Tai Ji Quan for Preventing Falls in Mild Cognitive Impairment

Overseen By Fuzhong Li, Ph.D.

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon Research Institute

Disqualifiers: Parkinson's, Multiple sclerosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

Duration: 6 months

336 Participants Needed

Trial Summary

What is the purpose of this trial?

To determine the efficacy of a dual-task tai ji quan training therapy in reducing the incidence of falls in older adults with mild cognitive impairment.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of this treatment for preventing falls in individuals with mild cognitive impairment?

Research shows that Tai Chi can improve cognitive function and reduce the risk of falls in older adults with mild cognitive impairment. Studies indicate that Tai Ji Quan, a form of Tai Chi, enhances physical performance and confidence, which may help prevent falls. ^{1 2 3 4 5}

Is Tai Ji Quan safe for humans?

Research suggests that Tai Ji Quan, also known as Tai Chi, is generally safe for older adults, as it is often used to improve mobility and reduce fall risk without significant safety concerns. ^{1 2 5 6 7}

How is the treatment Tai Ji Quan unique for preventing falls in mild cognitive impairment?

Tai Ji Quan is unique because it combines traditional martial arts movements with cognitive and physical exercises to improve balance, mobility, and cognitive function, which can help prevent falls in older adults with mild cognitive impairment. ^{2 3 5 7 8}

Eligibility Criteria

This trial is for older adults, aged 65 and above, who have mild cognitive impairment. They must have experienced at least one fall in the past year or take longer than normal to complete a walking test. Participants should not be currently doing tai ji quan exercises regularly and must be able to walk on their own for short distances.

Inclusion Criteria

I am 65 years old or older.

I am experiencing memory loss.

I have fallen at least once in the past year or take 12 seconds or more to stand up, walk, and sit down.

Exclusion Criteria

I am not willing to be assigned to a treatment by chance.

Scoring <24 on the Mini-Mental State Examination

Having medical clearance

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo dual-task tai ji quan, standard tai ji quan, or stretching exercise interventions to reduce falls

6 months

Monthly phone calls for fall reporting

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Assessments at 4, 6, and 12 months

Treatment Details

Interventions

• Dual-Task Tai Ji Quan
• Standard Tai Ji Quan
• Stretching

Trial Overview The study is testing if special exercise training called dual-task tai ji quan can help prevent falls compared to standard tai ji quan or simple stretching exercises. Older adults with memory complaints will practice these activities to see which is more effective.

Participant Groups

Group I: Stretching exercise Experimental Treatment 1 Intervention

This active control intervention includes light activities that consist of breathing, stretching, and relaxation exercises. Each exercise session encompasses a variety of light and static stretches for joints and muscles, performed in a seated or standing position. Exercise involves the upper body (arms, neck, upper back, shoulder, back, and chest), lower extremities (quadriceps, hamstrings/calfs, and hips), and gentle and slow trunk rotations. Also included are intermittent light walking, deep abdominal breathing exercises that emphasize inhaling and exhaling to maximum capacity, and progressive relaxation of major muscle groups.

Group II: Standard tai ji quan Experimental Treatment 1 Intervention

This intervention includes training of tai ji quan forms with synchronized breathing, supplemented by a set of mini-therapeutic exercises. The training involves repeated practice of (a) symmetrical, coordinated, trunk-driven tai ji quan form movements, (b) controlled displacement (weight-shifting) of the body's center of mass over varying sizes of the base of support, (c) dynamic eye-hand movements during whole-body motion, and (d) multidirectional (anterior-posterior and medial-lateral) stepping. As a balance training therapy, movement practices emphasize a dynamic interplay of stabilizing and self-induced destabilizing postural actions and balance exercises that target mobility, stability limits, and sensory integration.

Group III: Dual-task taj ji quan Experimental Treatment 1 Intervention

This intervention includes training of (a) symmetrical postural tai ji quan forms/movements synchronized with breathing, (b) controlled displacement (weight-shifting) of the body's center of mass over the base of support, (c) dynamic eye-hand movements during whole-body motion, (d) multidirectional (anterior-posterior and medial-lateral) stepping, and (e) rotational ankle sway and self-induced reactive postural recovery actions. The training practices are integrated, gradually over time, with a mix of interactive, cognitively stimulating, dual-task exercises that challenge attention control, working memory, verbalization, response inhibition, processing speed, dual tasking, task switching/prioritization, and spatial orientation and postural awareness.

Dual-Task Tai Ji Quan is already approved in United States for the following indications:

Approved in United States as Tai Chi for:

• Prevention of falls in older adults with mild cognitive impairment
• Improvement of global cognition and dual-task walking ability

Who Is Running the Clinical Trial?

Oregon Research Institute

Lead Sponsor

Trials

87

Recruited

62,600+

Findings from Research

A randomized controlled trial with 66 older adults showed that 15 weeks of combined center- and home-based Tai Chi training significantly improved cognitive abilities, particularly in tasks like memory recall and problem-solving.

Participants in the Tai Chi group also experienced a moderate reduction in fall risk, as indicated by improvements in strength, reaction time, and balance, suggesting that Tai Chi can enhance both mental and physical health in older adults with mild cognitive impairment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial. Sungkarat, S., Boripuntakul, S., Chattipakorn, N., et al.[2022]

This systematic review will evaluate the effectiveness and safety of Tai Chi (TC) for individuals with mild cognitive impairment (MCI) by analyzing randomized controlled trials from various databases, covering studies published from January 1990 to March 2019.

The review aims to provide updated evidence on whether TC can improve cognitive function in MCI patients compared to placebo, conventional treatments, or no treatment, potentially highlighting TC as a beneficial intervention for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Chi for patients with mild cognitive impairment: A protocol for a systematic review and meta-analysis of randomized controlled trials. Yang, J., Chon, TY., Li, G., et al.[2023]

Tai Chi training significantly improved memory and executive function in older adults with amnestic mild cognitive impairment (a-MCI), as evidenced by better performance on cognitive tests compared to a control group of 66 participants.

The improvement in cognitive function may be linked to an increase in plasma brain-derived neurotrophic factor (BDNF) levels in the Tai Chi group, suggesting a potential mechanism for how Tai Chi benefits cognitive health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Chi Improves Cognition and Plasma BDNF in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. Sungkarat, S., Boripuntakul, S., Kumfu, S., et al.[2022]

A six-month program of Tai Chi Chuan significantly improved memory performance in elderly patients with Mild Cognitive Impairment, as evidenced by better scores on the Rivermead Behavioral Memory Test and Subjective Memory Complaint Scale.

The study found a correlation between the ability to learn Tai Chi Chuan exercises and improved memory performance, suggesting that engaging in Tai Chi may enhance cognitive function in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Tai Chi Chuan on cognition of elderly women with mild cognitive impairment. Kasai, JY., Busse, AL., Magaldi, RM., et al.[2022]

Tai Ji Quan training significantly improved dual-task walking capacity in older adults, which in turn led to better physical performance, increased activity confidence, and enhanced cognitive function, while also reducing falls.

In a study of 670 older adults at high risk of falling, Tai Ji Quan was more effective than multimodal and stretching exercises in improving these outcomes, highlighting its potential as a beneficial intervention for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dual-Task Walking Capacity Mediates Tai Ji Quan Impact on Physical and Cognitive Function. Li, F., Harmer, P., Chou, LS.[2021]

Tai Chi Chuan (TCC) significantly improved cognitive adaptations and reduced fear of movement in older adults with mild cognitive impairment, as shown by increased scores on relevant scales after 12 weeks of exercise.

The study, involving 20 participants who practiced TCC twice a week for 35-40 minutes, suggests that TCC can be safely implemented in nursing homes to enhance physical activity and cognitive status in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of Tai Chi Chuan on fear of movement, prevention of falls, physical activity, and cognitive status in older adults with mild cognitive impairment: A randomized controlled trial. Birimoglu Okuyan, C., Deveci, E.[2022]

A Tai Ji Quan-based program was successfully implemented in outpatient settings, with a 62% adoption rate among healthcare providers and a 67% enrollment rate among referred individuals, indicating strong dissemination potential.

Participants in the program experienced a significant reduction in falls and improvements in balance and physical performance, demonstrating the program's efficacy and potential for public health impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing an evidence-based fall prevention program in an outpatient clinical setting. Li, F., Harmer, P., Stock, R., et al.[2023]

Tai Ji Quan, a traditional martial art, is being scientifically validated for its health benefits, particularly in preventing and managing diseases while improving quality of life for middle-aged and older adults.

The program 'Tai Ji Quan: Moving for Better Balance' adapts traditional Tai Ji Quan movements into a contemporary therapeutic approach aimed at enhancing balance, gait, and mobility, which is crucial for reducing falls in older adults and those with neurodegenerative conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transforming traditional Tai Ji Quan techniques into integrative movement therapy-Tai Ji Quan: Moving for Better Balance. Li, F.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Tai Chi for patients with mild cognitive impairment: A protocol for a systematic review and meta-analysis of randomized controlled trials. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Tai Chi Improves Cognition and Plasma BDNF in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial. [2022]

4. Brazil pubmed.ncbi.nlm.nih.gov

Effects of Tai Chi Chuan on cognition of elderly women with mild cognitive impairment. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Dual-Task Walking Capacity Mediates Tai Ji Quan Impact on Physical and Cognitive Function. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

The effectiveness of Tai Chi Chuan on fear of movement, prevention of falls, physical activity, and cognitive status in older adults with mild cognitive impairment: A randomized controlled trial. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Implementing an evidence-based fall prevention program in an outpatient clinical setting. [2023]

8. China pubmed.ncbi.nlm.nih.gov

Transforming traditional Tai Ji Quan techniques into integrative movement therapy-Tai Ji Quan: Moving for Better Balance. [2022]