Effects of a Biomechanical-based Tai Chi Program on Gait and Posture in People With Parkinson's Disease
Condition: Parkinson Disease
MeSH terms: Parkinson Disease
Study type: Interventional

Summary: 
      Parkinson's disease (PD) is associated with changes in gait and posture that can lead to a
      higher frequency of falls and injuries in this population. Research has shown a positive
      effect of tai chi (TC) training on the movement capacity for those with PD, however the
      understanding of the impact of TC training on gait and postural stability in PD is lacking.
      This study aims to examine the impact of a biomechanical-based TC intervention on dynamic
      postural stability and how it relates to walking performance. It is hypothesized that the
      effects of the TC intervention will help to improve measures relating to postural stability,
      gait, and cognition.
    

Detailed description: 
      A prospective, single-blind, randomized control trial of 40 individuals with early-stage PD
      (Hoehn & Yahr stages 1 to 3). Those with PD will be randomly assigned to either a TC group or
      a control group. The TC group will participate in a biomechanical-based TC training program
      that is formed based on the movement analysis of TC and will be practiced two to three times
      a week for 12 weeks. The control group will be asked to engage or maintain their regular
      physical activity for a period of 12 weeks. The primary and secondary outcomes will be
      assessed at baseline, 6-week, and 12-week after commencing the study protocol. The primary
      outcome measures will include gait speed, cadence, step length during level surface walking
      (simple task) and fixed-obstacle crossing (challenging task); the dynamic postural stability
      will be indicated by the center of mass and center of pressure (COM-COP) separation distance
      and clearance distance measured during fixed-obstacle crossing. The secondary measures will
      be the Unified Parkinson's disease Rating scale (UPDRS-III), single leg-stance test with eyes
      open and closed, and three cognitive scores (Stroop Test, Trail Making Test- Part B, and the
      Wisconsin Card Sorting Test).
    

Intervention name(s): Tai Chi intervention; Regular Physical Activity (control) group
Intervention type(s): Other; Other
Intervention description(s): TC classes will be 60 minutes long, offered three times per week over a 12-week period. The participants who receive the TC intervention will be encouraged to attend at minimum two of the three sessions offered per week. The TC classes will follow the same order that will begin with a 5 to 10 minutes warm up, 40 minutes of core activities, and 5 minutes of cool-down. The training intensity and difficulty level of the TC program will gradually proceed from low, moderate, to advance. The classes will be offered in a group setting at a convenient location within a community centre or gymnasium. Alternatively, classes will be offered outdoors in the park or by the canal during the spring-summer months. Due to the COVID-19 situation, additional adaptive measures will be taken using online social platforms such as ZOOM or Hangout to deliver the classes.; Regular Physical Activity group who will not be receiving the TC intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, single-blind, randomized control trial of 40 individuals with early-stage PD (Hoehn & Yahr stages 1 to 3).
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Parkinson's disease; Gait; postural stability; falls; Tai Chi