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
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
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 G, Osypiuk K, Hausdorff JM, Bonato P, Gow BJ, Miranda JG, Sudarsky LR, Tarsy D, Fox MD, Gardiner P, Thomas CA, Macklin EA, Wayne PM. (2018). Tai Chi for Reducing Dual-task Gait Variability, a Potential Mediator of Fall Risk in Parkinson's Disease: A Pilot Randomized Controlled Trial. Center for Integrated Primary Care Publications. https://doi.org/10.1177/2164956118775385. Retrieved from https://escholarship.umassmed.edu/cipc/51
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License