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Adaptation of an evidence-based, fall-prevention, Tai Ji Quan exercise program for adults with traumatic brain
Dina L Jones1, Amanda Acord-Vira2, Maura B Robinson3
1Department of Orthopaedics, Division of Physical Therapy, and Injury Control Research Center, West Virginia University, Morgantown, USA.
Introduction:
Fall risk is increased in people with traumatic brain injury (TBI).
Purpose:
This study adapted an evidence-based fall-prevention program Tai Ji Quan: Moving for Better Balance (TJQMBB) for adults with TBI and convened an online focus group with the target population for input on its delivery, content/safety, and potential benefits.
Methods:
Fall prevention and TBI experts adapted TJQMBB. Eight adults with TBI were recruited. Participants watched demonstrations of the adapted TJQMBB exercises online over ZOOM©. Themes, subthemes, and participant quotes were extracted.
Results:
Five women (71%) and 2 men (29%) participated with a mean age of 45 years. Nine themes and 5 subthemes were identified. Participants recommended a learning sequence of exercise demonstration with verbal directions and visual cues, followed by simple written instructions. Participants identified physical and cognitive barriers to participation and recognized that possible balance loss during exercise was a safety issue. Potential benefits included improved balance, navigation of challenging terrain, quality of life, and social inclusion.
Conclusion:
Participants viewed the adapted program as safe and appropriate, given modifications for physical (e.g. balance) and cognitive impairments. The TJQMBB program may be underutilized in this population due to the complexity of the exercises, but is possible with modifications.
