scholarly journals 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

2020 ◽  
Author(s):  
Jonathan Williams ◽  
Samuel Nyman
Keyword(s):  
Randomised Controlled Trial ◽  
Tai Chi ◽  
Training Stimulus ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
People With Dementia ◽  
Significant Difference ◽  
Randomised Controlled

Abstract Background Previous research has identified that Tai Chi is effective for reducing risk of falls and improving timed up and go scores. However, our previous research identified no-significant difference in time to complete the timed up and go test following a Tai Chi intervention in people with dementia. Aim To conduct a secondary analysis to extend our understanding of the effect of Tai Chi on the instrumented Timed Up and Go test. Methods This is a secondary analysis of a randomised controlled trial set in the community. People with dementia, recruited from NHS databases, memory clinics, local charities and self-referral across the south of England, received either 20 weeks of Tai Chi plus normal care or normal care. Outcomes were assessed using the instrumented Timed Up and Go test, completed at baseline and after 6 months. Results From 83 people with dementia volunteering for the study, 67 complete datasets were available for analysis. Within-group pairwise comparison across time revealed no-significant gains for any of the instrumented Timed Up and Go variables, and no-significant difference for between-group pairwise comparisons. Discussion This suggests that Tai Chi had no effect on the instrumented Timed Up and Go in people with dementia. This lack of effect may be due to the lack of specificity of the training stimulus to the outcome measure. Conclusion Tai Chi had no effect on any instrumented Timed Up and Go variables, suggesting Tai Chi may not be best placed to enhance the sub-elements of the instrumented Timed Up and Go to reduce fall risk among community-dwelling people with dementia. Clinical trial registration number: NCT02864056.

scholarly journals 89 Randomised Controlled Trial of the Effect of Tai Chi on Postural Balance of People with Dementia

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Samuel Nyman ◽  
Wendy Ingram ◽  
Jeanette Sanders ◽  
Peter Thomas ◽  
Sarah Thomas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tai Chi ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
People With Dementia ◽  
Secondary Outcomes ◽  
Randomised Controlled

Abstract Introduction We investigated the effect of Tai Chi exercise on postural balance among people with dementia (PWD), and the feasibility of a definitive trial on falls prevention. Method We conducted a randomised controlled trial. Dyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus the intervention (n=42). For the intervention, over 20 weeks, Tai Chi classes were provided weekly and Tai Chi home practice was facilitated by the carer. The primary outcome was the timed up and go test. Secondary outcomes for PWD included functional balance, static balance, fear of falling, cognitive functioning, quality of life, and falls. Secondary outcomes for carers included dynamic balance, static balance, quality of life, and carer burden. Outcomes were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period. Results For PWD, there was no significant difference at follow-up on the timed up and go test (mean difference [MD] = 0.82, 95% confidence interval [CI] = -2.17, 3.81, standardised effect size [ES] = 0.14). Among the secondary outcomes, at follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, ES = 0.51) and a significantly lower rate of falls (rate ratio = 0.35, 95% CI =0.15, 0.81), which was no longer significant when an outlier was removed. Carers in the Tai Chi group at follow-up were significantly worse on the timed up and go test (MD = 1.83, 95% CI = 0.12, 3.53, ES = 0.61). The remaining secondary outcomes were not significant. No serious adverse events were related to participation in Tai Chi. Conclusion With refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD.

scholarly journals Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia

2019 ◽  
Vol Volume 14 ◽  
pp. 2017-2029 ◽  
Author(s):  
Samuel R Nyman ◽  
Wendy Ingram ◽  
Jeanette Sanders ◽  
Peter W Thomas ◽  
Sarah Thomas ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Postural Balance ◽  
Tai Chi ◽  
Controlled Trial ◽  
People With Dementia ◽  
Randomised Controlled

scholarly journals Agreement between electronic and paper Epworth Sleepiness Scale responses in obstructive sleep apnoea: secondary analysis of a randomised controlled trial undertaken in a specialised tertiary care clinic

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019255 ◽  
Author(s):  
Lily Chen ◽  
Julia L Chapman ◽  
Brendon J Yee ◽  
Keith K H Wong ◽  
Ronald R Grunstein ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Obstructive Sleep Apnoea ◽  
Epworth Sleepiness Scale ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Sleep Apnoea ◽  
Care Clinic ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Randomised Controlled

ObjectivesOriginally developed as a paper questionnaire, the electronic Epworth Sleepiness Scale (ESS) is widely used in sleep clinics and sleep population research. Despite potential differences between computer-based and conventional questionnaire delivery, studies have not evaluated the agreement between electronic and paper versions of the ESS. Given the widespread use of the ESS, a bias between results would present considerable data concerns. Thus, the aim of this study was to examine agreement between electronic and paper ESS responses in obstructive sleep apnoea (OSA).DesignWe undertook a secondary analysis of baseline data from a randomised controlled trial (ANZCTR: ACTRN12611000847910).SettingData were collected in a tertiary sleep research laboratory located in Sydney, Australia.ParticipantsData were analysed from 112 adult patients with OSA.MeasurementsPatients were given the English version of the ESS as part of a battery of sleep laboratory questionnaires. They completed electronic and subsequently paper ESS questionnaires on the same day.ResultsWe found no significant difference between electronic and paper ESS questionnaires (mean=0.1, SD=2.1, 95% CI −0.3 to 0.5, P=0.57) or heteroscedasticity. There was no evidence of bias along the range of the measure. 95% limits of agreement at 4.3 and −4.1 were comparable with previous data.ConclusionsWe found no evidence of bias between electronic and paper ESS questionnaires in this sample of patients with OSA, as the two formats displayed sufficient agreement to be clinically comparable. Regardless of severity, patients reported the same level of daytime sleepiness with the same level of accuracy across both measures.Trial registration numberACTRN12611000847910; Pre-results.

scholarly journals Exercise and education for community-dwelling older participants with knee osteoarthritis: a video-linked programme protocol based on a randomised controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lin Wang ◽  
Suhang Xie ◽  
Tianjie Bao ◽  
Siyi Zhu ◽  
Qiu Liang ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Controlled Trial ◽  
Pressure Pain Threshold ◽  
Estimating Equation ◽  
Community Dwelling ◽  
Self Report ◽  
Exercise Programmes ◽  
Randomised Controlled

Abstract Background Neuromuscular and quadriceps exercises have been shown to be effective approaches to relieve pain and to improve function for patients with knee osteoarthritis. In this study, we aim to provide an informative feasible model in which therapeutic exercise and education will be undertaken with physiotherapy supervision and instruction via video link. We also aim to explore the relationship between program-induced pain alleviation/functional improvements and reduction in irritability, which might be mediated through program-induced psychosocial benefits. Methods In this proposed two-parallel group (neuromuscular exercise versus quadriceps exercise), single-blinded, randomised controlled trial, participants aged ≥50 years with osteoarthritic knee pain will undergo a 12-week intervention, comprising video-linked education, supervised exercises, and a 12-week follow-up. Seven measurements will be taken to collect longitudinal data. A generalised estimating equation will be used to establish the adjusted difference in effectiveness on pain, function, irritability, and psychosocial outcomes between participants undertaking neuromuscular exercises and those undertaking quadriceps exercises. The primary outcomes are overall average pain in the knee joint during walking, as assessed through the 11-point Numerical Pain Rating Scale, and the Western Ontario and McMaster Universities osteoarthritis index physical function subscale. Furthermore, pressure pain threshold and changes in self-report pain scores pre-, during, and post-exercise were also measured as an indication of irritability. In addition, both the 6-min walk test and a timed up & go test were used to assess walking function performance. Finally, patients’ emotions (e.g., fear and catastrophising), self-trust, needs in terms of disease knowledge, mental resilience, social support and health-related quality of life were investigated. Two four-wave cross-lagged models will be used to investigate directional relationships, aiming to investigate the complex mechanisms concerning the effects of exercise programmes. Discussion Through summarising the study’s strengths and limitations, this study may provide promising insights in terms of exercise therapy optimisation for people with knee osteoarthritis and/or other chronic pain within a psychosocial framework. Trial registration ChiCTR2100041978 (chictr.org.cn), January 10, 2021.

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