The influence of tai chi and yoga on balance and falls in a residential care setting: a randomised controlled trial

Abstract

Falls amongst older people is a global public health concern. Whilst falling is not a typical feature of ageing, older people are more likely to fall. Fall injuries amongst older people are a leading cause of death and disability. Many older people do not do regular exercise so that they lose muscle tone, strength, and flexibility which affect balance and predispose them to falls. The management of falls in residential care settings is a major concern with strategies for prevention and monitoring a focus in this setting. Yoga and tai chi have shown potential to improve balance and prevent falls in older adults. They also have potential to improve pain and quality of life. The aim of this study was to determine the feasibility of conducting a 3-arm RCT with frail older people in a residential care setting to test the hypothesis that a 14 week modified tai chi or yoga program is more effective than usual care activity in improving balance function, quality of life, pain experience and in reducing number of falls. There were no statistically significant differences between the three groups in the occurrence of falls. Yoga demonstrated a slight decrease in fall incidence; quality of life improved for the tai chi group. Only the yoga group experienced a reduction in average pain scores though not statistically significant. The findings of the study suggest it is possible to safely implement modified yoga and tai chi in a residential care setting and evaluate this using RCT design. They show positive changes to balance, pain and quality of life and a high level of interest through attendance amongst the older participants. The results support offering tai chi and yoga to older people who are frail and dependent with physical and cognitive limitations.

Systematic Review of Randomized Controlled Trials in Australian Nursing Homes from 2000 to 2018

“…Specifically, the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) trial, 16,17 the foot massage trial, 18,19 and the PARO trial 20‐22 had multiple articles which reported separate outcome measures. Fifteen studies were published prior to 2010 23‐37 and 28 studies were published from 2010 until the date of the search (December 18, 2018) 16‐22,38‐58 . Of the 39 RCTs, 17 were parallel‐group, 24,25,29‐34,36,37,44,45,50,52,53,55,56 16 were cluster RCTs, 16,17,20‐23,26,27,35,38‐40,42,46‐48,54,58 five were crossover trials, 18,19,43,49,51,57 and one was a factorial RCT 41 …”

“…Geographic location of studies according to jurisdiction was dominated by the eastern states of Australia: Queensland (QLD), New South Wales (NSW), and Victoria (VIC), where the majority of Australia's population (78%) resides. Fourteen (32.6%) studies were conducted in NSW, 16,17,23‐26,36,37,40,41,45,53,55,58 10 (23.3%) in QLD, 18‐22,31,43,49,50,56 nine (20.9%) in VIC, 32,33,42,44,46,48,51,54,57 three (7.0%) in Western Australia (WA), 34,39,52 two (4.7%) in South Australia (SA) 27 . One (2.3%) study did not specify the jurisdiction 30 .…”

“…The mean number of NHs was 22.4 (standard deviation (SD) = 27.0) and the median was 14.5 (interquartile range (IQR) = 27.8). Three (7.1%) studies recruited one NH, 32,49,55 15 (35.7%) studies recruited between 2 and 10 NHs, 18,19,27,31,33,36,40,42,43,45,46,50,52,56,57 20 (47.6%) studies recruited between 11 and 50 NHs 16,17,20‐27,30,34,38,39,41,44,47,48,51,54 and four (9.5%) studies recruited over 50 NHs 29,35,53,58 . One study did not report the number of NHs 37 …”

Understanding and Preventing Falls: Perspectives of First Responders and Older Adults

“…Helping older adults be more aware of their surroundings using mindfulness techniques may help decrease falls (Padmapriya et al, 2014). Older adults' desire for independence and reluctance to change set habits and behaviors may lead them to avoid seeking help despite multiple falls.…”

Tai chi and yoga in residential aged care: Perspectives of participants: A qualitative study

“…A concurrent mixed‐methods study was conducted to examine the feasibility, appropriateness and acceptability of modified 14‐week tai chi and yoga programmes in an Australian RAC setting. The first phase involved investigating the feasibility of a three‐arm randomised controlled trial (RCT) that compared outcomes of participants of yoga, tai chi and usual care groups (Saravanakumar, Higgins, van der Riet & Sibbritt, ). The second and qualitative arm of the study was designed to complement the findings of the RCT by providing a broader perspective, leading to a comprehensive understanding of the feasibility and appropriateness of the yoga and tai chi interventions for older adults in RAC setting.…”