Tai Chi exercise may reduce falls in adult stroke survivors

Compared to survivors receiving usual care or participating in a national fitness program for Medicare-eligible adults called SilverSneakers®, those practicing Tai Chi had the fewest falls.

Tai Chi is a martial art dating back to ancient China. It includes physical movements, mental concentration and relaxed breathing.

"Learning how to find and maintain your balance after a stroke is a challenge," said Ruth E. Taylor-Piliae, Ph.D., R.N., the study's principal investigator and assistant professor at the University of Arizona College of Nursing in Tucson, Ariz. "Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls. Tai Chi is readily available in most U.S. cities and is relatively inexpensive."

Stroke survivors experience seven times as many falls each year than healthy adults, Taylor-Piliae said. These falls can cause fractures, decrease mobility and increase fear of falling that can result in social isolation or dependence. Tai Chi has significantly reduced falls in healthy older adults.

Researchers recruited 89 stroke survivors -- most of whom had ischemic strokes -- for a randomized prospective study outside of a hospital setting. Participants were an average 70 years old, 46 percent were women and most Caucasian, college educated and living in the Tucson area, and suffered a stroke on average three years prior to beginning the study.

Among the participants, 30 practiced Tai Chi, 28 took part in usual care and 31 participated in SilverSneakers®. The Tai Chi and SilverSneakers® groups participated in a one-hour exercise class three times each week for 12 weeks. The usual care group received a weekly phone call and written material about participating in community-based physical activity.

During the 12-week trial, there were a total of 34 reported falls in participants' homes mainly from slipping or tripping: five falls in the Tai Chi group; 15 falls in the usual care group; and 14 falls in the Silver Sneakers group. Only four people sought medical treatment.

Yang-style Tai Chi, as practiced in the study, is the most popular of five styles used in the United States because of its emphasis on health benefits, both physical and psychosocial benefits, researchers said.

"The main physical benefits of Tai Chi are better balance, improved strength, flexibility and aerobic endurance," Taylor-Piliae said. "Psycho-social benefits include less depression, anxiety and stress, and better quality of life."

Co-authors are: Tiffany Hoke, R.N.; Bijan, Najafi, Ph.D.; and Bruce Coull, M.D. Author disclosures are on the abstract.

An American Heart Association Scientist Development Grant and a Robert Wood Johnson Foundation Nurse Faculty Scholars Grant funded the study.