Feasibility of Remote-Delivery Interventions: Tai Chi and Wellness for PTSD and Pain in Veterans - Project Summary
Posttraumatic stress disorder (PTSD) affects almost one quarter of military Veterans seeking care from
Veterans Administration healthcare facilities. PTSD is associated with many health-related issues, especially
chronic musculoskeletal pain, and is increasingly considered a systemic disorder, affecting both mind and
body. Accessible treatments that address PTSD and chronic pain are urgently needed. Tai Chi is an ancient
Chinese exercise that uses an integrated mind-body approach to enhance quality of life. Tai Chi delivered in
groups has been shown to improve both mental health and physical health in patients with a variety of chronic
conditions. However, no studies to date have examined Tai Chi for PTSD and pain in Veterans. Since the
onset of COVID-19, interventions that can be delivered without the need for face-to-face contact are greatly
needed. Remote mind-body interventions delivered via videoconferencing platforms can reduce barriers to
treatment for Veterans isolated by PTSD-related avoidance, travel related challenges, or public health social
distancing restrictions. The proposed study will evaluate the feasibility of remotely delivered Tai Chi for PTSD
and pain in Veterans. This trial represents first steps toward a long-term goal of establishing this mind-body
treatment to address these maladies for Veterans via a remote videoconferencing platform. In Phase One, the
research team will adapt and do a ‘dry run’ of two existing 12-week, twice per week interventions (Tai Chi and
a Wellness control) for delivery via videoconferencing for the study population. In Phase One, the team will
recruit 12 participants (6 in each group) and utilize quantitative and qualitative feedback to refine and
standardize the interventions. In Phase Two, 36 participants will be randomly assigned over 3 cohorts (n = 12
for each cohort, n = 6 for each group) to either a Tai Chi or a Wellness group for 12 weeks with a three-month
post-treatment follow up assessment. The feasibility and acceptability of a remotely delivered randomized trial
of these two interventions and the assessment protocols will be determined. Feasibility will be quantified using
rates of participant eligibility, recruitment, attrition, and adherence to the treatment and assessment protocols.
Feasibility will be indicated (1) by the ability to meet recruitment goals, including women and minority
participation, and (2) by having at least 75% of participants regularly attend sessions and engage in home
practice and 70% complete post-intervention and follow-up assessments. Acceptability will be assessed via
participants’ ratings on a standardized measure of treatment satisfaction, supplemented by qualitative exit
interviews. Acceptability will be indicated by 70% of the participants reporting treatment satisfaction and
credibility. Information from this trial will be utilized to design a large randomized control study evaluating the
efficacy of Tai Chi for improving outcomes for Veterans with PTSD and chronic musculoskeletal pain. The
proposed study will be pivotal to establish procedures to fully evaluate a novel, accessible, nonpharmacologic
approach for symptom management of PTSD and chronic pain in a future large-scale trial of Tai Chi.