Despite interest as to the benefits of Tai Chi, there remains a controversy over its effectiveness as an exercise intervention for preventing falls among older adults. This review synthesizes the evidence base with a focus on meta-analyses and randomized controlled trials with community-dwelling older adults. It provides a critical lens on the evidence and quality of the trials. High-quality evidence suggests that Tai Chi is an effective intervention for preventing falls in community settings; however, there is unclear evidence for long-term care facilities and an absence of evidence for hospital settings. When compared directly with other exercise interventions, Tai Chi may offer a superior strategy for reducing falls through its benefits on cognitive functioning. Using data from the current Cochrane review, a new synthesis is presented suggesting that 71–81% of community-dwelling older adults are adherent to class-based Tai Chi interventions. The practical opportunities and challenges for practitioners are discussed.
Samuel R. Nyman and Lucy Yardley
This study evaluated a Web site providing tailored advice to encourage older people to undertake strength and balance training (SBT). Adults age 60–88 (N = 302) were randomized to read either generic advice or advice tailored to their self-perceived balance problems and activity preferences. Between-groups differences in attitudes toward SBT after reading the advice did not quite reach significance (p = .059), but the tailored group reported higher ratings than the generic group that the advice was personally relevant (p = .017) and that the activities would be good for them (p = .047). Within-groups differences in the tailored group showed that completing an action plan increased confidence in undertaking SBT (p = .006). These findings were supported by a meta-analysis that pooled the effect sizes with those of a previous study. Thus, a tailored Web site might be a cost-effective way of encouraging some older people to undertake SBT.
Yolanda Barrado-Martín, Michelle Heward, Remco Polman and Samuel R. Nyman
Exercise is effective in preventing falls among older adults. However, few studies have included people living with dementia and their carers and explored their experiences. The aim of this study is to explore what affects the acceptability of exercise interventions to better meet the needs of people with dementia and their carers as a dyad. Observations, field notes containing participant’s and instructor’s feedback, and focus groups with 10 dyads involved in Tai Chi classes for 3 or 4 weeks in two sites in the South of England were thematically analyzed to understand their experiences. Findings suggest that dyads’ determination to achieve the benefits of Tai Chi facilitated their adherence, whereas a member of the dyad’s low sense of efficacy performing the movements during classes was a barrier. Simplifying class content and enhancing the clarity of instructions for home-based practice will be key to support the design of future exercise interventions.