Comparison of 2 Different Exercise Approaches: Tai Chi Versus Otago, in Community-Dwelling Older Women

Background and Purpose: Regular exercise can delay age-related risk factors and can maintain or improve physical health and activity in older adults leading to a decrease in fall risk. The purpose of this study was to compare 2 different interventions for fall prevention, tai chi (TC) and Otago, by examining lower extremity strength, balance, and spatiotemporal gait parameters in community-dwelling older women. Methods: We performed a randomized trial in which subjects were assigned to 1 of 2 groups: the TC group (n = 21; age, 72.8 +/- 4.7 years, range: 65-83 years), which participated in a modified Sun-style TC exercise program; and the Otago group (n = 24; age, 71.5 +/- 3.6 years, range: 65-79 years), which participated in the Otago exercise program. The Timed Up and Go (TUG) test, functional reach (FR) test, one-leg standing (OLS) test, 5 times sit-to-stand test (5xSTS), 30-second sit-to-stand (30s STS) test, and gait parameters (gait velocity, step length, step width, stride time, and cadence) were measured before and after the intervention. Results: Both groups showed statistically significant improvements in balance (TUG and OLS tests), lower extremity strength (5xSTS and 30s STS tests), and spatiotemporal gait parameters, except for step width and step length (P < .05). The Otago group showed a significantly improved FR, whereas the TC group showed a significantly improved step length after the intervention (P < .05). Furthermore, the Otago group exhibited greater improvements in the TUG (P < .001), FR (P < .001), 5xCST (P < .01), and 30-second CST (P < .01) tests: a faster cadence (P < .001) and shorter stride time (P < .001) when compared with the TC group. The TC group showed greater improvements in the OLS test, step length, and step width (P < .01) and faster gait velocity (P < .05) than the Otago group. Discussion and Conclusions: The findings from this study support the efficacy of the TC and Otago exercise programs in improving mobility in this sample of subjects. Furthermore, the Otago group showed greater improvement in lower extremity strength, whereas the TC group showed greater improvement in balance (OLS test). Also, the TC group showed a greater improvement in gait velocity after TC training program compared with the Otago exercise program. However, this study does not elucidate which exercise program is a more effective intervention method with older women for fall prevention.