Health Outcomes of Two Different Tai Chi Interventions

NCT ID: NCT04407403

Last Updated: 2020-05-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 42 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-11-01
• Study Completion Date: 2018-11-30

Brief Summary

Tai Chi results in numerous health benefits but whether it can be tailored to elicit different health outcomes is not clear. Therefore, investigators compared the health benefits of two different Tai Chi interventions tailored for improvements in blood pressure (BP) (PRESSURE) or balance (BALANCE). Investigators tailored PRESSURE to emphasize breathing techniques and mental relaxation and BALANCE to emphasize movement principles that challenged balance. Participants were randomized to PRESSURE (n=12), BALANCE (n=13), or CONTROL (n=10). Tai Chi was practiced 3 sessions/week, 60 minute/session for 12 weeks. CONTROL performed normal daily activities. Investigators tested the change in cardiometabolic health, balance, and functional fitness outcomes among groups. Investigators hypothesized that PRESSURE would elicit greater BP reductions compared to BALANCE; meanwhile, BALANCE would elicit greater improvements in balance measures than PRESSURE.

Detailed Description

By 2030, older adults (≥65 years) will comprise approximately 20% (~72 million) of the United States (US) population. Currently in the US, over 70% of older adults have hypertension, and approximately 30% of healthy US older adults experience a fall annually. Therefore, preventing and treating high blood pressure (BP) and improving balance to reduce falling are priorities for healthy aging. Tai Chi is a low impact, social, and enjoyable form of exercise that is particularly suitable for older adults. In addition, BP and balance are the two most studied health outcomes of Tai Chi. Of note, Tai Chi varies considerably in terms of the styles (e.g., Yang), forms (e.g., cloud hands), and combinations of breathing techniques, mental relaxation, and movement principles. However, Tai Chi is rarely tailored for the health outcomes being targeted in research studies. Therefore, it is still unclear if healthcare professionals should recommend or design specific types of Tai Chi practice based on the health outcomes being targeted to maximize the benefits.

Investigators compared two different Tai Chi interventions, one tailored for reductions in BP (PRESSURE) and the other for improvements in balance (BALANCE) for their resultant health benefits among community dwelling older adults. Investigators hypothesized that PRESSURE would elicit statistically significantly greater BP reductions compared to BALANCE; meanwhile, BALANCE would elicit statistically significantly greater improvements in balance measures than PRESSURE.

All participants participated in three research visits. Visit1, and Visit 2 before, and Visit 3 after the 12-week Tai Chi exercise intervention or control group assignments. During Visit 1, investigators: 1) measured resting BP and completed the screening checklist; 2) administered questionnaires assessing life style habits (i.e., the Paffenbarger Physical Activity Questionnaire, the Block Rapid Food Screener, the Pittsburgh Sleep Quality Index), mental health (i.e., the Perceived Stress Scale Short Form, the Geriatric Anxiety Inventory); and 3) gave participants accelerometers to wear at home for 96 consecutive hours to measure habitual physical activity levels. Between Visits 1 and 2, investigators: 1) obtained medical clearance for all participants; and 2) perform the randomization of participants. During Visit 2, investigators assessed balance function (i.e., the Single Leg Stance Test, the Timed Up and Go Test, the Four Square Step Test, the Postural Stability Test, the Limits of Stability Test, the Modified Clinical Test of Sensory Interaction and Balance Test); BP; and functional fitness (i.e., the Hand Grip Test, the 30-Second Sit-to-Stand Test, the Chair Sit-and-Reach Test, the 10-Meter Walk Test). During the 12-week Tai Chi exercise intervention or control group assignments, participants assigned to BALANCE and PRESSURE groups were asked to attend Tai Chi exercise sessions for 3 sessions/week 60 minutes/session. Participants assigned to the control group did attend Tai Chi exercise sessions and were asked to maintain their regular level of physical activity. During Visit 3, investigators administered all measurements completed in Visit 2, and questionnaires administered in Visit 1.

Conditions

Hypertension; Fall

Keywords

Tai Chi; Hypertension; Balance function; Older adults

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Tai Chi tailored for lowering blood pressure (PRESSURE)

During the 12-week Tai Chi intervention, participants in the PRESSURE group attended supervised Tai Chi sessions led by a certified Tai Chi instructor for 3 sessions/week, 60 minutes/session for 12 weeks. In addition, participants in the PRESSURE group were instructed: 1) to maintain their regular level of physical activity outside of the supervised Tai Chi exercise sessions, and diet during the study; and 2) to inform the researchers when there is a change(s) in a medical condition or medication prescribed.

Group Type: EXPERIMENTAL

Tai Chi tailored for lowering blood pressure (PRESSURE)

Intervention Type: BEHAVIORAL

PRESSURE Tai Chi routine consisted of eight forms following Yang style. PRESSURE was tailored for the targeted health outcome of BP in consultation with the professional, certified Tai Chi instructor and an experienced physical therapist. Specifically, investigators tailored PRESSURE to emphasize slow, deep breathing and relaxation by utilizing Tai Chi movements that: 1) were slow and smooth; 2) without break or pause; and 3) had minimal muscular force and exertion. Investigators included the following eight forms in PRESSURE: 1) Begin Tai Ji Quan; 2) Part the Horse's Mane; 3) Brush Knee and Push; 4) Cloud Hands; 5) Open and Close; 6) Part the Grass; 7) Single Whip; and 8) Finish Tai Ji Quan.

Tai Chi tailored for improving balance (BALANCE)

During the 12-week Tai Chi intervention, participants in the BALANCE group attended supervised Tai Chi sessions led by a certified Tai Chi instructor for 3 sessions/week, 60 minutes/session for 12 weeks. In addition, participants in the BALANCE group were instructed: 1) to maintain their regular level of physical activity outside of the supervised Tai Chi exercise sessions, and diet during the study; and 2) to inform the researchers when there is a change(s) in a medical condition or medication prescribed.

Group Type: EXPERIMENTAL

Tai Chi tailored for improving balance (BALANCE)

Intervention Type: BEHAVIORAL

BALANCE Tai Chi routine consisted of eight forms following Yang style. BALANCE was tailored for the targeted health outcome of balance in consultation with the professional, certified Tai Chi instructor and an experienced physical therapist. Specifically, investigators tailored BALANCE to provide moderate to high levels of challenge to balance control by emphasizing movement principles (e.g., consciously control weight shifting during multi-directional stepping), and integrating Tai Chi movements that: 1) reduced the base of support; 2) moved the center of gravity; and 3) improved lower-extremity strength. Investigators included the following eight forms in BALANCE: 1) Begin Tai Ji Quan; 2) Roll the Ball; 3) Kick with Heel; 4) Repulse the Monkey; 5) Gather the Earth's Qi; 6) White Crane Spread Wing; 7) Fairy Weaves the Shuttle; and 8) Finish Tai Ji Quan.

control group (CONTROL)

During the 12-week Tai Chi intervention, participants in the CONTROL group performed their regular daily activities. In addition, participants in the CONTROL group were instructed: 1) to maintain their regular level of physical activity and diet during the study; and 2) to inform the researchers when there is a change(s) in a medical condition or medication prescribed. Of note, both PRESSURE and BALANCE were offered to participants assigned in the CONTROL group after data collection was completed.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Tai Chi tailored for lowering blood pressure (PRESSURE)

PRESSURE Tai Chi routine consisted of eight forms following Yang style. PRESSURE was tailored for the targeted health outcome of BP in consultation with the professional, certified Tai Chi instructor and an experienced physical therapist. Specifically, investigators tailored PRESSURE to emphasize slow, deep breathing and relaxation by utilizing Tai Chi movements that: 1) were slow and smooth; 2) without break or pause; and 3) had minimal muscular force and exertion. Investigators included the following eight forms in PRESSURE: 1) Begin Tai Ji Quan; 2) Part the Horse's Mane; 3) Brush Knee and Push; 4) Cloud Hands; 5) Open and Close; 6) Part the Grass; 7) Single Whip; and 8) Finish Tai Ji Quan.

Intervention Type: BEHAVIORAL

Tai Chi tailored for improving balance (BALANCE)

BALANCE Tai Chi routine consisted of eight forms following Yang style. BALANCE was tailored for the targeted health outcome of balance in consultation with the professional, certified Tai Chi instructor and an experienced physical therapist. Specifically, investigators tailored BALANCE to provide moderate to high levels of challenge to balance control by emphasizing movement principles (e.g., consciously control weight shifting during multi-directional stepping), and integrating Tai Chi movements that: 1) reduced the base of support; 2) moved the center of gravity; and 3) improved lower-extremity strength. Investigators included the following eight forms in BALANCE: 1) Begin Tai Ji Quan; 2) Roll the Ball; 3) Kick with Heel; 4) Repulse the Monkey; 5) Gather the Earth's Qi; 6) White Crane Spread Wing; 7) Fairy Weaves the Shuttle; and 8) Finish Tai Ji Quan.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. The participant was enrolled in one of the three programs at Seabury including: the Seabury at Home program, the Independent Living program, and the Assisted Living program.

2. The participant was 50 or older, which was the age limit to be enrolled in any Seabury programs.

3. The participant was ambulatory without using an assistive device (e.g., walkers, canes, crutches).

Exclusion Criteria

• 1. Older adults who enrolled in the Memory Support Assisted Living program or the Skilled Nursing program at Seabury were not invited to participate because Tai Chi practice could be too cognitively and/or physically challenging for them.

2. To ensure the safety of exercise and avoid potential exercise-related cardiac events, if the participant had blood pressure (BP) be systolic BP <90 and/or systolic BP ≥160 mmHg and/or diastolic BP <60 and/or diastolic BP ≥100 mmHg during screening, this participant was excluded from further participation.

3. Participants were removed from the study if they were not willing to comply with all study procedures. Participants were also removed from the study in the event of injury, illness, or other change that may influence the outcome variables being measured.

• Minimum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Connecticut

OTHER

Sponsor Role: lead

Responsible Party

Linda Pescatello

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Linda Pescatello, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Connecticut

Locations

Seabury

Bloomfield, Connecticut, United States

Countries

United States

Other Identifiers

H16-262

Identifier Type: -

Identifier Source: org_study_id