- Design
- Systematic review and meta-analysis of randomised trials
- Population
- 21 RCTs of adults aged 60+ with frailty or pre-frailty
- Primary outcome
- Frailty, mobility, balance and cognitive outcomes
- Effect
- Berg balance SMD 1.32 (1.00–1.64); TUG SMD 0.75; gait speed not improved
This meta-analysis included 21 randomised trials, 15 in the main analysis, of traditional Chinese exercise — mostly Tai Chi and Baduanjin — in adults aged 60 and over with frailty, pre-frailty or cognitive frailty.
Exercise improved Edmonton Frail Scale scores (SMD 0.55), Fried frailty phenotype scores (SMD 2.70), timed up-and-go (SMD 0.75), Berg balance (SMD 1.32) and Montreal Cognitive Assessment scores (SMD 1.02). Gait speed did not improve significantly, and the effect on grip strength was small and imprecise. Heterogeneity was substantial for several outcomes, and prescriptions varied widely.
These are low-impact, group-based, equipment-free forms of exercise that suit many older adults, including those in Indian community settings where similar mind-body practices such as yoga are familiar. The evidence supports offering them for balance and frailty, though not as a replacement for progressive resistance training where strength is the goal.
- Consider Tai Chi or similar balance-based group exercise for frail and pre-frail older adults
- Combine with progressive resistance training where strength is the main deficit
- Use balance and timed up-and-go to track response
- Match the programme to what the person will sustain
Why it matters
Gives an accessible, low-cost option for frail older adults who will not use a gym.
Don't overread it
Substantial heterogeneity and variable prescriptions; no optimal dose can be drawn from this review.
The statistics, in plain English
Standardised mean differences above 0.8 are large, but substantial heterogeneity means trials disagreed on size, and some very large effects (such as 2.70) usually reflect small trials with variable methods.
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