UMMS Affiliation

Center for Integrated Primary Care; Department of Family Medicine and Community Health

Publication Date

5-17-2018

Document Type

Article

Disciplines

Alternative and Complementary Medicine | Integrative Medicine | Movement and Mind-Body Therapies | Nervous System Diseases

Abstract

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.

Keywords

Parkinson’s disease, Tai Chi, dual-task performance, feasibility, gait analysis, randomized trial

Rights and Permissions

Copyright © The Author(s) 2018. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

DOI of Published Version

10.1177/2164956118775385

Source

Glob Adv Health Med. 2018 May 17;7:2164956118775385. doi: 10.1177/2164956118775385. eCollection 2018. Link to article on publisher's site

Journal/Book/Conference Title

Global advances in health and medicine

Comments

At the time of publication, Paula Gardiner was not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID

29796338

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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