Every week in Murfreesboro, Tenn., Zibin Guo guides veterans in wheelchairs through slow-motion tai chi poses as a Bluetooth speaker plays soothing instrumental music.
“Cloudy hands to the right, cloudy hands to the left,” he tells them, referring to the move traditionally known as “cloud hands.” “Now we’re going to open your arms, grab the wheels and 180-degree turn.”
The participants swivel about-face and continue to the next pose. Guo modified the ancient Chinese martial art to work from a seated position. Even though many of those in his class don’t rely on wheelchairs for mobility, using the mobile chairs makes it easier for them to get through a half-hour of movement.
The Department of Veterans Affairs has given $120,000 in grant money to Guo to spread his special wheelchair tai chi course. He started in Chattanooga, Tenn., and has expanded his classes to Murfreesboro.
This idea of going beyond prescriptions — and especially beyond opioid painkillers — has been a key focus of the VA nationally.
In Tennessee, nearly a quarter of all VA patients with an active medical prescription were on opioids in 2012. That number has dropped to 15 percent, but that’s still higher than in most other parts of the country.
According to a national survey from 2015, nearly every VA hospital now offers some kind of alternative health treatment — like yoga, mindfulness and art therapy.
Guo is teaching people in a half-dozen VA hospitals in Florida, Texas, Utah and Arizona to use his version of tai chi. He believes the focus on breathing and mindfulness — paired with manageable physical activity — can help ease a variety of ailments.
“When you have a good amount of body harmony, people tend to engage in proactive life,” he says, “so that helps with all kinds of symptoms.”
While wheelchair tai chi would provide activity for those who’ve lost some use of their legs, the exercise program is also geared toward helping vets who have mental health issues, including post-traumatic stress disorder.
Thomas Sales of Nashville, Tenn., recalls his most recent panic attack: “Night before last, when we had the thunderstorm,” he said. “The thunder is a big trigger for some people.”
Sales still has panic attacks regularly — 25 years after he fought in the first Gulf War with the Navy Special Warfare Command.
“You’ll find yourself flashing back to being out there with the fellas, and you’ll just kind of snap,” he said. “And I found myself, for some reason, thinking about doing the breathing techniques [from tai chi], and doing the ‘heaven and earth,’ and then breathing deep and slow.”
Sales said he knows it must look crazy to some people when he reaches to the sky and then sweeps his arms to the ground. There was a time when he would have agreed. Most of the patients in this class had some skepticism going into the tai chi program. But Vietnam veteran Jim Berry of Spring Hill, Tenn., says he’s now convinced.
“My daughter sent me a T-shirt that sums it up,” he said. “Tai chi is more than old folks chasing trees.”
Berry credits meditation and tai chi with helping him quit smoking. “No cigarettes for three months now,” he said.
Zarita Croney, a veteran with the National Guard, said tai chi has helped her, too, with chemical dependence. She now makes the nearly-two-hour drive from Hopkinsville, Ky., to Murfreesboro each week, and has reduced her use of opioids for pain..
“My whole life … revolved around, ‘Oh shoot, when can I take my next pill? When can I take my next pill?'” Croney recalled. “I’ve gone from about 90 percent of my day being on my bed to being able to come out and be social.”
The Department of Veterans Affairs has been aggressively trying to wean vets from reliance on strong narcotics — partly by using prescription data as a key measurement to judge VA hospitals across the country — while trying to make sure alternatives don’t cause their own harmful side effects.
The VA acknowledges that there’s very little evidence at this point that tai chi or mindfulness therapy or acupuncture will do any good for PTSD or addiction, though recently there has been research into the quality of life benefits of tai chi among the older adults.
But these alternative therapies have been in use by the department long enough that the VA aims to more closely track the treatments’ effectiveness. It is especially targeting people for alternative treatment who have only recently completed their military service.
The goal, proponents say, is to have veterans incorporate these techniques into their weekly routine, not just rely on a drug prescription to ease pain or anxiety.
“Whole health, along with how many opiates are being prescribed — we’re going to look at how does this impact that,” said Aaron Grobengieser, who oversees alternative medicine for VA hospitals in Tennessee.
“I believe this is going to be an avenue,” he said, “to really help address that group of folks that are really looking for ways to manage those types of conditions without popping another pill.”
This story is part of a partnership that includes Nashville Public Radio, NPR and Kaiser Health News.