Sitting Tai Chi to help thinking and function after chronic stroke

Effects of a Sitting Tai Chi Programme for Chronic Stroke Survivors With Post-stroke Cognitive Impairment: A Pilot Randomised Controlled Trial

This program will try sitting Tai Chi for people with chronic stroke who have mild-to-moderate thinking problems to improve cognition, arm use, balance, mood, and daily activities.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 176 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Chinese University of Hong Kong (Academic / other)
• Locations: 1 site (Kunming, Yunnan)
• Trial ID: NCT07512739 on ClinicalTrials.gov

What this trial studies

This is a feasibility and preliminary-effectiveness trial of a tailored sitting Tai Chi programme for chronic stroke survivors with post-stroke cognitive impairment (PSCI). Participants meeting cognitive and physical inclusion criteria (MoCA 19–25, able to sit independently and lift at least one arm, Chinese-speaking, with a primary caregiver) will take part in the sitting Tai Chi intervention while adherence, safety, and clinical outcomes are tracked. Outcome measures include cognitive test scores, upper-limb function, balance control, activities of daily living, depressive symptoms, and quality of life, with feasibility metrics such as recruitment rate and session attendance. The programme is delivered at a geriatric rehabilitation ward in Kunming and builds on prior positive results of sitting Tai Chi in subacute stroke without cognitive impairment.

Who should consider this trial

Good fit: Ideal candidates are adults in the chronic stage of ischemic or hemorrhagic stroke who meet DSM-5 criteria for PSCI with MoCA scores of 19–25, can sit independently and raise at least one arm, can communicate in Chinese, have a primary caregiver, and are currently hospitalized at the participating rehabilitation ward.

Not a fit: Patients with more severe cognitive impairment (MoCA below the eligibility range), those unable to sit or raise an arm, non-Chinese speakers, or people not admitted to the participating hospital are unlikely to benefit from this specific programme.

Why it matters

Potential benefit: If successful, the programme could offer a low-cost, low-impact rehabilitation option that improves thinking, arm function, balance, mood, and daily independence for chronic stroke survivors with mild-to-moderate cognitive impairment.

How similar studies have performed: Several systematic reviews and studies have reported that Tai Chi benefits people with mild cognitive impairment, and the investigators' prior randomized trial of a sitting Tai Chi programme improved function in subacute stroke survivors without cognitive impairment, but sitting Tai Chi in chronic PSCI is less studied.

Eligibility criteria

Inclusion Criteria for stroke patients:

\- Individuals who meet the following criteria will be recruited: i. aged 18 years or above; ii. have been admitted to a hospital with a clinical diagnosis of first or recurrent ischaemic or haemorrhagic stroke, and meet the diagnostic criteria of PSCI (classified according to DSM-5 criteria); iii. in the chronic stage of stroke; iv. MoCA score: 19-25 (two points are added if the individual has ≤ 6 years of education; one point is added if the individual has \> 6 and ≤ 12 years of education, no points are added for the individual with \> 12 years of education); v. be able to sit independently with or without sitters; vi. be able to use and raise at least one arm while sitting (upper extremity muscle strength ≥ Ⅲ); vii. have a primary caregiver (a paid or unpaid person who provides most assistance to the stroke survivor); viii. be able to communicate in Chinese and provide informed consent; ix. is currently hospitalised in this geriatric rehabilitation ward and unlikely to be discharged within 3 months.

Exclusion Criteria for stroke patients:

* Individuals will be excluded if other causes of cognitive impairment are present, such as Alzheimer's disease, acquired immune deficiency syndrome, a National Institutes of Health Stroke Scale (NIHSS) score \>16, severe hearing or visual impairment, severe complications following a stroke (e.g., limited comprehension and receptive aphasia, venous thrombosis), a history of severe medical conditions or current serious illnesses (e.g. myocardial infarction, use of a cardiac pacemaker or a defibrillator, organ failure, malignancy, mental diseases, other neurological diseases such as multiple sclerosis or Parkinson's disease, having received thrombolytic therapy or surgery, joint replacement surgeries or fractures within the past six months), pregnant or lactating women; prior regular (at least three times/week) Tai Chi practice or other mind-body exercises (e.g., Yoga, Qigong, Ba Duanjin, or mindfulness training) within the past six months; and those participating in other clinical trials that might influence this study.

Inclusion criteria for caregivers:

i. age ≥ 18 years; ii. be able to communicate in Chinese and provide informed consent; iii. medically stable and physically able to provide support.

Exclusion criteria for caregivers:

i. impaired cognitive functions (Abbreviated Mental Test, AMT ≤ 7); ii. being a medical resident/trainee or a physical therapist; iii. having prior regular (at least three times/week) Tai Chi practice or other mind-body exercises (e.g., Yoga, Qigong, Ba Duanjin, or mindfulness training) within the past six months; iv. participating in other clinical trials that might influence affect this study.

Where this trial is running

Kunming, Yunnan

• The Second People's Hospital of Kunming — Kunming, Yunnan, China (Recruiting)

Study contacts

• Study coordinator: Jie Zhao Dr., PhD

Conditions Stroke; Cognitive Impairment