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Balance and Functional Outcomes for Older Community-Dwelling Adults Who Practice Tai Chi and Those Who Do Not

A Comparative Study

Bubela, Deborah PT, PhD1; Sacharko, Laddie MA2; Chan, Judy PT, DPT1; Brady, Maegen PT, DPT1

Journal of Geriatric Physical Therapy: October/December 2019 - Volume 42 - Issue 4 - p 209–215
doi: 10.1519/JPT.0000000000000153
Research Reports

Background and Purpose: A growing body of literature substantiates that Tai Chi is a form of exercise that may help older adults increase strength, improve balance, lower fall rates, and experience less fear of falling. Few studies, however, offer controlled experimental design and simultaneously investigate multiple factors known to contribute to fall risk. The purpose of this study was to compare performance on measures relating to fall risk (strength, balance, functional mobility, and fear of falling) in older community-dwelling adults who participated in a community-based Tai Chi program with a control group of their peers who had no Tai Chi training over the same time period.

Methods: A quasi-experimental comparative pre- and posttest design was used to compare an experimental group of 16 community-dwelling older adults, mean (SD) age = 80.4 (6.8) years, participating in a 16-week Tai Chi training program with a group of 13 adults, mean (SD) age = 71.2 (6.1) years, who had no Tai Chi experience in the areas of knee extension strength (measured by handheld dynamometry), functional strength (by five-time sit to stand), mobility (by Timed Up and Go [TUG] test and Fifty-Foot Walk Test), balance (by Functional Reach and Berg Balance Scale), and fear of falling (by Activity-specific Balance Confidence scale). Within-group and between-groups comparisons were made using 2×2 mixed analysis of variance.

Results: Tai Chi participants improved in nearly all measures, whereas controls did not. Tai Chi participants experienced significant improvement in the TUG test during the training period (P = .003), with significant difference when compared with controls (P = .049) and moderate effect size and observed power (ηp2 = 0.165; observed power = 0.512). Significant knee extension strength improvement occurred (P = .042) with moderate effect size and observed power (ηp2 = 0.183; observed power = 0.543). While the total balance confidence scale score did not change significantly, responses on many individual items did reach a level of significant change for persons participating in the Tai Chi training.

Conclusion: Older adults' participation in a community-based Tai Chi program may lead to improvement in strength, mobility, and confidence in performing functional tasks. Incorporation of elements of Tai Chi into therapy programs for older adults at risk for fall and referral to community-based Tai Chi programs may be viable options in the continuum of health-related care for older adults.

1Physical Therapy Program, Kinesiology Department, University of Connecticut, Storrs.

2Starfarm Tai Chi Qigong Search Center, Chaplin, Connecticut.

Address correspondence to: Deborah Bubela, PT, PhD, Physical Therapy Program, Department of Kinesiology, University of Connecticut, 3107 Horsebarn Hill Rd, Unit 4137, Storrs, CT 06269 (

The authors declare no conflicts of interest.

Kerstin Palombaro was the Decision Editor.

© 2019 Academy of Geriatric Physical Therapy, APTA
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