises or education used to address balance Outcomes- Number of falls and improvements in balance.
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