PTRCTEuropean journal of physical and rehabilitation medicine2024

Distinct effects of long-term Tai Chi Chuan and aerobic exercise interventions on motor and neurocognitive performance in early-stage Parkinson's disease: a randomized controlled trial.

Cheng-Liang Chang, Tsu-Kung Lin, Chien-Yu Pan and 4 others

PMID 38888734

WHAT IT FOUND

Both 12-week aerobic exercise and Tai Chi improved Parkinson's motor symptoms.

Only aerobic exercise improved reaction time; Tai Chi did not. Accuracy did not improve. Control participants worsened.

Key findings

01Both exercise groups improved motor symptoms: the aerobic group's UPDRS-III score changed from 6.43±5.02 to 3.79±2.15, and the Tai Chi group's score changed from 8.00±5.27 to 4.69±2.92; the control group worsened from 6.92±4.39 to 9.77±4.64.

02Only the aerobic group improved reaction time, changing from 632.41±40.56 ms to 537.54±39.15 ms; no other group or time interaction was found.

03A brain measure called P3 amplitude increased in both exercise groups (aerobic 9.92±1.66 microvolts to 11.67±1.37 microvolts; Tai Chi 11.86±1.55 microvolts to 13.40±1.29 microvolts) and decreased in the control group (13.78±1.72 microvolts to 11.56±1.43 microvolts).

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study tested only the medication on state, so it does not tell you what happens when medication is off. Participants had early-stage Parkinson's disease and were excluded for dementia, depression, or other neurological disease, so the results do not extend to more advanced or cognitively impaired patients. 13 participants withdrew and 2 were excluded for insufficient attendance. The analysed groups were 13 control, 14 aerobic exercise, and 16 Tai Chi Chuan. The Tai Chi programme was Yang-style short form, and the authors note other Tai Chi styles may have different cognitive effects. The supplied text does not name a single primary outcome, and it reported several motor, behavioural, and brain measures, so some positive findings may be secondary or exploratory. Assessments were done between 09:00 and 12:00 in the on state, which may not reflect daily fluctuations.

The easy way to misread this

Do not conclude that Tai Chi improved cognition in this trial. It improved motor scores and an attention-related brain measure, but reaction time and accuracy did not improve, and only the aerobic group showed faster reaction time.

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The study

Participants
13 control, 14 aerobic exercise, and 16 Tai Chi Chuan analysed; 56 recruited and randomly assigned to 18 aerobic exercise, 20 Tai Chi Chuan, and 18 control; 13 withdrew and 2 were excluded.
Certainty of evidence
Moderate

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Cheng-Liang Chang, Tsu-Kung Lin, Chien-Yu Pan, et al. Distinct effects of long-term Tai Chi Chuan and aerobic exercise interventions on motor and neurocognitive performance in early-stage Parkinson's disease: a randomized controlled trial. European journal of physical and rehabilitation medicine. 2024.

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