We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Effects of Home-Based Tai Chi and Lower Extremity Training and Self-Practice on Falls and Functional Outcomes in Older Fallers from the Emergency Department-A Randomized Controlled Trial.
- Authors
Hwang, Hei‐Fen; Chen, Sy‐Jou; Lee‐Hsieh, Jane; Chien, Ding‐Kuo; Chen, Chih‐Yi; Lin, Mau‐Roung
- Abstract
Objectives To compare the effects of guided home-based tai chi chuan ( TCC) and lower extremity training ( LET) and of levels of self-practice on falls and functional outcomes in older fallers. Design Randomized controlled trial. Setting Taipei, Taiwan. Participants Individuals aged 60 and older who had fall-related emergency department visits at least 6 months before participating in the study and ambulated independently at baseline (N = 456). Intervention Six months of TCC or LET. Measurements Four types of fall measures (falls, time to first fall, fallers, recurrent fallers) and six functional measures (handgrip strength, balance, mobility, fear of falling, depression, cognitive function). Results The TCC group was significantly less likely than the LET group to experience any falls during the 6-month intervention (incidence rate ratio (IRR) = 0.30, 95% confidence interval ( CI) = 0.15-0.60), and the effects remained significant after 12 months of follow-up ( IRR = 0.32, 95% CI = 0.14-0.71). These effects remained significant for injurious falls during the 6-month intervention (IRR = 0.33, 95% CI = 0.16-0.68) and the entire 18-month study (IRR = 0.39, 95% CI = 0.18-0.83). Similar results were obtained when another two fall measures (time to first fall, number of fallers) were used. Moreover, participants who independently practiced TCC or LET seven times per week or more were significantly less likely to experience injurious falls during the 6-month intervention (IRR = 0.41, 95% CI = 0.20-0.83) and the 18-month study (IRR = 0.43, 95% CI = 0.21-0.87) than their counterparts, had a significantly longer time to first injurious fall, and were significantly less likely to have an injurious fall during the 6-month intervention. Cognitive function improved to a greater extent in the TCC group than in the LET group over the 18-month study. Conclusion Home-based TCC may reduce the incidence of falls and injurious falls more than conventional LET in older fallers, and the effects may last for at least 1 year.
- Subjects
TAIWAN; TAI chi; LEG injuries; ACCIDENTAL falls in old age; RISK factors of accidental falls in old age; EXERCISE for older people; CONFERENCES &; conventions; THERAPEUTICS; ACCIDENTAL fall prevention; RISK factors of falling down; ACADEMIC medical centers; GERIATRIC assessment; CHINESE people; CHRONIC diseases; COGNITION; COMPARATIVE studies; CONFIDENCE intervals; MENTAL depression; EMERGENCY medical services; POSTURAL balance; EXERCISE; EXERCISE tests; ACCIDENTAL falls; FEAR; GRIP strength; HOME care services; HOSPITAL emergency services; LEG; LIFE skills; LONGITUDINAL method; NEUROPSYCHOLOGICAL tests; MUSCLE contraction; MUSCLE strength; PATIENT compliance; PATIENTS; REHABILITATION; RESEARCH funding; SCALE analysis (Psychology); SELF-efficacy; STRETCH (Physiology); T-test (Statistics); LOGISTIC regression analysis; LEG exercises; STATISTICAL power analysis; SOCIOECONOMIC factors; BODY movement; RANDOMIZED controlled trials; RELATIVE medical risk; TREATMENT effectiveness; INDEPENDENT living; PROPORTIONAL hazards models; GERIATRIC Depression Scale; RELAXATION techniques; DATA analysis software; DIARY (Literary form); DESCRIPTIVE statistics; TRAUMA severity indices; OLD age
- Publication
Journal of the American Geriatrics Society, 2016, Vol 64, Issue 3, p518
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.13952