A Pilot Study: Comparative Effects of Tai-Chi Combined with Frenkel Exercises versus Swiss-Ball Combined with Frenkel Exercises on Balance and Fear of Falling in Older Adults

Abstract

Background: Ageing is associated with physiological changes that may adversely affect postural control, balance, and functional independence, thereby increasing the risk of falls among older adults. Falls are an important public health concern because they are associated with morbidity, mortality, reduced functional independence, and increased healthcare burden. Exercise-based interventions such as Tai-Chi and Swiss-ball exercises have been reported to improve balance and fall-related outcomes in older adults. However, the comparative effects of these interventions when combined with Frenkel exercises require further investigation. Therefore, the present study compared the effects of Tai-Chi exercises combined with Frenkel exercises and Swiss-ball exercises combined with Frenkel exercises on balance and fall-related self-efficacy in elderly individuals.
Methods: This exploratory pilot study was conducted among 50 elderly participants who were randomly allocated into two equal groups of 25 participants each. Group A received Tai-Chi exercises combined with Frenkel exercises, whereas Group B received Swiss-ball exercises combined with Frenkel exercises. Both groups received the intervention for 8 weeks, 5 days per week. Outcomes were assessed at baseline, 4 weeks, and 8 weeks using the Berg Balance Scale (BBS) for balance and the Fall Efficacy Scale (FES) for fall-related concerns. Between-group differences at 8 weeks were analysed using analysis of covariance (ANCOVA), adjusting for baseline outcome scores, age, and gender.
Results: Both groups demonstrated progressive improvement in BBS scores and reduction in FES scores over the 8-week intervention period. Mean BBS scores increased from 37.20 to 47.16 in Group A and from 33.80 to 42.84 in Group B. Mean FES scores decreased from 79.88 to 66.52 in Group A and from 79.20 to 69.24 in Group B. Baseline BBS scores differed significantly between groups; therefore, baseline-adjusted ANCOVA was performed. After adjustment for baseline BBS, age, and gender, a significant between-group difference was observed in 8-week BBS scores, with Group A demonstrating a higher adjusted mean score than Group B (F(1,45) = 9.29, p = 0.004, partial η² = 0.17). For FES, baseline scores were comparable between groups, and ANCOVA adjusted for baseline FES, age, and gender demonstrated a significant between-group difference at 8 weeks (F(1,45) = 16.97, p < 0.001, partial η² = 0.27), favouring Group A.
Conclusion: Both Tai-Chi combined with Frenkel exercises and Swiss-ball combined with Frenkel exercises were associated with improvements in balance and fall-related outcomes over 8 weeks. After adjustment for baseline scores and demographic variables, Tai-Chi combined with Frenkel exercises demonstrated more favourable outcomes than Swiss-ball combined with Frenkel exercises. These findings suggest that Tai-Chi combined with Frenkel exercises may be a useful physiotherapy-based intervention for improving balance and reducing fall-related concerns in elderly individuals.