TCA community exercise empowerment model for chronic disease client in Hong Kong
Wilfred Kwok, Physiotherapist/ Ergonomist
The Hong Kong Society for Rehabilitation Community Rehabilitation Network
In Community Rehabilitation Network (CRN) Exercise Rehabilitation Model, we aim at getting our clients more active more of the time. Our Physiotherapists, with the theoretical framework in Exercise Therapy and Social Learning Theory, had enhanced the mutual help among clients and also facilitate the exercise habitual changes into a more active healthy lifestyle.
Since 2000, we have introduced the Tai Chi for Arthritis (TCA) Program in Hong Kong's rehabilitation arena. Through these years, we are very fortunate to have Dr. Paul Lam to come to run the Train the trainer workshop for us in Asia. The Workshop usually attracted participants from overseas such as Taiwan and Korea. We chose to introduce TCA as a good mode of exercise for our clients, as it is more readily accept and familiar to the Chinese culture and research also support that the same cultural exercise is easier for people to continue practice.
After our physiotherapist learn, practice and teach TCA to our arthritis patient, we found that it should also be a good exercise skills for our chronic disease clients, hence we broaden the target population, to cover other chronic illness patient such as cardiac disease and minor stroke.
The strategy we incorporate is first through formal training of rehabilitation professional as TCA trainer, who will help to spread the exercise program to their own clients through exercise class. Through our CRN TCA class, we recruited a group of highly motivated patients as potential group leaders, then we setup TCA exercise mutual and self help group (MASH) at our centers for them to get experience in running exercise group for ex-class member.
The next step is to setup training courses for those group leaders to equip them with group skills, these groups will help to further enhance their exercise habits and also facilitate the mutual help among the clients with chronic disease. The final step is to get the patient leader to achieve the Certified TCA Trainer status by attending the TCA Train-the-trainer Workshop, thereafter they can further assisted in teaching exercise class and facilitating the exercise MASH groups.
Since the first official TCA train-the-trainer workshop in Asia held in 2000, up till now we have organized the train-the-trainer yearly and also started the TCA Part 2 level workshop since 2002. In total we have over 150 trainers in Hong Kong.
In Community Rehabilitation Network achievement, our physiotherapists have run over 50 courses, has successfully trainer over 500 clients and form 6 exercise MASH in our CRN centres. We also had trained up 10 clients as certified TCA trainers, who in term assist in CRN TCA training courses for other people with chronic illness.
In the other rehabilitation and exercise fields, we also help to introduce the TCA in various non-government organisations and some local fitness center as a new alternative in physical activity training.
In the evidence-based practice, there are a few TCA research done all over the world, a most recent example is in Korea, which has shown significant results.
The TCA exercise program, with its training method and beneficial effect on clients, it is shown to be an effective and popular exercise program for Hong Kong people with Chronic Illness. And through the CRN exercise empowerment model, with reference to self efficacy and mutual help for patient empowerment, we hope to spread the TCA Tai Chi Chuan, an East meet West exercise program in Hong Kong Community Based Rehabilitation arena.