Effects of chronic Tai Chi Chuan and aerobic exercise interventions on motor and neurocognitive performance in early-stage Parkinson’s disease

The 12-week aerobic exercise program consisted of a 30 min training session performed three times weekly on a recumbent stationary bicycle. Before every training session, each participant’s resting heart rate was measured to calculate their heart rate reserve (HRR). The aerobic exercise protocol included a 4 min warm-up phase, followed by 24 min of moderate-to-high-intensity interval aerobic training (eight cycles of 1 min with 70–75% HRR followed by a 2 min active recovery period [target RPE: 9–11]), and finally a 2 min cool-down period. The target HR was monitored using a Polar HR monitor (RS800CX, Polar Electro Oy, Kempele, Finland). The participants were verbally encouraged to achieve the appropriate intensity for each phase, and they exercised under the medical supervision of a physical therapist. The 12-week Tai Chi Chuan program comprised two 60 min sessions per week, and each session was led by a Tai Chi Chuan master with over 20 years of experience. The session consisted of a warm-up and the main exercise, and all movements were adapted from the Yang-style short form. The warm-up session included the bear swing, the Tai Chi walk, and a range of motion exercises. It focused on kinesthetic awareness, mind–body preparation, and stretching and incorporated high-amplitude and diagonal movements. The main exercise phase focused on weight-shifting skills; bilateral coordination; and postural control, including preparation, beginning, roll back, ward off, push, press, and single whip elements. The Tai Chi master first demonstrated a movement, then deconstructed it and taught it step by step. To ensure accuracy, the master corrected each participant’s movements. One to two new movements were taught in each session, and the entire sequence of learned postures was practiced together to reinforce the connection between the mental tracking and the physical aspect. In addition to the postures, the participants were taught other essential elements of Tai Chi Chuan, such as body orientation, breathing, and relaxation. 1. The aerobic exercise will be run individually and the Tai Chi Chuan will be a group class with the ratio of 1:5~1:10 (5~10 participants with 1 leader) 2. Each participant will only attend in one group. 3. Attendance record will be done in each intervention to monitor the adherence. Each participant will only attend in one group, one program.