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Dancing in the Chair: Wheelchair Taijiquan for People with Ambulatory Impairment
Zibin Guo, Ph.D. and Yuyang Zang
Abstract
As large number of individuals with a physical impairment continue experiencing enormous social and cultural barriers to participating in physical activity, it has become imperative to develop a culturally and socially sound model of physical fitness program for this population. This paper, through discussing the development and promotion of wheelchair Taijiquan program in China, suggests that to effectively promote physical activity participation among people with a disability it is important to develop the type of fitness programs that would take their social and cultural conditions into consideration.
Introduction
Although the treatment of people with disabilities is improving, the high prevalence of physical inactivity among this population remains a serious public health concern in China. According to the report on “(Chinese) National Living Condition Survey on Disability” released recently, 70% of the surveyed population indicated that they never participated in any physical fitness program (CDPF 2008). Studies suggest that a host of social and cultural factors have contributed to this trend. In addition to the lack of affordability, low self-confidence, inaccessibility to program sites, lack of transportation and suitable programs, the widespread social stigma toward people with disabilities also tends to discourage individuals, especially those with severe ambulatory impairment, away from engaging in physical activity in the public(Zhang 2007; CDPF 2008).
Physical inactivity is not only one of the leading causes of premature death, it also tends to increase the risk for functional limitations and secondary health conditions among people with a disability (DHHS 2000; Boslaugh 2006). Therefore, it has become imperative to develop and promote an effective, low-cost, accessible, culturally and socially sound model of physical fitness program for people with disability in China.
The purpose of this paper is to discuss the process of a collaborative effort with China Disabled Person’s Federation (CDPF) and China Olympics/Paralympics Committee (COPC) to successfully implement a wheelchair Taijiquan program - an innovative, effective and graceful mind-body exercise especially developed for people with ambulatory impairment.
The Initiative
We made a recommendation to CDPF in 2005 to consider wheelchair Taijiquan as an intervention strategy promoting physical activity participation for people with ambulatory impairment. This recommendation was made based on the following considerations.
First, a large volume of clinical studies have demonstrated that regularly practiced Taijiquan– a slow, gentle, circular and self-paced fitness regime, not only can provide various health benefits to the general population (Taylor-Piliae 2004; Jones, Dean et al. 2005), but it can also improve functional ability and general health condition of a sedentary population (Taggart, Arslanian et al. 2003; Taylor-Piliae 2003; Mustian, Katula et al. 2004; Wang, Collet et al. 2004; Wang, Roubenoff et al. 2005; Cheung, Tsai et al. 2007; Taylor-Piliae and Haskell 2007). Since portions of the upper body perform significant numbers of Taijiquan movements, the seated form would still be able to yield an enormous amount of health benefits to people with an ambulatory disability. By integrating Taijiquan moves with wheelchair motion, the practice of wheelchair Taijiquan would also give the practitioner a sense of uplifting and empowerment. Second, wheelchair Taijiquan would be a low-cost, safe and accessible form of exercise and since it is a sitting form, it can be practiced anywhere, and at anytime to suit the participant’s convenience while requiring no additional equipment and space. Third, Taijiquan is one of the most popular mind and body fitness programs in China. Therefore, the form of wheelchair Taijiquan, requiring no additional adaptive device, would be more likely to gain social acceptance - to normalize the practitioners and to increase their intrinsic motivation for participation.
These two organizations welcomed the recommendation and invited us to work with them in developing a strategy to promote this program nationwide. Sponsored and organized by these two organizations, in October 2006 we conducted the first national wheelchair Taijiquan instructor’s workshop at Beijing. More than forty professionals representing eighteen provincial disability organizations in China were invited to the four-day long training workshop.
The success of this training workshop, especially the enthusiastic support for the wheelchair Taijiquan program that was expressed by all workshop participants, further encouraged the two organizations to bring the wheelchair Taijiquan program to national attention. In the spring of 2007, CDPF issued an official request to all provincial organizations responsible for providing services for people with disabilities to promote the wheelchair Taijiquan program in their regions.
Consequences
Supported by local government agencies and organized by provincial and regional disability organizations, wheelchair Taijiquan instructor workshops were conducted throughout China and led by those who participated in the first national workshop in Beijing. Subsequently, free wheelchair Taijiquan classes have been offered in cities as well as in agricultural areas of China. Class participants gather daily, both at dawn and at dusk, in city parks and town centers to practice the wheelchair Tai Chi Chuan alongside hundreds of Taijiquan lovers from the general population.
Since wheelchair Taijiquan is being seen as a new and welcomed phenomenon, state and local news media including newspapers, web based organizations, TV and radio stations also have taken a special interest in reporting and promoting wheelchair Taijiquan to the public. As the news and the successful stories spread out, the demand for offering wheelchair Taijiquan has also grown exponentially throughout China.
Encouraged by the initial success, COPC and the CDPF then decided to include a wheelchair Taijiquan demonstration at the 2007 Olympics Cultural Festival in Beijing to further promote this program. On June 23, 2007, eighty individuals with ambulatory impairments representing various regions of China demonstrated the wheelchair Taijiquan at the opening ceremony of this festival. The demonstration was the very first time that wheelchair Taijiquan had been brought to a national stage, and it further ignited the enthusiasm and the popularity of wheelchair Taijiquan practice across the country. Major cities including Shanghai, Beijing, Tianjin, Hebei and Taiyuan have also included wheelchair Taijiquan as a demonstration event in their local festivities and Paralympics.
The overwhelmingly positive response to the development of wheelchair Taijiquan from both the general public and people with ambulatory impairment also prompted the decision by COPC and CDPF to showcase the wheelchair Taijiquan program to the community of the International Paralympics during Beijing 2008 Olympics/Paralympics. On September 5, 2008, fifty wheelchair Taijiquan practitioners, dressed in white silk Tai Chi uniforms and moving in slow graceful harmony, performed the “13 Postures of Wheelchair Taijiquan” on the main stage of the Beijing 2008 Olympics/Paralympics Cultural Festival as one of the kickoff events for the opening ceremony of the Beijing 2008 Paralympics on September 6.
“They moved so beautifully and it was so inspirational as if they were dancing in the chair,” one of the reporters on the scene described.
Due to the apparent effectiveness of wheelchair Taijiquan in promoting the participation of physical activity and its popularity among people with ambulatory impairment throughout China, the CDPF has included wheelchair Taijiquan as part of their national health promotion program.
Discussion
From its conception in 2005 through the International Paralympics demonstration in the summer of 2008, in a span of three years, wheelchair Taijiquan has become a popular fitness activity benefitting tens of thousands of people throughout China. In addition to the systematic promotional efforts engaged by CDPF and COPC, the suitability of wheelchair Taijiquan to the social and cultural conditions of people with ambulatory impairment in China, along with the cultural significance of Taijiquan practice and its effectiveness in improving physical and mental wellbeing have all played an important part toward contributing to the fast growing popularity of wheelchair Taijiquan in China.
Similar to many other societies, the majority of people with ambulatory impairment in China find the economic hardship, poor health condition, less predictable daily routine, prevalent social stigma, lack of mobility and accessibility would often time discourage them from participating in community-based fitness programs. In addition, the lack of awareness regarding suitable programs and the fear of injury would also prevent them from engaging in physical activity on their own. The form of wheelchair Taijiquan however, is a no-cost and convenient method of establishing a fitness program, the practice does not require any special equipment or space, and it can be practiced at anytime, anywhere that is convenient for the practitioner. In addition, since the body movements in wheelchair Taijiquan are gentle, slow and circular, practitioners can adjust the speed and the range of motion according to their physical condition, thereby minimizing the practitioners’ fear of injury.
Taijiquan has been a part of Chinese health and popular cultural for centuries. With the mind directing the body, the circular, slow, graceful movements performed in Taijiquan are seen as an effective and ideal way to obtain optimal mental and physical fitness through improving one’s ability at harmonizing with physical and social worlds. This culturally constructed perception has also played an important role in facilitating the public acceptance of wheelchair Taijiquan. The enthusiastically expressed public support and praise to the practice of wheelchair Taijiquan has therefore not only normalized the practice, but it has also empowered the practitioners and mitigated their concern of social stigma.
During our interaction with wheelchair Taijiquan practitioners in China, many told us that their health condition including body mobility have improved significantly since they began the practice. The effect of self-efficacy resulting from the practice has certainly played a significant role in promoting the practice and the growing popularity of wheelchair Taijiquan.
Implications
As an effort to promote physical wellbeing for people with disabilities, over the years China has allocated large resources and placed significant emphasis on developing Paralympic sports and other forms of competitive activities at both state and local levels. To a great extent this approach has improved social perception and image toward disability and has cultivated a significant number of world-class Paralympics athletes while providing enormous inspiration to people with disabilities. However, it has had far less impact on the improvement of physical activity participation among the typical person with ambulatory impairment. This discordance has been illustrated by the fact that while China ranked number one in both gold and the total medal counts in the 2008 Beijing Paralympics, the prevalence of physical inactivity among people with disability reached a level of more than 70% in the country.
The fast growing popularity of wheelchair Taijiquan in China not only demonstrates the important role that a fitness program, developed according to the social and cultural conditions of people with physical disabilities, can play to effectively promote physical activity participation, it also suggests the need to modify current efforts and approaches in developing effective and sustainable fitness programs for people with disabilities in China. While the effort to promote Paralympic sports, develop adaptive fitness technology, and improve environmental accessibility are essential to promoting participation in physical activities for people with disability, great consideration toward developing the type of fitness programs that are culturally meaningful and socially practical (low-cost and less reliant on external factors) would have equal importance.
References
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DHHS (2000). Health People 2010: Disability and Secondary Conditions Washington (DC), U.S. Government Printing Office 1.
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Contributors
Zibin Guo is UC Foundation Professor of Medical Anthropology at University of Tennessee Chattanooga, USA.
Email: Zibin-guo@utc.edu
http://www.utc.edu/Academic/SociologyAnthropologyAndGeography/
Professor Yuyang Zhang is an associate director in the department of Physical Education, at Nanjing University Yuyang Zhang, China
http://www.nju.edu.cn/cps/site/tyb/index.htm
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