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Comparison of telecommunication, community, and home-based Tai Chi exercise programs on compliance and effectiveness
Ge Wu1, Lawrence Keyes, Peter Callas
1Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05405, USA. ge.wu@uvm.edu
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.
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