Can Tai Chi Xiao Jin Chong Central Elongation Exercises Empower the Self-management of Patients with Chronic Diseases?

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Authors (including presenting author) :
CHAN LC(1), WU WY(1), WONG H(1), TAM MP(1), KONG R(2), LAW YT(1)
Affiliation :
(1) Department of Physiotherapy, Pok Oi Hospital, (2) Patient Resources Center, Pok Oi Hospital
Introduction :
The management of chronic diseases had imposed increasing demand on the health care system. Patients with chronic diseases will usually receive intervention from different health care professions for a long period of time. Studies showed that exercises, multidisciplinary approach and self-management with peer support program were effective in chronic disease management. Tai Chi Xiao Jin Chong central elongation exercises (太極小金鐘伸展運動) integrated traditional Taichi Qiqong and modern exercise physiology into 13 movements which emphasize good postural alignment, central elongation with muscle stretching and activation of the body. The incorporation of the central elongation exercises taught by physiotherapists into the peer support program organized by Patient Resources Centre of Pok Oi Hospital aims to improve the well-being of patients with chronic diseases and thus to decrease the reliance on health care system .
Objectives :
To investigate the impact of Tai Chi Xiao Jin Chong central elongation exercises in self-management of patients with chronic diseases.
Methodology :
A ‘Pre-test’ vs. ‘Post-test’ design with 3 months follow-up was employed. Subjects were patients suffering from chronic diseases. They participated in a 6-week program of Tai Chi Xiao Jin Chong central elongation exercises taught by a physiotherapist and peer support group with experience sharing of chronic diseases at Patient Resources Center of Pok Oi Hospital. After that, patients continued practicing the exercises weekly by following the video of Tai Chi Xiao Jin Chong and peers sharing at Patient Resources Center facilitated by social worker. They were assessed at pre and post the program and 3 months afterwards. Outcome measures were different patient self-rated scores which included health status, psycho-social symptoms, tiredness, pain score, shortness of breath (SOB), activity daily living (ADL) and self-efficacy.
Result & Outcome :
A total of 26 patients (6 males and 20 females) completed the 6-week program in 2017 and 2018. There was statistically significant improvement in patient self-rated scores after the program in terms of health status, psycho-social symptoms and shortness of breath. The self-rated health status improved from 3.84 + 0.47 points (out of 5) to 3.12 + 0.65 points (p< 0.01). The self-perceived psycho-social symptoms decreased from 1.90 + 1.13 point (out of 5) to 1.27 + 0.76 point (p< 0.01). The feeling of shortness of breath dropped from 3.27 + 2.13 (out of 10) to 2.50 + 2.20 points (p=0.047). 14 patients were interviewed 3 months afterwards, there was further improvement of SOB symptom (1.50 + 1.61 points, p< 0.01) while the improvement in health status and psycho-social symptoms was maintained. Patient self-rated scores in tiredness, pain, ADL and self-efficacy showed improvement though there was no statistical significance observed. Conclusion: The incorporation of Tai Chi Xiao Jin Chong central elongation exercises and peer sharing was effective to empower patients and to improve well-being of patients in self-management. Therefore, it may decrease the demand on health care system.

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