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

Author: Cheng-Liang Chang1, Chien-Yu Pan2, Tsai-Chiao Wang1,3, Yu-Ting Tseng4, Chung-Yao Chien5, Tsu-Kung Lin6,7,8, Chia-Liang Tsai9
Affiliation: <sup>1</sup> Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan (ROC). <sup>2</sup> Department of Physical Education, National Kaohsiung Normal University, Kaohsiung, Taiwan (ROC). <sup>3</sup> General Research Service Center, National Pingtung University of Science and Technology, Pingtung, Taiwan (ROC). <sup>4</sup> Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan (ROC). <sup>5</sup> Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan (ROC). <sup>6</sup> Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan (ROC). <sup>7</sup> Center for Parkinson&#x27;s Disease, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (ROC). <sup>8</sup> Center for Mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (ROC). <sup>9</sup> Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan (ROC) - andytsai@mail.ncku.edu.tw.
Conference/Journal: Eur J Phys Rehabil Med
Date published: 2024 Jun 18
Other: Special Notes: doi: 10.23736/S1973-9087.24.08166-8. , Word Count: 327


Background:
Parkinson's disease (PD) is a neurodegenerative condition characterized by movement disorders and probable cognitive impairment. Exercise plays an important role in PD management, and recent studies have reported improvement in motor symptoms and cognitive function following aerobic and Tai Chi Chuan exercise.

Aim:
To explore the different effects of Tai Chi Chuan and aerobic exercise on the clinical motor status and neurocognitive performance of patients with early-stage PD.

Design:
A randomized controlled trial.

Setting:
Parkinson's Disease Center at Kaohsiung Chang Gung Memorial Hospital and National Cheng Kung University Hospital.

Population:
Patients with idiopathic PD.

Methods:
Fifty-six patients with PD were recruited and divided into three groups: aerobic exercise (AE, N.=14), Tai Chi Chuan exercise (TE, N.=16), and control (CG, N.=13). Before and after a 12-week intervention period, we used unified Parkinson's disease rating scale Part III (UPDRS-III) scores and neuropsychological (e.g., accuracy rates [ARs] and reaction times [RTs]) and neurophysiological (e.g., event-related potential [ERP] N2 and P3 latencies and amplitudes) parameters to respectively assess the patients' clinical motor symptoms and neurocognitive performance when performing a working memory (WM) task.

Results:
Compared to baseline, UPDRS-III scores were significantly lower in the AE and TE groups after the intervention period, whereas those for the CG group were higher. In terms of the neurocognitive parameters, when performing the WM task after the intervention period, the AE group exhibited significantly faster RTs and larger ERP P3 amplitudes, the TE group exhibited an improvement only in ERP P3 amplitude, and the CG group exhibited a significantly reduced ERP P3 amplitude. However, neither the TE nor the AE group exhibited improved ARs and ERP N2 performance.

Conclusions:
The present study supported the distinct effectiveness of Tai Chi Chuan and aerobic exercise for improving motor symptoms and providing neurocognitive benefits in PD patients.

Clinical rehabilitation impact:
These results have important implications regarding the use of these exercise interventions for managing PD, particularly in the early stages.


PMID: 38888734 DOI: 10.23736/S1973-9087.24.08166-8