Zum Einsatz von Tai-Chi in der Sturzprophylaxe bei Senioren

Zusammenfassung

Stürze im Alter sind eine große Belastung für das Gesundheitssystem. Einige randomisierte und kontrollierte Studien konnten aufzeigen, dass Tai-Chi Interventionen sturzrelevante Outcomes bei selbständig lebenden Senioren reduzieren, nicht jedoch bei Senioren in Pflegeheimen. Die Effekte sind primär auf die Beeinflussung von Komponenten der posturalen Kontrolle zurück zu führen. Die Mindestdauer der Interventionen sollte 3–6 Monate betragen.

Abstract

Falls in older people are a major public health problem. A limited number of randomised controlled trials could show that Tai Chi interventions reduce falls outcomes in independent living older people but not in the institutionalised setting. The effectiveness can primarily be attributed to improvements in postural stability. The minimum duration of interventions should be 3–6 months.

Schlüsselwörter

Tai-Chi - Sturz - Alter - posturale Kontrolle - Dosis-Wirkungs-Beziehung

Key words

Tai Chi - accidental falls - aged - postural stability - dose-response

• Literatur

• 1 Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol 1989; 44: M112-M117
• 2 Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Ann Intern Med 1994; 121: 442-451
• 3 Aschkenasy MT, Rothenhaus TC. Trauma and falls in the elderly. Emerg Med Clin North Am 2006; 24: 413-432
• 4 Donald IP, Bulpitt CJ. The prognosis of falls in elderly people living at home. Age Ageing 1999; 28: 121-125
• 5 Wijlhuizen GJ, de Jong R, Hopman-Rock M. Older persons afraid of falling reduce physical activity to prevent outdoor falls. Prev Med 2007; 44: 260-264
• 6 Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. J Forensic Sci 1996; 41: 733-746
• 7 Lord SR, Sherrington C, Menz HB et al. Falls in the Elderly. Risk factors and strategies for prevention. 2^nd edition New York: Cambridge University Press; 2007
• 8 Gillespie LD, Robertson MC, Gillespie WJ et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2009; Apr 15; CD007146
• 9 Sherrington C, Whitney JC, Lord SR et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008; 56: 2234-2243
• 10 Cameron ID, Murray GR, Gillespie LD et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev 2010; Jan 20; CD005465
• 11 Wolf SL, Coogler C, Xu T. Exploring the basis for Tai Chi Chuan as a therapeutic exercise approach. Arch Phys Med Rehabil 1997; 78: 886-892
• 12 Li F, Harmer P, Fisher KJ et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2005; 60: 187-194
• 13 Woo J, Hong A, Lau E et al. randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing 2007; 36: 262-268
• 14 Logghe IH, Zeeuwe PE, Verhagen AP et al. Lack of Tai Chi Chuan in preventing falls in elderly people living at home: A randomized clinical trial. J Am Geriatr Soc 2009; 57: 70-75
• 15 Voukelatos A, Cumming RG, Lord SR et al. randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc 2007; 55: 1185-1191
• 16 Wolf SL, Barnhart HX, Kutner NG et al. Atlanta FICSIT Group. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc 1996; 44: 489-497
• 17 Logghe IH, Verhagen AP, Rademaker AC et al. Explaining the ineffectiveness of Tai Chi fall prevention training for community-living older people: A process evaluation alongside a randomized clinical trial (RCT). Arch Gerontol Geriatr 2010; in Druck
• 18 Faber MJ, Bosscher RJ, Chin A et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabil 2006; 87: 885-896
• 19 Wolf SL, Sattin RW, Kutner M et al. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003; 51: 1693-1701
• 20 Lan C, Chen SY, Lai JS. The exercise intensity of Tai Chi Chuan. Med Sport Sci 2008; 52: 12-19
• 21 Wong AM, Lan C. Tai Chi and balance control. Med Sport Sci 2008; 52: 115-123
• 22 Wong AM, Pei YC, Lan C et al. Is Tai Chi Chuan effective in improving lower limb response time to prevent backward falls in the elderly?. Age 2009; 31: 163-170
• 23 Hong Y, Li JX. Biomechanics of Tai Chi: A review. Sports Biomech 2007; 6: 453-464
• 24 Meyer PF, Oddsson LI, de Luca CJ. Reduced plantar sensitivity alters postural responses to lateral perturbations of balance. Exp Brain Res 2004; 157: 526-536
• 25 Xu D, Hong Y, Li J et al. Effect of Tai Chi exercise on proprioception of ankle and knee joints in old people. B J Sports Med 2004; 38: 50-54
• 26 Audette JF, Jin YS, Newcomer R et al. Tai Chi versus brisk walking in elderly women. Age Ageing 2006; 35: 388-393
• 27 Lai JS, Lan C, Wong MK et al. Two-year in cardiorespiratory function among older Tai Chi Chuan practitioners and sendentary subjects. J Am Geriatr Soc 1995; 43: 1222-1227
• 28 Rosengren KS, Christou E, Yang Y et al. Quantification of Taiji learning in older adults. J Am Geriatr Soc 2003; 51: 1186-1187
• 29 Mao DW, Hong Y, Li JX. Characteristics of foot movement in Tai Chi exercise. Phys Ther 2006; 86: 215-222
• 30 Gatts S. Neural mechanisms underlying balance control in Tai Chi. Med Sport Sci 2008; 52: 87-103
• 31 Zijlstra GA, van Haastregt JC, van Rossum E et al. Interventions to reduce fear of falling in community-living older people: A systematic review. J Am Geriatr Soc 2007; 55: 603-615
• 32 Chou KL, Lee PW, Yu EC et al. Effect of Tai Chi on depressive symptoms amongst chinese patients with depressive disorders: a randomized clinical trial. Int J Geriatr Psychiatry 2004; 19: 1105-1107
• 33 Deandrea S, Lucenteforte E, Bravi F et al. Risk factors of falls in community-dwelling older people. A systematic review and meta-analysis. Epidemiology 2010; 21: 658-668
• 34 Han A, Robinson V, Judd M et al. Tai Chi for treating rheumatoid arthritis. Cochrane Database Syst Rev 2004; CD004849
• 35 Wu G, Keyes L, Callas P et al. Comparison of telecommunication, community, and home-based Tai Chi exercise programs on compliance and effectiveness in elders at risk for falls. Arch Phys Med Rehabil 2010; 91: 849-856