Effect of Tai Chi on Physical Function, Fall Rates and Quality of Life Among Older Stroke Survivors

Objective: To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. Design: Single-blind, randomized controlled trial. Setting: General community. Participants: Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged >= 50 years and were >= 3 months poststroke. Interventions: Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Main Outcome Measures: Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. Results: During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (x(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F-2,(142)=4.69, P <.01). Post hoc tests indicated that the TC (t(53)=2.45, P =.02) and SS (t(44)=4.63, P <.01) groups had significantly better aerobic endurance over time, though not in the UC group (t(48)= 1.58, P =.12). Intervention adherence rates were 85%. Conclusions: TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended. (C) 2014 by the American Congress of Rehabilitation Medicine