More physios are now using exercise patterns which have their roots in China.
A growing number of physiotherapists are not only doing t'ai chi themselves, but are adapting it so that its movements can be used to help those clients whose disabilities prevent them from practising a full t'ai chi programme. Practitioners report that, among other benefits, the ancient Chinese art improves clients' mobility, confidence and concentration. In the forefront of promoting t'ai chi are members of the T'ai Chi and Chi Kung Forum for Health. The forum includes physiotherapists and other health professionals, as well as t'ai chi teachers and practitioners interested in introducing these techniques into mainstream health and social care. As part of this push to widen the availability of t'ai chi, the forum also runs training courses for health professionals (for details of forthcoming dates for physios and assistants see below). Some of the forum's teachers, like spokesman Mike Tabrett - already run classes, such as falls prevention, for people who cannot manage a regular t'ai chi class. 'T'ai chi can help with a range of disabilities,' Mike says. 'Recently the National Institute for Clinical Excellence listed t'ai chi as among the complementary therapies thought to bring benefits to people with multiple sclerosis, and research in the US in the 1990s showed that t'ai chi played a significant role in falls prevention.' Mike believes that the basic principles underlying t'ai chi make it adaptable to a wide range of circumstances. 'T'ai chi is essentially a practical art. You don't have to memorise a code of movements. It is not the movements themselves, but the quality of the movements that is important. We learn to make the practiced patterns work in another time and place. 'You can extract the essence of any exercise, and then work in various ways to achieve its aim. For example, the principles of body alignment can be understood by standing on one leg for 10 minutes. We can take this understanding and learn to apply it to someone largely confined to a wheelchair.' Although traditional t'ai chi is performed standing up, Mike and other practitioners have adapted it to work with older people and others who have balance and falls problems, who often need to remain seated when undertaking the moves. 'With some groups I may do around 45 minutes of the class seated and then do some movements standing,' Mike explains. 'I get them to take slow breaths and become centred, and they become more aware of their bodies and what's happening to them. The gentle growth in awareness can help a person who has fallen to recover their confidence.' Two physiotherapist members of the forum have also successfully used t'ai chi as part of falls prevention programmes. Marna Howie, a superintendent community physio based in Greenock, near Glasgow, began introducing the therapy into her work after she became interested eight years ago. Most of Marna's work is with the rehabilitation of patients who have left hospital, but last year she got funding for an 'early intervention' falls prevention group. After falls some people were beginning to lose confidence about moving around. The aim was to keep them mobile so they did not become isolated. 'Falls are a huge problem, and a particular hobbyhorse of mine,' she explains. 'T'ai chi is a natural thing for physiotherapists to do, as movement is our work. I find that it improves balance, coordination, postural awareness and stamina. Moreover it makes people aware of their improvement and this empowers them and gives them greater confidence. 'Many of the participants initially lacked confidence, and had the kind of anxieties about life that you often find among older people. Although most of the programme consisted of evidence-based exercise, I selected certain t'ai chi moves that were good for balance and particularly heart, lung and kidney energies. I used a mixture of sitting and standing exercises. But we did not do the full flowing form of t'ai chi. Many said that t'ai chi had made them feel calmer.' The programme was a success, and further funding has been given for this year. Meanwhile, in Aberdeen, Edna Matthew, a private practitioner, has been using the Chinese art with older people living in care homes. She says: 'I am selective about whom I use t'ai chi on, because my clients are frail. But I find is useful to encourage them to move, relax and focus. They do the movements while sitting, and you have to have good posture to do them.' She adds: 'The great thing about t'ai chi is that, no matter what the difficulty, there is always something you can do. It is not threatening; you do what you can. As physiotherapists, I think we often push people to do the full extent of their possible movement. With t'ai chi you use about 70 per cent of the maximum. Also, it gives frail people the pleasure of doing something that is achievable. It is very empowering.' Edna has practised t'ai chi for 11 years, and says she has learned a lot about movement from the teachers in the forum. She feels that other physiotherapists could also benefit from finding out about their techniques. While she feels it would be too much for most physiotherapists to take on t'ai chi as a skill, she sees other opportunities. She says: 'Even if they worked alongside a t'ai chi teacher they would learn huge amounts from them. It would give them another approach.' Further info: www.taichiforum.co.uk T'ai chi training courses for physios and assistants are available in Birmingham on September 24 to 25, October 22 to 23 and November 12 to 13. Contact Linda Broda, course coordinator 01614 451568, Mike Tabrett, tutor 01223 503390 or email email@example.com
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