Physical Therapy · May 18, 2026
Role of Thai boxing dance program on fall prevention and physical performance in community-dwelling older adults at risk: a randomized controlled study
By Areeudomwong P, Mahikul W, Khunthason S et al.
IMPORTANCE: Falls among older adults are a major public health concern, but evidence on Thai boxing dance (TBD) interventions for prevention remains inconclusive. OBJECTIVE: This study aimed to evaluate the effectiveness of a 6-month TBD program in reducing fall incidence and improving physical performance, fear of falling, and cognitive function among community-dwelling older adults at risk of falling. DESIGN: This study was a 3-arm parallel-group, assessor-blinded randomized controlled trial. SETTING: The study was conducted at 3 primary health care centers in Chiang Rai, Thailand. PARTICIPANTS: Among the 123 participants enrolled, 115 older adults aged ≥60 years were identified as being at risk of falling and completed the study. INTERVENTIONS: Participants were randomly allocated to 1 of 3 groups: TBD, conventional balance exercise (CBE), or a control group (CG). All groups participated in biweekly sessions over a 24-week period. MAIN OUTCOMES AND MEASURES: Falls were monitored over a 180-day period, whereas physical performance, fear of falling, and cognitive function were assessed at baseline and at the 6-month intervention period. RESULTS: Of the 123 participants, 115 completed the trial. Incident rates of falls in the TBD and CBE group (0.18 and 0.17 per person-month, respectively) were lower than the rate of 0.62 in the CG. The TBD group showed a 76% reduction in the fall rate compared to CG. TBD also led to significantly greater improvements in physical performance, including postural sway, gait parameters, and lower-limb strength, compared with the CG after the 6-month intervention. The CBE group showed greater improvements in gait parameters only. No significant between-group differences were observed in fear of falling or cognitive function. CONCLUSIONS AND RELEVANCE: A 6-month TBD and CBE program reduced falls. TBD improved physical performance more broadly, whereas CBE yielded targeted gait improvements in community-dwelling older adults at risk of falling.