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.