***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: BACKGROUND recent studies have found that moderate intensity exercise is an effective intervention strategy for preventing falls  in older people . However , research is required to determine whether supervised group exercise programmes , conducted in community setting s with at-risk older people referred by their health care practitioner are also effective in improving physical functioning and preventing falls in this group . OBJECTIVES to determine whether participation in a weekly group exercise programme with ancillary home exercises over one year improves balance , muscle strength , reaction time , physical functioning , health status and prevents falls in at-risk community-dwelling older people . METHODS the sample comprised 163 people aged over 65 years identified as at risk of falling using a st and ardised assessment screen by their general practitioner or hospital-based physiotherapist , residing in South Western Sydney , Australia . Subjects were r and omised into either an exercise intervention group or a control group .  Physical performance and general health measures were assessed at baseline and repeated 6-months into the trial . Falls were measured over a 12-month follow-up period using monthly postal surveys . RESULTS at baseline both groups were well matched in their physical performance , health and activity levels . The intervention subjects attended a median of 23 exercise classes over the year , and most undertook the home exercise sessions at least weekly . At retest , the exercise group performed significantly better than the controls in three of six balance measures ; postural sway on the floor with eyes open and eyes closed and coordinated stability . The groups did not differ at retest in measures of strength , reaction time and walking speed or on Short-Form 36 , Physical Activity Scale for the Elderly or fear of falling scales . Within the 12-month trial period , the rate of falls in the intervention group was 40 % lower than that of the control group ( IRR=0.60 , 95 % CI 0.36 - 0.99 ) . CONCLUSIONS these findings indicate that participation in a weekly group exercise programme with ancillary home exercises can improve balance and reduce the rate of falling in at-risk community dwelling older people OBJECTIVES To compare the effectiveness of tai chi and low-level exercise in reducing  falls in older adults ; to determine whether mobility , balance , and lower limb strength improved and whether higher doses of tai chi result ed in greater effect . DESIGN R and omized controlled trial . SETTING Eleven sites throughout New Zeal and . PARTICIPANTS Six hundred eighty-four community-residing older adults ( mean age 74.5 ; 73 % female ) with at least one falls risk factor . INTERVENTION Tai chi once a week ( TC1 ) ( n = 233 ) ; tai chi twice a week ( TC2 ) ( n = 220 ) , or a low-level exercise program control group ( LLE ) ( n = 231 ) for 20 wks . MEASUREMENTS Number of falls was ascertained according to monthly falls calendars . Mobility ( Timed-Up- and -Go Test ) , balance ( step test ) , and lower limb strength ( chair st and test ) were assessed . RESULTS The adjusted incident rate ratio ( IRR ) for falls was not significantly different between the TC1 and LLE groups ( IRR = 1.05 , 95 % confidence interval ( CI ) = 0.83 - 1.33 , P = .70 ) or between the TC2 and LLE groups ( IRR = 0.88 , 95 % CI = 0.68 - 1.16 , P = .37 ) . Adjusted multilevel mixed-effects Poisson regression showed a significant reduction in logarithmic mean fall rate of -0.050 ( 95 % CI = -0.064 to -0.037 , P < .001 ) per month for all groups . Multilevel fixed-effects analyses indicated improvements in balance ( P < .001 right and left leg ) and lower limb strength ( P < .001 ) but not mobility ( P = .54 ) in all groups over time , with no differences between the groups ( P = .37 ( right leg ) , P = .66 ( left leg ) , P = .21 , and P = .44 , respectively ) . CONCLUSION There was no difference in falls rates between the groups , with falls reducing similarly ( mean falls rate reduction of 58 % ) over the 17-month follow-up period . Strength and balance improved similarly in all groups over time Purpose : To assess some fall-related clinical variables ( balance , gait , fear of falling , functional autonomy , self-actualization and self-efficacy ) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program . Methods : The participants ( 152 older adults over 65 who were admitted to a geriatric day hospital program ) were r and omly assigned to either a supervised Tai Chi group or the usual physiotherapy . The presence of the clinical variables related to falls was evaluated before the intervention ( T1 ) , immediately after ( T2 ) , and 12 months after the end of the intervention ( T3 ) . Results : Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls . For both groups , most variables followed the same pattern , i.e. showed significant improvement with the intervention between T1 and T2 , and followed by a statistically significant decrease at the T3 evaluation . However , self-efficacy was the only variable that improved solely with the Tai Chi intervention ( p = 0.001 ) . Conclusions : The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance , gait and fear of falling . It appeared to be related to an increase of general self-efficacy , a phenomenon which is not seen in the conventional physiotherapy program . Implication s for Rehabilitation Each participant received a multidisciplinary intervention with either Tai Chi or physical therapy . Both interventions were associated with improved balance , gait , less fear of falling , improved functional autonomy and greater self actualisation . Only Tai Chi decreased the incidence of falls which appeared to be related to self-efficacy .  Tai Chi seems to be a good alternative to physical therapy exercises to prevent falls in frail older people CONTEXT Because Tai Chi ( TC ) is beneficial to elders without cognitive impairment ( CI ) , it also may benefit elders with CI . But elders with CI have generally been excluded from TC studies because many measurement tools require verbal reports that some elders with CI are unable to provide . OBJECTIVES To test the efficacy of a TC program in improving pain and other health outcomes in community-dwelling elders with knee osteoarthritis ( OA ) and CI . METHODS This pilot cluster-r and omized trial was conducted between January 2008 and June 2010 ( Clinical Trials.gov Identifier : NCT01528566 ) . The TC group attended Sun style TC classes , three sessions a week for 20 weeks ; the control group attended classes providing health and cultural information for the same length of time . Measures included the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) pain , physical function and stiffness subscales ; the Get Up and Go test ; the Sit-to-St and test ; and the Mini-Mental State Examination ( MMSE ) , administered at baseline , every four weeks during the intervention and at the end of the study ( post-test ) . RESULTS Eight sites participated in either the TC group ( four sites , 28 participants ) or control group ( four sites , 27 participants ) .  The WOMAC pain ( P = 0.006 ) and stiffness scores ( P = 0.010 ) differed significantly between the two groups at post-test , whereas differences between the two groups in the WOMAC physical function score ( P = 0.071 ) and the MMSE ( P = 0.096 ) showed borderline significance at the post-test . WOMAC pain ( P = 0.001 ) , physical function ( P = 0.021 ) , and stiffness ( P ≤ 0.001 ) scores improved significantly more over time in the TC group than in controls . No adverse events were found in either group . CONCLUSION Practicing TC can be efficacious in reducing pain and stiffness in elders with knee OA and CI Balance ability decreases with age , which results in an increased risk of  falls  for people over age 65 .  Tai Chi exercise appears to offer potential benefits in the reduction of  falls  for the elderly . The purpose of the present study was to examine the effects of extended ( 6- and 12-month ) Tai Chi exercise interventions on balance and selected motor functions for senior citizens . Forty-seven subjects were recruited from two local senior centers . Twenty of them ( M = 71.8 years , SD = 7.1 ) , 11 in the  Tai Chi exercise group and 9 in the control group , completed the pre- , mid- and post-tests over 12 months on five selected functional performance tests : static balance , dynamic balance , choice reaction time , heel-rise strength , and ankle flexibility . The Tai Chi group was provided with a one-hour Tai Chi exercise session per week for 12 months ; the control group did not participate in any exercise program . Results showed that static balance improved significantly after a 6-month Tai Chi intervention . Moreover , the Tai Chi group maintained a higher level in the test performance compared with the control group at the end of the 12-month intervention , but there was no significant difference between the two groups . Data suggested that Tai Chi exercise intervention could produce a positive influence on balance control for the elderly over a prolonged period , but not on muscle strength and ankle flexibility 
    Output:
    
In conclusion , TCC practice was beneficial to improve the balance control ability and flexibility of older adults , which may be the reason of preventing falls