Stroke Survivors' Feelings and Perceptions of Their Recovery After a Tai Chi Exercise Intervention

Abstract

Background Most tai chi studies conducted among stroke survivors have focused on physical functioning, whereas inclusion of stroke survivors' feelings and perceptions of participating in tai chi is lacking. Objective The aim of this study was to identify stroke survivors' feelings and perceptions of participating in a tai chi intervention during their poststroke recovery. Methods This qualitative descriptive study examined stories from community-dwelling stroke survivors, collected as part of a larger randomized clinical trial. To examine these stories, an inductive content analysis approach was used with a priori theoretical codes (and subcodes): (1) Feelings (confidence, enjoy, hopeful, helpful, other) and (2) Perceptions of Impact (physical abilities, mental/cognitive abilities, challenges, other). Lincoln and Guba's criteria were followed to ensure trustworthiness of the study findings. Results Participants (n = 17) were on average 71 years old (range, 54–87 years), mainly men (65%), and had the option of writing their own story or having someone write it for them. Stories from these stroke survivors revealed feelings of confidence (n = 4), enjoyment (n = 7), hope (n = 1), and helpfulness (n = 15). Perceptions of the impact of tai chi on their poststroke recovery process identified improved physical abilities (n = 23), better mental/cognitive abilities (n = 12), moving forward (n = 7), and developing friendships (n = 4), with few challenges (n = 1). Conclusions Using storytelling, healthcare providers can discuss the benefits of tai chi and then relate the feelings and perceptions of other stroke survivors' experiences to encourage engagement in regular physical activity to aid in the poststroke recovery process.

Stroke Survivors’ Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study

“…In addition, they were surprised and pleased about how their ability to do the tai chi movements improved each week. Our findings that these stroke survivors experienced greater personal efficacy beliefs after participating in tai chi is similar to findings from a prior qualitative study with participants reporting greater confidence in their body and their own abilities [ 20 ]. Moreover, a mixed methods study examining the feasibility of tai chi for stroke rehabilitation [ 14 ] reported significantly greater self-efficacy in performing activities of daily living post-intervention.…”

“…However, natural freer breathing was mentioned frequently in the tai chi classes [ 11 , 39 ]. Moreover, we found that the social interactions and sense of belonging among these stroke survivors was a key active ingredient with therapeutic value as in prior studies [ 14 , 20 , 21 ], which led to self-discovery [ 11 , 13 , 40 ]. Furthermore, participants related a collective sense of the shared experience during the focus group, which was illuminated during the focus group interactions.…”

“…Prior qualitative research conducted among stroke survivors to explore the potential benefits and challenges of participating in tai chi exercise during stroke recovery is limited to those without depression [ 14 , 20 , 21 ]. However, those findings indicated that stroke survivors perceive tai chi as being beneficial for improving their physical abilities, psychosocial well-being, and greater confidence in performing activities of daily living.…”

“…Collectively, these stroke survivors shared that tai chi exercise was enjoyable and provided social support with new friendships developed during the classes. They reported few, if any, challenges associated with participating in tai chi exercise as part of their stroke recovery [ 14 , 20 , 21 ]. It is unknown if post-stroke depression would alter these perceptions of tai chi exercise, what personal efficacy beliefs, besides exercise self-efficacy, are evident; or how stroke survivors view outcome expectations of tai chi.…”

The Feasibility of Tai Chi Exercise as a Beneficial Mind-Body Intervention in a Group of Community-Dwelling Stroke Survivors with Symptoms of Depression

“…Tai Chi is a safe form of exercise for stroke survivors, including those with hemiparesis or poststroke depression [ 36 , 37 , 56 ], though intervention safety or adverse events are frequently not reported [ 57 – 59 ]. While stroke survivors typically report great enjoyment and satisfaction when performing Tai Chi [ 37 , 56 , 60 ], the acceptability or fidelity of Tai Chi interventions among stroke survivors are frequently not reported [ 58 , 59 ].…”