This study filled a gap in the gerontological literature and showed that exposure to a 6-month Tai Chi exercise program can effect long-term changes in HRQL identified by the General Health Survey, a well-established HRQL measure which includes distinct dimensions of quality of life indicators.
On all measures, Tai Chi exercise resulted in significant changes in the HRQL indicators except social functioning, compared to the no-Tai Chi waiting-list control. Overall, Tai Chi participants reported significant improvements over the 6-month period in physical-, role-functioning, bodily pain, mental health, and health status.
Malegra
Over the 6-month intervention, we observed an 18% drop-out rate in the Tai Chi group. This is relatively low given the fact that many who decide to become more physically active return to a sedentary lifestyle within three to six months (Dishman, 1988; Martin & Sinden, 2001). Failure to complete the study was attributed to traveling or family-related commitments rather than dissatisfaction with the program itself. In fact, people who completed the study looked forward to enrolling in further courses offered in the community. Such a finding corroborates findings of Wolf et al. who noted that almost half of their Tai Chi participants chose to continue meeting informally after the study was completed.

Results from present study have a number of implications. First, important domains of HRQL such as physical and psychological health can be enhanced through Tai Chi because it improves balance and coordination in a framework of meditation and concentration thus, theoretically, integrating one’s physical and mental states. This is important because global wellness is predicated not merely on the functioning of each domain but the interaction between the two.

Second, physical functioning is an important HRQL indicator which affects continued independence of older adults. As with other studies that have shown difficult-to-observe change in physical functioning (Kutner et al., 1997; Stewart et al., 1997), this study demonstrated that physical functioning could be improved through a relatively short 6-month Tai Chi program. Overall, the Tai Chi group had 83% improvement across the six individual functional status items, suggesting the Tai Chi intervention enabled participants to improve aspects of their physical functioning. Thus, Tai Chi should be considered favorably as a health promoting program for older adults with or without physical limitations. Finally, results from this study appear to support health promotion and disease prevention benefits of Tai Chi in older adults, which may be achieved without the strenuous physical impact of more common activities such as jogging or aerobics.

There are several limitations of the current study. First, the study used exclusively self-report (self-rated) health measures, which rely on respondents’ memories. Future studies need to consider use of objective physical health measures (e.g., functional tests) that would not only allow us to confirm the current findings but also more rigorously examine the effects of Tai Chi on quality of life. Another limitation is that the study sample was comprised of volunteers who might have been more highly motivated to participate in activity than the typical sedentary older adult population. Additionally, the mode of advertising the study (local newspapers, senior center flyers, retirement community notices) could also have created a selection bias toward people who receive and read newspapers and those who live in or visit certain locales in the community. Therefore, the sample might not be representative of the older adult population as a whole. Finally, although the randomized nature of the study is a strength, we must be mindful of the absence of an attention control group. This experimental protocol does not control for the influence of attention on the outcome measures. It is possible that the participants in the Tai Chi group were benefiting from the social support and attention provided by the instructors and members of the classes, with respect to both the outcome variables and compliance. Further studies should control for this effect by having the control participants attend non-exercise health education classes in a group format (Wolf et al., 1996).

In summary, we conclude that Tai Chi classes taught by experienced Tai Chi teachers improved self-reported quality of life among older persons in a 6-month randomized controlled study. The results confirm that Tai Chi can also be considered a suitable and acceptable health promoting activity for older adults over a long term period, as evidenced by the low rate of attrition in the classes. The extent to which the Tai Chi – HRQL relationship is moderated by psychosocial variables could be explored in future studies. Similarly, it would be useful to replicate our findings using individuals with functional deficits and psychological impairment.