Exploring the Challenges, Facilitators, and Changes With Older Adults Taking Part in a Randomized Inspiratory Muscle Training Tai Chi Trial: A Reflexive Thematic Analysis.

Abstract

As the global population ages, interventions that support physical and respiratory health in older adults are essential. This study investigates the experiences of older participants in a combined 8-week Tai Chi and Inspiratory Muscle Training (IMT) program, aiming to explore the facilitators and barriers to participation. Thirty-one adults aged 60+ were recruited and assigned to either an experimental or sham IMT plus Tai Chi intervention with a double-blind, randomized controlled trial approach. Qualitative data were gathered from 10 participants (6 IMT; 4 sham-IMT), through semistructured focus groups and individual interviews, and reflexive thematic analysis identified 4 key themes: external disruptions and the struggle for consistency, physical discomfort and adaptation, challenges in sustained engagement, and balancing social interaction with personalized support. In particular the themes show distinction between: (1) challenges, including external disruptions and the struggle for consistency, physical discomfort, and difficulties in sustaining engagement and motivation; (2) facilitators, such as social connection, perceived health benefits, and initial support from instructors; (3) adaptations, including strategies participants used to overcome discomfort, manage routines, and seek personalized ways to engage with the program. Findings highlight that while participants value the health benefits of Tai Chi and IMT, they encounter social and environmental constraints, physical discomfort, motivational challenges, and a need for clear guidance and personalized feedback. These insights underscore the importance of designing flexible, adaptive interventions that consider older adults' unique needs to improve engagement and outcomes. Future research should further investigate dual interventions like Tai Chi and IMT to refine delivery strategies and maximize health benefits for aging populations.