Tai Chi and Qigong may not be the first approaches that come to mind when considering neurorehabilitation. Yet their emphasis on slow, structured movement, balance, attention and breath closely reflects many of the goals occupational therapists work towards with people living with acquired brain injury, stroke and other neurological conditions.

For Mark Peters, the connection emerged through an unusual combination of engineering and Tai Chi. His interest in structure and the mechanics of human movement led him first into falls prevention and cardiac rehabilitation, and then into work with hospitals supporting brain injury, stroke recovery and neurorehabilitation. He came to see Tai Chi as a practical way to explore how the mind and body function together.

Occupational therapist Alison Noakes recognised its potential from a different starting point. People with brain injury can find conventional exercise programmes difficult to follow, particularly when memory, motivation, apathy or anxiety affect participation. Tai Chi and Qigong can instead be graded around what the person wants and needs to do in daily life, with breathing and relaxation incorporated into the movement rather than treated as separate tasks.

“People do not always see Tai Chi as exercise. That can remove some of the assumptions or resistance associated with being given another exercise programme.”
 

Connecting movement with everyday occupation

The aim is not to teach a fixed sequence for its own sake. Alison and Mark focus instead on the principles beneath each movement and how these can support meaningful occupation. Reaching into a cupboard, bending down, getting out of a chair, opening the curtains, showering independently or loading the car can all provide a more tangible purpose than completing a prescribed number of repetitions.

For Alison, the starting point should be the individual’s priorities and grading the activity towards them. A movement that helps one person build the strength and control needed to shower may be adapted for somebody else who wants to stand more easily or reach safely. This creates a direct link between practice and progress that the person can recognise in their own life.

The approach can also offer short strategies for emotional regulation. Alison recalls using just two or three movements with a client who found it difficult to regulate anger following a brain injury. Slowing the movement and returning attention to breathing helped interrupt the escalation and support regulation. The intervention did not need to become a complete class to be useful.

“It can be done individually or in a group, and it can be adapted very quickly to what the client wants and needs. There are both quick and longer ways it can help.”

Mark describes the same idea as a principles-led approach. Controlled weight transfer, alignment, connection to the ground, spatial awareness, breath and energy management can be applied to many different activities. For people experiencing neurological fatigue, the focus may be on using the body efficiently and managing energy. For others, it may be on balance, mobility or confidence in movement.
 

A richer mind and body experience

Tai Chi and Qigong can make functional movement more engaging by combining physical action with attention, imagery, breathing and story. Rather than asking someone simply to practise standing up ten times, a therapist might connect the same movement with opening the curtains, breathing in and seeing the sunrise. Named movements and imagery can make the experience feel fuller and less clinical, while still working towards a rehabilitation goal.

This may also support motivation. When people can picture the difference a movement could make, practice has a clearer purpose. As Alison notes, traditional neurorehabilitation still has an essential place, but repeatedly completing the same exercises without recognising functional gains can make it difficult for people to remain engaged.

The evidence base is strongest around Tai Chi and falls prevention, including balance, posture, alignment, functional mobility and awareness of the body in space. Mark says research relating specifically to neurorehabilitation is growing, while both speakers acknowledge that more focused research is still needed for acquired brain injury. They hope greater interest and collaboration within occupational therapy will help develop that evidence further.
 

Participation without a perfect form

Safety and accessibility depend on a person-centred approach. In traditional Tai Chi, people may spend years refining a form and reproducing precise positions. Tai Chi for rehabilitation has a different purpose: enabling people to participate using the movement available to them. There is no requirement for everyone in a group to look the same.

Mark has seen people join community sessions using wheelchairs or crutches and later attend with a walking aid or the support of another person. The shape of a movement may not be exact, but the participant may still gain social connection, confidence and a sense of wellbeing. Alison stresses that practitioners must still understand balance, risk and safe grading, but adaptation is central rather than a compromise.

“This is Tai Chi for rehabilitation. It is about helping people do what they can do with it. There is no right or wrong, provided we make sure they are safe.”
 

A session designed for active learning

At the Occupational Therapy Show, Alison and Mark want participants to experience the approach, not simply hear about it. Attendees will be invited to explore grounding, controlled weight transfer, breathing, whole-body expansion and energy flow, before considering how these principles could be applied or adapted within an occupational therapy context.

A practical handout will help participants take the learning back into practice. The goal is not for someone new to Tai Chi or Qigong to leave as an instructor, but to gain the confidence to recognise useful principles, ask informed questions and begin thinking creatively about their own client group. The ideas may be relevant not only in neurological services but wherever anxiety, low mood, fatigue, balance or engagement affect a person’s participation.

For Alison and Mark, the link between occupational therapy and Tai Chi and Qigong is ultimately straightforward. Both place the individual’s goals at the centre, look at the relationship between mind, body and environment, and use meaningful activity as the route to change. By reframing rehabilitation movement around real occupations, Tai Chi and Qigong can help exercise feel less like a programme to comply with and more like progress towards the life a person wants to live.