Reducing the fear of falling among community-dwelling elderly adults through cognitive-behavioural strategies and intense Tai Chi exercise: A randomized controlled trial

Aim. To examine the effectiveness of cognitive-behavioural strategies with/without intense Tai Chi exercise in reducing fear of falling among community-dwelling elderly adults. Background. Fear of falling is a major health problem among community-dwelling older persons. The prevalence of this fear ranges from 29% to 77%, indicating the importance of developing effective strategies to reduce fear of falling among elderly adults. Methods. Data were collected from January to December 2007. A randomized controlled trial with three groups (control, cognitive-behavioural and cognitive-behavioural with Tai Chi). Participants were assessed at baseline for demographic data, falls-related history, and fear of falling. Data on these variables plus falls, mobility, social support behaviour and satisfaction, and quality of life were also collected at 2 and 5months after interventions. Results. Participants in the three groups differed significantly in both measures of fear of falling (F=20·89, P<0·001; F=6·09, P<0·001) and mobility (F=30·33, P<0·001), social support behaviour and satisfaction (F=3·32, P<0·05 and F=6·35, P<0·001, respectively), and quality of life (F=16·66, P<0·001). In addition, participants who received the cognitive-behavioural intervention with Tai Chi had significantly lower fear of falling scores (P<0·001) and higher mobility (P<0·001), social support satisfaction (P<0·01) and quality of life (P<0·001) than the cognitive-behavioural alone and control groups at 5months. The three groups did not differ significantly in falls. Conclusion. The results of this trial suggest that the cognitive-behavioural intervention with Tai Chi exercise helped community-dwelling elderly adults to enhance their mobility, to manage their fear of falling and to increase their quality of life.