Date Presented 03/27/20
This research project is intended to evaluate Tai Chi’s impact on balance self-efficacy in occupational performance— specifically in regard to individuals with mild cognitive impairment (MCI). On average, functional self-efficacy scores of participants with MCI increased from 59.8% to 74.6% (p-value = .00736). Results indicate that Tai Chi is an effective intervention to increase balance self-efficacy when performing daily activities in both individuals with and without MCI.
Primary Author and Speaker: Christopher Taylor
PURPOSE: This research project is intended to evaluate Tai Chi’s impact on balance self-efficacy during occupational performance— specifically in regards to individuals with Mild Cognitive Impairment (MCI). MCI is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. In general, reduced balance control and increased cognitive impairment are both well-established risk factors for falls among older adults; as a result, falls and fall-related injuries are more common in individuals with MCI than in healthy controls (Tangen, Engedal, Bergland, Moger & Mengshoel, 2014). Tai Chi has been shown to be effective in improving balance, proprioception, muscle strength, and endurance (Huang, Feng, Li & Lv, 2017). Tai Chi may be particularly beneficial to older adults with MCI because it incorporates both physical and mental activity. Tai Chi requires whole-body coordination of continuous, rhythmic movements with dynamic weight shifting and single limb support (Sungkarat, Boripuntakul, Chattipakorn, Watcharasaksipl & Lord, 2017).
DESIGN: Quasi-Experimental. Participants (N=18) were individuals and their partners pre-screened and accepted into the Mayo Clinic’s HABIT (Health Actions to Benefit Independence & Thinking) Program. HABIT is a 10-day holistic wellness program offered to individuals living with a diagnosis of amnestic MCI. Participants were required to have a partner who would be included in the program; partners were friends or family members, without a diagnosis of MCI, dedicated to the participant’s successful completion of the program.
METHODS: Participants engaged in daily 45-minute standing, seated, and/or floor exercises for two weeks (10 sessions). Each 45-minute session included a 15-minute warm-up (range of motion, stretching), 20 minutes of Tai Chi exercises, and a 10-minute cool-down (mindfulness, breathing exercises). The majority of exercises involved movements associated with the Tai Chi for Arthritis and Fall Prevention Program through the Tai Chi for Health Institute. Participants completed a Likert scale questionnaire which measured balance self-efficacy when completing various daily tasks (e.g. dressing lower body, moving in/out of the bathtub, getting on/off the toilet, etc.).
RESULTS: Average self-efficacy scores of participants with MCI increased from 59.8% to 74.6%. Partners’ average scores increased from 65.9% to 86.2% A Wilcoxon Signed-Ranked Test reported z-value of -2.6783 and p-value of .00736; the results are significant at p < .05. Studies show that targeting self-efficacy is an effective means of increasing physical activity and occupational performance (Williams & French, 2011).
CONCLUSION: The findings from this study adds to the growing evidence that supports the biomechanical and psychosocial benefits of Tai Chi. Results indicate Tai Chi is an effective intervention to increase balance self-efficacy when performing daily activities in both individuals with and without Mild Cognitive Impairments.
References
Huang, Z. G., Feng, Y. H., Li, Y. H., & Lv, C. S. (2017). Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ open, 7(2), e013661.
Sungkarat, S., Boripuntakul, S., Chattipakorn, N., Watcharasaksilp, K., & Lord, S. R. (2017). Effects of tai chi on cognition and fall risk in older adults with mild cognitive impairment: a randomized controlled trial. Journal of the American Geriatrics Society, 65(4), 721-727.
Tangen, G. G., Engedal, K., Bergland, A., Moger, T. A., & Mengshoel, A. M. (2014). Relationships between balance and cognition in patients with subjective cognitive impairment, mild cognitive impairment, and Alzheimer disease. Physical Therapy, 94(8), 1123-1134.
Williams, S. L., & French, D. P. (2011). What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour—and are they the same? Health education research, 26(2), 308-322.
