The Effect of Tai Chi on Physical Function, Fall Rates and Quality of Life among Older Stroke Survivors.

Author: Taylor-Piliae RE1, Hoke TM2, Hepworth JT2, Latt LD3, Najafi B3, Coull BM3.
1College of Nursing, University of Arizona, Tucson, AZ. Electronic address: 2College of Nursing, University of Arizona, Tucson, AZ. 3College of Medicine, University of Arizona, Tucson, AZ.
Conference/Journal: Arch Phys Med Rehabil.
Date published: 2014 Jan 16
Other: Pages: S0003-9993(14)00010-0 , Special Notes: doi: 10.1016/j.apmr.2014.01.001 , Word Count: 313

To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life.
Single-blind, randomized clinical trial.
General community.
Community-dwelling stroke survivors (n=145), aged ≥ 50 years and ≥ 3 months post-stroke.
Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS, n=44), or Usual Care (UC, n=48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. Main Outcome Measures: Physical Function: Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest. Quality of Life: Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index.
A total of 145 stroke survivors (47% women, mean age=70 years, time post-stroke=3 years, ischemic stroke=66%, hemiparesis=73%) enrolled. During the intervention, TC participants had ⅔ fewer falls (n=5 falls), than the SS (n=14 falls) and UC (n=15 falls) groups (χ2=5.60, p=0.06). There was a significant group by time interaction for the 2-Minute StepTest (F2,142=4.69, p<0.01). Post-hoc tests indicated TC (t53=2.45, p=0.02) and SS (t44=4.63, p<0.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, p=0.12). Intervention adherence rates were 85%.
TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling stroke survivors is recommended.
Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
CES-D, Center for Epidemiological Studies Depression scale, Medical Outcomes Study Short Form-36 items, PSQI, Pittsburgh Sleep Quality Index, RCT, Randomized Clinical Trial, SF-36, SPPB, SS, Short Physical Performance Battery, SilverSneakers® strength and range of movement exercises, TC, Tai Chi, UC, Usual Care, accidental falls, clinical trial, stroke

PMID: 24440643