Learning to breathe with Tai Chi online - qualitative data from a randomized controlled feasibility study of patients with cystic fibrosis

Author: Patricia Ronan1, Awais Mian1, Siobhán B Carr2,3, Susan L Madge4, Ava Lorenc5, Professor Nicola Robinson1,6
Affiliation: <sup>1</sup> Allied Health Sciences, School of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA. <sup>2</sup> Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP. <sup>3</sup> National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, 1B Manresa Road, London, SW3 6LR. <sup>4</sup> Adult Cystic Fibrosis Department, Royal Brompton and Harefield NHS Foundation Trust, London, Sydney Street, London, SW3 6NP. <sup>5</sup> Population Health Sciences Department, University of Bristol, Beacon House, Queens Road, Bristol, BS8 1QU. <sup>6</sup> Centre for Evidence based Chinese Medicine, Beijing University of Chinese Medicine No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029.
Conference/Journal: Eur J Integr Med
Date published: 2020 Oct 22
Other: Special Notes: doi: 10.1016/j.eujim.2020.101229. , Word Count: 268


Introduction:
Tai Chi (TC), a gentle exercise, incorporates meditative movement and respiratory control. The high risk of cross infection for people with cystic fibrosis (CF) requires close management in healthcare settings, limiting group activities such as TC. A mixed-methods randomized controlled feasibility study compared teaching TC over the internet with in-person, face to face TC tuition provided to CF patients. This article explores qualitative data from patients and TC instructors on their attitudes, acceptability and engagement with the two modes of TC delivery.

Methods:
Qualitative data from CF patients (>6 years) were collected using Skype interviews/focus groups and written feedback. TC instructors provided weekly written feedback, and took part in interviews/ focus groups at the end of the study. Patients and instructors interviews explored their experiences and engagement with TC online delivery and ability to practice.

Results:
Irrespective of the type of TC delivery, all CF participants interviewed (n=28) practiced between lessons and most wanted to continue TC. Teenagers were more likely to miss TC appointments. Internet delivery was well received by both patients and TC instructors. Two patients reported difficulties with screen size/camera and one with internet connectivity.

Conclusion:
Both face-to-face and internet delivery of Tai Chi lessons were equally well received and perceived as beneficial. In the current COVID-19 pandemic, CF patients self-isolating may find this intervention provides important support, therefore the programme was made available on YouTube in April 2020 and linked to the websites of the CF charities funding the research.

Keywords: Breathing; Cystic fibrosis; Feasibility study; Internet delivery; Qualitative; Remote learning; Social isolation; Tai chi; Telemedicine.

PMID: 33106755 PMCID: PMC7578181 DOI: 10.1016/j.eujim.2020.101229