Objective: To describe the design and feasibility of a randomised controlled pilot study evaluating an Enhanced Tai Chi intervention for people with Parkinson’s disease (NCT07297368).

Background: Increasing evidence supports exercise-based interventions as an important adjunct therapy for symptom management of Parkinson’s Disease (PD) [1,2]. However, designing exercise trials in PD presents methodological challenges, including intervention standardisation, participant adherence, and integration within routine clinical care [3,4]. Developing pragmatic study designs that allow structured exercise interventions to be evaluated within healthcare settings is essential to facilitate translation of rehabilitation approaches into clinical practice.

Method: This single site randomised controlled pilot was conducted at a tertiary centre in London. Individuals with idiopathic PD (Hoehn and Yahr stages 1-3) were recruited from outpatient clinics. Participants were randomised (1:1) to either Enhanced Tai Chi training in addition to usual care or usual care alone. The intervention, led by the Tai Chi Master with experience in PD, delivered one face-to-face and two virtual sessions per week for 12-weeks. The programme integrated tailored Tai-Chi movements, Qigong breathing techniques, and PD-balance-focused exercises. Preliminary feasibility outcomes included recruitment capability, retention up-to first follow-up and the challenges and barriers of delivering the intervention.

Results: Twenty-nine participants were randomised with one participant withdrawing from the control group following randomisation due to unavailability at the start of the sessions. Intervention adherence was high, with participants attending a mean of 29.2±4.9 of 35 sessions (83.3%) over the 12-week programme. Baseline assessments were successfully completed in all participants, demonstrating good participant engagement and acceptable burden of assessments.

Conclusion: We demonstrated the initial feasibility of conducting a randomised controlled trial evaluating an Enhanced Tai Chi intervention for people with PD within a tertiary clinical service. The findings support the practicality of delivering such a programme within clinical settings and provide a methodological foundation for larger controlled trials evaluating exercise-based interventions in PD. Full feasibility of the study will be reported at the trial completion.

References: [1] Kalia LV, Lang AE. Parkinson’s disease. Lancet. 2015 Aug 29;386(9996):896-912. doi: 10.1016/S0140-6736(14)61393-3. Epub 2015 Apr 19. PMID: 25904081.
[2] Giardini M, Nardone A, Godi M, Guglielmetti S, Arcolin I, Pisano F, Schieppati M. Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson’s Disease. Neural Plast. 2018 Mar 7;2018:5614242. doi: 10.1155/2018/5614242. PMID: 29706993; PMCID: PMC5863303.
[3] Li G, Huang P, Cui S, He Y, Jiang Q, Li B, Li Y, Xu J, Wang Z, Tan Y, Chen S. Tai Chi improves non-motor symptoms of Parkinson’s disease: One-year randomized controlled study with the investigation of mechanisms. Parkinsonism Relat Disord. 2024 Mar;120:105978. doi: 10.1016/j.parkreldis.2023.105978. Epub 2024 Jan 12. PMID: 38244460.
[4] Li G, Huang P, Cui SS, Tan YY, He YC, Shen X, Jiang QY, Huang P, He GY, Li BY, Li YX, Xu J, Wang Z, Chen SD. Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson’s disease patients. Transl Neurodegener. 2022 Feb 7;11(1):6. doi: 10.1186/s40035-022-00280-7. PMID: 35125106; PMCID: PMC8819852.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/development-and-initial-feasibility-of-a-randomised-pilot-trial-of-enhanced-tai-chi-for-parkinsons-disease/