An outpatient Tai Chi program: Effects on veterans' functional outcomes

Brown, Lana M.; Sawyer, Linda M.; Lensing, Shelly; Taylor, Tanya S.; Bopp, Melinda M.; Ferrier, Ileina; Sullivan, Dennis H.

doi:10.1111/nuf.12532

Cited by 5 publications

(13 citation statements)

References 15 publications

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“…Prior studies have demonstrated the positive effects of both CIH therapies and patient-centered care on patient adherence, engagement, and clinical outcomes, including perceptions of pain. [13][14][15][16][17][18][47][48][49][50][51][52][53][54] These studies, however, focus on discrete interventions and do not fully capture the impact of a system-level holistic approach to care.…”

Section: Policy Changes Resulting From Evaluation Findingsmentioning

confidence: 99%

“…Moreover, it required an evaluation of the effect of CIH and other approaches on the health and well-being of Veterans. Prior research in VA demonstrated the positive impact of CIH therapies such as yoga, Tai Chi, acupuncture, and mindfulness practices for Veterans, [13][14][15][16][17][18] yet the implementation of these services had up to that point been unsystematic and poorly coordinated overall. [19][20][21] In response, OPCC&CT formalized the WHS, and in October 2017, each Veterans Integrated Service Network (VISN -regional networks) identified and funded a WH flagship VA medical center for a 3-year WHS pilot.…”

Section: Policy "Window Of Opportunity"mentioning

confidence: 99%

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From patient outcomes to system change: Evaluating the impact of VHA's implementation of the Whole Health System of Care

Bokhour

Hyde

Kligler

et al. 2022

Health Services Research

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Objective To describe how a partnered evaluation of the Whole Health (WH) system of care—comprised of the WH pathway, clinical care, and well‐being programs—produced patient outcomes findings, which informed Veterans Health Administration (VA) policy and system change. Data Sources Electronic health records (EHR)‐based cohort of 1,368,413 patients and a longitudinal survey of Veterans receiving care at 18 WH pilot medical centers. Study Design In partnership with VA operations, we focused the evaluation on the impact of WH services utilization on Veterans' (1) use of opioids and (2) care experiences, care engagement, and well‐being. Outcomes were compared between Veterans who did and did not use WH services identified from the EHR. Data Collection Pharmacy records and WH service data were obtained from the VA EHR, including WH coaching, peer‐led groups, personal health planning, and complementary, integrative health therapies. We surveyed veterans at baseline and 6 months to measure patient‐reported outcomes. Principal Findings Opioid use decreased 23% (31.5–6.5) to 38% (60.3–14.4) among WH users depending on level of WH use compared to a secular 11% (12.0–9.9) decrease among Veterans using Conventional Care. Compared to Conventional Care users, WH users reported greater improvements in perceptions of care (SMD = 0.138), engagement in health care (SMD = 0.118) and self‐care (SMD = 0.1), life meaning and purpose (SMD = 0.152), pain (SMD = 0.025), and perceived stress (SMD = 0.191). Conclusions Evidence developed through this partnership yielded key VA policy changes to increase Veteran access to WH services. Findings formed the foundation of a congressionally mandated report in response to the Comprehensive Addiction and Recovery Act, highlighting the value of WH and complementary, integrative health and well‐being programs for Veterans with pain. Findings subsequently informed issuance of an Executive Decision Memo mandating the integration of WH into mental health and primary care across VA, now one lane of modernization for VA.

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Section: Policy Changes Resulting From Evaluation Findingsmentioning

confidence: 99%

Section: Policy "Window Of Opportunity"mentioning

confidence: 99%

From patient outcomes to system change: Evaluating the impact of VHA's implementation of the Whole Health System of Care

Bokhour

Hyde

Kligler

et al. 2022

Health Services Research

View full text Add to dashboard Cite

show abstract

“…When a participant completed his/her last class, parts of the baseline assessment were repeated. During the course, participants were taught to be more proficient in performing each of the basic six movements of the Sun Style Tai Chi program “Tai Chi for Arthritis.” 19 A physical therapist and two occupational therapists served as course instructors. As described elsewhere, 17 each instructor was trained and certified as a Tai Chi instructor by a Tai Chi Master (TCM).…”

Section: Methodsmentioning

confidence: 99%

“…Tai Chi meets these criteria 11 . When practiced regularly, Tai Chi appears to have benefits not only for balance, fitness, and flexibility but also for the relief of pain and depression 11–19 . Traditionally, Tai Chi classes are offered face‐to‐face in a group setting.…”

Section: Introductionmentioning

confidence: 99%

“…11 When practiced regularly, Tai Chi appears to have benefits not only for balance, fitness, and flexibility but also for the relief of pain and depression. [11][12][13][14][15][16][17][18][19] Traditionally, Tai Chi classes are offered face-to-face in a group setting. However, since the implementation of COVID-19 restrictions, these types of classes are not allowed in most Department of Veterans Affairs hospital (VA) settings.…”

mentioning

confidence: 99%

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Rapid conversion of Tai Chi classes from face‐to‐face to virtual during the COVID‐19 pandemic: A quality improvement project

et al. 2022

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Purpose: The purpose of this quality improvement project was to examine the feasibility of rapidly converting a Tai Chi program for older Veterans from face-toface to virtual classes.Methods: Eighteen Veterans attending our face-to-face Tai Chi course were invited to transition to virtual classes. Feasibility was defined as the ability of program staff and participants to successfully connect and complete the initial and subsequent classes by VA Video Connect (VVC) with little to no technical difficulties, participant ability to participate in the course without safety concerns, and favorable feedback from participants and program staff.Results: Nine of 18 Veterans agreed to transition to the virtual program and attended a median (interquartile range) of 11 (4-15) classes; they were younger (62.7 + 11.5 vs. 70.5 + 7.0 years, p < .05) and more likely to have the knowledge and equipment needed to participate (78% vs. 0%, p < .01) than nonparticipants. Tai Chi instructors and participating Veterans reported being able to connect to and complete the classes virtually with only minimal technical problems. No adverse events were reported. Feedback from the instructors and Veterans was positive and included comments on ease of use and enjoyability. Conclusion:Results suggest that virtual Tai Chi classes via VVC are feasible for some older Veterans.

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The effect of Tai Chi lower extremity exercise on the balance control of older adults in assistant living communities

Mao,

Mercer,

et al. 2024

BMC Complement Med Ther

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Background Although Tai Chi (TC) is an evidence-based fall prevention training for older adults, its effective movements remain unclear, which may limit the practice of TC. The purpose of this study was to compare the effectiveness of TC lower extremity exercise (TC LEE), the 8-form Tai Chi (8-form TC), and a stretching control intervention for improving balance and functional mobility among older adults. Methods This was a randomized controlled trial. A total of 102 participants (79 ± 6 years old) were recruited from assisted living facilities. All participants were randomly assigned to the TC LEE (n = 40), 8-form TC (n = 31), and stretching (n = 31) groups in which they received the respective interventions for 16 weeks. The Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and center of pressure (COP) measurements during quiet stance were collected prior to and following the 16-week interventions. Comparisons on all measurements were conducted among all groups. Results Significant improvements were found in BBS (P = 0.002), TUG test (P = 0.001), root mean square amplitude of COP displacement in the anterior–posterior (P = 0.001) and medial–lateral (P = 0.001) directions, and average COP speed in the anterior–posterior (P = 0.001) and medial–lateral (P = 0.001) directions after training in the TC intervention groups compared with the stretching group. The upper limit of the 95% confidence interval (CI) of differences in change scores on the BBS (-0.8 – 1.3 points) between the TC LEE group and the 8-form TC group was within equivalence margins (1.8 points), while the upper limit of the 95% CI of differences in change scores on the TUG test (0.1 – 2.1 s) exceeded the equivalence margin (0.7 s) with the TC LEE group having the larger change scores. Conclusion TC LEE can improve balance and functional mobility in older adults, and may have greater effect than the 8-form TC on improving functional mobility as measured by the TUG test. Trial registration ChiCTR2300070600 retrospectively registered.

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An outpatient Tai Chi program: Effects on veterans' functional outcomes

Cited by 5 publications

References 15 publications

From patient outcomes to system change: Evaluating the impact of VHA's implementation of the Whole Health System of Care

From patient outcomes to system change: Evaluating the impact of VHA's implementation of the Whole Health System of Care

Rapid conversion of Tai Chi classes from face‐to‐face to virtual during the COVID‐19 pandemic: A quality improvement project

The effect of Tai Chi lower extremity exercise on the balance control of older adults in assistant living communities

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