OBJECTIVE: To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. DESIGN: Single-blind, randomized clinical trial. SETTING: General community. PARTICIPANTS: Community-dwelling stroke survivors (n = 145), aged >= 50 years and >= 3 months post-stroke. INTERVENTIONS: Yang style 24-posture short-form TC (n = 53), strength and range of movement exercises (SS, n = 44), or usual care (UC, n = 48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. MAIN OUTCOME MEASURES: Physical function: Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest. Quality of life: Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index. RESULTS: A total of 145 stroke survivors (47% women, mean age 70 years, time post-stroke 3 years, ischemic stroke 66%, hemiparesis 73%) enrolled. During the intervention, TC participants had (2/3) fewer falls (n = 5 falls), than the SS (n = 14 falls) and UC (n = 15 falls) groups (Chi2 = 5.60, p = 0.06). There was a significant group by time interaction for the 2-Minute StepTest (F[2,142] = 4.69, p < 0.01). Post-hoc tests indicated TC (t[53] = 2.45, p = 0.02) and SS (t[44] = 4.63, p < 0.01) groups had significantly better aerobic endurance over time, though not in the UC group (t[48] = 1.58, p = 0.12). Intervention adherence rates were 85%. CONCLUSIONS: TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling stroke survivors is recommended.

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