The effectiveness of Tai Chi as a fall prevention intervention for older adults: a systematic review

Aim: To critically appraise the evidence for the effectiveness of the use of Tai Chi as a falls prevention intervention in the older age group. Background: Falls in the older population and their resulting injuries are a major public health issue. Tai Chi is an intervention that some nurses in the UK promote, but the research into its effectiveness is of varying quality with conflicting findings. It is crucial to review the evidence base for this intervention in order to inform best practice. Methods: A systematic literature review was conducted using the following major inclusion criteria: Tai Chi intervention, randomized controlled trials, participants aged 60 or more, falls occurrences as outcome measure. Eight electronic databases were searched. Two reviewers independently assessed methodological quality using the Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklist. Results: 66 potentially relevant articles were identified. A total of 6 randomized controlled trials were included with a total of 1857 participants, the majority being female. Intervention period duration ranged from 15 weeks to 2 years. No completed trials in the UK were identified. The level of evidence ranged from 1- to 1++. Conclusions: The evidence presented suggests that Tai Chi practice by older adults may be beneficial in reducing fall occurrences. However, the trials examined suggest that it may only be effective in a more robust older population and may not benefit frail participants. The implementation of Tai Chi schemes in the UK needs further investigation. Also, more research is needed with male participants.