Center for Integrated Primary Care; Department of Family Medicine and Community Health
Alternative and Complementary Medicine | Integrative Medicine | Movement and Mind-Body Therapies | Nervous System Diseases
Objectives: To assess the feasibility and inform design features of a fully powered randomized controlled trial (RCT) evaluating the effects of Tai Chi (TC) in Parkinson's disease (PD) and to select outcomes most responsive to TC assessed during off-medication states.
Design: Two-arm, wait-list controlled RCT.
Settings: Tertiary care hospital.
Subjects: Thirty-two subjects aged 40-75 diagnosed with idiopathic PD within 10 years.
Interventions: Six-month TC intervention added to usual care (UC) versus UC alone.
Outcome Measures: Primary outcomes were feasibility-related (recruitment rate, adherence, and compliance). Change in dual-task (DT) gait stride-time variability (STV) from baseline to 6 months was defined, a priori, as the clinical outcome measure of primary interest. Other outcomes included: PD motor symptom progression (Unified Parkinson's Disease Rating Scale [UPDRS]), PD-related quality of life (PDQ-39), executive function (Trail Making Test), balance confidence (Activity-Specific Balance Confidence Scale, ABC), and Timed Up and Go test (TUG). All clinical assessments were made in the off-state for PD medications.
Results: Thirty-two subjects were enrolled into 3 sequential cohorts over 417 days at an average rate of 0.08 subjects per day. Seventy-five percent (12/16) in the TC group vs 94% (15/16) in the UC group completed the primary 6-month follow-up assessment. Mean TC exposure hours overall: 52. No AEs occurred during or as a direct result of TC exercise. Statistically nonsignificant improvements were observed in the TC group at 6 months in DT gait STV (TC [20.1%] vs UC [-0.1%] group [effect size 0.49; P = .47]), ABC, TUG, and PDQ-39. UPDRS progression was modest and very similar in TC and UC groups.
Conclusions: Conducting an RCT of TC for PD is feasible, though measures to improve recruitment and adherence rates are needed. DT gait STV is a sensitive and logical outcome for evaluating the combined cognitive-motor effects of TC in PD.
Parkinson’s disease, Tai Chi, dual-task performance, feasibility, gait analysis, randomized trial
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DOI of Published Version
Glob Adv Health Med. 2018 May 17;7:2164956118775385. doi: 10.1177/2164956118775385. eCollection 2018. Link to article on publisher's site
Global advances in health and medicine
Vergara-Diaz, Gloria; Osypiuk, Kamila; Hausdorff, Jeffrey M.; Bonato, Paolo; Gow, Brian J.; Miranda, Jose Gv.; Sudarsky, Lewis R.; Tarsy, Daniel; Fox, Michael D.; Gardiner, Paula; Thomas, Cathi A.; Macklin, Eric A.; and Wayne, Peter M., "Tai Chi for Reducing Dual-task Gait Variability, a Potential Mediator of Fall Risk in Parkinson's Disease: A Pilot Randomized Controlled Trial" (2018). Center for Integrated Primary Care Publications. 51.
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This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License