A Tai Chi Class Collaboratively Developed for Persons With Interstitial and Other Lung Diseases: An Ethnographic Investigation

Author: Karen Kilgore1,2, Jesse Leinfelder3, Joan Campbell3, Peter M Wayne2,4, Robert W Hallowell4,5, Aliaa Barakat1
1 Interstitial Lung Disease Collaborative, Pulmonary Care and Research Collaborative, Boston, MA, USA.
2 Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA.
3 Tai Chi Foundation, New York City, NY.
4 Harvard Medical School, Boston, MA, USA.
5 Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.
Conference/Journal: Glob Adv Integr Med Health
Date published: 2023 Oct 25
Other: Volume ID: 12 , Pages: 27536130231206122 , Special Notes: doi: 10.1177/27536130231206122. , Word Count: 373

Participating in physical activity (PA) can be challenging for persons with chronic and significant lung disease due to the multifaceted disruptive effects of their symptoms and variable disease course.

Our study investigates a novel approach to increasing PA by collaboratively and adaptively developing a Tai Chi (TC) class for and by persons with lung diseases and explores participants' perceptions of their experiences in the co-developed TC class.

We initiated a collaboration between the Interstitial Lung Disease (ILD) Collaborative and the Tai Chi Foundation to develop a TC class appropriate for persons with ILD and other lung diseases. The TC class was offered online, during the early phases of the COVID-19 pandemic, when pulmonary patients were isolated socially. TC class sessions were held twice weekly for 12 weeks with 12 participants. Ethnographic field methods were used to collect observations and conduct interviews with teachers and students. The Social Ecological Model (SEM) for understanding factors in intrapersonal, interpersonal, social, and organizational contexts was used to explore ways in which wellness practices, particularly those involving changes in health behaviors, can be collaboratively conceived, and developed by persons with the lived experience of illness and community organizations that are sensitive to their personal and social contexts. The constant comparative method was used for data analysis.

Our findings include the importance of (1) creating a supportive class environment, characterized by interactive and reciprocal relationships among students and teachers; (2) alternating segments of movement and meditation to avoid fatigue and breathlessness; (3) cultivating sensory awareness and body trust, resting when needed and rejoining the movements when ready; (4) increasing the capacity to meditate through deepening presence and renewing the vital connection with inner and outer sources of energy; (5) reducing, through meditative movement, the persistent anxiety, isolation, and sense of loss that accompany chronic disease diagnosis and progression.

We documented a collaboration between the TC and pulmonary communities to design a TC class for persons with chronic and significant lung disease. We employed the SEM to provide insights into how teachers, informed by their students, can use effective pedagogical skills to create core curricula with modifications appropriate for a specific population.

Keywords: Tai Chi; interstitial lung disease; meditative movement; physical activity; sociocultural model of health behavior change.

PMID: 37901846 PMCID: PMC10605663 DOI: 10.1177/27536130231206122