Multifactorial Fall Prevention Intervention with Tai Chi on Physical Function in Urban Community-Dwelling Older Adults with Fall History

Abstract

Background: Falls among older adults are a significant public health concern associated with reduced lower extremity muscle strength and balance. Objective: This study aimed to evaluate the effectiveness of a multifactorial fall prevention intervention with Tai Chi on lower extremity muscle strength and balance among community-dwelling older adults with a fall history in Bangkok, Thailand. Methods: A quasi-experimental, two-group pretest–posttest design was employed (n = 60; experimental = 30, comparison = 30). The experimental group received an 8-week program incorporating fall prevention education and fall risk assessment, Tai Chi training, scenario-based risk management, home hazard assessment, digital reinforcement via LINE Official Account, and family-engaged home visits. The comparison group received usual care and a fall prevention manual. Results: Post-intervention, the experimental group demonstrated a statistically significant improvement in lower extremity muscle strength compared with the comparison group. The mean Five Times Sit-to-Stand Test (FTSST) completion time decreased from 11.64 ± 2.07 seconds to 9.63 ± 1.53 seconds in the experimental group, whereas only a minimal change was observed in the comparison group (15.08 ± 3.40 seconds to 15.74 ± 3.75 seconds). ANCOVA-adjusted means confirmed a significant between-group difference in lower extremity function, with the experimental group demonstrating a shorter FTSST completion time than the comparison group (11.04 vs. 14.20 seconds; F (1,57) = 36.33, p < .001, partial η² = .389). Dynamic balance also improved significantly in the experimental group compared with the comparison group. Dynamic balance improved significantly following the intervention. The mean Timed Up and Go (TUG) test time decreased from 10.45 ± 1.86 to 8.75 ± 1.55 seconds in the experimental group, compared with a marginal reduction from 14.13 ± 3.95 to 13.93 ± 4.08 seconds in the comparison group. ANCOVA-adjusted mean TUG times demonstrated a significant between-group difference, favoring the experimental group (10.34 vs. 12.34 seconds; F(1,57) = 17.53, p < .001, partial η² = .235). Static balance also showed significant improvement. Within the experimental group, Wilcoxon signed-rank test results indicated a significant increase in static balance performance (pre-intervention: median = 40.00 s, IQR = 7.75; post-intervention: median = 40.00 s, IQR = 0.00; Z = -2.437, p = .015). Furthermore, post-intervention static balance was significantly better in the experimental group than in the comparison group, as demonstrated by the Mann–Whitney U test (Z = -2.762, p = .006). Conclusion: This multifactorial program incorporating Tai Chi significantly improved lower extremity muscle strength and balance, providing a feasible, low-cost model to improve physical function and reduce fall risk among community-dwelling older adults.