Tai Chi reduces falls in the older adults.

Abstract

Falls are the leading cause of injury among the elderly persons across the globe. Therefore, the need to establish an effective physical training programme for the community-dwelling elderly to encourage them to maintain a more active lifestyle and prevent falls is of paramount importance for every country around the world. Tai Chi (TC) is one of the lights to moderate physical exercises that may have the potential to reduce falls among the elderly population. Besides, it is well tolerated by the elderly, enjoyable, cost-effective and can be integrated as a long-term habit as part of a community-dwelling exercise programme. This review evaluates the TC studies performed in the community that used it as the main physical intervention as compared with no physical exercises to determine whether it reduces falls among community-dwelling people aged 55 years and over. As an inclusion criterion, both qualitative, quantitative and mixed research designs in English language published peer-reviewed articles were considered. No restrictions were made on the TC forms used and on the duration of the studies. Participants with neurological disorders, severe debilitating stroke or arthritis, remarkable vision impairment or unable to walk unaided were excluded from this review. Therefore, the following Patient or Population, Intervention, Comparison and Outcomes (PICO) question for this review is: In older adults living in the community, does the application of Tai Chi reduce the incidence of falls? A number of databases such as (EBSCO- CINAHL plus with full text), Academic Search Complete, Ageline, Cochrane Central Register of Controlled Trails, Cochrane Database of Systematic reviews, Cochrane Methodology Register, Ingentaconnect, Inspec, PsycoiNFO, Pub Med, SociNDEX and SPORTDiscuss with full text were systematically searched. However, after the inclusions and exclusions were finally confirmed from 24 articles, 5 individual randomized control trials (RCTs) were included with a total amount of 1158 participants, the majority of them being females. Besides, 9 systematic reviews (SRs) and 2 SRs and meta-analysis (MAs) full-text articles that included some RCTs that can answer the PICO question were included in this review. The PEDro scale that is appropriate to aid in the appraisal of the individual RCTs was used. Furthermore, to assess the legal and ethical issues of the RCTs, the critiquing criteria developed by LoBondi-Wood and Haber (201 0) was used. The Critical Appraisal Tool Programme (CASP) checklist was used to appraise the relevant parts that can answer the PICO question of SRs and MAs found. TC exercises were found to be effective in reducing falls only in community-dwelling older adults who are still fit and mobile. The initiation of a large longitudinal RCT study with a large enough sample size and longer post intervention follow-up period that involves TC in the intervention group, and no intervention in the control groups is suggested. Such a study could also lead to help clear any gaps and inconsistencies found within the literature that have not yet been tackled by the researchers in the studies appraised.