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Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

ABSTRACT: The incidence of strokes in industrialized nations is on the rise, particularly in the older population. In Canada, a minority of individuals who have had a stroke actually receive intensive rehabilitation because most stroke patients do not have access to services or because their motor recovery was judged adequate to return home. Thus, there is a considerable need to organize home-based rehabilitation services for everyone who has had a stroke. To meet this demand, telerehabilitation, particularly from a service center to the patient's home, is a promising alternative approach that can help improve access to rehabilitation services once patients are discharged home.This non-inferiority study will include patients who have returned home post-stroke without requiring intensive rehabilitation. To be included in the study, participants will: 1) not be referred to an Intensive Functional Rehabilitation Unit, 2) have a Rankin score of 2 or 3, and 3) have a balance problem (Berg Balance Scale score between 46 and 54). Participants will be randomly assigned to either the teletreatment group or the home visits group. Except for the delivery mode, the intervention will be the same for both groups, that is, a personalized Tai Chi-based exercise program conducted by a trained physiotherapist (45-minute session twice a week for eight consecutive weeks). The main objective of this research is to test the non-inferiority of a Tai Chi-based exercise program provided via telerehabilitation compared to the same program provided in person at home in terms of effectiveness for retraining balance in individuals who have had a stroke but do not require intensive functional rehabilitation. The main outcome of this study is balance and mobility measured with the Community Balance and Mobility Scale. Secondary outcomes include physical and psychological capacities related to balance and mobility, participants' quality of life, satisfaction with services received, and cost-effectiveness associated with the provision of both types of services.ClinicalTrials.gov: NCT01848080.

SUBMITTER: Tousignant M

PROVIDER: S-EPMC3912257 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

Tousignant Michel M Corriveau Hélène H Kairy Dahlia D Berg Katherine K Dubois Marie-France MF Gosselin Sylvie S Swartz Richard H RH Boulanger Jean-Martin JM Danells Cynthia C

Trials 20140130

<h4>Background</h4>The incidence of strokes in industrialized nations is on the rise, particularly in the older population. In Canada, a minority of individuals who have had a stroke actually receive intensive rehabilitation because most stroke patients do not have access to services or because their motor recovery was judged adequate to return home. Thus, there is a considerable need to organize home-based rehabilitation services for everyone who has had a stroke. To meet this demand, telerehab ...[more]

PMID: 24479760

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Project description:Background:The newly compiled Bafa Wubu of Tai Chi (Eight Methods and Five Footworks) is a fitness routine that has been developed in accordance with the appeal of the General Administration of Sport of China and promoted both in China and abroad. This paper aims to compare the differences in energy consumption and related parameters between the two types of Tai Chi. Methods:A total of 60 healthy participants were recruited; 37 males (aged 37.4?±?10.4?years) and 23 females (aged 31.9?±?12.8?years). The maximal exercise capacity of participants was measured at baseline. Then, they received Tai Chi training for 12-week and their energy metabolism was measured dynamically. Results:A set of the Bafa Wubu of Tai Chi requires approximately 3?min, while a set of 24 form simplified Tai Chi approximately 5?min and 40?s. The average oxygen uptake/kg (VO2/kg, 10.8?±?2.52?ml/kg/min vs. 12.9?±?2.59?ml/kg/min, P?=?0.000), the highest VO2/kg (19.3?±?6.03?ml/kg/min vs. 24.1?±?7.50?ml/kg/min, p?=?0.000, the average metabolic equivalent (METs,2.3?±?0.16 METs vs. 3.2?±?0.14 METs, p?=?0.000), the highest oxygen pulse (VO2/HR, 11.1?±?0.99?ml vs. 13.9?±?0.93?ml, p?=?0.000) and rate of perceived exertion (RPE, 10.7?±?0.70 vs. 1.3?±?0.62, p?=?0.000) gained immediately after Bafa Wubu of Tai Chi exercise were significantly lower than those in 24 form simplified Tai Chi; heart rate recovery (HRR,1.5?±?0.41 vs. 1.3?±?0.45, p?=?0.008) at 1?min after the practice was significantly higher than after the 24 form simplified Tai Chi. Meanwhile, the average heart rate (HR, 104.1?±?11.41?bpm vs. 105.7?±?9.68?bpm, p?=?0.696) and the highest respiratory quotient (RQ, 1.0?±?0.06 vs. 0.9?±?0.09, p?=?0.643) were not significantly different. The intensity of Tai Chi was described as the highest oxygen uptake of the participants when they performed the Tai Chi divided by their individual maximal oxygen uptake. Tai Chi intensity during Bafa Wubu of Tai Chi (50%?±?11.7% vs. 64%?±?12.5%) was significantly lower than during 24 form simplified Tai Chi. Conclusion:The newly compiled Bafa Wubu of Tai Chi is characterized by lower energy consumption than 24 form simplified Tai Chi. Trial registration:Ethics Committee of Sports Science Experiment, Beijing Sport University- 2018010H. Registered 19 June 2018.

Project description:BackgroundPrevious research has suggested that tai chi offers a therapeutic benefit in patients with fibromyalgia.MethodsWe conducted a single-blind, randomized trial of classic Yang-style tai chi as compared with a control intervention consisting of wellness education and stretching for the treatment of fibromyalgia (defined by American College of Rheumatology 1990 criteria). Sessions lasted 60 minutes each and took place twice a week for 12 weeks for each of the study groups. The primary end point was a change in the Fibromyalgia Impact Questionnaire (FIQ) score (ranging from 0 to 100, with higher scores indicating more severe symptoms) at the end of 12 weeks. Secondary end points included summary scores on the physical and mental components of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). All assessments were repeated at 24 weeks to test the durability of the response.ResultsOf the 66 randomly assigned patients, the 33 in the tai chi group had clinically important improvements in the FIQ total score and quality of life. Mean (+/-SD) baseline and 12-week FIQ scores for the tai chi group were 62.9+/-15.5 and 35.1+/-18.8, respectively, versus 68.0+/-11 and 58.6+/-17.6, respectively, for the control group (change from baseline in the tai chi group vs. change from baseline in the control group, -18.4 points; P<0.001). The corresponding SF-36 physical-component scores were 28.5+/-8.4 and 37.0+/-10.5 for the tai chi group versus 28.0+/-7.8 and 29.4+/-7.4 for the control group (between-group difference, 7.1 points; P=0.001), and the mental-component scores were 42.6+/-12.2 and 50.3+/-10.2 for the tai chi group versus 37.8+/-10.5 and 39.4+/-11.9 for the control group (between-group difference, 6.1 points; P=0.03). Improvements were maintained at 24 weeks (between-group difference in the FIQ score, -18.3 points; P<0.001). No adverse events were observed.ConclusionsTai chi may be a useful treatment for fibromyalgia and merits long-term study in larger study populations. (Funded by the National Center for Complementary and Alternative Medicine and others; ClinicalTrials.gov number, NCT00515008.)

Dataset Information

Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

Publications

Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

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