Tai Chi and falls prevention in older people.

BACKGROUND: Considerable research evidence has been accumulated since 1990 that practicing Tai Chi can ameliorate multiple characteristics in older adults that place them at increased risk of falling, including poor balance, loss of strength, limited flexibility, and fear of falling. However, relatively few studies have directly examined the influence of Tai Chi practice on falls in this population. RESULTS: Nine randomized controlled trials utilizing Tai Chi (n = 6), or Tai Chi-inspired exercise (n = 3), were published between 1996 and July, 2007. The studies varied considerably on study settings, participant characteristics, sample size, type of Tai Chi intervention, length of intervention and quality of the study design. Of the six studies that used Tai Chi forms, three showed significant improvement in fall-related outcomes. One study using Tai Chi-inspired exercise also had a significant fall-related outcome. CONCLUSION: Despite the evidence demonstrating the beneficial influence of Tai Chi practice on known risk factors for falling in older adults, evidence indicating an actual impact on falls-related outcomes is equivocal. More large-scale, longitudinal studies with consistent intervention parameters and clinically meaningful outcome variables are needed to a clarify the role of Tai Chi in effective falls prevention programs. The recent development of a standardized, research-to-practice Tai Chi falls prevention program may be an important step in this process.