Skip Navigation
Skip to contents

J Korean Acad Nurs : Journal of Korean Academy of Nursing

OPEN ACCESS

Articles

Page Path
HOME > J Korean Acad Nurs > Volume 43(3); 2013 > Article
Original Article
Effects of Tai Chi on Fall Risk Factors: A Meta-Analysis
Moonkyoung Park, Rhayun Song
Journal of Korean Academy of Nursing 2013;43(3):341-351.
DOI: https://doi.org/10.4040/jkan.2013.43.3.341
Published online: June 28, 2013

College of Nursing, Chungnam National University, Daejeon, Korea.

Address reprint requests to: Song, Rhayun. College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 301-747, Korea. Tel: +82-42-580-8331, Fax: +82-42-580-8309, songry@cnu.ac.kr
• Received: December 7, 2012   • Accepted: March 13, 2013

© 2013 Korean Society of Nursing Science

  • 18 Views
  • 0 Download
  • 10 Scopus
prev next
  • Purpose
    This study was done to analyze the effects of Tai Chi on fall-related risk factors through meta-analysis of randomized clinical trials published in English and Korean between 2000 and 2010.
  • Methods
    Using health related database and hand search of references and Google, 28 randomized studies were collected from doctoral dissertation and published peer reviewed articles. The Comprehensive Meta-analysis version 2.0 was used for the analysis.
  • Results
    The effect sizes for Tai Chi for 3 months were significant with ES=0.54 for static balance, ES=0.24 for dynamic balance, ES=0.69 for balance measured by scale, and ES=0.40 for flexibility, ES=0.48 for muscle strength, ES=0.71 for ADL, and ES=0.37 for fear of falling. Also, the effect sizes of Tai Chi for 6 months were significant for most fall-related variables. The 6 month data for flexibility was not analyzed since only one study was published.
  • Conclusion
    The analysis of studies of randomized clinical trials indicate that Tai Chi is effective in improving balance, flexibility, muscle strength, activities of daily living, and fear of falling when applied for 3 or 6 months. The findings provide the objective evidence to apply Tai Chi as a fall preventive intervention.
  • 1. American Geriatrics Society, British Geriatrics Society. American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49(5):664–672.ArticlePubMed
  • 2. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. Chichester, WS: Wiley; 2009.
  • 3. Carter ND, Kannus P, Khan KM. Exercise in the prevention of falls in older people: A systematic literature review examining the rationale and the evidence. Sports Med. 2001;31(6):427–438.PubMed
  • 4. Choi JH, Lee EO, Lee HY, Eun Y. Analysis of the effects of Tai Chi on muscle strength and flexibility. J Rheumatol Health. 2005;12(1):69–80.
  • 5. Cohen J. Statistical power analysis for the behavioral sciences. New York, NY: Academic Press; 1977.
  • 6. Erim Z, Beg MF, Burke DT, de Luca CJ. Effects of aging on motor-unit control properties. J Neurophysiol. 1999;82(5):2081–2091.ArticlePubMed
  • 7. Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J. Physical activity for osteoarthritis management: A randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Rheum. 2007;57(3):407–414. http://dx.doi.org/10.1002/art.22621ArticlePubMed
  • 8. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146. http://dx.doi.org/10.1002/14651858.CD007146.pub3Article
  • 9. Glass GV. Primary, secondary, and meta-analysis of research. Educ Res. 1976;5(10):3–8.ArticlePDF
  • 10. Harling A, Sompson JP. A systematic review to determine the effectiveness of Tai Chi in reducing falls and fear of falling in older adults. Phys Ther Rev. 2008;13(4):237–248.Article
  • 11. Health Insurance Review & Assessment Service. 2011 statistics indicators of medical expenses. 2012;Retrieved December 26, 2012. from http://www.hira.or.kr/dummy.do?pgmid=HIRAA020045030000&cmsurl=/cms/information/05/03/03/1214408_13609.html&subject=2011%eb%85%84+%ec%9d%98%eb%a3%8c%ea%b8%89%ec%97%ac+%ec%a7%84%eb%a3%8c%eb%b9%84+%ed%86%b5%ea%b3%84%ec%a7%80%ed%91%9c
  • 12. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions: Cochrane book series. Chichester, WS: John Wiley & Sons Ltd; 2008.
  • 13. Lam P. A handbook for Tai Chi for arthritis. Narwee: East Acton Publishing; 2000.
  • 14. Lee YJ. The effects of Tai Chi exercise program using transtheoretical model applied to degressive arthritis patients. Seoul, Hanyang University. 2008;Unpublished doctoral dissertation.
  • 15. Liu B, Liu ZH, Zhu HE, Mo JC, Cheng DH. Effects of tai chi on lower-limb myodynamia in the elderly people: A meta-analysis. J Tradit Chin Med. 2011;31(2):141–146.ArticlePubMed
  • 16. Logghe IH, Verhagen AP, Rademaker AC, Bierma-Zeinstra SM, van Rossum E, Faber MJ, et al. The effects of Tai Chi on fall prevention, fear of falling and balance in older people: A meta-analysis. Prev Med. 2010;51(3-4):222–227. http://dx.doi.org/10.1016/j.ypmed.2010.06.003ArticlePubMed
  • 17. Low S, Ang LW, Goh KS, Chew SK. A systematic review of the effectiveness of Tai Chi on fall reduction among the elderly. Arch Gerontol Geriatr. 2009;48(3):325–331. http://dx.doi.org/10.1016/j.archger.2008.02.018ArticlePubMed
  • 18. Menz HB, Morris ME, Lord SR. Foot and ankle risk factors for falls in older people: A prospective study. J Gerontol A Biol Sci Med Sci. 2006;61(8):866–870.ArticlePubMed
  • 19. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6(7):e1000097. http://dx.doi.org/10.1371/journal.pmed.1000097ArticlePubMedPMC
  • 20. Orwin RG. A fail-safe N for effect size in meta-analysis. J Educ Stat. 1983;8(2):157–159.ArticlePDF
  • 21. Rand D, Miller WC, Yiu J, Eng JJ. Interventions for addressing low balance confidence in older adults: A systematic review and meta-analysis. Age Ageing. 2011;40(3):297–306. http://dx.doi.org/10.1093/ageing/afr037ArticlePubMed
  • 22. Rothstein HR, Sutton AJ, Borenstein M. Publication bias in meta-analysis, prevention, assessment and adjustments. New York, NY: John Wiley and Sons Ltd; 2005.
  • 23. Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing. 2008;37(1):19–24. http://dx.doi.org/10.1093/ageing/afm169ArticlePubMed
  • 24. Scottish Intercollegiate Guidelines Network. SIGN 50; A guideline developer's handbook. 2008;Retrieved July 1, 2010. from http://www.sign.ac.uk/guidelines/fulltext/50/
  • 25. Song R, Lee EO, Lam P, Bae SC. Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: A randomized clinical trial. J Rheumatol. 2003;30(9):2039–2044.PubMed
  • 26. Stump TE, Clark DO, Johnson RJ, Wolinsky FD. The structure of health status among Hispanic, African American, and white older adults. J Gerontol B Psychol Sci Soc Sci. 1997;52(Spec No):49–60.ArticlePubMed
  • 27. Sutton AJ, Duval SJ, Tweedie RL, Abrams KR, Jones DR. Empirical assessment of effect of publication bias on meta-analyses. BMJ. 2000;320(7249):1574–1577.ArticlePubMedPMC
  • 28. Tideiksaar R. Falls in older people: Prevention and management. 3rd ed. Baltimore, MD: Health Professions Press; 2002.
  • 29. Wooton AC. An integrative review of Tai Chi research: An alternative form of physical activity to improve balance and prevent falls in older adults. Orthop Nurs. 2010;29(2):108–116. quiz 117-108. http://dx.doi.org/10.1097/NOR.0b013e3181d243b3PubMed
  • 30. World Health Organization. Falls. 2012;Retrieved November 26, 2012. from http://www.who.int/mediacentre/factsheets/fs344/en/
Figure 1
Analysis framework of Tai Chi for fall risk factors.
jkan-43-341-g001.jpg
Figure 2
Flow diagram of study selection process.
jkan-43-341-g002.jpg
Table 1
Characteristics of Included Studies in Meta-Analysis: Tai Chi for Fall Risk Factors
jkan-43-341-i001.jpg

FE=Frail elderly; HE=Healthy elderly; OA=Osteoarthritis; AS=Ankylosing spondylitis; BBS=Berg balance scale; FRT=Functional reach test; OLS=One leg stance; POMA=Performance oriented mobility assessment; PPS=Physical performance scale; TS=Tandem stance; TUG=Timed up and go test; ROM=Range of motion; ADL=Activities of daily living; FAS=Functional ability scale; GARS=Groningen activity restriction scale; HAQ=Health assessment questionnaire; OARS=Older American resource survey; WOMAC=Western Ontario and McMaster University osteoarthritis index questionnaire; ABC=Activities-specific balance confidence scale; FES=Fall efficacy scale; SAFFE=Survey of activities and fear of falling in the elderly; MS=Muscle strength; Italic=No report about method of random assignment.

Table 2
Effect Size of 3 and 6 Months Tai Chi Exercise for Fall Risk Factors
jkan-43-341-i002.jpg

*Random effect model; AS=Asymmetric; S=Symmetric.

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  

      • Cite
        CITE
        export Copy Download
        Close
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        Effects of Tai Chi on Fall Risk Factors: A Meta-Analysis
        J Korean Acad Nurs. 2013;43(3):341-351.   Published online June 28, 2013
        Close
      • XML DownloadXML Download
      Figure
      • 0
      • 1
      We recommend
      Related articles
      Effects of Tai Chi on Fall Risk Factors: A Meta-Analysis
      Image Image
      Figure 1 Analysis framework of Tai Chi for fall risk factors.
      Figure 2 Flow diagram of study selection process.
      Effects of Tai Chi on Fall Risk Factors: A Meta-Analysis

      Characteristics of Included Studies in Meta-Analysis: Tai Chi for Fall Risk Factors

      FE=Frail elderly; HE=Healthy elderly; OA=Osteoarthritis; AS=Ankylosing spondylitis; BBS=Berg balance scale; FRT=Functional reach test; OLS=One leg stance; POMA=Performance oriented mobility assessment; PPS=Physical performance scale; TS=Tandem stance; TUG=Timed up and go test; ROM=Range of motion; ADL=Activities of daily living; FAS=Functional ability scale; GARS=Groningen activity restriction scale; HAQ=Health assessment questionnaire; OARS=Older American resource survey; WOMAC=Western Ontario and McMaster University osteoarthritis index questionnaire; ABC=Activities-specific balance confidence scale; FES=Fall efficacy scale; SAFFE=Survey of activities and fear of falling in the elderly; MS=Muscle strength; Italic=No report about method of random assignment.

      Effect Size of 3 and 6 Months Tai Chi Exercise for Fall Risk Factors

      *Random effect model; AS=Asymmetric; S=Symmetric.

      Table 1 Characteristics of Included Studies in Meta-Analysis: Tai Chi for Fall Risk Factors

      FE=Frail elderly; HE=Healthy elderly; OA=Osteoarthritis; AS=Ankylosing spondylitis; BBS=Berg balance scale; FRT=Functional reach test; OLS=One leg stance; POMA=Performance oriented mobility assessment; PPS=Physical performance scale; TS=Tandem stance; TUG=Timed up and go test; ROM=Range of motion; ADL=Activities of daily living; FAS=Functional ability scale; GARS=Groningen activity restriction scale; HAQ=Health assessment questionnaire; OARS=Older American resource survey; WOMAC=Western Ontario and McMaster University osteoarthritis index questionnaire; ABC=Activities-specific balance confidence scale; FES=Fall efficacy scale; SAFFE=Survey of activities and fear of falling in the elderly; MS=Muscle strength; Italic=No report about method of random assignment.

      Table 2 Effect Size of 3 and 6 Months Tai Chi Exercise for Fall Risk Factors

      *Random effect model; AS=Asymmetric; S=Symmetric.


      J Korean Acad Nurs : Journal of Korean Academy of Nursing
      Close layer
      TOP