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Tai Chi reduces falls in older people and people who are at higher risk of falling

Lomas-Vega R, Obrero-Gaitan E, Molina-Ortega FJ, et al. Le tai-chi pour le risque de chutes: une méta-analyse. J Am Geriatr Soc. 2017;65:2037-43.

Review question

In older people and people who are at higher risk of falling, does Tai Chi reduce the risk of falling?

Background

Falls can cause serious injuries and are a main cause of traumatic death in older people. People often fall because they have poor balance, have difficulty walking, or take multiple medications. Tai Chi focuses on flexibility and body coordination and may help people reduce the risk factors for falls.

How the review was done

The researchers did a systematic review, searching for studies that were published up to May 2016.

They found 10 randomized controlled trials, including 2,673 people (age 56 to 98 years).

The key features of the studies were:

  • people had different risks of falling;
  • people did Tai Chi for 1 hour, 1 to 3 times each week, for 12 to 26 weeks;
  • Tai Chi was compared with usual care, yoga, physical therapy, walking, low-intensity exercises, balance training, and resistance exercise; and
  • outcomes were measured from immediately after the 12- to 26-week session up to 1½ years later.

What the researchers found

Compared with not doing Tai Chi, Tai Chi:

  • reduced falls in the short-term (less than 1 year) and long-term (1 year and longer);
  • reduced falls causing injury in the short-term and long-term; and
  • did not reduce the time until a person’s first fall.

Conclusion

In older people and people who are at higher risk of falling, Tai Chi reduces falls.

Tai Chi vs control in older people and people who are at risk of falling

Outcomes

Time point

Number of trials (and people)

Effect of Tai Chi

Quality of the evidence

Falls

Less than 1 year

5 trials (1,432 people)

People who practiced Tai Chi had about half as many falls per month compared with people who did not do Tai Chi.

High

 

1 year and longer

6 trials (1,546 people)

People who practiced Tai Chi had 13% fewer falls per month compared with people who did not do Tai Chi.

High

Falls causing injury

Less than 1 year

1 trial (357 people)

People who practiced Tai Chi had half as many falls causing injury compared with people who did not do Tai Chi.

Very low

 

1 year and longer

1 trial (334 people)

People who practiced Tai Chi had 28% fewer falls per month compared with people who did not do Tai Chi.

Very low

Time to first fall

Not applicable

5 trials (1,320 people)

No effect.

Moderate

 




Glossaire

Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Risk factors
Aspects making a condition more likely.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.
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