Evidence-based Tai Chi Research Articles

METHODS AND BASELINE CHARACTERISTICS FOR THE TECHSAGE TELE TAI CHI CLINICAL TRIAL

Abstract Individuals aging with long-term mobility disabilities encounter a range of significant barriers to participating in physical and social activities, from challenges with transportation, to lack of accessibility and access to appropriate instruction. We developed a Tai Chi telewellness intervention to facilitate both physical and social wellness through accessible, virtual group classes. The intervention translated an in-person, evidence-based tai chi program (Tai Chi for Health Institute’s Tai Chi for Arthritis) to be 1) a virtual experience (via Zoom) that includes a social component and 2) accessible and appropriate for those aging with mobility disabilities. We conducted the TechSAge Tele Tai Chi clinical trial to examine the effect of the intervention on physical activity and social connectedness (primary outcomes), as well as exercise self-efficacy, falls efficacy, depression, quality of life, and pain (secondary outcomes) for this population. The participant sample was community-dwelling adults (60-80 years of age) with a self-identified mobility disability (i.e., using a mobility aid or having serious difficulty walking or climbing stairs) for at least 10 years. The presentation will describe the rationale for the study, as well as the study design, methodology, and baseline data for the trial. We will also highlight the user-centered, iterative design approach we used in the design and evaluation of the intervention protocol.

Delivering a Tai Chi Intervention to Adults Aging with Mobility Disabilities Using Zoom

Many individuals aging with mobility disabilities experience barriers to participating in physical activity, including transportation challenges and the need for specialized instruction. Since the COVID-19 pandemic began, these participation barriers have been amplified due to lockdowns and restrictions. Tele-technologies, including videoconferencing platforms like Zoom, can facilitate access to exercise classes from one’s home. Virtual group exercise classes that incorporate social interaction have particular potential to support the physical and mental health of this population. This session will highlight lessons learned from launching the ‘Tele Tai Chi’ study, in which we are delivering an evidence-based Tai Chi program (Tai Chi for Arthritis) via Zoom to small group classes of older adults with long-term mobility disabilities. We will describe adaptations made in translating the in-person program to an interactive, online class, and provide an overview of a ‘Telewellness’ Tool that provides guidelines for using Zoom to deliver exercise classes to older adults.

Using Inclusive Design to Develop a Tele–Tai Chi Intervention for Older Adults With Long-Term Mobility Disability

Tele-technologies may be able to increase access to evidence-based exercise interventions for adults aging with long-term mobility disabilities. This population experiences substantial barriers in attending such programs in person, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. It is critical to overcome such barriers to ensure this population has an opportunity to receive the benefits of evidence-based programs. In this study we are translating an in-person evidence-based tai chi intervention, Tai Chi for Arthritis, to an online platform using videoconferencing software for those aging with long-term mobility disabilities. We will describe our approach of including users from the target population and industry representatives (videoconferencing software developer, Tai Chi for Arthritis program developer as well as local master trainer) in the adaptation of the intervention and present the key findings from doing so.

Leveraging Opportunities to Advance the Potential of Technology to Support Independence and Aging in Place

Technology holds great potential to support those aging with and into disability. Research and development efforts in the aging space (aging into disability) have traditionally focused on improving health conditions, whereas those in the disability space (aging with disability) have primarily focused on supporting activity and participation. Bridging these perspectives and approaches adds rich context to guide the development and evaluation of technology interventions. Examples of technology interventions that support activity and participation and thereby improve health outcomes for adults aging with mobility disabilities show the need for bridging. The Telewellness research study used videoconferencing to deliver an evidence-based tai chi intervention to small groups. The Digital Assistant study explored the potential of the Amazon Echo to support controlling the home environment, engaging in physical activity, interacting with others, and managing health. Both projects offer credence to the value of supporting adults aging-in-place with wide range of capabilities and limitations. Part of a symposium sponsored by the Lifelong Disabilities Interest Group.

Development and validation of a Tai chi intervention protocol for managing the fatigue-sleep disturbance-depression symptom cluster in female breast cancer patients

ObjectiveTo develop an evidence-based tai chi intervention protocol for managing the fatigue-sleep disturbance-depression symptom cluster (FSDSC) in breast cancer (BC) patients. MethodsThe Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions (the MRC framework) was utilized to guide the study design. This study focused on Phase І of the MRC framework—the development of the intervention—to develop an evidence-based tai chi intervention protocol for managing the FSDSC in BC patients based on existing research evidence, theories, practice standards/guidelines, and experts’ consensus. An extensive literature search was performed to identify current systematic reviews, theories, and practice standards/guidelines that can be utilized to inform the intervention dosage and techniques of tai chi and practice instructions. Content validity assessment was also conducted to assess the content validity of the tai chi protocol through expert panel consensus. The content validity index (CVI) was calculated to identify whether the intervention required further refinement. ResultsThe components of the tai chi protocol were identified by current research evidence and relevant practice standards/guidelines, including the selection of an appropriate tai chi modality and intensity and the duration of the intervention. The Easy 8 form Yang-style tai chi was selected based on the guidelines of the National Comprehensive Cancer Network, the American College of Sports Medicine, and China’s State Commission for Physical Culture and Sports. The intensity and duration of the tai chi intervention were scheduled, respectively, twice per week, with each session lasting about one hour, for eight weeks based on the current systematic review evidence on traditional Chinese exercise for the alleviation of cancer-related symptoms. The practise techniques of tai chi were identified from practise standards released by the State Sport General Administration of China. All the items in the tai chi protocol were determined to be content valid after the first round of rating, with all item-level CVIs at 1.00. The scale-level CVI for the tai chi protocol was also identified as excellent, at 1.00. ConclusionAn evidence-based tai chi program for managing the FSDSC in BC patients was developed by following the MRC framework. The results provided a clear specification of the tai chi intervention protocol for healthcare professionals and researchers in the next phase of the study—pilot testing the tai chi intervention protocol for FSDSC management through a preliminary randomized controlled trial.

Using Tai Chi to Reduce Fall Risk Factors Among Older Adults: An Evaluation of a Community-Based Implementation.

This study aimed to evaluate a community-based implementation of an evidence-based fall prevention program, in which 131 individuals participated in Tai Chi: Moving for Better Balance. Self-report and functional performance assessments included demographics, health and fall history, the Activities-Specific Balance Scale, the Timed Up and Go test, and the Functional Reach test. Pre-post scores were compared with the Wilcoxon signed rank test. The mostly female participants were 73 years old, on average. At baseline, 18% reported being afraid or very afraid of falling, and 18% had fallen in the past 6 months. At follow-up, there was significant improvement in Timed Up and Go ( p < .001), Functional Reach ( p < .01), and Activities-Specific Balance Scale scores ( p < .01). These results demonstrate that a 12-week evidence-based Tai Chi program can be feasibly implemented by novice instructors, is well-received by older adults, and can effectively reduce fall risk when implemented in community settings.

Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program

Tai chi--moving for better balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the re-aim framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings.