Tai Chi Via DVD Instruction as an Introduction to Physical Activity for Women With Morbid Obesity: a Feasibility Study
Phase: NA
Conditions: Morbid Obesity
Sponsor: Husson University

Tai Chi and Resistance exercise in obesity 
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Title:  Tai Chi via DVD instruction as an introduction to physical activity for women with morbidly obese: a 
feasibility study 
 
Document date: September 23, 2016 
 
Primary investigator and Corresponding author: 
 
Cathy L. Stucker, PT, DSc1 
 
stuckerc@husson.edu 
 
Co-investigator: 
 
Sondra G. Siegel, PT, PhD1 
 
siegels@husson.edu 
 
1  Husson University 
    Department of Physical Therapy 
    1 College Circle 
    Bangor, ME 04401 
 
 
 
Clinical Trial Registration Number:  NCT04106661 
 
 
 

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1 
TITLE 
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Tai Chi via DVD instruction as an introduction to physical activity for women with morbidly obese: 
a feasibility study 
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Purpose: 
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The purpose of this study is to investigate alternative approaches to physical activity in 
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people who are morbidly obese to improve their overall health, functional mobility, and 
6 
quality of life. Although physical activity is recommended in most weight management 
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programs, the type of physical activity that results in the most successful outcomes has 
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not been determined. Walking programs are among the most common forms 
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recommended, however few parameters or guidelines are provided, and well-controlled 
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comparisons to other types of exercise are lacking. Compliance with exercise programs 
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is also a factor that impacts success, therefore offering solutions that improve 
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compliance would be beneficial as well. Our study will investigate the use of home- 
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based exercise enhanced with DVDs along with weekly, supervised group sessions to 
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compare Tai Chi and resistance exercise in participants who are morbidly obese. 
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History 
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Obesity is a significant health problem in the United States, with approximately 35% of 
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adults having a body mass index (BMI) of over 30 (Ogden, Carroll, Kit, & Elegal, 2014). 
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Body mass index is a commonly used measure that indicates the relationship between 
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body weight and height. A BMI of 30 or over is considered indicative of obesity, while a 
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BMI of over 40 characterizes morbid obesity. Obesity is associated with a poorer quality 
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of life as well as additional health-related conditions including osteoarthritis, poor 
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mobility, pain, lower levels of physical activity (Garver, et al., 2014), decreased 
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independence with ADLs (Pajecki, Kanagi, Riccioppo, de Cleva, & Cecconello, 2014) 
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and greater risk for falls (Jeon, 2013). In a longitudinal study involving over 36,000 
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participants, Rillamas-Sun and colleagues found that obese women are at a greater risk 

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28 
for chronic disease, mobility disability and mortality compared to others who were not 
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obese, with the risk of disability increasing with the degree of obesity. The implications of 
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these measures can be translated into increased financial burden (Rillamas-Sun, et al., 
31 
2014). A study conducted by Wang and colleagues identified higher direct health care 
32 
costs associated with increased adiposity and physical inactivity (Wang, McDonald, 
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Reffitt, & Edington, 2005). This study found that active obese individuals had lower 
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direct healthcare costs than their inactive obese counterparts. This further endorses the 
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need to identify effective and long-term alternatives for physical activity in people who 
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struggle with obesity. 
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Several types of exercise are known to enhance mobility and function in people who are 
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overweight. Aerobic and walking programs have resulted in improvements in BMI, 
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weight reduction, gait tolerance, strength (Lee, Seo, & Chung, 2013) and self-reported 
42 
quality of life (Baillot, W, Comeau, Meziat-Burdin, & Langlois, 2013) in this population. 
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Other benefits of aerobic exercise programs include improvement in mood, and 
44 
improvement in VO2 max (Sarsan, Ardic, Ozgen, Topuz, & Sermez, 2006). These 
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studies support the use of exercise for women with obesity, but do not provide sufficient 
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information to determine which type of exercise is optimal. 
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Comparisons between aerobic exercise programs and strengthening or resistance 
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exercise programs in the obese population show that these two forms of exercise have 
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different effects on a variety of parameters, though both are beneficial. For example, 
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Geliebter et al found that in obese participants who are restricting caloric intake, 
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resistance exercise limits the loss of fat free mass more than aerobic exercise, but does 
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not protect against the decrease in metabolic rate observed with dieting (Geliebter, 

Tai Chi and Resistance exercise in obesity 
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Maher, Gerace, Gutin, Heymsfield, & A, 1997). Both exercise protocols were more 
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effective than diet alone in promoting positive mood changes. Similarly, Sanal 
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compared aerobic exercise to the combination of aerobic and resistance exercise, and 
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found differential effects on fat free mass (Sanal, Ardic, & Kirac, 2013), and Sarsan’s 
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results supported the hypothesis that aerobic exercise is more beneficial than resistance 
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exercise in enhancing depression scores (Sarsan, Ardic, Ozgen, Topuz, & Sermez, 
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2006). 
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Tai Chi is typically considered a form of aerobic exercise, but is performed slowly and 
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deliberately, with attention to quality of movement. In the general population, it 
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improves mobility, attitudes toward exercise, and may lead to improvements in immune 
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function (Yeh, H, L-W, C-Y, & L, 2006) . It helps augment physiological measures of 
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function and strength in elderly people (Audette, Jin, Newcome, Stein, Duncan, & 
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Frontera, 2006) and people with arthritis (Song, Lee, Lam, & Bae, 2003) and has 
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positive effects on people who are overweight as well. Liu demonstrated that performing 
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Tai Chi exercise in a group improves several indicators of mental health, such as 
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depression, anxiety and stress however these results may have simply been due to 
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performing an exercise program, not specifically a Tai Chi program, as the control group 
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did not participate in an exercise program (Liu, et al., 2015). 
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The unique characteristics of Tai Chi may make it a desirable form of exercise for people 
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with morbid obesity. Xu studied the influence of a 16-week, twice per week Tai Chi 
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intervention in a group of obese women over 60 years old, who had not previously been 
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involved in an exercise program, and compared their results to a no-exercise control 
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group (Xu, et al., 2015). The intervention group improved in weight loss, blood pressure, 

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sit to stand measures, and flexibility. Dechamps’ results were similar using a protocol 
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that involved only one session per week of Tai Chi compared to one session of resisted 
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exercise (Deschamps, Gatta, Bourdel-Marchasson, Tabarin, & Roger, 2009). On the 
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other hand, Maris et al. studied a group of older obese women who participated in a combined 
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program of tai chi and resistance exercises and found that the only difference in outcomes 
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measures between the two groups was in Timed Up and Go scores; no differences were noted in 
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gait speed, chair stand, flexibility, and strength (Maris, et al., 2014). Together, these studies 
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suggest that Tai Chi produces desirable functional outcomes in obese people, but they 
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do not specifically target people who are morbidly obese, with BMIs of greater than 40. 
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Furthermore, many of the studies cited have included only women in their samples, 
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resulting in questionable applicability to men. The morbidly obese population is 
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desperately in need of strategies to promote physical activity and its benefits, but has 
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largely been ignored by the literature. Due to the magnitude of the problem of obesity, 
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and the potential benefits of exercise with this population, it is important to determine the 
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elements of a feasible and effective physical activity program. 
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SPECIFIC AIMS AND SCOPE OF THE PROPOSED RESEARCH 
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The proposed research is a collaborative study involving the Eastern Maine Medical 
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Center Weight Management Program. This program currently has no formal physical 
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activity recommendation for its non-surgical participants. The Weight Management 
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Program managers are seeking guidance as to successful physical activity 
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recommendations for their patients. It is anticipated that a wide demographic will be 
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represented allowing the results to be applied across the spectrum of age and gender. 
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Objectives: 
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1. 
Identify any difference in the functional outcome measures resulting from 
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participation in the different forms of physical activity 

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2. 
Identify differences in compliance among the various types of physical activity with 
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the supervised group and individual sessions. 
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3. 
Determine the impact of the type of physical activity on the health measures 
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collected including blood pressure, and weight. 
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4. 
Identify differences in self-reported quality of life measures resulting from 
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participation in the different physical activities. 
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Clearly, an intervention that would reduce mobility deficits in this population and 
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improve overall health could have a tremendous impact on quality of life for a large 
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portion of the population. The overarching aim of the proposed study is thus to help 
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identify a beneficial and feasible program to impact activity level and therefore health 
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and well-being of people with morbid obesity. 
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PARTICIPANT RECRUITMENT AND SELECTION: Participants will be recruited from the Eastern 
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Maine Medical Center Weight Management practice in Bangor, Maine. The anticipated number 
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of participants will be 45 with 15 participants in each of 3 groups. Adult clients will be included 
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if they are at least 21 years old with no restriction on upper age range. Male and female clients 
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will both be included. Inclusion criteria are as follows: Body mass index (BMI) greater than 40, 
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as determined by the physician’s office, and successful performance on the Four Square Step 
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Test balance assessment at pre-screening to determine falls risk (described below), and the 
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ability to walk independently (with or without an assistive device) for at least 50 feet. 
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Participants must also be able to attend at least one supervised session at Husson University per 
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week for 8 weeks. Data will be included in our analysis if a person has attended at least half of 
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the supervised sessions. Exclusion criteria include: history of bariatric surgery; history of 
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neurological condition (stroke, brain injury, etc.); high fall risk (as indicated by pre-screening); 
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absence of medical clearance received from the physician’s office; inability to consistently 
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attend exercise sessions; and pregnancy. 

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LOCATION: Participants will continue to attend routine physician appointments while enrolled 
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in the Weight Management Program at Eastern Maine Medical Center during the study for 
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medical monitoring and diet consultation. The proposed study does not modify any interaction 
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with the patient’s current medical management. The Tai Chi and General Exercise groups will 
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meet once a week for 8 weeks at the Kenduskeag Laboratory on the campus of Husson 
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University in Bangor, Maine, along with 2 additional sessions for pre and post testing. 
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Participants will perform the exercises or Tai Chi forms at their homes or at another location of 
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their choice 2 additional times per week. Participants in the control group will also attend 2 
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sessions at the Kenduskeag Laboratory for pre- and post-testing; the remainder of their 
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participation will occur at a location of their choice. Functional outcome data, anthropometric 
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measures, height, weight, and vital signs will also be collected at the Kenduskeag Laboratory. 
 
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DURATION: The supervised exercise sessions will take place for 8 consecutive weeks. 
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Following the 8-week intervention, the participants will return for reassessment of the outcome 
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measures; thus each participant’s time involvement in this study will be approximately 10 weeks 
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(including pre and post testing). We anticipate that this study will be done in two consecutive 
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phases, each spanning approximately one academic year, with the entire study taking place 
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between August of 2016 and May of 2018. The first phase of the study will include participants 
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who are in the Tai Chi group and a control group, and the other phase will include those who are 
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doing resistance training along with another control group. After each intervention phase (Tai 
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chi or resistance training), a shorter, 4-week intervention program will be offered to those 
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people who have participated in the control group. This will serve as a reward for participation, 
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and will also encourage people to return for measurements. Thus it should take approximately 
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21 months to complete the entire study. We understand that we will need to apply for an 
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extension of the protocol after the first year of progress on this study. 

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RESEARCH DESIGN: This pilot study will compare three different approaches to provision of 
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physical activity with morbidly obese participants in a Weight Management Program. The 
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participants will be recruited through Eastern Maine Weight Management Program using flyers 
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and pamphlets (See page 28 for an example of the flyer). If they meet the pre-screening 
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minimum requirement for safe dynamic standing balance, they will be eligible to complete the 
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initial outcome measures at that time, and to participate in the rest of the program. 
 
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In order to allow the researchers to feasibly carry out this study, it will be completed over two 
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academic years. During the first year, data will be collected for the control group and for one of 
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the intervention groups (Tai Chi). The following year, data will be collected for the other 
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intervention group (resistance exercise) and an additional control group. This is a repeated 
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measures study with measures being taken just prior to the initiation of the exercise program 
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and then again after the conclusion of 8 weeks of interventions. The use of control groups for 
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both phases will allow researchers to be blinded to group assignment as they take the pre-and 
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post-test measurements. 
 
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After providing informed consent, each potential participant will first be asked to perform the 
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Four Square Step Test (FSST) to determine eligibility for admission to the study. This test will 
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identify those at risk for falls, and they will be excluded from the rest of the study. For this test, 
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participants begin by standing in one quadrant of a square formed by one-inch PVC pipes 
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secured together with a cross connector placed on the floor forming a grid (Figures 1 and 2). 
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They are asked to step in a specific sequence through each of the quadrants of the square. A 
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time of greater than 15 seconds or an incidence of imbalance during the test would result in 
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exclusion from the study. The FSST score of greater than 15 seconds has been found to be 
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associated with a high fall risk in older adults (Dite & Temple, 2002) though no specific 
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parameters have been determined for the morbidly obese population. 

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If a person is eligible based on the FSST results, he or she will fill out a basic demographic form 
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(see pages 29-30). The researchers will then collect data on the following medical parameters: 
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Body-mass index (requires measurement of weight and height), blood pressure, neck 
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circumference, and weight. Participants will complete a quality of life self-assessment using the 
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SF-36 Questionnaire (Appendix 1). The SF-36 is a valid and reliable tool for self-assessment of 
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the overall health of obese individuals (Wadden & Phelan, 2002). They will also complete the 
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Rapid Assessment of Physical Activity (Appendix 2), to provide us with an idea of their general 
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level of activity. (http://depts.washington.edu/hprc/rapa) 
 
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The general mobility status of each participant will be assessed by the following measures:: 
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Short Physical Performance Battery (SPPB) (Guralnik, et al.), Timed Up and Go Test (TUG) 
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(Podsiadlo & Richardson, 1991), 6 Minute Walk Test (6MWT) (Larsson & Reynisdottir, 2008), 30 
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second sit to stand (Jones, Rikli, & Beam, 1999), and the FSST (Dite & Temple, 2002). The SPPB 
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assesses how well people perform some simple balance activities, how fast they walk, and how 
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quickly they rise from a chair (Appendix 3). It is typically completed in 10-15 minutes. The TUG 
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is a test that requires the participant to stand from a chair, walk approximately 10 feet, turn 
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around and come back to the chair (Appendix 4). It is timed, and the time to complete the test 
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is used to identify changes in balance over time. To perform the 6MWT, participants will walk 
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back and forth between two cones or other markers, placed 100 feet apart, as many times as 
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they can comfortably, within 6 minutes. Chairs will be placed at both markers so that 
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participants may sit as needed during the 6 minutes. Total distance walked in 6 minutes is 
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recorded. The 30 second Sit to Stand test simply requires participants to rise to a stand from a 
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chair, and sit back down as many times as possible within 30 seconds. The number of completed 
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rises is recorded. Lastly, the researchers will ask the participants to walk down a Zeno walkway, 
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which is an instrumented 20-foot pad that records gait parameters electronically. The 

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researchers performing the outcome measures data collection will be blinded to the group 
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assignment of the participants. 
 
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The groups of participants will include two intervention groups and two corresponding control 
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groups. The control groups will receive the instruction in participation in physical activity 
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currently provided by the Weight Management Program, but will receive no formal interaction 
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with an exercise instructor or physical therapist during the study period. This is the current 
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standard protocol, so no treatment is being withheld from this group of participants. One 
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intervention group will be instructed in Tai Chi exercises during weekly supervised exercise 
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sessions. A commercially available DVD will be utilized to lead the exercise session with close 
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supervision of technique and safety by the assigned researchers. Participants in this group will 
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be provided with an identical Tai Chi DVD to use during their home sessions. The DVD was 
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created by Dr. Paul Lam, a Tai Chi master who is also a medical doctor, and is specifically geared 
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towards people with arthritis who want to enjoy Tai Chi. We chose this because we could not 
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find a DVD that had been developed for people with obesity, and since many obese people 
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would also benefit from joint protection techniques, we felt that the modifications the master 
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has made for this population would be appropriate for our targeted research participants. 
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Following completion of the 8-week study period, the people who were assigned to the 
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corresponding control group will be offered a 4-week supervised Tai Chi program along with the 
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accompanying DVD. We hope that this will help provide an incentive for them to return for the 
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second measurement session, and will also reward them for participating as part of the control 
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group. 
 
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In the second phase of the study, a group will be instructed in an exercise program of resisted 
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exercises for trunk, upper and lower extremities and stretching exercises. These participants 
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will attend one supervised session per week and will have a DVD to use at home to remind them 

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of the exercises. This DVD will be created and produced by the researchers specifically for this 
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population, based on their knowledge of exercise. Resistance to the exercise will be achieved by 
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the use of elastic bands with varying amounts of resistance. Resistance will be increased during 
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the supervised exercise sessions, as appropriate, on an individual basis. The exercises will 
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become progressively harder over the 8-week period. An additional control group will be 
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recruited as a comparison for this resistance exercise group. The addition of a control group for 
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this phase of the study will allow the researchers to be blinded as they take measurements, and 
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will allow each phase of the study to stand on its own as a complete project with a valid 
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comparison group. After the 8-week study period is completed and post-study measurements 
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have been completed, the control group participants will be offered a 4-week supervised 
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exercise session of resistance training. As described above, this should provide incentive to 
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return for the second measurement session, and will serve as a reward for their participation. 
 
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All of the group exercise sessions will be supervised and led by student physical therapists, with 
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a licensed physical therapist (one of the co-investigators) present at all times. The students and 
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physical therapists are well trained in identifying and guarding patients who may be at risk for 
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falls, though the initial screening should have identified these people and allowed us to exclude 
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them from the study. Prior to starting the exercise sessions with the participants, the 
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researchers will attend instructional sessions with a local experienced Tai Chi teacher (Shih Wah 
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Noh) to learn the correct positions and movements in order to provide effective supervision. 
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During the exercise sessions, the researchers will be observing the participants closely and 
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suggesting modifications in Tai Chi forms or resistance exercises when appropriate, according to 
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the participant’s individual abilities. In this sense, the Tai Chi and the resistance exercises will be 
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tailored to the appropriate level for the individual. 

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Participants in both intervention groups will be instructed to carry out a home program twice a 
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week that is similar to what they have done in the supervised session. In addition to the group 
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and individual exercises in which two groups will participate, all study participants will be 
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instructed to walk daily for exercise, as per the current protocol. All participants will maintain 
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an exercise log to track their compliance with the home program and any additional activity they 
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perform, including walking. They will be instructed to stop exercising if they experience 
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significant shortness of breath, chest pain, dizziness, leg pain, or joint pain. They will be 
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instructed in the use of the BORG Rating of Perceived Exertion (RPE) Scale (Figure 3) with a 
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target range of 12-16. The Borg RPE Scale is a simple scale that allows an individual to quantify 
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his or her response to exercise. A rating of 12-16 encompasses a level of exercise that is rated 
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subjectively as “somewhat hard.” To increase safety in the home exercises, our participants will 
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be instructed to perform the exercises or Tai Chi forms near a support such as a chair, counter, 
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or railing that could be used for assistance in the event of a loss of balance. Participants may be 
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encouraged to discontinue the exercise and exit the study if they experience any discomfort or 
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injury as a result of participation. 
 
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POTENTIAL RISKS: There is always a risk related to falls and/or musculoskeletal injuries as a 
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result of participation in daily activity. There is an increased risk of falls associated with the Tai 
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Chi group due to the type of exercise and movement that is required with that activity. The FSST 
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was selected as a fall risk screening tool because of the similarity in activity between the FSST 
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and the Tai Chi positions. Thus people who can perform adequately on the FSST should be able 
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to safely perform the Tai Chi positions. These positions, while providing a challenge to balance, 
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should not be so difficult for participants that they will provoke a fall. Tai Chi is performed with 
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slow, controlled movements as well which will allow the participants to attend to their balance 
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as they perform the movement patterns. Additionally, all exercises (Tai Chi and resistance 

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exercises) will be performed at a supervised exercise session before a participant will be 
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performing them at home, which will allow the researchers to ensure that they are being 
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performed correctly and safely. During these exercise sessions, researchers will be present for 
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guarding to prevent falls. The exercises will be modified on an individual basis as necessary for 
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safe performance at home. Participants will be instructed to perform the exercises near a 
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support during their home session in the event that they would need a balance assist. 
 
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Participants in all groups will be instructed in safe levels of exercise and when to stop activity. 
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They will be instructed to stop exercising if they experience shortness of breath, dizziness, leg 
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pain, chest pain, or joint pain. Since walking is the common activity that is being encouraged, 
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safety with walking will be emphasized. Walking is presently a part of the program at Eastern 
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Maine Medical Center Weight Management, and thus will not increase the patient’s risk level 
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above the current protocol. 
 
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Any time an individual begins an exercise program, or increases the intensity of an exercise 
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program, there is a risk of mild to moderate muscle soreness. This is expected and does not 
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cause alarm. This should resolve within 2-3 days of initiating the activity, but may return again 
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when new exercises are added to the program. 
 
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There have been some reports of the exercise bands breaking while patients are using them, 
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which may lead to injury. The Theraband company, which fabricates the elastic bands we will 
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be using, recommends that users inspect them for tears before use, and inspect them for color 
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fading, which could indicate weakness. Recommendations also include use of a stabilizing 
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component that they manufacture, so that the band cannot slip out of a doorway. Participants 
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will be provided with new elastic bands on a regular basis to prevent breakage from wear and 

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tear. In addition, they will be educated on how to inspect their bands for age or wear and tear, 
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in order to avoid injury. 
 
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POTENTIAL BENEFITS: Physical activity has been shown to be an important element for weight 
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loss and improved physical condition. The participants in all groups stand to benefit from the 
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increased activity from the walking program. The experimental groups may see benefits in 
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strength, balance, and overall fitness level. Although the duration of the study is brief, the 
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participants may also benefit from weight loss and improvement in the results from their 
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medical exam. Participants may benefit psychologically from exercising, and those involved in 
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the two intervention groups may benefit psychologically from the group activity. The results of 
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this study may provide guidance towards improving mobility and health in people who are 
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morbidly obese. 
 
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DATA COLLECTION: Measurements will be taken on one session prior to, and on one session 
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following completion of the 8 weeks of exercise sessions. A sample data collection form is found 
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on page 31. The participant identification numbers will be the only identifying information 
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utilized during data collection and analysis. Records of the identification codes for the 
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participants will be kept by the primary investigators only, and will be stored in hard copy in 
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their locked offices, and on their password-protected computers. These codes will be stored in 
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a separate file from the research data, so that if there were a breach of the computer, the 
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identity codes would not be obvious. Any data created and collected on paper by this study will 
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be kept in the locked offices of the primary investigators. The paper data will be transferred to 
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spreadsheets on the computers of the primary investigators, which are password 
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protected. When the data are transferred to the electronic spreadsheets, only the numerical 
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codes will be used, so even if there were a breach of the computer, individual identities would 
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not be revealed. The researchers who are assigned to collect pre-test and post-test outcome 

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measures will be excluded from participation in the exercise class instruction for all groups in 
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order to maintain blinding of the researchers. The data will be analyzed using SPSS software. 
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Analysis of the test results among the test groups will include repeated measures ANOVA to 
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compare performance on the outcome measures from initiation of the exercise program to the 
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conclusion. 
 
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FUNDING: A small internal grant from Husson University will cover the cost of the DVDs and the 
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resistance equipment required for the resistance training group. No additional funding will be 
328 
necessary. The exercise sessions will be monitored by students who are receiving course credit 
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and therefore do not receive reimbursement for their time, and the faculty members who will 
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be present are required to carry out this research as part of their teaching loads. 
 
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CONSENT FORM: See attached Informed Consent Form. This form has a Fleish-Kincaid 
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readability level of 9.0. All researchers will be instructed as to how to properly administer an 
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informed consent form to a study participant. 
 
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Figure 1: Equipment shown for the Four Step Square Test. This figure demonstrates a 
person with bilateral amputations completing the FSST. 
 
 
http://www.oandp.org/jpo/library/popup.asp?xmlpage=2013_04S_056&type=image&id=f 
2 
 
Figure 2: Pictoral representation of the sequence of squares a person will walk through in 
completion of the FSST. 
 
 
 
 
 
http://www.monterotherapyservices.com/articles/finding-your-balance-part-4-four- 
square-step-test-fsst 

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Figure 3: BORG Rate of Perceived Exertion Scale. 
 
http://www.runningthroughpregnancy.com/heart-rate-monitoring-try-the-borg- 
rating-scale-instead/ 

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Works Cited 
 
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Audette, J. F., Jin, Y. S., Newcome, R., Stein, L., Duncan, G., & Frontera, W. R. (2006). Tai Chi 
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Baillot, A., W, M., Comeau, E., Meziat-Burdin, A., & Langlois, M. (2013). Feasibility and 
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impacts of supervised exercise training in subjects withobesity awaiting bariatric surgery: A 
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pilot study. Obesity Surgery , 23, 882-891. 
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Deschamps, A., Gatta, B., Bourdel-Marchasson, I., Tabarin, A., & Roger, P. (2009). Pilot study 
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of a 10-week multidisciplinary Tai Chi intervention in sedentary obese women. Clinical 
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Journal of Sports Medicine , 19, 49-53. 
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Dite, W., & Temple, V. A. (2002). A clinical test of stepping and change of direction to identify 
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multiple falling . Archives of Physical Medicine and Rehabilitation , 83 (11), 1566-71. 
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239-43. 
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466 
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RESEARCH PARTCIPANTS’ RIGHTS 
The rights below are the right of every person who is asked to be in a research study. As 
a research subject you have the following rights: 
 
1. To be told what the study is trying to find out. 
 
2. 
To be told what will happen to you and whether any of the procedures, drugs or 
devices are experimental. 
 
3. 
To be told about the reasonably anticipated risks or discomforts that may 
happen to you related to the research. 
 
4. 
To be told if you can reasonably expect any benefit from taking part, and if so, 
what that benefit might be. 
 
5. 
To be told what other appropriate treatment might be worthwhile. 
 
6. 
To be allowed to ask questions concerning the study both before agreeing to 
take part and during the course of the study. 
 
7. 
To be told what sort of medical treatment is available if any injury arises. 
 
8. 
To refuse to take part at all or to change your mind about taking part after the 
study is started. 
 
9. 
To receive a copy of the signed and dated consent form. 
 
10. 
To be free of pressure or undue influence concerning whether you wish to agree 
to be in the study. 

Tai Chi and Resistance exercise in obesity 
22 
 
 
 
497 
Demographic Survey 
498 
499 
Identification number: 
500 
501 
Age: 
502 
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504 
Gender: M / F 
505 
506 
507 
1. How would you rate your average pain over the last 3 days, during periods while 
508 
you were resting or sitting? To answer this question, consider “0” as meaning that 
509 
you have had no pain, and “10” as indicating horrible pain. 
510 
511 
(No pain) 0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 (Horrible pain) 
512 
513 
514 
2. How would you rate your average pain over the last 3 days during times in which 
515 
you were active (walking, doing housework, exercising, etc). 
516 
517 
(No pain) 0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 (Horrible pain) 
518 
519 
520 
3. Do you have any orthopedic conditions that would cause pain? Examples of these 
521 
might be: arthritis, back pain, foot pain, etc. Yes / No 
522 
523 
If yes, please specify  
 
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525 
4. Have you had any orthopedic surgeries? Yes / 
No 
526 
527 
If yes, please describe 
528 
 
 
529 
 
 
530 
531 
532 
5. What prescription medications are you taking? 
533 
534 
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536 
6. Do you use an assistive device such as a walker or a cane to help you while 
537 
walking? 
538 
539 
540 
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Tai Chi and Resistance exercise in obesity 
23 
 
 
How many falls have you had in the past year, approximately?  
 
When did those falls occur?  
 
How long does it take you to get from you home to Husson?  
 
 
 
What is your primary reason for participating in this study?  
 
554 
 
 
555 
 
 
556 
557 
558 
10. What is your occupation?  
 
559 
560 
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562 
11. How many hours per week do you work? 
 
563 
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566 
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543 
7. 
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546 
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8. 
550 
551 
552 
553 
9. 

Tai Chi and Resistance exercise in obesity 
24 
 
 
568 
569 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
570 
571 
Data Collection Form: 
 
Pretest 
Participant ID number: 
Anthropometric Data: 
Height 
Weight 
BMI 
Neck Circumference 
Physical Outcome Measures: 
FSST (Time) 
6 Minute Walk test 
Blood Pressure 
Heart Rate 
Distance 
30 Sec Sit to Stand (#) 
TUG Score (time) 
Gait Measures 
Gait speed 
Step length 
Step width 
Double limb support time 
Cadence 
Paper and pencil surveys 
SF-36 Score 
Rapid Assessment of Phys Activ 
Number of sessions attended at 
Husson 
Number of times exercised 
independently 

Tai Chi and Resistance exercise in obesity 
25 
 
 
572 
573 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
574 
575 
Data Collection Form: 
 
Post test 
Participant ID number: 
Anthropometric Data: 
Height 
Weight 
BMI 
Neck Circumference 
Physical Outcome Measures: 
FSST (Time) 
6 Minute Walk test 
Blood Pressure 
Heart Rate 
Distance 
30 Sec Sit to Stand (#) 
TUG Score (time) 
Gait Measures 
Gait speed 
Step length 
Step width 
Double limb support time 
Cadence 
Paper and pencil surveys 
SF-36 Score 
Rapid Assessment of Phys Activ 
Number of sessions attended at 
Husson 
Number of times exercised 
independently