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GPs go forth

GP-led tai chi class reduces falls in elderly

A GP-led program has successfully boosted physical activity levels and reduced falls among the elderly by teaching them tai chi, researchers have found.

One year after taking part in the ProAct65+ trial, patients were exercising for an extra 15 minutes per day on average compared to a usual-care control group, according to an evaluation published in the Health Technology Assessment journal.

They also experienced a 26% reduction in the incidence of falls 12 months after participating in the program, which was run through general practices in London, Nottingham and Derby and involved 1256 patients aged 65 and older.

Participants attended a one-hour group exercise class at a local community centre comprising tai chi, leg muscle strengthening and balance and flexibility training. They were also advised to complete two 30-minute home exercise sessions and to go for two moderate-paced walks per week over a 24-week period.

One-year follow-up results showed 49% of participants were completing the recommended 150 minutes of moderate to vigorous physical activity per week, up from 40% before the trial began.

The intervention, known as Falls Management Exercise (FaME), cost around £269 per patient in London and £218 in Nottingham.

It is one of only two evidence-based programs designed specifically to increase physical activity among over-65s living in the community. The other, the home-based Otago Exercise Programme, was also tested in the trial but did not deliver statistically significant benefits.

The ProAct65+ trial was designed to provide patient-friendly alternatives to ‘exercise on prescription’ - the mainstay of the NHS’s approach to falls prevention in the elderly. This is offered by 89% of Primary Care Trusts but typically involves referral to leisure centres, which are more intimidating and less appealing to the elderly than community centres or home-based exercise programs, according to the study authors.

Tai chi meanwhile has been shown to reduce the risk of falls in older adults by as much as 29%, according to a 2012 Cochrane Review.

Health Technology Assessment Journal; available online August 2014

Readers' comments (2)

  • Vinci Ho

    Different schools of Tai Chi. The myth is this type of 'soft' martial art was founded by Zhang Sanfeng , a legendary Chinese Taoist priest in 12th century .
    It combines a ritualistic physical manoeuvres and breathing exercise . The slow pace and low intensity are certainly suitable to older people.
    My old man used to teach me that but wasn't paying much attention . Sorry, Dad......

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  • Its good to see results of latest trial done of one of the old modalities of exercise, which reiterates the same message again (about its benefits). There are quite a few trials published with varying success rate, most of them linking to reduction in falls. It might not be a bad idea to make this type of exercises available to wide range of public freely and also considering to provide free gym services to all to encourage healthy lifestyle to public at large. These type of investments should reap positive returns on long run with fewer admissions and fewer morbidities.

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