Dementia Clinical Trial
Official title:
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
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.
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.
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