Implementing an Online Virtual Falls Prevention Intervention During a Public Health Pandemic for Older Adults with Mild Cognitive Impairment: A Feasibility Trial

Purpose: This study evaluates the feasibility of delivering a virtual (online) falls prevention intervention for older adults with mild cognitive impairment (MCI).

Methods: Community-dwelling older adults with MCI (mean age = 76.2 years, 72% women) were randomized to either a Tai Ji Quan (n = 15) or stretching group (n = 15) and participated in 60-minute virtual exercise sessions, via Zoom, twice weekly for 24 weeks. The primary outcome was the incidence of falls. Secondary outcomes were the number of fallers and changes from baseline in the 4-Stage Balance Test, 30-second chair stands, and Timed Up and Go Test under both single- and dual-task conditions.

Results: The intervention was implemented with good fidelity, an overall attendance rate of 79%, and 13% attrition. Compared with stretching, Tai Ji Quan did not reduce falls (incidence rate ratio = 0.58; 95% confidence interval [CI], 0.32 to 1.03) or the number of fallers (relative risk ratio = 0.75; 95% CI, 0.46 to 1.22) at week 24. The Tai Ji Quan group, however, performed consistently better than the stretching group in balance (between-group difference in change from baseline, 0.68 points; 95% CI, 0.12 to 1.24), 30-second chair stands (1.87 stands; 95% CI, 1.15 to 2.58), and Timed Up and Go under single-task (-1.15 seconds; 95% CI, -1.85 to -0.44) and dual-task (-2.35; 95% CI, -3.06 to -1.64) conditions. No serious intervention-related adverse events were observed.

Conclusion: Findings from this study suggest the feasibility, with respect to intervention fidelity, compliance, and potential efficacy, of implementing an at-home, virtual, interactive Tai Ji Quan program, delivered in real-time, as a potential balance training and falls prevention intervention for older adults with MCI. The study provides preliminary data to inform future trials.