Tai Chi for Stroke Rehabilitation on Balance and Cognition

Study Overview
=================
Brief Summary
-----------------
Tai Chi, an ancient Chinese martial art, is a low intense aerobic exercise characterized by continuous movements that embrace the mind, body, and spirit. Tai Chi addresses the integration and balance of mind and body using the fundamental principles of slow, smooth, and continuous movement control, and the transfer of body weight while maintaining an upright and relaxed posture. The present randomized clinical trial project aims to apply the suggested principles as the typical features of Tai Chi applied stroke rehabilitation, and to evaluate the effects on physical (balance), psychological, and cognitive function.

Detailed Description
-----------------
Cerebrovascular disease is a major global concern. The individuals with stroke would suffer from disease associated symptoms which influence their functioning in everyday life. These symptom clusters were usually known to be sharing similar underlying mechanisms. It is clear that the development of effective stroke rehabilitation involves interdisciplinary team approach to manage physical, social, cognitive, and psychological functioning in this population. Tai Chi, an ancient Chinese martial art, is a low intense aerobic exercise characterized by continuous movements that embrace the mind, body, and spirit. Tai Chi addresses the integration and balance of mind and body using the fundamental principles of slow, smooth, and continuous movement control, and the transfer of body weight while maintaining an upright and relaxed posture. The newly developed style of Tai Chi for health programs is the seated Tai Chi, which shares the common Tai Chi principles while being modified to adjust the movements for patients with limited mobility. The present randomized clinical trial project aims to apply the suggested principles as the typical features of Tai Chi applied stroke rehabilitation, and to evaluate the effects on physical (balance), psychological, and cognitive function. Only a few studies ever addressed the feasibility of Tai Chi for stroke rehabilitation, and the relationship between cognition and balance in this population is still very early stage of investigation. The main purpose of our collaborating project is to explore the direct relationship between cognition and balance in stroke patients during their rehabilitation process.

Official Title
-----------------
Evaluating the Effect of Tai Chi Applied Stroke Rehabilitation on Physical and Cognitive Functioning

Conditions
-----------------
Stroke

Intervention / Treatment
-----------------
* Behavioral: Tai Chi exercise
* Behavioral: symptom management


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: diagnosed as stroke at least for 3 months upto 2 years eligible to participate rehabilitation therapy referred by primary physician Exclusion Criteria: not able to understand questionnaires not able to stand alone for balance test

Ages Eligible for Study
-----------------
Minimum Age: 30 Years
Maximum Age: 70 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tai Chi group<br>Tai Chi exercise, twice a week, one hour per session. participated in Tai Chi either while seated or standing upon their comfort level. | Behavioral: Tai Chi exercise<br>* exercise twice a week each for one hour<br>* Other names: seated Tai Chi;|
| Active Comparator: Symptom management group<br>manage stroke symptom through phone and text message along with other rehabilitation therapy. | Behavioral: symptom management<br>* sending text message weekly to manage symptoms related to stroke<br>* Other names: message counselling;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| balance | postural stability test will be measured by standard computerized test | 3 months, 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| activities of daily living | activities of daily living will be measured by Modified rankin scale | 3 months, 6 months | 
| knee muscle strength | knee flexor and extensor strength by isokinetic testing measured by Biodex | 3 months, 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
stroke, Tai ji, postural balance, cognition