October 24, 2016 - Falls are associated with morbidity, loss of independence, and mortality. While land-based group exercise and Tai Chi programs reduce the risk of falls, aquatic therapy may allow patients to complete balance exercises with less pain and fear of falling; however, limited data exist.
Ai Chi is a water-based total body strengthening and relaxation progression that bridges East and West philosophies, and integrates mental, physical, and spiritual energy. It combines Tai Chi concepts with Shiatsu and Watsu techniques, and is performed standing in shoulder-depth water using a combination of deep breathing and slow, broad movements of the arms, legs, and torso. The Ai Chi progression moves from simple breathing, to the incorporation of upper-extremity, trunk, lower-extremity, and finally total body involvement.
An Australian project piloted the implementation of the Ai Chi (Aquabalance) program to evaluate the safety, intervention acceptability, and intervention effect sizes.
Forty-two outpatients underwent a single 45-minute weekly group aquatic Ai Chi-based session for eight weeks. Safety was monitored using organizational reporting systems. Patient attendance, satisfaction, and self-reported falls were also recorded. Balance measures included the Timed Up and Go (TUG) test, the Four Square Step Test (FSST), and the unilateral Step Tests.
All 42 patients completed the program. It was feasible to deliver the Ai Chi program, as evidenced by the median (IQR) attendance rate of 8.0 out of 8. No adverse events occurred and participants reported high satisfaction levels. Improvements were noted on the TUG, 10-meter walk test, the Functional Reach Test, the FSST, and the unilateral step tests. The proportion of patients defined as high falls risk reduced from 38% to 21%. The study was limited by its small sample size, single-center nature, and the absence of a control group.
These results, published in the latest issue of Physiotherapy theory and practice, show that the Ai Chi program was safe, well-attended, and acceptable to participants.