A randomised controlled trial comparing the effectiveness of tai chi alongside usual care with usual care alone on the postural balance of community-dwelling people with dementia: protocol for the TACIT trial (TAi ChI for people with demenTia)

Nyman, Samuel R.; Hayward, Christopher; Ingram, Wendy; Thomas, Peter; Thomas, Sarah; Vassallo, Michael; Raftery, James; Allen, Helen; Barrado‐Martín, Yolanda

doi:10.1186/s12877-018-0935-8

Cited by 17 publications

(22 citation statements)

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“…The trial was approved by the West of Scotland Research Ethics Committee 4 (reference: 16/WS/0139) and the Health Research Authority (IRAS project ID: 209193). A summary of the protocol is available along with details to access the full protocol and dataset 21. We randomised dyads, comprising a PWD and their informal carer, to either a control group (usual care) or an intervention group (usual care plus the TACIT Tai Chi intervention) in a 1:1 ratio at three recruitment sites in the south of England (see Figure 1).…”

Section: Methodsmentioning

confidence: 99%

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<p>Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia</p>

Nyman¹,

Ingram²,

Sanders³

et al. 2019

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PurposeTo investigate the effect of Tai Chi exercise on postural balance among people with dementia (PWD) and the feasibility of a definitive trial on falls prevention.Patients and methodsDyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus weekly Tai Chi classes and home practice for 20 weeks (n=42). The primary outcome was the timed up and go test. All outcomes for PWD and their carers were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period.ResultsFor 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). At follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, standardised effect size [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.ConclusionWith refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD [Trial registration: NCT02864056].

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Section: Methodsmentioning

confidence: 99%

“…Dyads were reminded prior to the home visit to conceal their treatment allocation. Full details of the outcome measures used have been reported previously 21…”

Section: Methodsmentioning

confidence: 99%

<p>Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia</p>

Nyman¹,

Ingram²,

Sanders³

et al. 2019

CIA

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“…This study used baseline data collected as part of the TACIT trial (NCT02864056) 37 . An observational crosssection design was used with all data collected at a home visit to the address of the PWD with their informal carer present.…”

Section: Methodsmentioning

confidence: 99%

Association between the instrumented timed up and go test and cognitive function, fear of falling and quality of life in community dwelling people with dementia

Williams

Nyman

2018

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Dementia is a highly prevalent neurodegenerative disorder characterised by changes in behaviour and cognition 1. The prevalence and incidence of dementia has been reported at approximately 15% and 3% respectively 2 and it has been reported to affect approximately 47 million people worldwide 1. People with dementia (PWD) show symptoms ranging from cognitive, social and motor impairment, all of which can significant affect quality of life (QoL) 3,4. PWD have been shown to have greater falls risk compared to those either with mild cognitive impairment or intact cognition 5. Indeed this appears to remain true for PWD within care homes 6 and for those within their own home, where the risk is double 5,7. In addition to a greater risk of falls, the risk of hip fracture has been found to be almost 5-fold that of matched-controls 5 and PWD are 58% more likely to be admitted to hospital with a hip fracture than those without dementia, where mortality following hip fracture can be as high as 30% 8. Therefore PWD are at great risk of injurious falling.

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“…A summary of the protocol is available along with details to access the full protocol and dataset. 21 We randomised dyads, comprising a PWD and their informal carer, to either a control group (usual care) or an intervention group (usual care plus the TACIT Tai Chi intervention) in a 1:1 ratio at three recruitment sites in the south of England (see Figure 1). Randomisation was stratified by site, and we used minimisation within each site by treatment condition and 12-month fall history at baseline (fallen/not fallen).…”

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confidence: 99%

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

et al. 2019

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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.

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A randomised controlled trial comparing the effectiveness of tai chi alongside usual care with usual care alone on the postural balance of community-dwelling people with dementia: protocol for the TACIT trial (TAi ChI for people with demenTia)

Cited by 17 publications

References 60 publications

<p>Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia</p>

<p>Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia</p>

Association between the instrumented timed up and go test and cognitive function, fear of falling and quality of life in community dwelling people with dementia

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

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