Stroke Survivors in a 12-week Yang-Style Tai Chi Intervention have Fewer Falls

Background: Compared to same age healthy adults, stroke survivors experience 7 times as many falls annually. Such falls often cause hip or other fractures, loss of mobility, and increased fear of falling resulting in social isolation and/or dependence. Effective interventions for preventing falls among stroke survivors are critically needed. Tai Chi exercise has been shown to significantly reduce the number of falls in healthy older adults.

Purpose: To examine the effect of a 12-week Yang-style Tai Chi (TC) intervention on fall rates among stroke survivors compared to SilverSneakers® (SS) and Usual Care (UC) groups.

Methods: A randomized prospective clinical trial was conducted among stroke survivors (n=89), aged ≥ 50 years, and at ≥ 3 months post-stroke (TC, n=30; SS, n=31; or UC, n=28). TC and SS groups attended a 1-hour class 3 times/week for 12 weeks. The UC group received a weekly phone call along with written materials for participating in community-based physical activity. All subjects were interviewed weekly to ascertain fall data over the 12 weeks. Falls were defined as: “events in which subjects end up on the floor or ground when they did not expect to.” Data were analyzed using χ2 statistics with Yate’s continuity correction.

Results: Subjects (46% women) were on average 70±10 years old. The majority reported an ischemic stroke (80%), were White/European-American (79%), married/partnered (60%), college-educated (79%), and retired/unemployed (93%). Over the 12-week trial, a total of 34 falls occurred; all happened at home, yet only 4 subjects sought medical attention for the fall. Most falls happened because subjects slipped or tripped (21%). The TC group had fewer falls (n=5 falls) than SS (n=14 falls) or UC (n=15 falls) groups (χ2=5.60, p=0.06). Post-hoc tests indicated that TC had significantly fewer falls than UC (χ2=4.29, p=0.04); while there was no significant difference between TC and SS (χ2=2.61, p=0.11), or SS and UC (χ2=0.29, p=0.59) groups.

Conclusion: Our data suggest that a 12-week Yang-style TC intervention decreases fall rates among stroke survivors. Future studies examining the effectiveness of TC as a fall prevention strategy are recommended.