The Effect of Tai Chi Exercise Among Elders With Sarcopenia

Study Overview
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Brief Summary
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Sarcopenia has been defined as a disease which presented as low muscles strength, low muscle quantity or quality and low physical activity. The prevalence of sarcopenia is increasing with the age and it is also included in one of geriatric syndromes. Several criteria have been mentioned for diagnosis of sarcopenia, such as European Working Group on Sarcopenia in Older People (EWGSOP)、Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project (FNIH) and Asian Working Group for Sarcopenia (AWGS). In European, the prevalence rate of sarcopenia is 9.25-18%; 5-7% Canadian and 14.4% Taiwanese elders have been diagnosed as sarcopenia, respectively. The sarcopenia has been found its relationship with adverse outcomes of fall down, fracture, disability, and death. The cytokines and decline in anabolic hormones play a role in the pathogenesis of sarcopenia. Tai Chi exercise is one of Qigong and well-popular in Chinese population, and is helpful to integration of body movements. Tai Chi exercise is less complicated and emphasized people's awareness of self-care which presented the relationship between human and nature. Tai Chi exercise could improve muscle performance, balance and have the benefit for fall down prevention in the elders and patients with frailty. Furthermore, Tai Chi has been found that it also could improve the muscle power and power strength in sarcopenic elders by team training. Furthermore, immune makers of inflammation process have been noted their diminishments by Qigong intervention. The aim of this study is to investigate the effect of Tai Chi exercise in sarcopenic elders through practicing at home. The differences of muscles strength, muscle quantity or quality and physical activity after interventions would be recorded and analyzed. The cytokines related to the sarcopenia process would also be sampled.

Official Title
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The Effect of Tai Chi Exercise Among Elders With Sarcopenia

Conditions
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Sarcopenia in Elderly, Tai Chi

Intervention / Treatment
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* Behavioral: Tai-Chi
* Behavioral: Comprehensive training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 60 or older; With a diagnosis of sarcopenia [defined as EWGSOP-2] (6); Without planned exercise program or unplanned admission in 6 months; Could tolerate tests of muscle power and strength. Exclusion Criteria: Uncontrolled diabetes mellitus; Uncontrolled cardiovascular diseases; Uncontrolled hypertension; Knee or hip prosthesis, pacemaker, fracture in the previous 6 months, Critical cognitive (MMSE<23) Mini Nutritional Assessment (MNA <17) Physical dysfunctions that could not tolerate our tests

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Tai Chi exercise<br>In addition to standard of care participants will be asked to apply Tai Chi. There are 8 movements. Each session consisted of 10 minutes of warm-up, 40 minutes of Tai Chi, and 10 minutes of cool down. The 8 movements are: Ward-off, Rollback, Push, Press, Grab, Split, Elbow strike, and shoulder strike. | Behavioral: Tai-Chi<br>* Tai Chi exercise could improve muscle performance, balance and have the benefit for fall down prevention in the elders and patients with frailty.<br>* Other names: Shoulder Strike;|
| Active Comparator: Comprehensive training<br>In addition to standard of care participants will be asked to apply Comprehensive training. There are 3 exercises. Each session consisted of 10 minutes of warm-up, 40 minutes of Tai Chi, and 10 minutes of cool down. The 8 movements are: stretch exercise, strengthening exercise, and balance exercise. | Behavioral: Comprehensive training<br>* There are 3 exercises. Each session consisted of 10 minutes of warm-up, 40 minutes of Tai Chi, and 10 minutes of cool down.<br>* Other names: Balance training;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Appendicular skeletal muscle mass in kilograms | The appendicular skeletal muscle mass is evaluated by bioelectrical impedance (BIA) analysis | baseline | 
| Change from baseline appendicular skeletal muscle mass at 8 weeks | The appendicular skeletal muscle mass is evaluated by bioelectrical impedance (BIA) analysis | 8 weeks | 
| Hand grip in kilograms | The muscle strength is evaluated with the hand-grip strength (kg) by dynamometer | baseline | 
| Hand grip in kilograms | The muscle strength is evaluated with the hand-grip strength (kg) by dynamometer | 8 weeks | 
| Times Chair-stand test (5-CST) in minutes | The 5CST is evaluated by recording the total time that patient repeat 5 times stand and sit motion from chair | baseline | 
| Times Chair-stand test (5-CST) in minutes | The 5CST is evaluated by recording the total time that patient repeat 5 times stand and sit motion from chair | 8 weeks |