Tai Chi for Risk of Falls. A Meta-analysis

Byline: Rafael Lomas-Vega, Esteban Obrero-Gaitan, Francisco J. Molina-Ortega, Rafael Del-Pino-Casado Keywords: tai chi; older adults; accidental falls Objectives To analyze the effectiveness of tai chi for falls prevention. Design Systematic review and meta-analysis. Setting Pubmed, Scopus, CINHAL, and Physiotherapy Evidence Database (PEDro) were searched to May 26, 2016. Participants Older adult population and at-risk adults. Intervention Randomized controlled trials analyzing the effect of tai chi versus other treatments on risk of falls. Measurements The incidence rate ratio (IRR) for falls incidence and hazard ratio (HR) for time to first fall. Results The search strategy identified 891 potentially eligible studies, of which 10 met the inclusion criteria. There was high-quality evidence of a medium protective effect for fall incidence over the short term (IRR = 0.57; 95% CI = 0.46, 0.70) and a small protective effect over the long term (IRR = 0.87; 95% CI = 0.77, 0.98). Regarding injurious falls, we found very low-quality evidence of a medium protective effect over the short term (IRR = 0.50; 95% CI = 0.33, 0.74) and a small effect over the long term (IRR = 0.72; 95% CI = 0.54, 0.95). There was no effect on time to first fall, with moderate quality of evidence (HR = 0.98; 95% CI = 0.69, 1.37). Conclusion In at-risk adults and older adults, tai chi practice may reduce the rate of falls and injury-related falls over the short term ( CAPTION(S): Figure S1. PRISMA flow diagram of the review process. Figure S2. Funnel plot for falls incidence for the short-term. Figure S3. Funnel plot for falls incidence for the long-term. Figure S4. Funnel plot for time to first fall. Table S1. Characteristics of the studies included in this review. Table S2. The assessment of risk of bias in the individual studies.