89 Randomised Controlled Trial of the Effect of Tai Chi on Postural Balance of People with Dementia

• Published in: Age and ageing Vol. 48; no. Supplement_4; pp. iv18 - iv27
• Main Authors: Nyman, Samuel, Ingram, Wendy, Sanders, Jeanette, Thomas, Peter, Thomas, Sarah, Vassallo, Michael, Raftery, James, Bibi, Iram, Barrado-Martín, Yolanda
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 20-12-2019; Oxford Publishing Limited (England)
• Subjects: Balance; Caregiver burden; Caregivers; Cognitive ability; Cognitive functioning; Critical incidents; Dementia; Dementia disorders; Falls; Feasibility; Home practice; Injury prevention; Intervention; Martial arts; Posture; Quality of life; Tai Chi; Tai Chi; Clinical Trial; Accidental Falls; Postural Balance; Dementia
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afz164.89

Abstract
Introduction
We investigated the effect of Tai Chi exercise on postural balance among people with dementia (PWD), and the feasibility of a definitive trial on falls prevention.
Method
We conducted a randomised controlled trial. Dyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus the intervention (n=42). For the intervention, over 20 weeks, Tai Chi classes were provided weekly and Tai Chi home practice was facilitated by the carer. The primary outcome was the timed up and go test. Secondary outcomes for PWD included functional balance, static balance, fear of falling, cognitive functioning, quality of life, and falls. Secondary outcomes for carers included dynamic balance, static balance, quality of life, and carer burden. Outcomes were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period.
Results
For PWD, there was no significant difference at follow-up on the timed up and go test (mean difference [MD] = 0.82, 95% confidence interval [CI] = -2.17, 3.81, standardised effect size [ES] = 0.14). Among the secondary outcomes, at follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, ES = 0.51) and a significantly lower rate of falls (rate ratio = 0.35, 95% CI =0.15, 0.81), which was no longer significant when an outlier was removed. Carers in the Tai Chi group at follow-up were significantly worse on the timed up and go test (MD = 1.83, 95% CI = 0.12, 3.53, ES = 0.61). The remaining secondary outcomes were not significant. No serious adverse events were related to participation in Tai Chi.
Conclusion
With refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD.