Introduction: Balance impairment in older adults is one of the main factors increasing fall risk and contributing to reduced functional mobility, independence, and quality of life. Structured physical exercise is required as a non-pharmacological intervention to improve balance and reduce fall risk among older adults. This study aimed to compare the effectiveness of conventional balance exercise and Tai Chi exercise in improving balance and reducing fall risk among older adults. Methods: This study used a quasi-experimental design with a pretest–posttest two-group design. The subjects consisted of 50 older adults divided into two groups, namely 25 participants in the conventional balance exercise group and 25 participants in the Tai Chi group. The intervention was conducted for 6–8 weeks with a frequency of 2–3 sessions per week. Balance was measured before and after the intervention using the Timed Up and Go test, while data were analyzed using normality testing, paired t-test, and independent t-test. Results: The results showed that the conventional balance exercise group experienced a decrease in mean Timed Up and Go time from 14.61 ± 1.52 seconds to 12.52 ± 1.65 seconds with p < 0.001. The Tai Chi group showed a decrease in mean Timed Up and Go time from 14.56 ± 1.66 seconds to 11.33 ± 1.54 seconds with p < 0.001. The change in Timed Up and Go time was greater in the Tai Chi group than in the conventional balance exercise group, namely 3.23 ± 0.57 seconds compared with 2.08 ± 0.64 seconds with p < 0.001). Conclusion: Conventional balance exercise and Tai Chi are effective in improving balance among older adults; however, Tai Chi demonstrates greater effectiveness in improving balance and reducing fall risk.
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