TY - JOUR PY - 2018// TI - Tai chi for reducing dual-task gait variability, a potential mediator of fall risk in Parkinson's disease: a pilot randomized controlled trial JO - Global advances in health and medicine A1 - Vergara-Diaz, Gloria A1 - Osypiuk, Kamila A1 - Hausdorff, Jeffrey M. A1 - Bonato, Paolo A1 - Gow, Brian J. A1 - Miranda, Jose Gv A1 - Sudarsky, Lewis R. A1 - Tarsy, Daniel A1 - Fox, Michael D. A1 - Gardiner, Paula A1 - Thomas, Cathi A. A1 - Macklin, Eric A. A1 - Wayne, Peter M. SP - e2164956118775385 EP - e2164956118775385 VL - 7 IS - 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.

Language: en

LA - en SN - 2164-957X UR - http://dx.doi.org/10.1177/2164956118775385 ID - ref1 ER -