Exergaming-based Sitting Tai Chi for Sarcopenia and/or Frailty

NCT07616219 | Enrolling By Invitation

• 1 other identifier: ETC - LTCF
• Study Type: interventional
• Target: 152
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial will evaluate the effects of an exergaming-based sitting Tai Chi program on muscle strength, physical function, cognition, and psychosocial outcomes in older adults living in residential care facilities who are at risk of sarcopenia and/or prefrailty. Eligible participants aged 60 years or older will be identified using simple screening criteria for sarcopenia and prefrailty and will not meet full diagnostic criteria for sarcopenia or frailty. A total of 152 participants will be randomly assigned to either an individually supervised exergaming-based sitting Tai Chi intervention or a group-based general health education control, each delivered twice weekly for 12 weeks. The primary outcome is dominant-hand grip strength, a core indicator of sarcopenia-related muscle weakness. Key secondary outcomes include sitting balance and functional reach assessed by the Modified Functional Reach Test, with additional secondary measures of muscle mass, lower-extremity function, activities of daily living, upper-limb dexterity, cognitive performance, reaction time, mood, and health-related quality of life. Outcomes will be assessed at baseline, mid-intervention, post-intervention, and 3-month follow-up. The findings will provide preliminary evidence on whether chair-based exergaming Tai Chi can be integrated into routine residential care to support healthy aging and functional independence.

Conditions

Sarcopenia in Elderly; Frailty at Older Adults

Keywords

exergaming; Tai Chi; sarcopenia; frailty

Outcome Measures

Primary Outcomes (1)

• Maximal handgrip strength

  Change in maximal handgrip strength (kg) measured with a Jamar Plus+ Digital Hand Dynamometer. Participants are seated with the elbow flexed at approximately 90 degrees. Three trials per hand are performed, and the highest value recorded from either hand is used. Higher values indicate greater muscle strength.

  Baseline (Week 0), mid-intervention (Week 6, after 12 sessions), post-intervention (Week 12, after 24 sessions), and 3-month follow-up (Week 24, approximately 12 weeks after the final intervention session).

Secondary Outcomes (10)

• Sitting Balance and Functional Reach (Modified Functional Reach Test)

  Baseline (Week 0), mid-intervention (Week 6, after 12 sessions), post-intervention (Week 12, after 24 sessions), and 3-month follow-up (Week 24, approximately 12 weeks after the final intervention session).

• Skeletal Muscle Mass Index (SMI)

  Baseline (Week 0), mid-intervention (Week 6, after 12 sessions), post-intervention (Week 12, after 24 sessions), and 3-month follow-up (Week 24, approximately 12 weeks after the final intervention session).

• Lower-Extremity Function (Five Times Sit-to-Stand Test)

  Baseline (Week 0), mid-intervention (Week 6, after 12 sessions), post-intervention (Week 12, after 24 sessions), and 3-month follow-up (Week 24, approximately 12 weeks after the final intervention session).

• Independence in Activities of Daily Living (Katz ADL-C)

  Baseline (Week 0), mid-intervention (Week 6, after 12 sessions), post-intervention (Week 12, after 24 sessions), and 3-month follow-up (Week 24, approximately 12 weeks after the final intervention session).

• Upper-Limb Dexterity on the Box and Block Test

  Baseline (Week 0), mid-intervention (Week 6, after 12 sessions), post-intervention (Week 12, after 24 sessions), and 3-month follow-up (Week 24, approximately 12 weeks after the final intervention session).

Study Arms (2)

Exergaming-based sitting Tai Chi

EXPERIMENTAL

Participants allocated to the intervention group will receive a structured exergaming-based seated Tai Chi program. The program uses a 12-form seated Tai Chi exergame delivered in 24 sessions over 12 weeks, with each session lasting approximately 60 minutes.

Behavioral: Exergaming-based sitting Tai Chi

General health education

PLACEBO COMPARATOR

Participants allocated to the control group will attend small-group health education sessions focusing on general health topics relevant to older adults (e.g., oral health, common colds, and skin care) for 24 sessions over 12 weeks, with each session lasting approximately 60 minutes.

Behavioral: General health education

Interventions

Exergaming-based sitting Tai Chi BEHAVIORAL

The structure and content of the 12-form seated Tai Chi routine build on earlier sitting Tai Chi programs developed by Tsang and colleagues for frail older adults and neurological populations. The program targets three domains: (i) balance control, (ii) eye-hand coordination, and (iii) limb flexibility. Training is organized into progressive phases (learning, skill-specific training, and game modes). Each session begins with a 5-minute warm-up and ends with cool-down stretching and breathing exercises.

Exergaming-based sitting Tai Chi

General health education BEHAVIORAL

Health education will be delivered using audio visual materials, brief talks and interactive discussion to provide engaging but non specific information about daily health management.

General health education

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• aged ≥60 years;
• at risk of sarcopenia and/or prefrailty. At risk of sarcopenia is defined as meeting at least one of the following criteria: SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls) score ≥4, calf circumference \<34 cm for men or \<33 cm for women, while prefrailty is defined as a Fried Frailty Phenotype score of 1-2;
• score ≥7 on the Chinese (Hong Kong) version of the Abbreviated Mental Test;
• can stand independently for assessment; and
• can understand and follow intervention and assessment instructions.

You may not qualify if:

• absence of full diagnostic criteria is required; therefore residents with confirmed sarcopenia as defined by the Asian Working Group for Sarcopenia 2019 or confirmed frailty as defined by the Fried Frailty Phenotype (score 3-5) will be excluded;
• severe cognitive, sensory, or communication impairments not adequately corrected with aids;
• uncontrolled medical, neurological, orthopaedic, cardiovascular, or psychiatric conditions that preclude safe participation;
• prior experience of regular practice of Tai Chi \>1 month; or
• current participation in another clinical trial.
• absence of full diagnostic criteria is required; therefore, residents with confirmed sarcopenia as defined by the Asian Working Group for Sarcopenia 2019 or confirmed frailty as defined by the Fried Frailty Phenotype (score 3-5) will be excluded;
• severe cognitive, sensory, or communication impairments not adequately corrected with aids;
• uncontrolled medical, neurological, orthopedic, cardiovascular, or psychiatric conditions that preclude safe participation;
• prior regular practice of Tai Chi for more than 1 month; or
• current participation in another clinical trial.

Sponsors & Collaborators

• Hong Kong Metropolitan University: lead

Study Sites (1)

Exergaming Research Centre, Hong Kong Metropolitan University

Ho Man Tin, Kowloon, Hong Kong

Location

Related Publications (1)

• Tsang WW, Gao KL, Chan KM, Purves S, Macfarlane DJ, Fong SS. Sitting tai chi improves the balance control and muscle strength of community-dwelling persons with spinal cord injuries: a pilot study. Evid Based Complement Alternat Med. 2015;2015:523852. doi: 10.1155/2015/523852. Epub 2015 Jan 21.

  PMID: 25688276 BACKGROUND

MeSH Terms

Conditions

Sarcopenia; Frailty

Condition Hierarchy (Ancestors)

Muscular Atrophy; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Atrophy; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pathologic Processes

Study Officials

• Tai Wa Liu, PhD

  Hong Kong Metropolitan University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Because of the nature of the intervention, participants and intervention providers cannot be blinded. However, all outcome assessments will be conducted by research staff who are blinded to group allocation, have no role in randomization or intervention delivery, and have no access to the allocation list, to minimize measurement bias in this complex intervention trial. Participants, residential care staff, and intervention providers will be instructed not to disclose allocation to assessors, and assessors will remind participants at each visit not to reveal details of their intervention.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: May 21, 2026
• First Posted: June 1, 2026
• Study Start: March 1, 2026
• Primary Completion (Estimated): September 30, 2027
• Study Completion (Estimated): December 31, 2027
• Last Updated: June 8, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP
• Time Frame: After the study published.

Locations

HK (1)