OBJECTIVE: To compare the adherence to and effectiveness of Tai Chi exercise program through a live, interactive, telecommunication-based exercise (tele-ex) with that of a similar program through a community center-based exercise (comm-ex) and a home video-based exercise (home-ex) among community-dwelling elders who are at risk for falls. DESIGN: Three groups randomized controlled trial with pretests and posttests. SETTING: Exercise programs were community-based, and the outcome measures were laboratory-based. PARTICIPANTS: Adults (n = 64) age 65+ years with positive fall history in the previous year and/or significant fear of falling. INTERVENTION: A 24-form, Yang-style Tai Chi for 15 weeks, 3 hours a week. MAIN OUTCOME MEASURES: Exercise compliance, number of falls, fear of falling (Activities-specific Balance Confidence (ABC) score), self-perceived health (Medical Outcomes Study 36-Item Short Form Health Survey (SF-36)), Timed Up and Go (TUG), single leg stance (SLS), and body sway during quiet stance (medial-lateral foot center of pressure (ML-COP)). RESULTS: Tele-ex and comm-ex groups demonstrated significantly higher exercise attendance and in-class practice time than the home-ex group (p < 0.01) and significant reductions in the mean number of falls and injurious falls (p < 0.01). There were significant improvements posttraining in SLS, ABC, ML-COP, and Physical Health subscore of the SF-36 (p < 0.05). Both tele-ex and comm-ex groups demonstrated larger improvements than the home-ex group in TUG, ML-COP, and the Social Function, Mental Health, and Physical Health subscores of the MOS SF-36. CONCLUSION: Compared with the home-ex, the tele-ex and comm-ex groups are better in exercise compliance, fall reduction and balance and health improvements. Tele-ex is an effective, affordable, and acceptable choice of exercise for elders.

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