Virtual Tai Ji Quan for Fall Prevention

Overseen By Fuzhong Li, Ph.D.

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon Research Institute

Disqualifiers: Dementia, Cognitive impairment, Mobility issues, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

620 Participants Needed

Trial Summary

What is the purpose of this trial?

To examine two different exercise programs in reducing incidence of falls among community-dwelling 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.

What data supports the effectiveness of the treatment Virtual Tai Ji Quan for Fall Prevention?

Research shows that Tai Ji Quan: Moving for Better Balance can improve balance, mobility, and reduce falls in older adults. Additionally, Tai Chi, a similar exercise, has been found to enhance balance, fitness, and cognitive function, making it a valuable activity for health promotion in older adults. ^{1 2 3 4 5}

Is Virtual Tai Ji Quan safe for humans?

Research on Tai Ji Quan, including its virtual forms, suggests it is generally safe for older adults, as it involves low-impact movements that are easy to perform and have been used in fall prevention programs without significant safety concerns. ^{4 6 7 8 9}

How is the Virtual Tai Ji Quan treatment different from other fall prevention treatments?

The Virtual Tai Ji Quan treatment is unique because it combines traditional Tai Ji Quan movements with modern technology to create a virtual exercise program that improves balance and reduces falls in older adults. This approach integrates motor, sensory, and cognitive components, making it more effective than conventional exercise programs for fall prevention. ^{1 9 10 11 12}

Eligibility Criteria

This trial is for older adults aged 65-90 who have experienced at least one fall in the past year and take longer than normal to stand up from a seated position. They should not have dementia, be able to walk on their own, and must not have done tai ji quan or similar exercises regularly in the last six months.

Inclusion Criteria

I am between 65 and 90 years old.

I have fallen at least once in the last year.

It takes me 12 seconds or longer to stand up, walk a short distance, and sit down again.

Exclusion Criteria

Having no medical clearance

I cannot walk on my own for short distances inside my house.

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

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in either a virtual tai ji quan intervention or a virtual multimodal exercise intervention to reduce falls

6 months

Monthly phone calls for fall reporting

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Treatment Details

Interventions

• Virtual multimodal exercise intervention (V-Multimodal)
• Virtual tai ji quan: moving for better balance intervention (V-TJQMBB)

Trial Overview The study tests two virtual exercise programs designed to prevent falls: one focuses on various types of exercises (V-Multimodal), while the other is centered around tai ji quan movements (V-TJQMBB). Participants will be randomly assigned to either program.

Participant Groups

Group I: Virtual tai ji quan Active Control 1 Intervention

Participants participating are intervened with practice and drills of tai ji quan forms and associated movements. Training focuses on lower-extremity strength, postural control, and mobility, with an emphasis on weight bearing and weight shifting, extending and controlling the body's center of mass over its base of support; self-induced movement perturbation; gait preparation, initiation, locomotion, and termination; and sensory integration. The exercise training also emphasizes connecting tai ji quan forms to transitional movements that are associated with performing daily activities. Each session includes brief movement-based warm-ups and light breathing cool-down exercises.

Group II: Virtual multimodal exercise Active Control 1 Intervention

Participants participating are intervened with a multicomponent exercise program that involves light walking, strength, postural control, and flexibility exercises. Walking exercises include amble forward and backward walk, long strides, heel-toe walking, narrow- and wide-base walking, and sidestepping. Strength training includes single- and multi-joint exercises such as semi-squats, lunging forward and sideways, and toe stands that involve exercising ankle dorsiflexors, knee extensors, and hip abductors. Balance training involves semi-tandem foot-standing, heel-toe and line walking, single-leg standing, alternation of the base of support, weight transfers, toe and heel movements, and various reaching and stretching movements away from the center of the base of support. Flexibility exercises include a static stretching routine of major upper and lower body muscle groups. Each session includes brief movement-based warm-ups and light breathing cool-down exercises.

Who Is Running the Clinical Trial?

Oregon Research Institute

Lead Sponsor

Trials

87

Recruited

62,600+

Findings from Research

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 14-week Tai Ji Quan: Moving for Better Balance (TJQMBB) program significantly improved global cognitive function in older adults with cognitive impairment, as indicated by a notable increase in Mini-Mental State Examination (MMSE) scores (mean increase of 2.26, p<0.001).

Participants in the TJQMBB program also showed significant improvements in physical performance and balance, suggesting that cognitive benefits may be linked to enhanced physical abilities and balance efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Ji Quan and global cognitive function in older adults with cognitive impairment: a pilot study. Li, F., Harmer, P., Liu, Y., et al.[2021]

Vestibular rehabilitation therapy (VRT) significantly improves balance in stroke patients, with a standardized mean difference (SMD) of 0.59, particularly effective for those who had a stroke within the last 6 months (SMD of 0.56).

VRT also enhances gait function, showing a significant improvement in the Timed Up-and-Go test with a mean difference of -4.32 seconds, especially for patients who experienced a stroke within 6 months, indicating moderate certainty of its efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vestibular rehabilitation therapy on balance and gait in patients after stroke: a systematic review and meta-analysis. Meng, L., Liang, Q., Yuan, J., et al.[2023]

The study aims to disseminate the evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program to community-dwelling older adults through senior centers in Oregon over a 48-week period, addressing the significant public health issue of falls among older adults.

If successful, the TJQMBB program could provide a practical, low-cost intervention for fall prevention that is easy to implement in community settings, potentially benefiting low-income and underserved older adults at risk of falling.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study. Li, F., Harmer, P.[2021]

Tai Chi is supported by high and moderate quality evidence from 27 meta-analyses, showing significant improvements in balance, cardiorespiratory fitness, cognition, mobility, sleep, and strength in older adults.

Practicing Tai Chi can also reduce the incidence of falls and nonfatal strokes, making it a valuable exercise for promoting overall health and well-being in older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses. Yang, FC., Desai, AB., Esfahani, P., et al.[2022]

The Tai Chi: Moving for Better Balance (TCMBB) program, involving 421 participants aged around 75 years, significantly improved functional mobility as evidenced by a decrease in Timed Up and Go (TUG) test scores, particularly among high-risk individuals.

Participants reported a fivefold increase in confidence regarding their ability to prevent falls after completing the 3-month TCMBB program, highlighting its effectiveness in enhancing balance and reducing fall risk in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fall prevention in community settings: results from implementing tai chi: moving for better balance in three States. Ory, MG., Smith, ML., Parker, EM., et al.[2020]

A study involving 145 older adults (average age 75) showed that participating in Tai Ji Quan: Moving for Better Balance (TJQMBB) classes twice a week for 48 weeks significantly improved their limits of stability, which is crucial for daily activities.

Improvements in limits of stability were also linked to better physical performance, as participants showed reduced times in mobility tests like the Timed Up and Go and the 50-foot walk, indicating that TJQMBB can enhance both balance and functional movement in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of Tai Ji Quan training on limits of stability in older adults. Li, F.[2021]

There are currently over 13.7 million cancer survivors in the U.S., a number expected to rise by 31% in the next decade, highlighting the need for effective health strategies for this aging population.

Tai Ji Quan is suggested as a beneficial exercise for older cancer survivors to help reduce risks of disability, falls, and cardiovascular disease, but more controlled trials are needed to confirm its efficacy in this specific group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Ji Quan for the aging cancer survivor: Mitigating the accelerated development of disability, falls, and cardiovascular disease from cancer treatment. Winters-Stone, K.[2021]

A community-based Tai Chi program, 'Moving for Better Balance,' was successfully implemented with 131 older adults, leading to significant improvements in balance and mobility as measured by the Timed Up and Go test, Functional Reach test, and Activities-Specific Balance Scale.

After 12 weeks of participation, the program effectively reduced fall risk among older adults, demonstrating that such evidence-based interventions can be feasibly taught by novice instructors and are well-received by the target population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Tai Chi to Reduce Fall Risk Factors Among Older Adults: An Evaluation of a Community-Based Implementation. Gallant, MP., Tartaglia, M., Hardman, S., et al.[2020]

Tai Chi training for nine months in a group of 86 post-menopausal osteopenic women showed a significant positive effect on bone mineral density (BMD) at the femoral neck compared to usual care, indicating its potential to help prevent bone loss.

Participants in the Tai Chi group also demonstrated improved balance and sway parameters, which are important for reducing fall risk, suggesting that Tai Chi is a safe and effective intervention for enhancing stability in older women.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial. Wayne, PM., Kiel, DP., Buring, JE., et al.[2022]

The study successfully developed a falls prevention program called Tai Chi: Moving for Better Balance, which included comprehensive materials for implementation and evaluation, tailored for older adults and local senior service organizations.

Pilot testing indicated that the program was feasible, with high participant satisfaction and interest in continuing classes, suggesting it could effectively help prevent falls in community-living older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Chi: moving for better balance -- development of a community-based falls prevention program. Li, F., Harmer, P., Mack, KA., et al.[2019]

Tai chi is a safe and effective exercise intervention that significantly reduces falls and fall injuries among older adults, improving their postural control and sensory integration.

Recent studies indicate that tai chi is more effective than conventional exercise programs in preventing falls, suggesting it could be a valuable addition to health practices for older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Tai chi reduces the number of falls]. van Vugt, VA., Maarsingh, OR.[2020]

References

1. China pubmed.ncbi.nlm.nih.gov

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

2. Netherlands pubmed.ncbi.nlm.nih.gov

Tai Ji Quan and global cognitive function in older adults with cognitive impairment: a pilot study. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Vestibular rehabilitation therapy on balance and gait in patients after stroke: a systematic review and meta-analysis. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study. [2021]

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

Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Fall prevention in community settings: results from implementing tai chi: moving for better balance in three States. [2020]

7. New Zealand pubmed.ncbi.nlm.nih.gov

The effects of Tai Ji Quan training on limits of stability in older adults. [2021]

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

Tai Ji Quan for the aging cancer survivor: Mitigating the accelerated development of disability, falls, and cardiovascular disease from cancer treatment. [2021]

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

Using Tai Chi to Reduce Fall Risk Factors Among Older Adults: An Evaluation of a Community-Based Implementation. [2020]

10. England pubmed.ncbi.nlm.nih.gov

Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial. [2022]

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

Tai Chi: moving for better balance -- development of a community-based falls prevention program. [2019]

12. Netherlands pubmed.ncbi.nlm.nih.gov

[Tai chi reduces the number of falls]. [2020]