1. Findings suggest that: Participants were willing to learn and perform tai-chi exercise Participants enjoyed socializing with others and group exercise Further implementation is warranted with evaluations conducted every three months over a year to evaluate long term effectiveness Tai-chi classes should be focused on improving strength and balance in community dwelling older adults, and should have regular review, progression and adjustment as needed. Title: Increasing Strength and Balance to Prevent Falls Project leader: Eyong E. Atem, BSN, RN Faculty advisor: Dr. Kathy Jo Ellison Auburn University School of Nursing BACKGROUND METHODS PURPOSE of STCSMALL TEST of CHANGE RESULTS Approximately 33% of community- dwelling adults over 65 years of age fall annually. Falls can cause problems for the elderly such as - death, - mobility issues, - and financial burden. A decrease in balance and strength has been linked to falls in this population. Six adults 65 years or older living in the community were recruited as participants in the small test of change. Following fall risk assessment and successful PAR-Q exercise readiness screening, participants who met criteria were pre-tested using the Berg Balance Scale and 30 –seconds chair-stand-test. After pre-test, participants began exercise with a certified instructor. Participants were encouraged to perform exercise at least 3 times a week for at least 30 minutes each session. A log was given to participants as a reminder keep a record of the number of times exercise was performed weekly and if they experienced any loss of balance or falls. Evaluation The MSN student evaluated participants after 3 weeks and was able to review logs and answer questions while the Tai-chi instructor was available to assist. At the end of the STC, participants were post tested using Berg balance scale and 30sec chair stand test. The logs were reviewed for any loss of balance/fall events. In community-dwelling adults 65 years or older who are still physically active, what is the evidence that tai chi exercise as compared to other exercise can help improve strength and balance and thereby decrease the risk of falls and improve a person’s quality of life? A special thanks to all the participants and Robert and Grace Hubert Senior Center. CONCLUSIONS School Logo The purpose of this small test of change (STC) is to increase strength and balance in community dwelling older adults and decrease fall risks, prevent and decrease the number of falls. PICO Search Strategy Literature search covering Medline, CINAHL, TRIP database, Guidelines.gov, CDC.gov and the Cochrane Database for Systematic Reviews (CDSR). For all databases, the search strategy focused on systematic reviews randomized clinical trials (RCTs) and clinical practice guidelines. Key References Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., & Lamb, S. E. (2012, September 12). Interventions for fall prevention in community dwelling older persons. Cochrane Database of Systematic Review, 19(CD007146). doi: 10.1002/14651858.CD0007144.pub3 Kenny, R. M., Rubenstien, L. Z., Tenetti, M., Brewer, K., Cameron, K., John, D.,...Suther, M. (2011). Summary of the updated American geriatric society/British geriatric society: Clinical practice guidelines for preventing falls in older person. Journal of American Geriatric Society, 59(1), 148-157. doi:10.1111/j.1532- 5415.2010.03234.x Voukelatos, A., Cumming, R. G., Lord, S. R., & Rissel, C. (2007, August). A randomized controlled trial of tai chi for the prevention of fall: The central Sydney tai chi trial. Journal of the American Geriatric Society, 55(8), 1185-1191. doi:10.1111/j.1532-5415.2007.012 40.67 45.33 13.1717.5 Summary of Evidence Community based exercise programs, usually containing some balance and strength training exercises, such as tai chi significantly reduce falls (Gillespie et al., 2012) Tai chi significantly increase strength and balance, and also reduces the risk of falls (Voukelatos et al., 2007). Performing tai chi exercise to prevent falls has been demonstrated as effective in increasing strength and balance and prevent falls in community dwelling adults. The outcomes outweighs the harms. It is given a grade of A (Li et al., 2005, Voukelatos et al., 2007).