We now have therapists certified in Tai Chi Fundamentals. This program is designed to be done while covered under the Physical Therapy insurance benefit to help individuals with pain and balance deficits to gradually develop the skills needed to safely join a community Tai Chi Chuan class. Tai Chi for Better Balance and Tai Chi for Arthritis are recognized by many including The Centers for Disease Control and The Arthritis Foundation as being among some of the very best methods to improve balance and reduce chronic pain.
Why Utilize Tai Chi in Physical Therapy
While several evidenced based programs have emerged in recent years to successfully reduce both the rate of falling as well as the fear of falling, Tai Chi continues to develop an impressive record in the literature of not only reducing the number of falls but also of easing the aches and pains of arthritis, improving self efficacy, reducing anxiety and depression, improving cardiovascular function and dampening or perhaps even preventing development of dementia.
As a point of reference, the Otago home exercise program utilized by many physical therapist including myself in outpatient clinics and home care agencies throughout the country has proven to be very impressive in reducing fall rates in the over 80 population by nearly 50%. According to the authors, this has resulted in a $2 to$7 return on investment for each $1 spent in studies that followed their participants through the year following the study. Yet randomized control studies utilizing the Yang style of Tai Chi have been able to demonstrate up to 68% reduction in the rates of falling. These types of results have inspired the Centers for Disease control to call on all health care providers to consider this option for our aging population. This offers a great opportunity to significantly reduce costs and suffering in a rapidly growing portion of our population.
Attached is a FAQ put together by the CDC to be sure that this is implemented following the principles that created the results in the literature. They just recently included the endorsement of the use of Tai Chi Fundamentals by certified physical therapists to help individuals build skill in therapy to the point where they can successfully join community Tai Chi groups. I have earned that certification at our most recent APTA conference this past January in San Diego.
Some of the guidelines are as follows: Exercise programs should be carried out over a longer time period (minimum 3 months) and include a minimal effective dosage of 50 hours, which often equates to 2 times per week over a 6-month period. They point out that interventions supervised and delivered by physical therapists have been shown to produce the most positive outcomes related to falls prevention. And to achieve a lasting falls-prevention effect, the research advocates for ongoing exercise intervention to maintain the benefits of exercise. Thus, we have teamed up with the YMCA to give our graduates an opportunity to continue with well trained Tai Chi Instructors following discharge from therapy.
A recent systematic review attempted to answer if we could reach these guidelines and get an effective outcome utilizing Group-based exercise:
“The high dosage and level of supervision necessary for effective exercise interventions for at-risk individuals have significant fiscal and administrative restraints, thus making adequate individualized therapy difficult to administer within the consumer’s and health care provider’s financial barriers. When third-party payers are involved, individualized PT treatment sessions can range from $60.00 to $90.00, while billable group therapy is only $19.74 per session. 19 Recent research has also demonstrated that group-based exercise can reduce direct medical costs for individuals, 20 , 21 while it also may provide better allocation of economic resources. 22 Therefore, group-based exercise may be a viable option for falls prevention, 2,3,5,8,23,24 with possible added benefits of convenience, peer support, social interaction, and potential cost savings to health care systems and consumers. “( J Geriatr Phys Ther 2013 ; XX : 1 – 12 )