Thirty-percent of ambulatory seniors over the age of 65 living in a community fall every year. Another 50% of the same age group living in long-term care facilities suffer from at least one fall annually. One in 10 of these falls in turn results in a fracture.1 Falls represent the leading cause of death for people over 65 and the number of fall-related deaths continues to increase with every passing year.
2 Shocking statistics such as these have recently been brought to the attention of trainers, physicians and therapists. Many in the medical world are well aware of the absolute necessity to pursue ways to lower these numbers and help elders to remain on their feet. Though it is now commonly accepted that any exercise is a successful intervention for fall prevention, the exact form of exercise is a debatable issue with major developments still to be made.
One of the rapidly emerging programs prescribed by a number of medical professionals is Tai Chi. What is Tai Chi? How Can it Help? Tai Chi Chuan, or simply Tai Chi, is a Chinese martial art derived from Taosim that dates back to the 13th century, when Chang San-Feng created the martial art in the model of Yin and Yang for Taoists who lived their lives according to the concept of balanced opposites.3 Tai Chi is the most prominent Chinese martial art of the internal style, all of which emphasize breathing and the mental component of training as opposed to the external style that utilizes vigorous body movements and harsh kicks.
The four styles of Tai Chi, Chen, Yang, Wu and Sun, vary depending on skill level, but each style consists of fluid, gentle, graceful and circular movements that are relaxed and slow in motion, making it appropriate for any age group. Exercises involve dynamic weight transition between different types of postures, exchange between loading and unloading of the two legs and coordination between lower-extremities and upper-body movements.
4 In practicing the internal martial art over time, Tai Chi accelerates blood circulation, strengthens and mobilizes joints and muscles, and significantly improves both physical fitness and mental relaxation.
3 The combined benefits of Tai Chi make those who participate in it more alert, flexible and physically active, all positive factors that could theoretically reduce the risk of falling. To observe exactly how much Tai Chi is capable of assisting elders, Fuzhong Li, PhD, from the Oregon Research Institute and colleagues conducted an in-depth study.
The Li Study - The study used with 256 physically inactive adults, ages 70-92. All subjects could ambulate independently and had no cognitive impairments. Each participant was randomly assigned to either the Tai Chi group or the stretching group (control). At the start of the study, subjects were asked to assess their current state of health; 84% rated themselves as good or better. - Both groups attended a training program for six months that consisted of a 50-minute exercise session given three times per week. - For the Tai Chi group, certified Tai Chi instructors led sessions using the 24-Form Yang style, one of the more popular modern styles favored for the short amount of time it takes to complete. The particular style focuses on weight changes in multiple directions and motor coordination, and involves movements in all major segments of the body.
Each session began with a 10 minute warm-up, followed by 30 minutes of Tai Chi, then a 10 minute cool-down.5 - The stretching group included low-intensity, low-impact exercises such as standing and seated stretches for the trunk/lower back and deep abdominal breathing and relaxation exercises. The main component lacking in the control group was the strength and balance exercises regularly employed with Tai Chi.6 - Three functional balance assessments were administered to each of the participants at baseline, three months into the program, after the program’s completion, then finally after the six month “post-intervention period” to determine long-term results, if any.
The three assessments used were dynamic gait index, which assessed subjects’ ability to alter his or her gait in response to a movement challenge (i.e. stepping over obstacles); the Berg Balance scale used 14 distinctive physical tasks that resemble activities of daily living; and a functional reach test measured the maximum distance each subject could reach forward beyond their arms’ length. -Each participant was also given a fall counter to track and record falls, which were defined as any accident resulting in the subject landing on the floor, stairs, etc.6 Results- Does Tai Chi Help Reduce the Chance of Falling? According to the Li Study, the functional balance of members of the Tai Chi group improved significantly in all three measurements during the intervention period, whereas the control group showed no such improvement. Only 28 falls were reported during the post-intervention period for the Tai Chi group, compared to 74 falls in the control.
Balance scores declined in both groups after the six-month post-intervention period, but members of the Tai Chi group declined to a lesser degree, showing a slower deterioration in functional balance. Also, 66% of participants in the Tai Chi group continued to perform some type of exercise activity during the post-intervention period, though none was directly recommended. Only 20% of the control group did likewise.5,6 In a similar study found in the Journal of Advanced Nursing that assigned 59 elders to nearly-identical groups as the Li Study, 31% of the Tai Chi group experienced a fall compared to 50% of the control group.
In addition, the physical fitness of the Tai Chi group was reported to have shown a drastic improvement, with stronger knee and ankle muscles, improved mobility, flexibility and better balance after enduring multiple weeks of training.1 While the combined results of the studies may not prove to put an absolute and immediate halt to elderly falls from a half-year’s worth of Tai Chi, they are nonetheless promising and a step in the right direction.
The “significant improvement” of balance and increased mobility, flexibility and muscle strength for those who participated in Tai Chi are factors rudimentarily necessary to curb senior fallings. Other results such as the slower deterioration in balance prove that Tai Chi took its toll accordingly, but needs to be continued. The massive increase in consistent exercise following the intervention for the Tai Chi group shows that the classes irrefutably encouraged elders to become more active. It appears that Tai Chi is designed more so to decrease the likeliness of falls in the long-term, due to its controlling of the displacement of body mass, overall range of motion and the muscle function of the abdominals and lower-extremities.
With eight centuries worth of further evidence of its health benefits, Tai Chi can no doubt assist, aid and improve overall well-being, especially balance, for the elderly community, and can likely reduce the rate of falls if it is carried out continuously over time.
Sources 1. Li, Vincent. “The History and Application of Tai Chi Chuan.” 2. “Tai Chi: An Overview.” Tai Chi from the Arthritis Foundation-Part Three. 3. Barclay, Laurie. “Tai Chi May Reduce Falls in the Elderly.”9 December 2004. Medscape-Medical News. 4. Kraviz, Len. “Improving Balance and Preventing Falls with Tai Chi.” 2004.