***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To use two different exercise programs over a 2-year period to reduce falls and their sequelae among residents of two long-term care facilities . DESIGN R and omized , controlled trial . SETTING The study took place at two long-term care facilities with services ranging from independent living to skilled nursing . PARTICIPANTS One hundred and ten participants whose average age was 84 and who were capable of ambulating with or without assistive devices and could follow simple directions . INTERVENTION Participants were r and omized to one of two exercise groups ( resistance/endurance plus basic enhanced programming or tai chi plus basic enhanced programming ) or to a control group ( basic enhanced programming only ) . Exercise classes were held three times per week throughout the study . MEASUREMENTS Participants were evaluated for cognitive and physical functioning at baseline and 6 , 12 , and 24 months . Falls were determined from incident reports filed by the nursing staffs at the facilities . RESULTS Time to first fall , time to death , number of days hospitalized , and incidence of falls did not differ among the treatment and control groups ( P>.05 ) . Among all participants , those who fell had significantly lower baseline Folstein Mini-Mental State Examination and instrumental activities of daily living scores and experienced significantly greater declines in these measures over the 2-year program . CONCLUSION There were no significant differences in falls among the two exercise groups and the control group . Lack of treatment differences and low adherence rates suggest that residents of long-term care facilities may require individualized exercise interventions that can be adapted to their changing needs The purpose of this study was to assess the effect of 18-week Tai Chi training on body balance in dynamic trial among elderly men . The study covered 49 subjects from age 60 to 82.1 years , who had osteopenia or osteoporosis . The subjects were recruited from the community by direct mailings and community efforts to participate in studies . The participants were r and omly assigned to either the exercise intervention ( n = 25 ) or control groups ( n = 24 ) . The Tai Chi group participated in an 18-week exercise class held for 45 min , twice a week . Body balance was assessed using a Computer Posturographic System PE 90 produced by the Military Institute of Aviation Medicine in Warsaw with modified software made in Pro-Med . During the measurement of body balance , the capacity to perform specific tasks was analyzed ( deflections in the set scope and direction ) . In the Tai Chi group , an increase ( p < or = 0.01 ) in effectiveness of balance task performance was noted from 80.95 % to 84.45 % after the training . In the control group , no statistically significant improvement in the level of body balance was found in the same period . Thus , an 18-week period of Tai Chi exercises twice a week for 45 min is beneficial for dynamic balance . It can be important for reducing fall risk factors OBJECTIVES To determine the effects of moderate intensity group-exercise programs on falls , functional performance , and disability in older adults ; and to investigate the influence of frailty on these effects . DESIGN A 20-week , multicenter r and omized controlled trial , with 52-week follow-up . SETTING Fifteen homes for the elderly . PARTICIPANTS Two hundred seventy-eight men and women ( mean age + /- st and ard deviation , 85+/-6y ) . INTERVENTIONS Two exercise programs were r and omly distributed across 15 homes . The first program , functional walking ( FW ) , consisted of exercises related to daily mobility activities . In the second program , in balance ( IB ) , exercises were inspired by the principles of Tai Chi . Within each home participants were r and omly assigned to an intervention or a control group . Participants in the control groups were asked not to change their usual pattern of activities . The intervention groups followed a 20-week exercise program with 1 meeting a week during the first 4 weeks and 2 meetings a week during the remaining weeks . MAIN OUTCOME MEASURES Falls , Performance Oriented Mobility Assessment ( POMA ) , physical performance score , and the Groningen Activity Restriction Scale ( GARS ) ( measuring self-reported disability ) . RESULTS Fall incidence rate was higher in the FW group ( 3.3 falls/y ) compared with the IB ( 2.4 falls/y ) and control ( 2.5 falls/y ) groups , but this difference was not statistically significant . The risk of becoming a faller in the exercise groups increased significantly in the subgroup of participants who were classified as being frail ( hazard ratio [ HR ] = 2.95 ; 95 % confidence interval [ CI ] , 1.64 - 5.32 ) . For participants who were classified as being pre-frail , the risk of becoming a faller decreased ; this effect became significant after 11 weeks of training ( HR = .39 ; 95 % CI , .18-.88 ) . Participants in both exercise groups showed a small , but significant improvement in their POMA and physical performance scores . In the FW group , this held true for the GARS score as well . Post hoc analyses revealed that only the pre-frail participants improved their POMA and physical performance scores . CONCLUSIONS Fall-preventive moderate intensity group-exercise programs have positive effects on falling and physical performance in pre-frail , but not in frail elderly OBJECTIVES To compare the effect of two 10-week balance training programs , Combined Balance and Step Training ( CBST ) versus tai chi ( TC ) , on balance and stepping measures . DESIGN Prospect i ve intervention trial . SETTING Local senior centers and congregate housing facilities . PARTICIPANTS Aged 65 and older with at least mild impairment in the ability to perform unipedal stance and t and em walk . INTERVENTION Participants were allocated to TC ( n = 107 , mean age 78 ) or  CBST , an intervention focused on improving dynamic balance and stepping ( n = 106 , mean age 78 ) . MEASUREMENTS At baseline and 10 weeks , participants were tested in their static balance ( Unipedal Stance and T and em Stance ( TS ) ) , stepping ( Maximum Step Length , Rapid Step Test ) , and Timed Up and Go ( TUG ) . RESULTS Performance improved more with CBST than TC , ranging from 5 % to 10 % for the stepping tests ( Maximum Step Length and Rapid Step Test ) and 9 % for TUG . The improvement in TUG represented an improvement of more than 1 second . Greater improvements were also seen in static balance ability ( in TS ) with CBST than TC . CONCLUSION Of the two training programs , in which variants of each program have been proven to reduce falls , CBST results in modest improvements in balance , stepping , and functional mobility versus TC over a 10-week period . Future research should include a prospect i ve comparison of fall rates in response to these two balance training programs BACKGROUND Aging adversely affects balance and increases the propensity to slip and fall . Loss of plantar sensation due to diabetic peripheral neuropathy and other diseases has been shown to further increase this propensity to fall . The ancient Chinese art of Tai Chi has been previously shown as a method to improve balance in healthy elderly adults . METHODS The aim of this study was to determine if Tai Chi intervention improved both balance and plantar sensory perception in healthy elderly adults and elderly adults with diabetes and plantar sensory loss . Elderly subjects ( mean + /- SD age = 73.1 + /- 5.9 years , n = 18 ) were tested for plantar sensory ability and several balance metrics before Tai Chi training and again after 6 months of weekly sessions . Participants were grouped by initial sensory perception scores ( as measured by a vibrometer ) in order to make inferences on the effects of Tai Chi on sensory perception . RESULTS Plantar sensation results show all participants showed significant improvement in sensory ability with the 6 months of Tai Chi training . All groups also had a general improvement in all balance measures , with the greatest improvement seen in those subjects with large sensory losses . Hemoglobin A1C measurements also decreased as a result of the intervention . CONCLUSION This study demonstrates the effectiveness of Tai Chi training as a method of improving plantar sensation and balance in elderly adults and elderly adults with diabetes with a large plantar sensation loss OBJECTIVES To determine the effectiveness of a 16-week community-based tai chi program in reducing falls and improving balance in people aged 60 and older . DESIGN R and omized , controlled trial with waiting list control group . SETTING Community in Sydney , Australia . PARTICIPANTS Seven hundred two relatively healthy community-dwelling people aged 60 and older ( mean age 69 ) . INTERVENTION Sixteen-week program of community-based tai chi classes of 1 hour duration per week . MEASUREMENTS Falls during 16 and 24 weeks of follow-up were assessed using a calendar method . Balance was measured at baseline and 16-week follow-up using six balance tests . RESULTS Falls were less frequent in the tai chi group than in the control group . Using Cox regression and time to first fall , the hazard ratio after 16 weeks was 0.72 ( 95 % confidence interval (CI)=0.51 - 1.01 , P=.06 ) , and after 24 weeks it was 0.67 ( 95 % CI=0.49 - 0.93 , P=.02 ) . There was no difference in the percentage of participants who had one or more falls . There were statistically significant differences in changes in balance favoring the tai chi group on five of six balance tests . CONCLUSION Participation in once per week tai chi classes for 16 weeks can prevent falls in relatively healthy community-dwelling older people PURPOSE To determine whether improved functional balance through a Tai Chi intervention is related to subsequent reductions in falls among elderly persons . METHODS Two hundred fifty-six healthy , physically inactive older adults aged 70 - 92 ( mean age + /- SD = 77.48 + /- 4.95 ) , recruited from a local health system in Portl and , OR , participated in a 6-month r and omized controlled trial , with allocation to Tai Chi or exercise stretching control , followed by a 6-month postintervention follow-up . Functional balance measures included Berg balance scale , dynamic gait index , and functional reach , assessed during the 6-month intervention period ( baseline , 3-month , and 6-month intervention endpoint ) and again at the 6-month postintervention follow-up . Fall counts were recorded during the 6-month postintervention follow-up period . Data were analyzed through intention-to-treat analysis of variance and logistic regression procedures . RESULTS Tai Chi participants who showed improvements in measures of functional balance at the intervention endpoint significantly reduced their risk of falls during the 6-month postintervention period , compared with those in the control condition ( odds ratio ( OR ) , 0.27 , 95 % confidence interval ( CI ) , 0.07 - 0.96 for Berg balance scale ; OR , 0.27 , 95 % CI , 0.09 - 0.87 for dynamic gait index ; OR , 0.20 , 95 % CI , 0.05 - 0.82 for functional reach ) . CONCLUSIONS Improved functional balance through Tai Chi training is associated with subsequent reductions in fall frequency in older persons BACKGROUND The authors ' objective was to evaluate the efficacy of a 6-month Tai Chi intervention for decreasing the number of falls and the risk for falling in older persons . METHODS This r and omized controlled trial involved a sample of 256 physically inactive , community-dwelling adults aged 70 to 92 ( mean age , 77.48 years ; st and ard deviation , 4.95 years ) who were recruited through a patient data base in Portl and , Oregon . Participants were r and omized to participate in a three-times-per-week Tai Chi group or to a stretching control group for 6 months . The primary outcome measure was the number of falls ; the secondary outcome measures included functional balance ( Berg Balance Scale , Dynamic Gait Index , Functional Reach , and single-leg st and ing ) , physical performance ( 50-foot speed walk , Up&Go ) , and fear of falling , assessed at baseline , 3 months , 6 months ( intervention termination ) , and at a 6-month postintervention follow-up . RESULTS At the end of the 6-month intervention , significantly fewer falls ( n=38 vs 73 ; p=.007 ) , lower proportions of fallers ( 28 % vs 46 % ; p=.01 ) , and fewer injurious falls ( 7 % vs 18 % ; p=.03 ) were observed in the Tai Chi group compared with the stretching control group . After adjusting for baseline covariates , the risk for multiple falls in the Tai Chi group was 55 % lower than that of the stretching control group ( risk ratio,.45 ; 95 % confidence interval , 0.30 to 0.70 ) . Compared with the stretching control participants , the Tai Chi participants showed significant improvements ( p<.001 ) in all measures of functional balance , physical performance , and reduced fear of falling . Intervention gains in these measures were maintained at a 6-month postintervention follow-up in the Tai Chi group . CONCLUSIONS A three-times-per-week , 6-month Tai Chi program is effective in decreasing the number of falls , the risk for falling , and the fear of falling , and it improves functional balance and physical performance in physically inactive persons aged 70 years or older BACKGROUND AND AIMS This study examined the effect of Tai Chi ( TC ) training on biomechanical responses to large , fast walking perturbations in balance-impaired seniors . METHODS Twenty-two seniors ( age 68 - 92 , BERG 44 or less ) with surgical interventions to knees , hips , and back were r and omly divided into control or TC groups . Groups trained 1.5h/day , 5 days/week for 3 weeks . Controls received TC training after post-control testing . Subjects walked across a force plate triggered to move forward  
    Output:
    
Improvements were reported in almost all of these measures .
This review indicates that TC may be an economic and effective exercise program for improving balance and balance confidence in older adults