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.