Over 24 weeks, a specific supervised tai chi balance programme had a lower fall rate than stretching or multimodal exercise. Participants were screened older adults at high fall risk; this does not establish the results of any routine, home self-study or years of practice.
Study and source overview
Does this trial show that any tai chi video will reduce falls?
- Participants
- 670 community-dwelling adults aged 70 or older in Oregon, with a fall history and professional referral or impaired mobility. Participants also had to be able to walk one or two blocks and be judged able to exercise safely by a health professional.
- Three groups
- 224 in the tai chi balance programme, 223 in multimodal exercise and 223 in stretching. The overall mean age was 77.7; about 65% were women and 92% were white.
- Class schedule
- All three groups met twice weekly for 60 minutes over 24 weeks. Tai Ji Quan: Moving for Better Balance used eight adapted movements plus functional training.
- Main outcome
- The rate of fall events over six months, not just a standing balance test and not a guarantee against individual falls.
Why were there two relative reductions?
| Over 24 weeks | Tai chi balance programme | Multimodal exercise | Stretching |
|---|---|---|---|
| Randomised participants | 224 | 223 | 223 |
| Fall events | 152 | 218 | 363 |
| People with at least one fall | 85 | 112 | 127 |
One person can fall more than once, so 152 events and 85 people are different outcomes. Compared with stretching, the tai chi programme had an incidence rate ratio of 0.42 (95% confidence interval 0.31–0.56), about 58% lower. Compared with multimodal exercise, the ratio was 0.69 (0.52–0.94), about 31% lower.
These model-based event-rate ratios account for observation time. They are not simply one table count divided by another, and they do not mean every person's risk fell by a fixed 58% or 31%. People in the tai chi group still fell.
What was the programme actually like?
The tai chi programme included eight adapted movements and functional work on weight shifting, loading and turning. Multimodal exercise included aerobic, strength, balance and flexibility activities. Stretching also involved organised classes. There was no Baduanjin, yoga or self-taught 24-form group.
581 participants completed their assigned intervention, while 664 supplied complete falls follow-up. Stopping classes and missing outcome data are different. The main analysis kept participants in their originally assigned groups rather than selecting only those who continued.
Participants knew their class type. Falls were mainly self-reported using calendars, with phone calls and other checks. The trial took place in one state, mostly among white participants able to travel to classes. The findings do not automatically extend to people with greater limitations. This summary covers the 24-week main trial, not long-term outcomes after stopping.
Were any falls or other events reported in class?
Yes. Seven falls without injury occurred during classes across all groups, including two in the tai chi group. One tai chi participant attended an emergency department for hyponatraemia during a class, recovered and completed the intervention. An event during practice does not by itself show that the movement caused it, but it must not be omitted to imply absolute safety.
Reported serious events were not judged intervention-related. That is different from saying there were no health events. Screening, classroom support and monitoring are part of the study conditions.
What could I ask before choosing a class?
- Does it use the actual programme in the paper, or only the tai chi name?
- Is the instructor trained in this programme, with ways to adapt movements and provide feedback?
- How does the class assess fall history, walking aids and movement limitations?
The findings are not a reason to increase balance difficulty or remove support on your own. Read the 2019 review for evidence across trials. The main trial and follow-up papers about the same people are not new independent samples.
Original source and review coverage
Li F et al. Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial. JAMA Internal Medicine. 2018;178(10):1301-1310.
DOI：10.1001/jamainternmed.2018.3915
Review coverage: Relevant full-text sections accessed through the official Europe PMC XML copy: eligibility, interventions, Tables 1–3, completion and follow-up, adverse events and limitations. This covers the 24-week main trial; later reports are not counted as new participants.
By First Chi; source checked .The paper was published in 2018; the website update date does not replace that date.
