Acute Effect of Exergaming Based Sitting Tai Chi

Acute Effect of Exergaming-Based Sitting Tai Chi on Prefrontal Cortex Efficiency in Young and Older Adults: An fNIRS Study

This study examines whether a single session of exergaming-based seated Tai Chi can acutely improve working memory, executive function, and prefrontal cortical efficiency in younger and older adults, compared with seated stretching. Using a within-subject crossover design, 40 participants aged 18-30 years and 60-75 years will complete both conditions in counterbalanced order on separate days. Cognitive performance will be assessed with Flanker and n-back tasks, while prefrontal activity will be recorded with fNIRS over the dorsolateral, ventrolateral, and frontopolar prefrontal cortex. Neural efficiency will be estimated by integrating task performance with task-evoked oxygenated hemoglobin responses.

The Tai Chi intervention is a 40-minute seated, exergame-guided 12-form routine preceded and followed by brief warm-up and cool-down periods. The control condition is a time-matched seated stretching programme without Tai Chi-specific movements or game feedback. Both conditions will be delivered at light-to-moderate intensity and supervised for safety and adherence.

The study tests whether acute exergaming-based seated Tai Chi produces greater post-intervention improvements in cognitive performance and more efficient prefrontal activation than stretching, and whether these effects differ by age group. Findings may clarify how a feasible seated mind-body exergame influences acute cognitive and neural responses across the adult lifespan.

This proposal examines the immediate cognitive and neural effects of a seated, exergame-supported Tai Chi session in younger and older adults. The study is designed to test whether a single bout of this low-impact mind-body exercise can influence working memory, inhibitory control, and prefrontal cortex activity more effectively than a seated stretching session of equal duration. By comparing two age groups, the project also seeks to determine whether age modifies the size or pattern of these acute responses.

The study uses a randomized within-subject crossover design, in which each participant completes both the exergaming-based seated Tai Chi condition and the control stretching condition on separate days. Forty older adults will be recruited, including 20 younger adults aged 18-30 years and 20 older adults aged 60-75 years. Before and after each session, participants will complete computerized cognitive tasks measuring executive function and working memory. At the same time, brain activity will be monitored with functional near-infrared spectroscopy, focusing on prefrontal regions linked to attention, control, and task monitoring.

The Tai Chi session is delivered through an interactive exergame platform that standardizes movement pace, provides visual and auditory cues, and includes a structured sequence of seated Tai Chi forms. This format is intended to preserve the cognitive-motor features of Tai Chi while making the activity accessible to adults who may have limited mobility. The comparison condition consists of seated stretching exercises matched for overall duration and physical effort but without Tai Chi-specific sequencing or game-based feedback.

Outcome analysis will compare changes in task performance, prefrontal oxygenation, and a combined neural efficiency index across conditions, time points, and age groups. The study aims to clarify whether this form of seated exergaming can produce measurable short-term benefits for cognition and brain efficiency, and whether such effects differ between younger and older adults.

Inclusion Criteria:

• Are aged 18-30 years (young adult group) or 60-75 years (older adults)
• Have no current regular participation (e.g., ≥1 session/week) in Tai Chi, martial arts, or other mind-body exercise (e.g., yoga or qigong) in the last 3-6 months
• Have no self-reported or clinically documented history of mild cognitive impairment, dementia, or other neurological (e.g., stroke) or psychiatric disorders (e.g., schizophrenia) known to affect cognition
• Score within the normal range on the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) based on established age- and education-adjusted cutoffs
• Are medically stable, with or without controlled chronic conditions (e.g., controlled hypertension or diabetes)
• Are able to tolerate light-to-moderate seated exercise (Chinese version of Physical Activity Readiness Questionnaire score = 0)
• Have no significant sensory impairment (e.g., vision) not corrected by assistive devices (e.g., glasses)
• Are not engaged in regular structured exercise involving moderate-to-vigorous intensity physical activity (e.g., brisk walking, running, or racquet sports) more than two times per week over the preceding three months
• Are able to communicate in Chinese (Moved from Exclusion for clarity)

Exclusion Criteria:

• Have medical conditions that may interfere with safe participation, including pacemaker implantation or prosthetic devices
• Have serious orthopedic or cardiovascular disorders that could affect participation in exergaming training
• Have significant motor or balance impairment that would prevent performing basic seated arm and trunk movements
• Are currently undergoing other clinical trials or structured exercise or cognitive training programmes >2 times/week during the preceding three months