The TACIT Trial: TAi ChI for People With demenTia

NCT ID: NCT02864056

Last Updated: 2018-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

172 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-04-06

Study Completion Date

2018-12-01

Brief Summary

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This is a three-centre parallel group randomised controlled trial with an embedded process evaluation and intervention pilot phase (details not provided in this summary). The overall research question is: Can a Tai Chi exercise programme prevent falls among people with dementia (PWD), specifically among older PWD living at home?

Primary Outcome measure:

• dynamic postural balance (as a surrogate for falls).

Secondary outcome measures:

* to explore the effects of a Tai Chi exercise programme on static and functional postural balance, fear of falling, cognitive functioning, falls, and quality of life. Also to explore the effects of a Tai Chi exercise programme on their informal carer's dynamic and static postural balance, quality of life, and carer burden
* to determine the acceptability and safety of the Tai Chi intervention
* to inform the design of a future definitive clinical trial.

Detailed Description

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Amongst people aged over 65, people with dementia (PWD) are much more likely to fall, and be injured, than those without dementia. Being injured from falling over is the main reason why older people attend the hospital A\&E department. PWD often experience longer hospital stays following a fall, and may become confused which can be stressful for the carer; and a considerable cost to the NHS.

There is evidence that exercise programmes help to prevent falling. Can a Tai Chi exercise programme prevent falls among PWD living at home? We will investigate whether practising Tai Chi over several months improves dynamic postural balance (because it is a good indicator of how likely someone is to fall). People with mild to moderate dementia who live at home are eligible to take part with their regular care-giver as a 'pair'. We will recruit 150 pairs, i.e. 150 people with dementia and their informal caregiver (300 people in total). The PWD must be aged 18 years or older and both must be willing and able to do standing Tai Chi.

At baseline, the researcher will visit the pair at home to assess the participants' balance, memory skills, and general well-being. Pairs will be randomly assigned to either Tai Chi and usual care (intervention) or usual care only (control).

Pairs in the intervention group will practice Tai Chi together in a weekly group class held locally, and at home, and will complete a diary of how much time was spent doing Tai Chi over six months.

All participants will complete diaries showing how often they fell and whether falls caused an injury.

The baseline assessment will be repeated at six months. A researcher will collect feedback from the pair to see whether the intervention could be (further) tailored to the need of PWD and carers. The change in ability to balance over six months will be compared between PWD in each group.

Conditions

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Dementia Accidental Falls

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control

Usual care

Group Type NO_INTERVENTION

No interventions assigned to this group

Tai Chi

Completes 50 hours of Tai Chi, a combination of in-class and at-home practise.

Group Type EXPERIMENTAL

Tai Chi

Intervention Type OTHER

Ancient Chinese form of mind/body gentle exercise; this will be done while standing to improve postural balance.

Interventions

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Tai Chi

Ancient Chinese form of mind/body gentle exercise; this will be done while standing to improve postural balance.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Person with dementia:

* Aged 18 or above
* Living at home
* Have a diagnosis of a dementia
* Able to do standing Tai Chi (e.g. not be wheelchair bound)
* Willing to attend weekly Tai Chi classes
* Willing to attend a focus group (intervention pilot phase only)

Carer:

* Able to commit to supporting the PWD by participating in data collection throughout the study and in the intervention components if allocated to the intervention group (minimum of 2 times per week in-person, but ideally more)
* Able to do standing Tai Chi (e.g. not be wheelchair bound)
* Willing to attend weekly Tai Chi classes
* Willing to attend a focus group (intervention pilot phase only)

Exclusion Criteria

Person with dementia

* Living in a care home
* In receipt of palliative care
* Indicate that they have:

* Severe dementia
* A Lewy body dementia or dementia with Parkinson's disease
* Severe sensory impairment
* Are already currently practising (on average once a week or more) or have been practising within the past six months (on average once a week or more) Tai Chi or similar exercise (Qigong, yoga, or Pilates)
* Are currently under the care of or have been referred to a falls clinic for assessment, or are currently attending a balance exercise programme (e.g. Otago classes)
* Lack mental capacity to provide informed consent

Carer:

* Indicate that they have severe sensory impairment
* Lack mental capacity to provide informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Southern Health NHS Foundation Trust

OTHER

Sponsor Role collaborator

Dorset HealthCare University NHS Foundation Trust

OTHER

Sponsor Role collaborator

University of Plymouth

OTHER

Sponsor Role collaborator

National Institute for Health Research, United Kingdom

OTHER_GOV

Sponsor Role collaborator

University of Southampton

OTHER

Sponsor Role collaborator

Elemental Tai Chi

UNKNOWN

Sponsor Role collaborator

Alzheimer's Society

OTHER

Sponsor Role collaborator

Solent NHS Trust

OTHER_GOV

Sponsor Role collaborator

Bournemouth University

OTHER

Sponsor Role lead

Responsible Party

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Samuel Nyman

Dr Samuel Nyman

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Samuel Nyman, PhD

Role: PRINCIPAL_INVESTIGATOR

Bournemouth University

Locations

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Memory Assessment Service, Dorset HealthCare University Foundation Trust

Poole, Dorset, United Kingdom

Site Status

Solent NHS Trust

Portsmouth, Hampshire, United Kingdom

Site Status

Memory Assessment and Research Centre, Southern Health NHS Foundation Trust

Southampton, Hampshire, United Kingdom

Site Status

Countries

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United Kingdom

References

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Nyman SR, Casey C, Greenwood N. Hypothesis: Dementia Diminishes Interdependence in Health and Quality of Life Among Spousal Partners. Alzheimer Dis Assoc Disord. 2023 Apr-Jun 01;37(2):174-177. doi: 10.1097/WAD.0000000000000539. Epub 2023 Jan 18. No abstract available.

Reference Type DERIVED
PMID: 36706322 (View on PubMed)

Williams J, Nyman S. A secondary analysis of a randomised controlled trial to investigate the effect of Tai Chi on the instrumented timed up and go test in people with mild to moderate dementia. Aging Clin Exp Res. 2021 Aug;33(8):2175-2181. doi: 10.1007/s40520-020-01741-7. Epub 2020 Nov 3.

Reference Type DERIVED
PMID: 33141417 (View on PubMed)

Nyman SR, Ingram W, Sanders J, Thomas PW, Thomas S, Vassallo M, Raftery J, Bibi I, Barrado-Martin Y. Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia. Clin Interv Aging. 2019 Nov 19;14:2017-2029. doi: 10.2147/CIA.S228931. eCollection 2019.

Reference Type DERIVED
PMID: 31819385 (View on PubMed)

Nyman SR, Hayward C, Ingram W, Thomas P, Thomas S, Vassallo M, Raftery J, Allen H, Barrado-Martin Y. 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). BMC Geriatr. 2018 Nov 3;18(1):263. doi: 10.1186/s12877-018-0935-8.

Reference Type DERIVED
PMID: 30390620 (View on PubMed)

Other Identifiers

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CDF-2015-08-030

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

16/WS/0139

Identifier Type: OTHER

Identifier Source: secondary_id

TACIT001

Identifier Type: -

Identifier Source: org_study_id