A comparative study on the effects of Tai Chi and Matter of Balance on measures of balance and fall efficacy in older adults


  • Thomas K. Skalko, PhD, LRT/CTRS, FDRT
  • Lacey A. Burgess, LRT/CTRS
  • Megan Janke, PhD, LRT/CTRS




Tai Chi, balance, fall efficacy, older adults


The purpose of this study was to compare two intervention strategies, Tai Chi (TC) (n = 12) and Matter of Balance (MOB) (n = 13) on balance and fall efficacy of older adults (≥65 years) as compared to a control group (n = 12). The study compared changes in balance and fall efficacy of the two strategies in an effort to evaluate fall reduction programs for future application. Participants were assessed via a pretest to post-test, 8-10 weeks apart using two balance tests: 8-Foot Up and Go test and the Multi-Directional Reach Test. Fall efficacy was measured with the Activities-specific Balance Confidence (ABC) Scale. Results from this study indicate that the TC group and MOB group were both effective in improving or maintaining balance and fall efficacy as compared to the control group. Results demonstrated trending toward TC as having a greater impact on participants’ overall balance measures.

Author Biographies

Thomas K. Skalko, PhD, LRT/CTRS, FDRT

Professor, Recreational Therapy, East Carolina University, Greenville, North Carolina; Honorary Professor, College of Health Sciences, University of Kwa-Zulu Natal, Durban, South Africa.

Lacey A. Burgess, LRT/CTRS

Recreational Therapist, Lighthouse Care Center of Conway, Conway, South Carolina.

Megan Janke, PhD, LRT/CTRS

Associate Professor, Recreational Therapy, East Carolina University, Greenville, North Carolina.


Census Bureau: 65+ in the United States: 2005. Available at http://www.census.gov/prod/2006pubs/p23-209.pdf.

Accessed November 18, 2015.

Centers for Disease Control and Prevention: Falls among older adults: An overview. Available at http://www.criticalsignaltechnologies.com/wp-content/themes/cst/distributorcenter-docs/articles/CDC-%20Falls%20Among%20Older%20Adults-An%20Overview.pdf. Accessed November 18, 2015.

Ge W: Evaluation of the effectiveness of Tai Chi for improving balance and preventing falls in the older population—A review. J Am Geriatr Soc. 2002; 50(4): 746-754.

Nyman S, Yardley L: Web-site-based tailored advice to promote strength and balance training: An experimental evaluation. J Aging Phys Act. 2009; 17(2): 210-222.

Alexander BH, Rivara FP, Wolf ME: The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health. 1992; 82(7): 1020-1023.

Roudsari BS, Ebel BE, Corso PS, et al.: The acute medical care costs of fall-related injuries among the U.S. older adults [Abstract]. Injury. 2005; 36(11): 1316-1322.

Centers for Disease Control and Prevention: Costs of falls among older adults. Available at http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html. Accessed November 18, 2015.

DiBrezzo R, Shadden B, Raybon H, et al.: Exercise intervention designed to improve strength and dynamic balance among community-dwelling older adults. J Aging Phys Act. 2005; 13(2): 198-209.

Brill PA, Matthews MM, Mason JJ, et al.: Improving functional performance through a group-based free weight strength training program in residents of two assisted living communities. Phys Occup Ther Geriatr. 1998; 15(3): 57-69.

Helbostad JL, Sletvold O, Moe-Nilssen R: Home training with and without additional group training in physically frail old people living at home: Effect on health-related quality of life and ambulation. Clin Rehabil. 2004; 18(5): 498-508.

Lambert CC, Sterbenz KA, Womack DE, et al.: Adherence to a fall prevention program among community dwelling older adults. Phys Occup Ther Geriatr. 2001; 18(3): 27-43.

Mobily KE, Mobily PR, Lane BK, et al.: Using progressive resistance training as an intervention with older adults. Ther Recreation J. 1998; 32(1): 42-53.

Fuzhong L, Harmer P, Mack KA, et al.: Tai Chi: Moving for better balance-development of a community-based falls prevention program. J Phys Act Health. 2008; 5(3): 445-455.

Hakim RM, Newton RA, Segal JJ, et al.: A group intervention to reduce fall risk factors in community dwelling older adults. Phys Occup Ther Geriatr. 2003; 22(1): 1-20.

Tsang WN, Hui-chan CY: Comparison of muscle torque, balance, and confidence in older Tai Chi and healthy adults. Med Sci Sports Exerc. 2005; 37(2): 280-289.

Tsang WW, Wong VS, Fu SN, et al.: Tai Chi improves standing balance control under reduced or conflicting sensory conditions. Arch Phys Med Rehabil. 2004; 85(1): 129-137.

Wolf S, Barnhart H, Kutner N, et al.: 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(5): 489-497.

Healy T, Peng C, Haynes P, et al.: The feasibility and effectiveness of translating A Matter of Balance into a volunteer lay leader model [Abstract]. J Appl Gerontol. 2008; 27(1): 34-51.

Org M, Smith M, Wade A, et al.: Implementing and disseminating an evidence-based program to prevent falls in older adults, Texas, 2007-2009. Prev Chronic Dis. 2010; 7(6): A130.

Southard V: A randomized control trial of the application of efficacy training to balance assessment. Phys Occup Ther Geriatr. 2006; 25(2): 51-66.

Tennstedt S, Howland J, Lachman M, et al.: A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults [Abstract]. J Gerontol. 1998; 53(6): 384-392.

MaineHealth: Partnership for Healthy Aging: A Matter of Balance. Available at http://www.mmc.org/mh_body.cfm?id=3498. Accessed November 18, 2015.

Järvilehto T: What is motor learning. Promotion Motor Skills Sports Physical Educ. 2006: 9-18.

Peterson E: Using cognitive behavior strategies to reduce fear of falling: A Matter of Balance [Abstract]. Am Soc Aging. 2002; 26(4): 53-59.

Greenspan AI, Wolf SL, Kelley ME, et al.: Tai Chi and perceived health status in older adults who are transitionally frail: A randomized controlled trial. Phys Ther. 2007; 87(5): 525-535.

Hakim RM, Kotroba EE, Cours JJ, et al.: A cross-sectional study of balance-related measures with older adults who participated in Tai Chi, Yoga, or no exercise. Phys Occup Ther Geriatr. 2010; 28(1): 63-74.

Mihay LM, Boggs KM, Breck AJ, et al.: The effect of Tai Chi inspired exercise compared to strength training: A pilot study of elderly retired community dwellers. Phys Occup Ther Geriatr. 2006; 24(3): 13-26.

Mihay LL, Iltzsche EE, Tribby AA, et al.: Balance and perceived confidence with performance of instrumental activities of daily living: A pilot study of Tai Chi inspired exercise with elderly retirement-community dwellers. Phys Occup Ther Geriatr. 2003; 21(3): 75-86.

Wolf SL, Barnhart HX, Ellison GL, et al.: The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Phys. Ther. 1997; 77(4): 371-381.

Li F, Harmer P, Fisher KJ, et al.: Tai Chi and fall reductions in older adults: A randomized controlled trial. J Gerontol. 2005; 60A(2): 187-194.

Lam P, Kircher P, Miller M: Tai chi for fall prevention. 2010. Available at http://taichiforhealthinstitute.org/tai-chifor-fall-prevention/. Accessed November 18, 2015.

Carmona J: Effects of a Functional-Based Training Program on the Performance of Instrumental Activities of Daily Living Among Older Adults Residing in Retirement Communities [master's thesis]. SPORTDiscus, Eugene, OR: Kinesiology Publications, 2005.

Ness KK, Gurney JG, Ice GH: Screening, education, and associated behavioral responses to reduce risk for falls among people over age 65 years attending a community health fair. Phys Ther. 2003; 83(7): 631-637.

MaineHealth: A Matter of Balance. Available at http://www.maine.gov/dhhs/oads/community-support/managingyour-health/balance.html.shtml. Accessed November 19, 2015.

Newton R: Validity of the Multi-Directional Reach Test: A practical measure for limits in stability in older adults [Abstract]. J Gerontol. 2001; 56(4): 248-252.

Powell L, Myers A: The Activities-specific Balance Confidence (ABC) scale [Abstract]. J Gerontol Med Sci. 1995; 50(1): 28-34.

Rose DJ, Jones CJ, Lucchese NN: Predicting the probability of falls in community-residing older adults using the 8-foot Up-and-Go: A new measure of functional mobility. J Aging Phys Act. 2002; 10(4): 466-475.

Podsiadlo D, Richardson S: The Time “Up & Go”: A test of basic functional mobility for frail elderly persons [Abstract]. J Am Geriatr Soc. 1991; 39(2): 142-148.

Rikli R, Jones J: Development and validation of a functional fitness test for community-residing older adults. J Aging Phys Act. 1999; 7(1): 129-161.

Stevens J, Dellinger A: Motor vehicle and fall related deaths among older Americans 1990–98: Sex, race, and ethnic disparities [Abstract]. Inj Prev. 2002; (8)4: 272-275.

Himes C, Reynolds S: Effects of obesity on falls, injury, and disability. J Am Geriatr Soc. 2012; 60(1): 124-129.

Kossuth PM, Bengtson V: Sociological theories of aging: Current perspectives and future directions. In Birren JE and Bengtson VL (eds.): Emergent Theories of Aging. New York: Springer Publishing Company, 1988.

Hampton R, Russell C: Activity theory: The encyclopedia of aging and the elderly. December 11, 2005. Available at http://www.medrounds.org/encyclopedia-of-aging/2005/12/activity-theory.html. Accessed November 19, 2015.

Wankel LM: The importance of enjoyment to adherence and psychological benefits from physical activity [Abstract]. Int J Sport Psychol. 1993; 24(2): 151-169.

Young T: Factors determining exercise adherence. Am Fit. 2005; 23(1): 46-50.

Hatch J, Lusardi M: Impact of participation in a wellness program on functional status and falls among aging adults in an assisted living setting. J Geriatr Phys Ther. 2010; 33(2): 71-77.



How to Cite

Skalko, PhD, LRT/CTRS, FDRT, T. K., Burgess, LRT/CTRS, L. A., & Janke, PhD, LRT/CTRS, M. (2016). A comparative study on the effects of Tai Chi and Matter of Balance on measures of balance and fall efficacy in older adults. American Journal of Recreation Therapy, 15(3), 29–39. https://doi.org/10.5055/ajrt.2016.0109