Abstract
Wu G, Keyes L, Callas P, Ren X, Bookchin B. Comparison of telecommunication, community,
and home-based Tai Chi exercise programs on compliance and effectiveness in elders
at risk for falls.
Objective
To compare the adherence to and effectiveness of Tai Chi exercise program through
a live, interactive, telecommunication-based exercise (Tele-ex) with that of a similar
program through a community center–based exercise (Comm-ex) and a home video–based
exercise (Home-ex) among community-dwelling elders who are at risk for falls.
Design
Three groups randomized controlled trial with pretests and posttests.
Setting
Exercise programs were community-based, and the outcome measures were laboratory-based.
Participants
Adults (N=64) age 65+ years with positive fall history in the previous year and/or
significant fear of falling.
Intervention
A 24-form, Yang-style Tai Chi for 15 weeks, 3 hours a week.
Main Outcome Measures
Exercise compliance, number of falls, fear of falling (Activities-specific Balance
Confidence [ABC] score), self-perceived health (Medical Outcomes Study 36-Item Short
Form Health Survey [SF-36]), Timed Up & Go (TUG), single leg stance (SLS), and body
sway during quiet stance (medial-lateral foot center of pressure [ML-COP]).
Results
Tele-ex and Comm-ex groups demonstrated significantly higher exercise attendance and
in-class practice time than the Home-ex group (P<.01) and significant reductions in the mean number of falls and injurious falls (P<.01). There were significant improvements posttraining in SLS, ABC, ML-COP, and Physical
Health subscore of the SF-36 (P<.05). Both Tele-ex and Comm-ex groups demonstrated larger improvements than the Home-ex
group in TUG, ML-COP, and the Social Function, Mental Health, and Physical Health
subscores of the MOS SF-36.
Conclusion
Compared with the Home-ex, the Tele-ex and Comm-ex groups are better in exercise compliance,
fall reduction and balance and health improvements. Tele-ex is an effective, affordable,
and acceptable choice of exercise for elders.
Key Words
List of Abbreviations:
ABC (Activities-specific Balance Confidence), ANOVA (analysis of variance), Comm-ex (Community center-based exercise), COP (center of pressure), CONSORT (Consolidated Standards of Reporting Trials), EC (eyes closed), EO (eyes open), Home-ex (Home video-based exercise), ML-COP (medial-lateral foot center of pressure), SF-36 (Medical Outcomes Study 36-Item Short Form Health Survey), SLS (single leg stance), Tele-ex (Telecommunication-based exercise)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The cost and frequency of hospitalization for fall-related injuries in older adults.Am J Public Health. 1992; 82: 1020-1023
- The injury fact book.Oxford University Pr, New York1992
- Deaths: final data for 1998: national vital statistics reports.National Center for Health Statistics, Hyattsville2000
- Public health and aging: trends in aging—United States and worldwide.MMWR CDC Surveill Summ. 2003; 52: 101-106
- Overview: surveillance for selected public health indicators affecting older adults—United States.MMWR CDC Surveill Summ. 1999; 48: 1-6
- Self-reported exercise before age 40: influence on quantitative skeletal ultrasound and fall risk in the elderly.Arch Phys Med Rehabil. 2001; 82: 801-806
- Strength and aerobic training attenuate muscle wasting and improve resistance to the development of disability with aging.J Gerontol A Biol Sci Med Sci. 1995; 50: 113-119
- Falls and fall prevention in the nursing home.Clin Geriatr Med. 1996; 12: 881-902
- 12-month Tai Chi training in the elderly: its effect on health fitness.Med Sci Sports Exerc. 1998; 30: 345-351
- Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners.Arch Phys Med Rehabil. 1996; 77: 612-616
- The effect of T'ai Chi Chuan training on balance, kinesthetic sense, and strength.Percept Mot Skills. 1997; 84: 27-33
- Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: a randomized controlled trial.Am J Med. 2004; 117: 541-548
- Self-report benefits of Tai Chi practice by older adults.J Gerontol B Psychol Sci Soc Sci. 1997; 52: 242-246
- Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training.J Am Geriatr Soc. 1996; 44: 489-497
- A randomized trial of exercise programs among older individuals living in two long-term care facilities: the FallsFREE program.J Am Geriatr Soc. 2001; 49: 859-865
- Women and cardiac rehabilitation: referral and compliance patterns.J Cardiovasc Nurs. 1999; 13: 83-92
- Arthritis foundation community-based physical activity programs: effectiveness and implementation issues.Arthritis Rheum. 2003; 49: 463-470
- Healthy people 2010: understanding and improving health.2nd ed. U.S. Government Printing Office, Washington (DC)2000
- Socio-economic predictors of alienation among the elderly.Int J Aging Hum Dev. 1990; 31: 205-217
- Mental health needs of the homebound elderly.J Long Term Home Health Care. 1995; 14: 5-20
- Evaluating the effectiveness of a home-based fall risk reduction program for rural community-dwelling older adults.J Gerontol A Biol Sci Med Sci. 2001; 56: M226-M230
- A pilot study on the effectiveness of a home-based Tai Chi exercise on physical risk factors for falls in frail elders.Gerontologist. 2002; 42 ([abstract]): 171
- Value of a supervised exercise program for the therapy of arterial claudication.J Vasc Surg. 1997; 25 (discussion 8-9): 312-318
Jones GR. Stay at home and exercise: The home support exercise program for frail older adults. Stride: Excellence in Seniors Care 2003/2004, 5:4-9.
- Group tele-exercise for improving balance in elders.Telemed J E Health. 2006; 12: 561-570
- The Activities-specific Balance Confidence (ABC) scale.J Gerontol A Biol Sci Med Sci. 1995; 50A: M28-M34
- Simplified Tai Chi Quan.2nd ed. China Publication Center, Beijing1983
Tinetti ME, Powell L. Fear of falling and low self-efficacy: a case of dependence in elderly persons. J Gerontol_1993 48 (Spec issue): 35-8.
- Empirical status of cognitive theory of depression.Psychol Bull. 1991; 110: 215-236
- SF-36 Health Survey: manual and interpretation guide.The Health Institute, Boston1993
- Evaluation of the effectiveness of Tai Chi for improving balance and preventing falls in the elderly population—a review.J Am Geriatr Soc. 2002; 50: 746-754
- The timed “Up and Go”: a test of basic functional mobility for frail elderly persons.J Am Geriatr Soc. 1991; 39: 142-148
- Lateral stability during forward-induced stepping for dynamic balance recovery in young and older adults.J Gerontol A Biol Sci Med Sci. 2001; 56: M589-M594
- Home versus center based physical activity programs in older adults.Cochrane Database Syst Rev. 2005; 1: CD004017
- Effects of home-based exercise training on neurovascular control in patients with heart failure.Eur J Heart Fail. 2006; 8: 851-855
- A program to prevent functional decline in physically frail, elderly persons who live at home.N Engl J Med. 2002; 347: 1068-1074
Article info
Footnotes
Supported by the National Institutes of Health (grant no. 5R44AG022795-04).
A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit on the author or one or more of the authors. Lawrence Keyes is affiliated with Microdesign Consulting, Inc, which is the developer of the DocBox.
Identification
Copyright
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
