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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether tai ji quan, a form of exercise, can help prevent falls in older adults with mild memory problems. Participants will engage in two types of tai ji quan: Dual-Task Tai Ji Quan, which combines exercise with mental challenges, and Standard Tai Ji Quan, which focuses on traditional movements. A comparison group will perform stretching exercises. Individuals who have noticed memory loss and experienced a fall in the past year might be suitable candidates. As an unphased trial, this study allows participants to contribute to innovative research that could improve fall prevention strategies for older adults.

Will I have to stop taking my current medications?

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

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that both Dual-Task Tai Ji Quan and Standard Tai Ji Quan are generally safe. One study found that the cognitively enhanced Tai Ji Quan, similar to Dual-Task Tai Ji Quan, was well-tolerated with no major side effects. Participants considered it safe and acceptable. Studies on Standard Tai Ji Quan also report no significant safety concerns. It is often used to improve thinking skills and balance in older adults.

The stretching exercises focus on light activities like breathing and relaxation, involving gentle movements that are usually safe. Overall, all three types of exercises appear well-tolerated, with no major safety issues reported in past studies. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about these Tai Ji Quan treatments for preventing falls in people with mild cognitive impairment because they offer more than just physical exercise; they integrate cognitive challenges that can enhance mental agility. Dual-Task Tai Ji Quan uniquely combines physical movement with tasks that stimulate attention, memory, and coordination, potentially addressing both physical balance and cognitive function. Standard Tai Ji Quan, while focusing more on physical stability and balance through synchronized movements, still provides therapeutic benefits beyond traditional exercise routines. Unlike current options like physical therapy or medications that primarily target physical symptoms, these treatments aim to improve both mental and physical well-being, offering a holistic approach to fall prevention.

What evidence suggests that this trial's treatments could be effective for preventing falls in mild cognitive impairment?

This trial will compare the effectiveness of dual-task Tai Ji Quan, standard Tai Ji Quan, and stretching exercises in enhancing thinking skills and reducing falls in older adults with mild memory problems. Studies have shown that dual-task Tai Ji Quan, which combines physical movements with mental challenges, can surpass standard Tai Ji Quan and stretching exercises in boosting overall thinking abilities and walking performance during multitasking. Standard Tai Ji Quan also improves balance and reduces falls, particularly among older adults at risk, and has been found to aid thinking skills and stability. Both Tai Ji Quan approaches show promise for helping individuals with mild memory issues stay safe and improve their mental and physical well-being. ^{1 3 6 7 8}

Are You a Good Fit for This Trial?

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

Scoring ≤0.5 on Clinical Dementia Scale

I am 65 years old or older.

I am experiencing memory loss.

Exclusion Criteria

Scoring <24 on the Mini-Mental State Examination

Having medical clearance

Having participated in any regular and structured tai ji quan-based exercise programs (≥2 times weekly) in the preceding 6 months

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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 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]

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]

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]

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 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]

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]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37903365/

Clinical Effectiveness of Cognitively Enhanced Tai Ji Quan ... Cognitively enriched tai ji quan therapy was superior to standard tai ji quan and stretching exercise in improving global cognition and reducing dual-task gait ...

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2828115

Physical Activity Engagement After Tai Ji Quan Intervention ... Clinical effectiveness of cognitively enhanced tai ji quan training on global cognition and dual-task performance during walking in older ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8787180/

A cognitively enhanced online Tai Ji Quan training ... This study examines the feasibility, acceptability, and safety of a newly developed cognitive-enhancing Tai Ji Quan training intervention, delivered via remote ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT05725668

NCT05725668 | A Study of Dual-task Exercise Training to ... 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.

5. researchgate.net researchgate.net/publication/375114916_Clinical_Effectiveness_of_Cognitively_Enhanced_Tai_Ji_Quan_Training_on_Global_Cognition_and_Dual-Task_Performance_During_Walking_in_Older_Adults_With_Mild_Cognitive_Impairment_or_Self-Reported_Memory_

Clinical Effectiveness of Cognitively Enhanced Tai Ji Quan ... Cognitively enriched tai ji quan therapy was superior to standard tai ji quan and stretching exercise in improving global cognition and reducing dual-task gait ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/35078407/

A cognitively enhanced online Tai Ji Quan training ... - PubMed This study examines the feasibility, acceptability, and safety of a newly developed cognitive-enhancing Tai Ji Quan training intervention, delivered via remote ...

7. bmcgeriatr.biomedcentral.com bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-021-02747-0

Cognitively Enhanced Tai Ji Quan for Older Adults w/ MCI The cognitively enhanced Tai Ji Quan intervention was shown to be acceptable to participants as well as safe, with no major intervention-related ...

8. acpjournals.org acpjournals.org/doi/10.7326/J24-0001

Cognitively enhanced tai chi improved ... A cognitively enhanced tai chi intervention improved global cognition and dual-task gait ability more than conventional tai chi or stretching exercise at 24 ...