The effects of a Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults living in long-term care facilities: a single group design with multiple time points

Int J Nurs Stud. 2008 Apr;45(4):501-7. doi: 10.1016/j.ijnurstu.2006.11.008. Epub 2007 Jan 11.


Background: Studies support the positive effects that Tai Chi has on the physical health of older adults. However, many older adults residing in long-term care facilities feel too weak to practice traditional Tai Chi, and a more simplified style is preferred.

Objective: To test the effects of a newly-developed, Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults who resided in long-term care facilities.

Design: A single group design with multiple time points: three pre-tests, one month apart; four post-tests at one month, two months, three months, and six months after intervention started.

Settings: Two 300-400 bed veteran homes in Taiwan.

Participants: The 51 male older adults were recruited through convenience sampling, and 41 of them completed six-month study. Inclusion criteria included: (1) aged 65 and over; (2) no previous training in Tai Chi; (3) cognitively alert and had a score of at least eight on the Short Portable Mental Status Questionnaire; (4) able to walk without assistance; and (5) had a Barthel Index score of 61 or higher. Participants who had dementia, were wheel-chair bound, or had severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses were excluded.

Methods: The STEP was implemented three times a week, 50 min per session for six months. The outcome measures included cardio-respiratory function, blood pressure, balance, hand-grip strength, lower body flexibility, and physical health actualization.

Results: A drop in systolic blood pressure (p=.017) and diastolic blood pressure (p<.001) was detected six months after intervention started. Increase in hand-grip strength from pre to post intervention was found (left hand: p<.001; right hand: p=.035). Participants also had better lower body flexibility after practicing STEP (p=.038).

Conclusions: Findings suggest that the STEP be incorporated as a floor activity in long-term care facilities to promote physical health of older adults.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Geriatric Assessment
  • Health Status*
  • Humans
  • Long-Term Care / methods
  • Longitudinal Studies
  • Male
  • Nursing Evaluation Research
  • Outcome Assessment, Health Care
  • Physical Fitness
  • Program Evaluation
  • Skilled Nursing Facilities*
  • Surveys and Questionnaires
  • Tai Ji / methods*
  • Taiwan