Impact of tai-chi on impairment, functional limitation and disability among pre-clinically disabled older people . A randomised controlled trial. 


Author: Day L, Hill KD, Jolley D, Cicuttini F, Flicker L, Segal L.

Affiliation: Monash University, Melbourne, Australia. 
Conference/Journal: Arch Phys Med Rehabil.
Date published: 2012 Mar 27
Other:
  Word Count: 278  
    OBJECTIVE:

To test the effect of tai-chi on the progression of pre-clinical disability to manifest disability, compared with seated flexibility exercise, and to examine whether tai-chi mediates delayed disability by reducing impairments in musculo-skeletal, cardiovascular and neurological systems, and related functional limitations

DESIGN:

Multi-site parallel group individually-randomised controlled trial

SETTING:

General community

PARTICIPANTS:

Pre-clinically disabled community-dwelling people 70+ yrs (n=503), without major medical conditions or moderate to severe cognitive impairment.

INTERVENTION:

Modified Sun style tai-chi exercise compared with seated flexibility exercise, both programs delivered in groups for 60 minutes twice weekly for 24 weeks.

MAIN OUTCOME MEASURES:

Disability measured with the Late Life Function and Disability Instrument. Secondary outcomes were impairments and functional limitations of the musculo-skeletal, neurological and cardio-vascular systems.

RESULTS:

There was little change within or between the two groups. The mean change in the Disability Frequency Score was 0.3 and 0.1 points (100-point scale) for the intervention and control groups respectively (adjusted difference -0.21 95% CI -0.99 to 0.56). The mean change in the Disability Limitation Score was -0.1 and -0.04 points for the intervention and control groups respectively (adjusted difference -0.6 95% CI -2.31 to 1.11). There was little effect on impairments or functional limitations. A higher proportion of intervention participants ceased attending the exercise program (difference=17.9%, 95% CI 9.6 to 25.8). Multiple imputation of missing data did not change the results.

CONCLUSIONS:

Modified Sun style tai-chi did not impact on impairment, functional limitations, or disability in pre-clinically disabled older people when delivered for 24 weeks. Withdrawal from the exercise classes was high but did not explain the null result. Improved compliance, or a longer or more intensive program, may be required.

Copyright © 2012 the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

PMID: 22465404