Trial Outcomes & Findings for Preventing Loss of Independence Through Exercise (PLIÉ) in Persons With Mild Cognitive Impairment (MCI) (NCT NCT03526146)

Last Updated: 2025-04-10

Results Overview

The Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog) is one of the most commonly used outcome measures in dementia drug treatment trials and is one of the measures considered by the Food and Drug Administration for approval of dementia medications. It includes direct assessment of learning (10-word list), naming (objects), following commands, constructional praxis (figure copying), ideational praxis (mailing a letter), orientation (person, time, place), recognition memory and remembering test instructions. Scores may range from 0 to 70 with higher scores reflecting worse cognitive function. Prior studies have found the ADAS-cog to be valid and reliable with Cronbach's alpha greater than 0.8 and test-retest reliability above 0.9. Because we examined the difference from baseline to post-treatment, a positive change score indicates improvement while a negative change score indicates decline.

Recruitment status

COMPLETED

Study phase

Target enrollment

41 participants

Primary outcome timeframe

baseline to 12 weeks

Results posted on

2025-04-10

Participant Flow

Forty-one (41) participants signed informed consent forms/were enrolled in the study. One participant did not meet study inclusion criteria; four participants withdrew for other reasons (e.g., time commitment/health issues, lack of interest); three participants were withdrawn after COVID-19 related shelter-in-place rules went into effect in San Francisco. Thirty-three(33) participants completed baseline assessments.

Participant milestones

Participant milestones
Measure	PLIE PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
Overall Study STARTED	33
Overall Study COMPLETED	18
Overall Study NOT COMPLETED	15

Reasons for withdrawal

Reasons for withdrawal
Measure	PLIE PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
Overall Study Lost to Follow-up	5
Overall Study Withdrawal by Subject	6
Overall Study class canceled due to COVID-19	4

Baseline Characteristics

Preventing Loss of Independence Through Exercise (PLIÉ) in Persons With Mild Cognitive Impairment (MCI)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	PLIE n=33 Participants PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
Age, Categorical <=18 years	0 Participants n=5 Participants
Age, Categorical Between 18 and 65 years	7 Participants n=5 Participants
Age, Categorical >=65 years	26 Participants n=5 Participants
Age, Continuous	74 years STANDARD_DEVIATION 9 • n=5 Participants
Sex: Female, Male Female	11 Participants n=5 Participants
Sex: Female, Male Male	22 Participants n=5 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	1 Participants n=5 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	31 Participants n=5 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	1 Participants n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants
Race (NIH/OMB) Asian	2 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	1 Participants n=5 Participants
Race (NIH/OMB) Black or African American	4 Participants n=5 Participants
Race (NIH/OMB) White	25 Participants n=5 Participants
Race (NIH/OMB) More than one race	0 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	1 Participants n=5 Participants
Region of Enrollment United States	33 participants n=5 Participants

PRIMARY outcome

Timeframe: baseline to 12 weeks

Outcome measures

Outcome measures
Measure	PLIE n=18 Participants PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
Change in Alzheimer's Disease Assessment Scale-cognitive Subscale (ADAS-cog)	2.83 score on a scale Standard Deviation 3.01

SECONDARY outcome

Timeframe: baseline to 12 weeks

The SPPB was developed by the National Institute on Aging to provide an objective tool for measuring physical performance in older adults. Lower body strength is assessed based on time to complete 5 chair stands without using arms. Balance is assessed based on the ability to hold different stands for 10 seconds, including the side-by-side, semi-tandem and full tandem stands. Mobility is assessed based on usual walking speed over a 3-meter walking course. The total SPPB score is the sum of the 3 component scores and may range from 0 to 12. Higher scores reflect better performance. Because we examined the difference from baseline to post-treatment, a negative change score indicates improvement while a positive change score indicates decline.

Outcome measures

Outcome measures
Measure	PLIE n=18 Participants PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
Short Physical Performance Battery (SPPB)	-0.8 score on a scale Standard Deviation 1.7

SECONDARY outcome

Timeframe: baseline to week 12

The MAIA is a 37-item self-report questionnaire, consists of eight scales: Noticing, Not-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Interoceptive Self-Regulation, Body Listening, and Trust. To avoid overburdening participants with the entire questionnaire, we will focus on interoceptive self-regulation, the ability to regulate distress by attention to body sensations, which has previously been shown to respond to mindfulness interventions. Interoceptive Self-Regulation scores on the MAIA-2 range from 0-5, with lower scores indicating lower ability to regulate distress by paying attention to body sensations. Because we examined the difference from baseline to post-treatment, a negative change score indicates improvement while a positive change score indicates decline.

Outcome measures

Outcome measures
Measure	PLIE n=18 Participants PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
Interoceptive Self-Regulation, Assessed With the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2)	-0.8 score on a scale Standard Deviation 1.0

SECONDARY outcome

Timeframe: baseline to week 12

The MAIA, a 37-item self-report questionnaire, consists of eight scales: Noticing, Not-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Interoceptive Self-Regulation, Body Listening, and Trust. To avoid overburdening participants with the entire MAIA-2 questionnaire, we focused the ability to sustain and control attention to body sensations (i.e., attention regulation), which has been shown to respond to mindfulness interventions. Attention Regulation scores on the MAIA-2 range from 0-5, with lower scores indicating lower ability to sustain and control attention to body sensations. Because we examined change from baseline to post-treatment, a negative change score indicates improvement in the ability to sustain and control attention to body sensations.

Outcome measures

Outcome measures
Measure	PLIE n=18 Participants PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
Attention Regulation, Assessed With the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2)	-0.5 score on a scale Standard Deviation 0.9

SECONDARY outcome

Timeframe: baseline to week 12

Population: Because this measure was not implemented at the beginning of the study, we do not have this measure for 6 study completers.

The Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation questionnaire assesses perceptions of being avoided, excluded, detached, disconnected from, or unknown by, others with 4 questions (1- I feel left out; 2- I feel that people barely know me; 3- I feel isolated from others; 4-I feel that people are around me but not with me). Subjects respond to each statement with a Likert scale ranging from 1 (never) to 5 (always). Total scores range from 0-20, with higher scores indicating greater feelings of social isolation. Because we calculated a change score (baseline - post-treatment), a positive change score indicates a decrease in feelings of social isolation from baseline to post-treatment.

Outcome measures

Outcome measures
Measure	PLIE n=12 Participants PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation. Behavioral: Preventing Loss of Independence through Exercise (PLIE): PLIE is an integrative exercise program that focuses on training procedural memory for the ability to perform the movements that are most needed for daily function (e.g., transitioning safely from sitting to standing) while increasing mindful body awareness and encouraging social connection. It combines elements from a wide range of Eastern and Western exercise modalities, including occupational therapy, physical therapy, yoga, tai chi, Feldenkrais, Rosen Method, dance movement therapy and mindfulness meditation.
PROMIS Social Isolation	1.7 score on a scale Standard Deviation 1.8

Adverse Events

PLIE

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Linda L. Chao

San Francisco Veterans Affairs Health Care System, San Francisco, CA

Phone: 415-221-4810

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place