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Tai Chi might help elderly avoid falls

NEW YORK - The ancient Chinese practice of tai chi might help reduce the risk of falls even among relatively frail elderly adults, new study findings suggest.

Researchers found that among adults in their 70s, 80s and 90s - many of whom relied on assistive devices to get around - tai chi exercises over a 48-weeek period reduced the risk of falling by 25 percent.

In research terms, this risk reduction was not significant statistically, but could still be important in real life, according to the study's lead author, Dr. Steven L. Wolf of Emory University School of Medicine in Atlanta .

In an interview, Wolf pointed out that in the early months of the study, many of the elderly participants had to get comfortable simply with giving up the support of their assistive devices, let alone getting the full benefit of a tai chi class.

When his team looked only at months four through 12 of the study, tai chi participants were almost half as likely to fall as those in a comparison group given wellness education classes.

Given past studies of healthier older adults in which tai chi nearly halved the risk of falls, the practice should continue to be studied among high-risk elderly, the researchers advise in the Journal of the American Geriatrics Society.

Tai chi focuses on building strength, balance and flexibility through slow, fluid movements combined with mental imagery and deep breathing. Studies have suggested that the elderly can reduce their risk of falls, lower their blood pressure and ease arthritis symptoms through the practice.

Last month, Great Britain 's national health service announced a new program offering older adults free tai chi classes, as part of a government campaign to cut the number of elderly who fall and break a hip.

However, past tai chi research has focused on "robust" older adults. Whether the practice can benefit less healthy individuals has been unclear.

In the new study, 311 older adults -- mostly women -- were randomly assigned to either tai chi instruction or wellness education, for 48 weeks. All of the participants were living in facilities for the elderly and were considered to be "transitioning to frailty."

Over the 48 weeks, participants who practiced tai chi were less likely to fall than those in the education group. Overall, about 52 percent in the tai chi group had no falls, compared with just fewer than 40 percent in the comparison group.

An editorial published with the report echoes Wolf's conclusion that the risk reduction in this study was "substantive," if not statistically significant.

"It is certainly a mistake to conclude that tai chi has failed to demonstrate benefit because of these new findings," write Drs. Laurie L. Lavery and Stephanie A. Studenski.

They agree that the difference in fall risk between the two groups may be a "clinically important" one.

According to Wolf, older adults who are living independently and want to try a tai chi class should first make sure the instructor has experience teaching older students. People with medical conditions, such as osteoarthritis, should also ask the instructor whether he or she knows how to modify movements for their particular limitations.

SOURCE: Journal of the American Geriatrics Society, December 2003.

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