Table 2 Tai Chi exercise prescription and instructional methods Evaluation Tool to transparently report the TACIT Tai Chi intervention [46]

 Time

Each session will last 90 min; 45 min’ Tai Chi followed by up to 45 min’ informal discussion.

 Length

20 week course designed for the trial.

 Frequency

Weekly Tai Chi class.

 Style

Old-frame Chen

 Number of forms

8 warm-up patterns (Baduanjin) and 5 Tai Chi form patterns

 Names of forms

8 warm-up patterns (Baduanjin):

Note: Some patterns differ to the more common Baduanjin patterns found online and Chinese government sponsored Baduanjin, as the Elemental Tai Chi lineage is different. Patterns are refined as the course progresses.

1. Raising the Sky

2. Gathering the Heavens

3. Cow Looks at the Moon

4. Directing the Ocean (slightly adapted for older generation)

5. Shaolin Archer

6. Qi Gong Punching

7. Separating Heaven and Earth

8. Shaking the Earth

5 Tai Chi form patterns

1. Grand Ultimate Beginning

2. Immortal Pounds Mortar

3. Lazy to Roll Sleeves

4. Six Seals and Four Closes

5. Single Whip

 Movement principles

The basic tenets of Tai Chi are emphasised throughout the course. Each class will emphasise good body posture, slow and controlled body movements, and correct joint positioning in regard to the knee (to never extend beyond the foot).

 Breathing techniques

The Baduanjin will emphasise moving with the breath, with slow and controlled breathing during body movements. Breathing during the Tai Chi form will be encouraged to be natural with no specific breathing emphasised, because the addition of Buddhist breathing or Daoist reverse breathing would be too advanced for beginners. Each class will end with standing meditation.

 Relaxation

The course itself is designed to elicit a mental state of calm without the requirement to explicitly instruct students to be calm. The meditation at the end of each class is also a relaxation exercise.

 Progression

Progression of Tai Chi will be taught over the 20-week course. In particular, participants will be encouraged to start from their current level of physical ability and develop over the course (e.g. if cannot stand for the whole session to begin with, work toward being able to stand for the whole session). In addition, participants will gradually be taught the warm-up patterns and Tai Chi form patterns with repetition of all patterns every week. New warm-up and Tai Chi form patterns will be gradually introduced

 Instructor credentials

Both instructors are experienced and have qualifications at senior instructor level for public Tai Chi classes.

 Number of instructors

2

 Unsupervised practice

Participants will be asked to practise Tai Chi at home 20 min per day (or if not possible then the equivalent across the week). Carers are to facilitate the person with dementia to practise Tai Chi at home. Home practice is encouraged by a 30-min home visit by the Tai Chi instructor and provision of coloured home exercise booklets and homework sheets for each week (see intervention section).

 Additional information

The intervention is delivered each week using as its ethos 7 core principles:

1. Safety is paramount

2. Instruction is to be tailored to each participant’s capability

3. Participants are to do Tai Chi standing up (not seated)

4. Participants are to be challenged to progress in their physical ability (e.g. to hold positions for longer periods)

5. Classes will have a friendly and enjoyable environment

6. Weekly emphasis on the importance of home practice

7. Weekly invitation for participants to socialise at the end of each class with each other and talk with the instructor