TY - JOUR
T1 - Tai chi for reducing dual-task gait variability, a potential mediator of fall risk in parkinson’s disease
T2 - A pilot randomized controlled trial
AU - Vergara-Diaz, Gloria
AU - Osypiuk, Kamila
AU - Hausdorff, Jeffrey M.
AU - Bonato, Paolo
AU - Gow, Brian J.
AU - Miranda, Jose G.V.
AU - Sudarsky, Lewis R.
AU - Tarsy, Daniel
AU - Fox, Michael D.
AU - Gardiner, Paula
AU - Thomas, Cathi A.
AU - Macklin, Eric A.
AU - Wayne, Peter M.
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - Dual-task performance
KW - Feasibility
KW - Gait analysis
KW - Parkinson’s disease
KW - Randomized trial
KW - Tai chi
UR - http://www.scopus.com/inward/record.url?scp=85070898750&partnerID=8YFLogxK
U2 - 10.1177/2164956118775385
DO - 10.1177/2164956118775385
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AN - SCOPUS:85070898750
SN - 2164-957X
VL - 7
JO - Global Advances In Health and Medicine
JF - Global Advances In Health and Medicine
ER -