Article

OBJECTIVES: To test the effect of tai chi on the progression of preclinical
disability to manifest disability compared with seated flexibility exercise, and
to examine whether tai chi mediates delayed disability by reducing impairments in
musculoskeletal, cardiovascular, and neurologic systems, and related functional
limitations. DESIGN: Multisite parallel group individually randomized controlled
trial. SETTING: General community. PARTICIPANTS: Preclinically disabled
community-dwelling people older than 70 years (n=503), without major medical
conditions or moderate to severe cognitive impairment. INTERVENTION: Modified Sun
style tai chi exercise compared with seated flexibility exercise, both programs
delivered in groups for 60 minutes twice weekly for 24 weeks. MAIN OUTCOME
MEASURES: Disability measured with the Late-Life Function and Disability
Instrument. Secondary outcomes were impairments and functional limitations of the
musculoskeletal, neurologic, and cardiovascular systems. RESULTS: There was
little change within or between the 2 groups. The mean change in the Disability
Frequency Score was 0.3 and 0.1 points (100-point scale) for the intervention and
control groups, respectively (adjusted difference -.21; 95% confidence interval
[CI] -.99 to .56). The mean change in the Disability Limitation Score was -0.1
and -.04 points for the intervention and control groups, respectively (adjusted
difference -0.6; 95% CI -2.31 to 1.11). There was little effect on impairments or
functional limitations. A higher proportion of intervention participants ceased
attending the exercise program (difference=17.9%, 95% CI 9.6-25.8). Multiple
imputation of missing data did not change the results. CONCLUSIONS: Modified Sun
style tai chi did not have an impact on impairment, functional limitations, or
disability in preclinically disabled older people when delivered for 24 weeks.
Withdrawal from the exercise classes was high but did not explain the null
result. Improved compliance, or a longer or more intensive program, may be required.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS