22 and 23 The Tai Chi trial of Chen and colleagues21 used a passive knee joint repositioning test,24 the Sensory Organisation Test,25 and concentric isokinetic strength of the knee flexors and extensors of the dominant leg as outcome measures. This trial showed a significant decrease (p = 0.032) in the percentage change of absolute angle error of passive knee joint repositioning, measured with a Cybex Norm dynamometer, in the intervention group (-26 ± 29%) compared to the control group (4 ± 31%). There was an overall significant difference in
favour selleck chemicals of the intervention group on the Sensory Organisation Test (p = 0.024), but there were also significant differences in the vestibular and visual ratios between the two groups. The intervention group achieved a greater (p = 0.048) percentage improvement in the vestibular ratio (33 ± 40%) compared to controls (–18 ± 57%) and a greater (p = 0.006) percentage change of visual ratio (58 ± 42%) compared to the control group (–2 ± 29%). There was no significant difference between the two groups in muscle strength in the dominant leg. Kovács and colleagues23 and Cheung and colleagues22 both reported outcomes using the Timed Up and Go test26
and the Berg Balance Score27 so these data were pooled for meta-analysis. Forest plots and weighted mean selleckchem differences for the Berg Balance Scale are presented in Figure 2 and for the Timed Up and Go test in Figure 3. In both cases the pooled estimates showed a favorable effect of the intervention. The pooled estimate indicated statistically significant differences between intervention and control groups for the Berg Balance Score (WMD 3.9 points, 95% CI 1.8 to 6.0). The pooled estimate of effect for the Timed Up and Go Adenylyl cyclase test indicated a between-group difference in favour of the intervention that did not reach statistical significance (WMD 1.5 seconds, 95% CI –1.7 to 4.6). The Berg Balance Scale estimates showed a low level of heterogeneity (I2 = 0%, Q = 0.45), as did the Timed Up and Go test estimates (I2 = 0%,
Q = 1.0). Cheung and colleagues22 also used a chair stand test and found that the intervention group showed significant improvement compared with the control group (mean time difference 2.35 seconds, 95% CI 0.03 to 4.67). Kovács and colleagues23 used the Barthel Activities of Daily Living Index28 but found no significant difference between intervention and control groups (p = 0.622). Only the VIP trial by Campbell and colleagues20 collected prospective falls data. The VIP trial was a 2 x 2 factorial design with prospective calendars and 12 months of follow-up. Community-dwelling older adults were randomised into: a home safety assessment and modification program; an exercise program; both the home safety and exercise programs; or social visits. The study found that home safety assessment and modification reduced falls (41% fewer falls, incidence rate ratio = 0.59, 95% CI 0.