Getting started with taiji: investigating students expectations and teachers appraisals of taiji beginners courses

Does Postural Awareness Contribute to Exercise-Induced Improvements in Neck Pain Intensity? A Secondary Analysis of a Randomized Controlled Trial Evaluating Tai Chi and Neck Exercises

STUDY DESIGN

Secondary analysis of a randomized controlled trial.

OBJECTIVE

This secondary analysis aims to examine associations of improvement of chronic neck pain with patients' and intervention-related characteristics.

SUMMARY OF BACKGROUND DATA

Previous research has found that Tai Chi and neck exercises significantly improved chronic nonspecific neck pain; however, the factors for treatment success remain unclear.

METHODS

Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises, and they attended 12 weekly sessions of 60 to 90 minutes. The interventions included exercises to improve body awareness, that is, interoceptive and postural awareness. A linear forward stepwise regression analysis was conducted to examine associations with improvements in neck pain intensity. Potential predictor variables included baseline pain, age, sex, the type of intervention, attendance rate and home practice duration, and changes in psychological well-being, perceived stress, and postural and interoceptive awareness during the study.

RESULTS

Overall 75 patients were randomized into Tai Chi or conventional exercises, with the majority being women (78.7%). Participants reported an average pain intensity of 50.7 ± 20.4 mm visual analog scale at baseline, and the average reduction of pain intensity in both groups was 21.4 ± 21.3 mm visual analog scale. Regression analysis revealed that reductions in pain intensity from baseline to 12 weeks were predicted by higher pain intensity at baseline (r = 0.226, P < 0.001), a decrease in anxiety (r = 0.102, P = 0.001), and an increase in postural awareness (r = 0.078, P = 0.0033), explaining a total of 40.6% of variance.

CONCLUSION

Neck pain improvement was significantly associated with changes in postural awareness in subject with chronic nonspecific neck pain independent of treatment characteristics. Training of postural awareness might be an important mechanism of action of different exercise-based interventions for chronic neck pain.

LEVEL OF EVIDENCE

N /A.

Mixed Methods in CAM Research: A Systematic Review of Studies Published in 2012

Background. Mixed methods research uses qualitative and quantitative methods together in a single study or a series of related studies. Objectives. To review the prevalence and quality of mixed methods studies in complementary medicine. Methods. All studies published in the top 10 integrative and complementary medicine journals in 2012 were screened. The quality of mixed methods studies was appraised using a published tool designed for mixed methods studies. Results. 4% of papers (95 out of 2349) reported mixed methods studies, 80 of which met criteria for applying the quality appraisal tool. The most popular formal mixed methods design was triangulation (used by 74% of studies), followed by embedded (14%), sequential explanatory (8%), and finally sequential exploratory (5%). Quantitative components were generally of higher quality than qualitative components; when quantitative components involved RCTs they were of particularly high quality. Common methodological limitations were identified. Most strikingly, none of the 80 mixed methods studies addressed the philosophical tensions inherent in mixing qualitative and quantitative methods. Conclusions and Implications. The quality of mixed methods research in CAM can be enhanced by addressing philosophical tensions and improving reporting of (a) analytic methods and reflexivity (in qualitative components) and (b) sampling and recruitment-related procedures (in all components).

Investigating short- and long-term transfer effects of a Taiji beginner course in participants' daily life

OBJECTIVE

In recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants' everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants' daily lives.

METHODS

We conducted a longitudinal observational study in 45 healthy participants at the end of their three-month Taiji beginner course (tp1) and at two months (tp2) as well as one year after course completion (tp3). Participants were asked to report their Taiji practice behavior at all time points, as well as to rate and describe perceived transfer effects of Taiji course contents on their daily life at tp1 and tp3.

RESULTS

Transfer effects were reported by 91.1% of all respondents after course completion (tp1) and persisted in 73.3% at the one-year follow-up assessment (tp3), counting "increase of self-efficacy", "improvement of stress management", and "increase of body awareness" as the most frequently mentioned effects. Transfer effects predominantly occurred in participants' work and social environments, as well as during everyday activities in public areas. While self-reliant Taiji practice frequency significantly decreased from 82.2% at tp1 to 55.6% at tp3 (P < 0.001), the magnitude of self-reported transfer effects did not (P = 0.35). As explorative analyses revealed, regular Taiji course attendance was highly correlated with stronger transfer effects at tp1 (r = 0.51; P < 0.001) and tp3 (r = 0.35; P = 0.020). Participants reporting high self-reliant Taiji practice frequency at tp2 were likely to maintain a regular practice routine at tp3 (r = 0.42; P < 0.004), whereas self-reliant practice frequency and transfer effects at tp1 were positively correlated with self-reliant practice frequency at tp3 on a trend level (r < 0.27; P > 0.08).

CONCLUSION

Our data underline the importance of regular course participation for pronounced and long lasting transfer effects into participants' everyday life. We discuss that several context and process-related aspects of a Taiji intervention are potentially relevant factors for enhancement of transfer effect.