Effects of Tai Chi on Multisite Pain and Brain Functions in Older Adults

Study Overview
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Brief Summary
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The main purpose of this randomized controlled trial was to assess the feasibility and acceptability of a 12-week Tai Chi program for community-dwelling older adults with chronic multisite pain and a history of falling. In addition, the investigators examined the effects of Tai Chi on pain characteristics, cognition, physical function, gait mobility, levels of pain-related biomarkers, fear of falling and rate of falls in these older adults.

Detailed Description
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Older adults aged ≥65 years with multisite pain who reported falling in the past year or current use of an assistive device were recruited from Boston area communities. Participants were randomized to either a Tai Chi (N=28) or a light physical exercise (N=26) program, offered twice weekly for 12 weeks. The primary outcomes were feasibility and acceptability of the 12-week Tai Chi/light exercise program. Secondary outcomes included pain characteristics (pain severity and pain interference), cognition (attention and executive function), physical function (walking speed, strength, and balance), gait mobility (singe-task and dual-task gait), levels of pain-related markers (C-reactive protein, interleukin 6, tumor necrosis factor alpha, and beta endorphin), fear of falling, and rate of falls.

Official Title
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Effects of Tai Chi on Multisite Pain and Brain Functions in Older Adults

Conditions
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Chronic Pain

Intervention / Treatment
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* Behavioral: Tai Chi
* Behavioral: Light Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age of 65 years and older Multisite (2 or more sites) musculoskeletal pain At least one fall in the past year, or currently on an assistive device A sedentary lifestyle Be able to walk 20-feet without personal assistance Be able to communicate in English. Exclusion Criteria: Regular Tai Chi practice Unstable cardiac disease Stroke Rheumatoid arthritis Degenerative neuromuscular disease Parkinson's disease Terminal disease Dementing illness

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tai Chi<br>Individuals in the Tai Chi intervention group participated in a 12-week Tai Chi program. | Behavioral: Tai Chi<br>* Individuals in the Tai Chi intervention group will participate in a 12-week Tai Chi program (one hour per class, two classes per week, plus home practice for 12 weeks) led by an experienced Tai Chi Instructor, assisted by an undergraduate research assistant.<br>|
| Active Comparator: Light Exercise<br>Individuals in the exercise control group performed a 12-week light exercise program. | Behavioral: Light Exercise<br>* Individuals in the exercise control group will meet for a twice weekly class involving walking, weight training, stretching and health education (one hour per class, two classes per week for 12 weeks, taught by a trained graduate research assistant, assisted by an undergraduate research assistant.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility and acceptability of the 12-week Tai Chi program | Feasibility and acceptability were evaluated by adherence, attendance, optimal program components, and safety. | Over the 12-week intervention period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain characteristics | Pain severity and interference were evaluated by using the Brief Pain Inventory (BPI) questionnaire. | Before and after the 12-week intervention period | 
| Cognition | Attention was evaluated by using the Test of Everyday Attention (TEA) questionnaire. Executive function was evaluated by using the Trailmaking A and B tests questionnaire. | Before and after the 12-week intervention period | 
| Physical function | Physical function was measured by using the Short Physical Performance Battery (SPPB) | Before and after the 12-week intervention period | 
| Gait mobility | Single-task and dual-task gait function was determined by using the PKMAS software and Zeno walkway. | Before and after the 12-week intervention period | 
| Pain-related biomarkers | Levels of inflammatory markers and beta endorphin were determined by using biochemistry assays. | Before and after the 12-week intervention period | 
| Fear of falling | Fear of falling was measured using the Tinetti Falls Effi- cacy Scale. | Before and after the 12-week intervention period | 
| Rate of falls | Rate of falls were recorded by using monthly fall calendars. | Over the 12-week intervention and 6 months following the intervention |