Refining the Delivery of a 16-form Tai Chi Program for Chronic Ankle Instability

Objective: To refine the delivery of a targeted 16-form Tai Chi program for chronic ankle instability (CAI) through a modified Delphi process. Methods: Eighteen Tai Chi and sports science experts were invited; 10 completed round 1 and 8 of these completed round 2. To improve geographic diversity, 4 nonresponders outside Mainland China were recontacted; 3 completed 2 rounds, and their feedback was integrated. A self-developed 10-item questionnaire (5-point Likert) was rated. Consensus was defined a priori as ≥70% of ratings 4 to 5, median ≥4, IQR ≤1, and CV ≤0.25. Internal consistency was assessed using Cronbach α, and overall agreement using Kendall W. Results: In round 1, all items had median ≥4, but several failed agreement thresholds, prompting revision; α = 0.93 and W = 0.704. In round 2, all items met consensus criteria; α = 0.94 and W = 0.712. The final delivery set included 10 modifications and 6 additions. Five CAI participants were recruited for preliminary validation; 4 provided feedback supporting deliverability and informing refinements. Conclusion: This study produced a standardized, consensus-based delivery framework for a 16-form Tai Chi program tailored to CAI. Clinical trials are needed to determine its effectiveness on ankle-related outcomes.