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

INTERVENTION: 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 CONDITION: Neurological ‐ Parkinson's disease Parkinson’s disease ; ; Parkinson’s disease PRIMARY OUTCOME: N2 event‐related potential (ERP) difference waveform latency recorded on electroencephalography (EEG) while conducting the S1‐S2 working memorytest[ Baseline and after 12 week‐intervention; ] Neuropsychological (i.e., reaction time and accuracy rate) of the S1‐S2 working memorytest[ Baseline and after 12 week‐intervention] P3 event‐related potential (ERP) difference waveform latency recorded on electroencephalography (EEG) while conducting the S1‐S2 working memorytest[ Baseline and after 12 week‐intervention] SECONDARY OUTCOME: Unified Parkinson’s disease rating scale part iii motor sub scale score[ Baseline and after 12 week‐intervention] INCLUSION CRITERIA: The clinical inclusion criteria were as follows: (a) a confirmed diagnosis of PD by neurologists at the Neurology Department of one of the above hospitals, and a medically stable status; (b) a modified Hoehn & Yahr score between 1 and 2, indicating early‐stage PD; (c) the absence of any major comorbidities, such as dementia or depression; (d) no brain abnormalities (e.g., stroke or malignant brain tumor) on structural MRI scans; (e) age between 50 and 80 years; (f) confirmed ability to complete exercise training, as determined using the Physical Activity Readiness Questionnaire (PAR‐Q) and by their treating neurologist; and (g) willingness to be randomly assigned to one of the exercise intervention groups or the control group.