Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia
Received 28 August 2019
Accepted for publication 26 September 2019
Published 19 November 2019 Volume 2019:14 Pages 2017—2029
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Richard Walker
Samuel R Nyman,1 Wendy Ingram,2 Jeanette Sanders,2 Peter W Thomas,3 Sarah Thomas,3 Michael Vassallo,4 James Raftery,5 Iram Bibi,1 Yolanda Barrado-Martín1
1Department of Psychology and Ageing & Dementia Research Centre, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK; 2Peninsula Clinical Trials Unit, Peninsula Medical School, University of Plymouth, Plymouth, Devon PL4 8AA, UK; 3Bournemouth University Clinical Research Unit, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK; 4Centre of Postgraduate Medical Research and Education, Faculty of Health and Social Sciences, Bournemouth University, Royal London House, Lansdowne Campus, Bournemouth, Dorset BH1 3LT, UK; 5Faculty of Medicine, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK
Correspondence: Samuel R Nyman
Department of Medical Science and Public Health, Faculty of Health and Social Sciences, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
Tel +44 1202 968179
Purpose: To investigate the effect of Tai Chi exercise on postural balance among people with dementia (PWD) and the feasibility of a definitive trial on falls prevention.
Patients and methods: Dyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus weekly Tai Chi classes and home practice for 20 weeks (n=42). The primary outcome was the timed up and go test. All outcomes for PWD and their carers were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period.
Results: For PWD, there was no significant difference at follow-up on the timed up and go test (mean difference [MD] = 0.82, 95% confidence interval [CI] = −2.17, 3.81). At follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, standardised effect size [ES] = 0.51) and a significantly lower rate of falls (rate ratio = 0.35, 95% CI =0.15, 0.81), which was no longer significant when an outlier was removed. Carers in the Tai Chi group at follow-up were significantly worse on the timed up and go test (MD = 1.83, 95% CI = 0.12, 3.53, ES = 0.61). The remaining secondary outcomes were not significant. No serious adverse events were related to participation in Tai Chi.
Conclusion: With refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD [Trial registration: NCT02864056].
Keywords: accidental falls, clinical trial, cognitive impairment, exercise, intervention
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