Wednesday, September 12, 2018

Effectiveness of a therapeutic Tai Ji Quan intervention vs a multimodal exercise intervention to prevent falls among older adults at high risk of falling: A randomized clinical trial

Does your stroke hospital even have a fall prevention protocol?  I had none, I was obviously expected never to fall, no training on what to do to get up off the ground. But with no group that tested out recovering from perturbations more research needs to be done.
https://www.mdlinx.com/journal-summaries/trauma-tai-ji-quan-exercise-geriatrics/2018/09/12/7544162/ZZ3559DFF1FDFD43F3965FF05AF76C7B18?

JAMA Internal MedicineLi F, et al. | September 12, 2018
Researchers conducted a single-blind, three-arm, parallel-design, randomized clinical trial to ascertain the effectiveness of a therapeutically tailored tai ji quan intervention, Tai Ji Quan: Moving for Better Balance (TJQMBB), and a multimodal exercise (MME) program relative to stretching exercise in reducing falls among older adults at high risk of falling. Results showed that, compared with conventional exercise approaches, a therapeutically tailored tai ji quan intervention was more effective in reducing the incidence of falls in this study population.

Methods

  • This trial was conducted in seven urban and suburban cities in Oregon from February 20, 2015, to January 30, 2018.
  • Researchers screened 1,147 community-dwelling adults aged ≥70 years for eligibility; of these, 670 who had fallen in the preceding year or had impaired mobility consented and were enrolled.
  • Intention-to-treat assignment was used in all analyses.
  • Interventions included 1 of 3 exercise interventions: two 60-minute classes weekly for 24 weeks of TJQMBB, entailing modified forms and therapeutic movement exercises; MME, integrating balance, aerobics, strength, and flexibility activities; or stretching exercises.
  • Incidence of falls at 6 months was the primary measure.

Results

  • Researchers randomized 670 adults (mean [standard deviation] age: 77.7 [5.6] years), of whom 436 (65%) were women, 617 (92.1%) were white, and 31 (4.6%) were African American.
  • During the trial, the TJQMBB group had 152 falls (85 individuals), the MME group had 218 falls (112 individuals), and the stretching-exercise group had 363 falls (127 individuals).
  • At 6 months, significantly lower incidence rate ratio (IRR) was observed in the TJQMBB (IRR, 0.42; 95% confidence interval [CI]: 0.31-0.56; P < 0 .001) and MME groups (IRR, 0.60; 95% CI: 0.45-0.80; P=0.001) vs the stretching group.
  • Falls were reduced by 31% for the TJQMBB group vs the MME group (IRR, 0.69; 95% CI: 0.52-0.94; P=0.01).
Read the full article on JAMA Internal Medicine

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