Tai Chi Modification and Supplemental Movements Quality Improvement Program
Background
The original program consisted of 12 movements that were to be split up between 3 weeks teaching 4 movements each week. Range of mobility was the main consideration for developing this HPE quality improvement project. Veterans who wanted to participate in Tai Chi were not able to engage in the activity due to the range of movement traditional Tai Chi required.
Innovation
The HPE Quality Improvement program developed a 15-movement warm-up, 12 co-ordinational movements consistent with the original program, 18 supplemental Tai Chi movements that were not included in the original program all of which focus on movements remaining below the shoulders and can be done standing or sitting. Four advanced exercises including “hip over heel” were included to target participants balance if able and to improve their hip strength, knee tendon/ligament strength. Tai Chi loses its potential to increase balance when performed in a sitting position.1 The movements drew upon Fu style Tai Chi and the program developer was given permission from Tommy Kirchoff to use his DVD Healing Exercises. The HPE program consisted of four 30–60-minute weekly sessions of learning the movements with another 4 weekly sessions of demonstrating the movements. Instructors were given written and visual documents to learn from and were evaluated by the developer during the last 4 weeks.
.
Results
Qualitative Data: Instructors notice a difference in how they feel, and appreciate having another option to offer veterans with mobility/standing issues. Patients expressed improvement in mobility relating to bending, arm extension, arm raising, muscle strengthening, hip strengthening and rotation.
Discussion
Future research will want to look at taking measurements before and after patient implementation to determine quantitative data related to balance, strength and range of movement including grip strength, stand up and go, and one-legged stands.