Taekwondo Program for Preventing Falls in Older Adults

Evaluating a Taekwondo-based Fall Prevention Exercise Program in Older Adults: a Feasibility Study

Falls in older adults are a public health crisis, as 30% of older adults fall each year, with a mortality rate of 78%.1 Fall-related healthcare costs are over 50 billion dollars.1 Therefore, preventing older adults from falling is important in both individual and public health aspects by increasing their quality of life and reducing healthcare costs. However, the current fall-prevention exercise programs have a limitation in maintaining exercise adherence behaviors or increasing physical activities once the intervention is completed.2 The theory-based exercise program shows a higher adherence and retention rate.3,4 Taekwondo (TKD), one type of martial arts, can be a potential channel to deliver a theory-based fall prevention exercise program. Therefore, this study aims to test the feasibility of the potential 12 Taekwondo-based fall prevention exercise program for older adults and its preliminary efficacy using a randomized controlled trial.

Study Overview

• Status: Active, not recruiting
• Conditions: Taekwondo-based Fall Prevention Exercise Condition; Fall Prevention Education Control Condition
• Intervention / Treatment: Behavioral: Fall prevention exercise using Taekwondo; Behavioral: Live Strong and Safe Program on Fall Prevention

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Early Phase 1

Contacts and Locations

Study Locations

• United States
  • South Carolina
    • Columbia, South Carolina, United States, 29201
      • University of South Carolina

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Older adults ages 55 and above
2. Adequate physical ability to perform walking independently
3. Able to use a smartphone app without assistance
4. Capable of providing informed consent
5. Agree to be randomized to the group

Exclusion Criteria:

1. Plan to have surgery or relocate outside the area within the next 3 months
2. Currently participate in other studies involving physical activity or fall-prevention research studies
3. Frail older adults screened by the FRAIL questionnaire

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Taekwondo exercise arm; Participants will received 12 sessions of Taekwondo-based fall prevention exercises. The exercise will be delivered twice a week for 6-weeks at the local recreational center. Each sessions includes three components: static and dynamic stretching warm-up, basic Taekwondo movement exercises, and kicking exercises. Static and dynamic warm-up was developed based on the evidence-based fall prevention exercise, The Otago Exercise Program. The basic Taekwondo movement exercises include three basic stances (walking, front, and horse riding stances) , and hand movements (low, middle, and high block, and middle punch). Kicking exercise includes target kicking using front kicks.	Behavioral: Fall prevention exercise using Taekwondo; Current fall-prevention exercise programs have a limitation in maintaining exercise adherence behaviors or increasing physical activities once the intervention is completed.2 The theory-based exercise program shows a higher adherence and retention rate.3,4 Taekwondo (TKD), one type of martial arts, can be a potential channel to deliver a theory-based fall prevention exercise program. Therefore, this study aims to test the feasibility of the potential 12 Taekwondo-based fall prevention exercise program for older adults and its preliminary efficacy using RCT.
Active Comparator: Fall prevention education arm; Participants will received the Live Strong and Safe Program on Fall Prevention online education program. It includes three modules. Module1 has three sessions that providing overview of fall prevention such as fall statistics, and preventable risk factors. Module2 has eight sessions that provides tips to ensure home safety for fall prevention. Module3 has 12 sessions that provides tips for personal safety from nutrition to mental health. Participants will complete this module at their own pace, and report their progress through email or text message each week.	Behavioral: Live Strong and Safe Program on Fall Prevention; Live Strong and Safe Program on Fall Prevention online education includes three modules. Module1 has three sessions that provide overview of fall prevention such as fall statistics, and preventable risk factors. Module2 has eight sessions that provide tips to ensure the home safety for fall prevention. Module3 has 12 sessions that provide tips for personal safety from nutrition to mental health. Participants will complete this module at their own pace, and report their progress through email or text message each week.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Recruitment Feasibility	The number of participants enrolled in the study per month; The number of participants who provided consent over the eligible participants.	Post-intervention at week 7.
Intervention Satisfaction	8-item questionnaire with 7-point Likert (adapted from Physical Activity Enjoyment Scale). The response scale ranges from 1-7, spanning from the lowest degree (=1) to the highest degree (=7).	Post intervention at week 7
Perceived feasibility	Using 5 points Likert Scale, and the response scale is (1): Completely disagree; (3) Neither agree or disagree; to (5): Completely agree. These items ask about participants' perceived program acceptability, appropriateness, and feasibility	Post intervention at week 7
Intervention fidelity	Fidelity checklist scored by the independent rater	Every exercise session
Adherence rate	Number of sessions each participant attended / total sessions provided (i.e., 12)	Post intervention (At Week 7)
Intention to reparticipate	Use 4-item questionnaire with 5-point Likert Scale. The response scale is (1): Strongly disagree; (3) Neither agree or disagree, to Maximum (5): Strongly agree	Post intervention (At Week 7)
Adverse event	The number of grade 1 adverse events occurred across all exercise sessions.	Anytime during the intervention period

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical function	Static and dynamic balance: Balance Error Scoring System (Outcome unit: number of errors occurred) Functional Gait Assessment (Outcome unit: a score ranging from 0-30) Muscle strength: 30-second chair-stand tests (Outcome unit: number of successful trials) Gait speed: Timed-Up and Go (Outcome unit: total time (seconds) to complete the task)	Baseline (Week 0) and post-intervention (Week 7)
Fear of falling	The Falls Efficacy Scale-International - 16 items with 4-point Likert Scale ranging from (1): Not at all concerned to (4): Very concerned.	Baseline (Week 0) and post-intervention (Week 7)
Activity and Sedentary fragmentation	Activity fragmentation: Transition probability from activity behavior to sedentary behavior every minute. Sedentary fragmentation: Transition probability from sedentary behavior to activity behavior every minute.	Baseline (Week 0) and post-intervention (Week 7)

Collaborators and Investigators

• Sponsor: University of South Carolina
• Investigators: Study Chair: Chih-Hsiang Yang, PhD, 2. University of South Carolina

Publications and helpful links

General Publications

• Webb TL, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010 Feb 17;12(1):e4. doi: 10.2196/jmir.1376.
• Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical Costs of Fatal and Nonfatal Falls in Older Adults. J Am Geriatr Soc. 2018 Apr;66(4):693-698. doi: 10.1111/jgs.15304. Epub 2018 Mar 7.
• Judy A. Stevens, Elizabeth R. Burns. A CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults. 3rd Ed. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2015.
• Prestwich A, Sniehotta FF, Whittington C, Dombrowski SU, Rogers L, Michie S. Does theory influence the effectiveness of health behavior interventions? Meta-analysis. Health Psychol. 2014 May;33(5):465-74. doi: 10.1037/a0032853. Epub 2013 Jun 3.

Study record dates

Study Major Dates

• Study Start (Actual): January 13, 2026
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: April 6, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 6, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Physical Activity; Feasibility; Randomized controlled trial; Older adults; Fall prevention exercise
• Additional Relevant MeSH Terms: Behavior; Motor Activity
• Other Study ID Numbers: Pro00137158

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The study will be conducted from a restricted area and the participants will be recruited from local senior centers, which has high risk of identifying the personal information of study participants.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No