A Mobile Phone App-Based Tai Chi Training in Parkinson's Disease: Protocol for a Randomized Controlled Study

Abstract

Introduction: With an increasing number of China's aging population, Parkinson's disease (PD) increases year by year. Persons with PD exhibit abnormal balance functions, leading to motor skills difficulties, such as unstable walking or even falling. Therefore, activities of daily living and quality of life are affected. This study aims to explore the effectiveness of Tai Chi training based on the mobile phone app in improving the balance ability of persons with PD.Methods and Analysis: A randomized, single-blind, parallel controlled trial will be conducted in this study. One hundred forty-four persons with PD who meet the inclusion criteria will be randomly divided into a 1:1:1 ratio: (1) control group, (2) basic experimental group (basic app with no Tai Chi training features), and (3) balanced-enhanced experimental group (basic app with Tai Chi training features). Individuals with PD will be evaluated on balance and motor function outcomes. The primary outcome measure is the limits of stability (including the maximum excursion and direction control); the secondary outcome measures include the Unified Parkinson's Disease Rating Scale III (UPDRS-III), Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up & Go (TUG), 6-Minute Walk Test (6MWT), and 39-item Parkinson's Disease Questionnaire (PDQ-39). Each group of patients will go through an assessment at baseline, 17 and 33 weeks.Discussion: This study will evaluate the effectiveness of the mobile phone app Tai Chi training on the balance function of persons with PD. We assume that a challenging Tai Chi project based on a mobile phone app will improve balance in the short and long term. As walking stability progresses, it is expected that daily activities and quality of life improve. These findings will be used to improve the effectiveness of future home management measures for persons with PD.Ethics and Dissemination: This study has been approved by the ethical review committee of the Shanghai University of Sport (approval number: 102772019RT056). Informed consent will be obtained from all participants or their guardians. The authors intend to submit the study findings to peer-reviewed journals or academic conferences to be published.Clinical Trial Registration: Chinese Clinical Trial Registry (ChiCTR2000029135).

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

“…Importantly, improvement in UPDRS-III scores from pre-to washout assessment for the sensory group is double the change needed to reach minimal clinical importance (greater than a 5-point change). 35,36 This is line with previous research utilizing similar exercise protocols involving slow and controlled moment (external focused exercise, 17 blindfolded balance training, 37 balance training HIBalance, 38 progressive modular rebalancing, 39 and Tai Chi exercises 40 ). The lasting improvements to disease severity post-sensory may have been due to the improved functioning of the remaining dopaminergic neurons as a result of the increased sensory stimulation passing through the basal ganglia during exercise.…”

The Efficacy of Tai Chi and Stretching Exercises Based on a Smartphone Application for Patients With Parkinson's Disease: A Protocol for a Randomized Controlled Trial

“…A new protocol was published on the effect of Tai Chi on daily activities and QoL for persons with PD based on the "Shoupa" app. However, the outcome assessments all require the physical interactions between patients and researchers, such as Limits of Stability (maximum excursion and directional control), Berg Balance Scale, Functional Reach Test, Timed Up and Go Test, and 6-Min Walk Test (34).…”

“…Patients can not only exercise under the guidance of tutorial videos but also track disease progression in the app. The most significant difference between our study and the protocol of Gao et al (34) is that our study is entirely based on the mobile app, which integrates subject recruitment, exercise intervention, and outcome evaluation. Gao et al introduced the platform of Care-PD in management and rehabilitation for persons with PD.…”

“…However, randomized controlled trials on Tai Chi and stretching exercises based on the app are yet to be conducted. This study will conduct recruitment of persons with PD, exercise intervention, and outcome evaluation solely based on the Care-PD app (34).…”

Smartphone Applications in the Management of Parkinson's Disease in a Family Setting: An Opinion Article

“…PD severely reduces the memory and cognitive abilities of individuals, which increases the risk of overdose, underdose, and forgetting to take the drug (38). Gao et al (39) designed a mobile application called Care-PD, which is dedicated to solving the problems of medication management for individuals with PD and such glitches that involve failing to take drugs and or taking the wrong medicine. Among them, the medication management function of the smartphone applications is centered on patients and caregivers, encouraging them to actively record medications, thus setting the name of the medication, medication dosage, medication time, and adverse reaction records.…”