Tai chi for enhanced inpatient mobilization: A feasibility study.

OBJECTIVE: To determine whether utilizing beginner, video-guided tai chi and qigong classes as an adjunct to physical therapy to enhance mobilization among hospitalized patients is feasible and acceptable. DESIGN: Single-arm feasibility study over a 15½-week period. SETTING: Three medical-surgical units at one hospital. INTERVENTIONS: Small-group video-guided beginner-level tai chi and qigong classes supervised by physical therapists occurred three times a week. MAIN OUTCOME MEASURES: The primary outcome was weekly class attendance. Secondary outcomes included patient and staff satisfaction, collected by surveys and semi-structured interviews. Process measures included class duration. Balancing measures included falls. RESULTS: One-hundred and fifty-seven patients were referred for recruitment, 45 gave informed consent, and 38 patients attended at least one class. The number of weekly class attendees increased during the study period. Based on first-class experience, 68% (26/38) of patients reported enjoying the class "quite a bit" or "extremely," 66% (25/38) of patients reported feeling "more mobile" afterward, and 76% (29/38) of patients agreed that the class made them more comfortable going home. Average class duration was 29 minutes. Zero falls occurred during or immediately following class. CONCLUSIONS: Video-guided tai chi and qigong classes are feasible and well-received at our hospital. Future studies of the impact on preserving mobility and function or reducing length of stay are of interest.

Taiji (Tai Chi) For Fall Prevention in the Elderly: Training the Trainers Evaluation Project.

Falls in the elderly are common and a major, costly health problem. Taiji addresses many issues related to fall risk. We determined whether intensive weekend training can sufficiently train persons who have baseline familiarity with Taiji to model and teach fundamentals of Taiji to the elderly. Prior to training, registrants received a manual, video and online links for review and practice. Assessments were completed pre-/post-training. Training occurred in four cities of one state. 34 adults completed training, two did not complete evaluations (ns = 12, 13, 4, and 5 at the four sites). Each training course consisted of two 9-hour days that educated prospective instructors on issues pertinent to the elderly, evaluation techniques, warm-up and cool-down movements and seated and standing Taiji postures. Assessments included pre-/post-knowledge test, Timed Up, and Go and Functional Reach Assessment. Nearly all participants with pre-/post-assessments (30/32, 94%) demonstrated adequate skills post-training. Knowledge of Taiji increased significantly from pre- to post-training (P < .01). Brief, intensive weekend training can increase the available workforce to train the elderly in fundamentals of Taiji for fall prevention.

Evaluating Exercise Prescription and Instructional Methods Used in Tai Chi Studies Aimed at Improving Balance in Older Adults: A Systematic Review.

OBJECTIVES: To develop an evaluation instrument to determine to what extent Tai Chi interventions aimed at improving the balance of older adults disclosed their exercise prescription (Ex Rx ) and instructional methods and met best-practice exercise recommendations for balance improvement. DESIGN: Review. SETTING: PubMed, Scopus, and CINAHL databases were searched from their inception until August 22, 2014. PARTICIPANTS: Adults aged 60 and older without debilitating disease. MEASUREMENTS: Three electronic databases were searched to identify randomized controlled trials (RCTs) of Tai Chi interventions aimed at improving balance in older adults without severe debilitating diseases. Three Ex Rx (frequency, time, intervention length) and 10 instructional (e.g., style, number of forms) methods of the included RCTs were evaluated. RESULTS: Twenty-seven interventions were identified from 26 RCTs. On average, Tai Chi was performed for a mean 56.5 ± 14.4 minutes per session for 2.8 ± 1.4 sessions per week for 19.7 ± 12.7 weeks. Most interventions reported all three Ex Rx methods items, with a mean reporting rate of 92.6 ± 19.2%. For the 10 instructional methods items, the mean reporting rate was 41.1 ± 18.0%, significantly lower than for the Ex Rx methods items (P < .001). Fewer than half of the interventions reported unsupervised practice (15%), progression (22%), or the use of breathing (30%) and relaxation (15%) techniques. The instructional methods items most important for targeting Tai Chi practice to improve balance were not routinely disclosed, with only 15% reporting names of forms and 52% reporting movement principles. CONCLUSION: Most Tai Chi interventions disclosed their Ex Rx methods yet routinely failed to report instructional methods. To increase the effectiveness of Tai Chi to improve balance in older adults, future RCTs should disclose their Ex Rx and instructional methods, especially methods that target balance.

Perceived Benefits of Group Exercise Among Individuals With Peripheral Neuropathy.

Exercise and training programs improve strength, functional balance, and prevent falls in a variety of populations. This article presents the qualitative findings related to the perceived benefits of participants in a randomized controlled trial that compared the effectiveness of group exercise on gait and balance in persons with peripheral neuropathy (PN). Participants with moderately severe PN were randomized into groups that received 10-week classes of Functional Balance Training (FBT) or Tai Chi or education alone. Perceptions of the intervention were overwhelmingly positive regardless of the study group. Perceived benefits reported by participants in the FBT and Tai Chi groups included awareness of how to deal with the effects of neuropathy by implementing balance strategies and a heightened sense of walking to prevent falls. This study offers a guide to design future exercise studies that promote simple balance exercises that can be performed in group settings.

Developing a positive emotion-motivated Tai Chi (PEM-TC) exercise program for older adults with dementia.

Exercise, particularly Tai Chi, has many known benefits, especially in reducing fall risk. However, exercise studies have tended to exclude older adults with dementia (OAD), who may be at high fall risk but have difficulty participating in formal exercise programs. This paper describes development and feasibility testing of a Tai Chi fall risk reduction exercise protocol, the positive emotion-motivated Tai Chi (PEM-TC) program for OAD, and explores strategies that facilitate their participation in and adherence to exercise programs. Preliminary data indicates that difficulties in delivering exercise to OAD may be eased by using the Sticky Hands Tai Chi teaching technique. Family members may have the optimum advantage in using Sticky Hands because of established emotional connections with their OAD.

Feasibility of computer-assisted Tai Chi education.

This study is an initial effort to examine the efficiency of a computer assisted Tai Chi educational model for learning the basics of Tai Chi, a Chinese exercise regime.

Clinical use of tai chi in elderly populations.

Tai chi, a type of low-intensity exercise, has received growing attention in both eastern and western cultures, especially its use with the most rapidly increasing segment of the population-elders. Previous research findings further supported the idea that tai chi is appropriate for elderly populations and helps promote their well-being. In this article, the beneficial effects of tai chi for elders are summarized, resources to increase awareness about the exercise are provided, and ways to promote tai chi in elderly populations are suggested.