Video Guided T'ai Chi: A Pilot Study to Assess Effectiveness

Falls impact up to 45% of community dwelling older adults each year, contributing to upwards of $30 billion dollars in direct health care costs. Independent of an actual fall many persons over age 65 years report a fear of falling that negatively impacts quality of life through a cycle of inactivity, weakness, depression, isolation and increased falls. There are a number of evidenced based programs available that address fall prevention.  T'ai Chi, an ancient Chinese martial art is thought to enhance awareness of body position, alignment, and range of motion.  Numerous studies provide evidence that T'ai Chi can be an effective strategy to reduce fear of falling among older adults.   This pilot study evaluated effects of a video-guided T'ai Chi group intervention on center of balance (COB) and falls efficacy, using a one arm, pretest posttest design. The study was completed in a rural setting that has a community with a high percentage of older adults (18.9%).  The study was an attempt to translate current evidence of the positive effects of T’ai Chi exercise in a low cost manner.  The T’ai Chi exercises were delivered via video, fear of falling was evaluated using the Falls Efficacy Scale International and center of balance was measured using a commercially available Wii Balance Board.^™ Thirty-two participants began the study, 17 completed pre- and post-testing and 15 were lost to follow-up. Outcomes were compared for the 17 participants who completed pre- and post-testing and subgroups were formed and analyzed based on session attendance. Irrespective of session attendance, participant COB scores improved. There was a significant negative correlation between number of sessions attended and pre and post scores on the fall efficacy (fear of falling) measure, indicating those with higher fear of falling were less likely to complete the study. Older participants were also less likely to continue participation. Findings indicate potential benefits of T'ai Chi in improving COB (a fall risk factor) among community-dwelling older adults. However, those with greater potential benefit (higher fear scores, older participants) were less likely to continue participation.