Falls were not significantly reduced after tai ji quan or strength training interventions compared with a stretching control intervention in postmenopausal cancer survivors. These findings were published in Journal of Clinical Oncology.

Chemotherapy is associated with increased risk for fall, accelerated aging, and the development of frailty. As such, effective fall prevention interventions are needed.

This study recruited 442 physically underactive women aged 50 to 75 years who had completed chemotherapy 3 or more months prior between 2013 and 2018 in Oregon. Patients were randomly assigned in a 1:1:1 ratio to participate in a tai ji quan (148 patients), strength training (147 patients), or stretch and relaxation (147 patients) intervention in groups of 10 to 15 participants twice weekly over 6 months. The outcome of interest was incidence of falls up to 12 months.

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The patients were mean age 62.1±6.3 years, had a BMI of 29.6 (SD, 6.7) kg/m2, had a functional comorbidity index score of 2.0±1.7 points, 71% had breast cancer, and 40% had stage II disease.

The 6-month fall rates prior to, during, and after the interventions were 21%, 26%, and 27%, respectively.

Compared with the stretching control condition, the rate of falls did not differ among the tai ji quan (incidence rate ratio [IRR], 1.01; 95% CI, 0.74-1.38) or strength training (IRR, 0.99; 95% CI, 0.73-1.35) participants. Trends were similar stratified in 6-month periods.

Similarly, no significant trends in incidence density ratios for falls or fall-related injuries were observed.

This study may have been limited by choosing stretching as the control intervention, which could have confounded some of the effects of exercise. The authors also suggest future studies should consider stratification by baseline fall history, as this study was not powered to examine specific types of injuries.

Strength of balanced-based training after completing chemotherapy was not found to reduce fall and fall-related injuries in postmenopausal cancer survivors, the study authors concluded. “However, there were some promising data to suggest that high-risk patients with a history of falls may benefit from engaging in regular balance-based exercise regimens after finishing chemotherapy to mitigate injury risk from treatment-related falls,” they noted.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Winters-Stone KM, Horak F, Dieckmann NF, et al. GET FIT: A Randomized Clinical Trial of Tai Ji Quan Versus Strength Training for Fall Prevention After Chemotherapy in Older, Postmenopausal Women Cancer Survivors. J Clin Oncol. 2023;JCO2201519. doi:10.1200/JCO.22.01519