Newsletter #18 - October 2002
- My Journey to Caracas, Venezuela
- Tai Chi Chuan as a Therapeutic Intervention by Robert F. Franklin, PhD & Faith Overton, PTA
- Diane's New TCA Classes
Just before I was to leave for Caracas to do a workshop, my friend Tony, who works for a major pharmaceutical company, told me that his company had special training for executives who were visiting Caracas. The training included how to cope if your chauffeur gets shot.
Needless to say, I felt even more uneasy going to an unstable country after listening to my friends and family reminding me that I have no reason to take such a risk. I'm not even sure why I ended up going. Actually, my sister, Celia, was one of the family members who warned me not to go. In the end, she decided to join me. I guess she didn't want me to take the risk alone.
The few days I spent there proved to be excellent. My host, Steve, was most hospitable, We trained in a cultural centre away from the city. There was a nice mountain view, beautiful trees- tranquil and wonderful. The people were friendly and incredibly hospitable. Like most workshops, the majority of participants were women, although we did have a few medical doctors. I was told that South American women are famous for their beauty. I found this to be true, not only in their looks and friendliness but also in their hearts. They are also most graceful in motion. Steve told me that everyone in Venezuela dances. No wonder the Tai Chi for Arthritis workshop participants learned so quickly!
Steve and his wife took us to some exciting restaurants and shops. The shops had lots of handicrafts and were fun and inexpensive. Venezuela is an artistic country.
Steve showed me a mountain that was full of matchbox-like houses. The side of the mountain had beautiful views, and any tourist would consider the area prime real estate. But much to my surprise, Steve informed me that the people who lived there were all squatters. He said a new house appears every few days. There are virtually hundreds of thousands of people living on the side of this mountain, all in shabbily-made houses. Some of the houses are several stories high with hardly any foundation, and Steve said that when there's a mudslide during rainy weather, some of the houses collapse and many people die.
This is a kingdom with its own laws. There are so many squatters here that the government doesn't dare evict them. Also, there are no utilities such as water and sewage. It's amazing! The country is a little bit disorganized, to say the least, but the people are beautiful in many ways. I'm so glad I made the trip.
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For the past two years we have been using Tai Chi Chuan (TCC) as a therapeutic intervention in skilled care rehabilitation. This effort began by applying fundamental TCC training to a patient recovering from bilateral, total hip replacements. After two years she was still hesitant to walk in crowds for fear of being jostled and knocked down. Then a young man of 53 came to us. Struggling to recover from a stroke, he had reached a plateau with conventional therapy and was still suffering from frustrating motor deficits. Training these people in the stances, weight shifts and the stepping motions of TCC taught them about their root. They acquired some of the stability that martial artists use to control the forces of physical conflict.
Since gait and balance problems are so commonly encountered in physical therapy our work quickly expanded to include locomotion and stability deficits related to total knee replacements, Parkinson's disease and cerebral palsy, among others. In general the work has centered on problems associated with orthopedic and neurological disorders.
Figure 1. Kelsey is a 10 year old with cerebral
palsy. Faith is teaching her to do lateral weight
shifts from a horse riding stance. Kelsey's
grandmother is a student in our Yang class
and they practice together.
Our basic treatment plan has been to ground patients in TCC fundamentals and matriculate them to an ongoing class. We teach Yang style at the local health club and patients who can are encouraged to attend as part of their continued treatment. Those who can't are trained in a short set for home exercise.
By invitation of the School of Allied Health Professions at Loma Linda University, we distilled our experience into a four-hour course, given last May, titled "Tai Chi Chuan as a Therapeutic Intervention". The audience consisted of physical therapists, occupational therapists, students and their professors. They all got up and experienced TCC, most for the first time. That seminar has expanded into a workshop that concentrates on treating gait and balance disorders. It is aimed primarily at physical therapists and will be offered at Sonoma State University in October of this year
Figure 2. Dotty and Bob doing the TCA form.
Dotty has Parkinson's disease and has been
working with us for the past eight months
After attending Dr. Lam's Tai Chi for Arthritis workshop last Fall and obtaining certification to instruct in TCA we started several classes in the community. These classes have been a valuable addition to our overall treatment repertoire. TCA works well not only for patients with arthritis but it is also helping with myofascial pain and improving balance. More than being a valuable addition to our group exercise programs, the Sun style has lent itself well to one-on-one treatment in the skilled care setting and is fast becoming the treatment of choice for some problems.
Regardless of the style used, treating individual patients with TCC has many benefits. Some of the most important are:
1) It treats the whole patient. In addition to working an affected part of the body, it works the overall patient internally and externally. Patients improve quickly and are involved in their rehabilitation.
2) The demands of learning Tai Chi motivate the patient to focus on the movements, diverting attention away from their problem.
3) Learning TCC requires that the patient integrate strengths and weaknesses into a functioning whole. Their movement problem is placed in a larger context.
4) TCC provides a continuum of treatment from a skilled care setting to group exercise programs or to private home practice.
5) Last but not least, its practice benefits the therapist as well as the patient.
A gradual awakening to "mindful" exercise in the United States has kindled an interest in Tai Chi Chuan as a therapeutic tool. The recent support of the American Arthritis Foundation for Dr. Lam's TCA program is a big step forward for all of us who use TCC in the health care setting. Having opened this door we hope that Tai Chi will become increasingly recognized as a therapeutic treatment. There is now a good body of evidence for its use in group settings. It will also be important to assess its value as a tool for treating individual problems.
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After attending the Tai chi for Arthritis workshop at Saddleback College
in November 2000 I did not have much luck finding a venue in which to
teach. I had a few private students, but after a three refusals (the
hospital wellness classes and two health clubs) I lost my confidence to
approach anyone else
This May I attended the Update Course and Part II in Oakland. I came
home encouraged to try again. I filled out a proposal to teach for
Sierra College Emeritus classes and received an immediate email from the
Dean. This last Wednesday (Sept.18) I came home elated after teaching
my first class. I have a class of 25 students with a waiting list of 36.
Had there been another classroom available I would have been asked to
teach a second class. My students were very enthusiastic and even
applauded me at the conclusion of the class.
Thank you Paul for being such an inspiration and encouraging me not to
Diane Bishop, Grass Valley, California
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