Martial arts training increases physical activity in adults with cognitive impairment

Key takeaways:

• The tai ji quan interventions led to improved MVPA in adults with MCI or memory concerns over stretching.
• The data are of “high public health importance” due to the health benefits of PA, researchers said.

A tai ji quan-based training program increased physical activity levels in older adults with mild cognitive impairment and increased risk for dementia, results from a secondary analysis of a randomized study showed.

The findings, published in JAMA Network Open, suggest that tai ji quan, also known as tai chi, delivered via a telehealth-based format can promote increases in moderate to vigorous physical activity that can achieve guidelines-based recommendations among older adults with cognitive impairment and memory issues, researchers.

”Tai ji quan, a therapeutic mind-body exercise, produces multiple health benefits for older

adults, including cognitive health in those with [mild cognitive impairment] and is recommended for older adults to increase their levels of [physical activity],” according to Fuzhong Li, PhD, from the Oregon Research Institute, and colleagues. “In addition, tai ji quan requires minimal space and no special equipment, and it has shown promise as a low-cost, cognitively enhancing, safe, and scalable modality; these features are clinically and pragmatically well suited for this at-risk population.”

In the secondary analysis, the researchers examined a randomized clinical trial, conducted virtually at community-dwelling participants’ homes, to assess the effectiveness of the exercise technique on moderate to vigorous physical activity volume.

The trial included 304 adults aged 65 years or older with mild cognitive impairment or self-reported memory concerns randomly assigned in a 1:1:1 ratio to either standard tai ji quan, cognitively enhanced tai ji quan or stretching for 1 hour semiweekly for 6 months.

The cognitive enhanced tai jin quan intervention “concomitantly added a set of cognitive exercises involving interactive, reactive, and verbal and nonverbal cueing,” Li and colleagues explained.

Researchers assessed moderate to vigorous physical activity at baseline, 2 months, 4 months and 6 months through the International Physical Activity Questionnaire.

Li and colleagues found that both tai ji quan groups had increased moderate to vigorous physical activity levels compared with the stretching control group at 12 months, with mean differences from baseline of:

• 66 minutes a week (95% CI, 25-108) with standard tai ji quan; and
• 65 minutes a week (95% CI, 24-108) with cognitively enhanced tai ji quan.

Meanwhile, results showed ORs for meeting the recommended 150 minutes per week of moderate to vigorous physical activity for older adults of 3.11 (95% CI, 1.75-5.53) for the standard tai ji quan group and 3.67 (95% CI, 2.02-6.65) for the cognitively enhanced tai ji quan group vs. stretching group.

The researchers acknowledged some study limitations. For example, participants self-reported moderate to vigorous physical activity, nor did the results offer insights into whether the increased moderate to vigorous physical activity observed “contributes to long-term ...behavior change,” they wrote.

Additionally, the study included mostly white individuals and women, limiting the general applicability of the results..

The underlying mechanisms behind tai ji quan leading to improved moderate to vigorous physical activity following the intervention “are currently an open question,” Li and colleagues explained.

“One hypothesis is that tai ji quan training improved participants’ movement confidence, as shown by ABC scores, and induced them to become more physically active.”

The findings are “of high public health importance” because increased physical activity is tied to health benefits like improved physical and cognitive function and lower risks for all-cause mortality, cognitive decline and dementia, the researchers added.

“Therefore, tai ji quan may be prescribed by clinicians as a means of promoting free-living physical activity in the community and managing [mild cognitive impairment] or memory concerns in clinical practice.”.