EFFECTS OF QIGONG ON BLOOD PRESSURE, HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND OTHER LIPID LEVELS IN ESSENTIAL HYPERTENSION PATIENTS

Exploring the effects of combining health qigong and dance on working memory in middle-aged and elderly women: A preliminary investigation

OBJECTIVE

Cognitive decline represents a critical clinical and public health issue that adversely affects the quality of life for older patients and their families. This concern was exacerbated by the reduced engagement in outdoor activities among seniors during the COVID-19 pandemic, presenting substantial challenges to aging societies. The objective of this study was to investigate the impact of health qigong combined with Tibetan dance on working memory in middle-aged and elderly women, and to determine its potential as a preventive strategy against cognitive disorders.

METHODS

A pilot study was conducted to compare the effects of a Health Qigong exercise intervention with those of everyday life and sports routines. The primary outcome measure was working memory assessed using a 2-Back working memory task research paradigm. Between July and September 2021, a total of 33 women were divided into four groups: two middle-aged groups (N = 18, with 8 women in the experimental group and 10 in the control group) and two elderly groups (N = 15, with 7 in the experimental group and 8 in the control group). Participants in the experimental groups underwent a 10-week intervention, consisting of three 60-min sessions per week. Each session included a warm-up, Health Qigong combined with Tibetan dance, and a cool-down. Throughout the study, all participants continued their daily routines. Response times and error rates were analyzed using a mixed-design repeated-measures analysis of variance.

RESULTS

A simple effects analysis revealed that Health Qigong combined with Tibetan dance significantly enhanced 2-Back response time and error rate in the middle-aged group. In contrast, the 2-Back error rate significantly increased in the elderly control group that did not receive the intervention (p < 0.05).

CONCLUSION

Health Qigong demonstrates beneficial effects on middle-aged and elderly women. Combining Health Qigong with dance may serve as a preventive measure against cognitive disorders. This pioneering study conducted during the COVID-19 pandemic, assesses the new possibility of Health Qigong and dance, with the objective to offer more diverse indoor exercise options for middle-aged and elderly women.

The Effect of Traditional Chinese Exercises on Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis

In the context of the increasing number of patients with hypertension, exercise intervention is an excellent alternative or adjunctive treatment for hypertension. Traditional Chinese exercises are excellent physical and mental exercise methods. Although some studies have reviewed the effects of Chinese traditional exercise on patients with hypertension, most of the reviews only involved a single category of traditional exercise. Furthermore, few studies have conducted in-depth analysis of the combined intervention methods of traditional Chinese exercise, and there are high heterogeneity. This study evaluates the current clinical evidence of Chinese traditional exercises in the treatment of essential hypertension. A total of 49 randomized controlled trials with 4207 hypertensive patients were selected according to the inclusion criteria by searching all relevant studies from the establishment of six electronic databases until September 10, 2022. Among them, 24 used tai chi and 25 used Qigong, including Yijinjing, Wuqinxi, Liuzijue, Baduanjin, and Guolin Qigong. This study divided four subgroups according to the type of intervention to explore the source of heterogeneity among studies and found that traditional Chinese exercises can assist or even may replace traditional treatments. The results of meta-analysis showed that compared with the use of antihypertensive drugs alone or in health education, the addition of Chinese traditional exercises showed significant effects in regulating the systolic blood pressure and diastolic blood pressure in hypertensive patients. Although the results show that traditional Chinese exercise are effective, the clinical evidence will be affected by the low quality of most randomized controlled trials. More rigorously designed trials are needed in the future to further validate it.

A pilot study on the impacts of lung-strengthening Qigong on wellbeing

BACKGROUND

Qigong embraces a range of self-care exercises originating from China. Lung-Strengthening Qigong (LSQ) is a specific technique for maintaining and improving physical and mental wellbeing.

METHODS

We recruited 170 practitioners and 42 non-practitioner/control samples to investigate the impacts of LSQ practice on body, mind, thoughts, and feelings. This is a pilot study pursued to plan for an adequately powered, non-clinical randomized controlled trials (RCT) on overall wellbeing and health and to evaluate the adequacy of delivering the physical activity intervention with fidelity. Self-evaluation-based data collection schemes were developed by regularly requesting completion of a questionnaire from both practitioner and control group, and an online diary and end of study survey (EOS) completion only from the practitioners. Diverse types of analyses were conducted, including statistical tests, machine learning, and qualitative thematic models.

RESULTS

We evaluated all different data resources together and observed that (a)the impacts are diverse, including improvements in physical (e.g., elevated sleep quality, physical energy, reduced fatigue), mental (e.g., increased positivity, reduced stress), and relational (e.g., enhanced connections to self and nature) wellbeing, which were not observed in control group; (b)measured by the level-of-effectiveness, four distinct clusters were identified, from no-effect to a high-level of effect; (c)a majority (84 %) of the LSQ practitioners experienced an improvement in wellbeing; (d)qualitative and quantitative analyses of the diary entries, questionnaires, and EOS were all found to be consistent, (e)majority of the positively impacted practitioners had no or some little prior experience with LSQ.

CONCLUSIONS

Novel features of this study include (i)an increased sample size vis-à-vis other related studies; (ii)provision of weekly live-streamed LSQ sessions; (iii)integration of quantitative and qualitative type of analyses. The pilot study indicated that the proportion of practitioners who continued to engage in completing the regular-interval questionnaires over time was higher for practitioners compared to the control group. The engagement of practitioners may have been sustained by participation in the regular live LSQ sessions. To fully understand the impacts of LSQ on clinical/physiological outcomes, especially for specific patient groups, more objective biomarkers (e.g. respiratory rate, heart rate variation) could be tracked in future studies.

Can Yoga, Qigong, and Tai Chi Breathing Work Support the Psycho-Immune Homeostasis during and after the COVID-19 Pandemic? A Narrative Review

Breathing is crucial in life; nevertheless, the healthcare community often overlooks the health potential of breathing techniques. Conscious manipulation of breathing to achieve specific health goals is found in yoga, Qigong and Tai Chi. This paper reviews the value of breathing exercises as a foremost mechanism for promoting, recuperating and maintaining health. Practices involving breathing techniques are described, and their prophylactic or therapeutic characteristics are explored. The main goals of this review are: (i) to summarize the evidence supporting the hypothesis that breathing practices have a significant beneficial impact on human health; (ii) to provide a deeper understanding of traditional biofeedback practices, particularly yoga, Qigong and Tai Chi, and outline their focus on breathing techniques; (iii) to outline specific immune-related responses, relevant for COVID-19 disorders; and (iv) to call for committed attention and action from the scientific community and health agencies in promoting the implementation of a practical and costless health program based on breathing techniques. This review shows the health potentials of breathing practices and exercises, which, by having a high benefit-cost ratio, could be selected and implemented as a primary standard routine in public health programs.

Effects of qigong on systolic and diastolic blood pressure lowering: a systematic review with meta-analysis and trial sequential analysis

BACKGROUND

The benefits of qigong for systolic and diastolic blood pressure (BP) reduction have been noted in previously published systematic reviews; however, the data on its effectiveness has been at best scarce. We aimed to update the evidence of qigong on blood pressure reduction after taking into consideration the risks of random error and reliability of data in the cumulative meta-analysis using trial sequential analysis (TSA).

METHODS

Included trials were assessed using Cochrane risk of bias instrument. We performed meta-analysis with random-effects model and random errors were evaluated with TSA. We performed the search for the eligible randomized controlled trial (RCT) through Medline, Cinahl, Cochrane Central Register of Controlled Trials and also PubMed.

RESULTS

A total of 370 subjects sourced from seven eligible RCTs were entered into the analysis. The pooled results demonstrated the significant reduction with the use of qigong of the systolic blood pressure [weighted mean difference (WMD), - 10.66 mmHg (95% confidence interval (CI) = - 17.69,-3.62, p < 0.001] and diastolic BP [WMD, - 6.76 mmHg, 95% CI = - 12.22, - 1.30, p < 0.001] as compared to the control group.

CONCLUSIONS

Significant reductions in BP is seen with the use of qigong as compared with the control group, suggesting that qigong may be used as a complementary therapy in the somewhat complicated management of hypertension.

Feasibility of Mind-Body Movement Programs for Cancer Survivors

PURPOSE/OBJECTIVES

To evaluate mind-body movement exercise (MBME) classes (yoga, tai chi, and Qigong) for cancer survivors. 
.

DESIGN

A single-group, repeated-measures design.
.

SETTING

The Ohio State University Wexner Medical Center-Arthur G. James Cancer Hospital in Columbus.
.

SAMPLE

33 adult cancer survivors, with any cancer diagnosis, participating in MBME classes.
.

METHODS

The researchers sought to examine feasibility of multiple data collection time points and data collection measures; acceptability; and changes to physical, emotional, and biometric measures over time, as a result of participation in MBME classes.
.

MAIN RESEARCH VARIABLES

Quality of life, sleep, depressive symptomatology, fatigue, stress, upper body strength, gait and balance, body mass index, heart rate, and blood pressure.
.

FINDINGS

The current study was feasible because survivors were willing to participate and completed most of the questionnaires. Participants found these classes to be beneficial not only for exercise, but also for social support and social connectedness. Poor sleep quality was consistently reported by participants. MBME classes should be recommended to survivors and are beneficial for oncology practices to offer.
.

CONCLUSIONS

Conducting MBME research with cancer survivors is feasible, and participants find the MBME acceptable and a way of addressing health and managing cancer-related symptoms.
.

IMPLICATIONS FOR NURSING

Nurses should help patients and caregivers identify locations and times when MBME class participation is possible, assess MBME class participation during each clinic visit to promote continued involvement and to understand if positive effects are occurring, and continue to provide support for MBME classes throughout the survivorship experience.

Efficacy of Tai Chi and qigong for the prevention of stroke and stroke risk factors: A systematic review with meta-analysis

BACKGROUND

This review aims to summarize the evidence of Tai Chi and qigong interventions for the primary prevention of stroke, including the effects on populations with major stroke risk factors.

METHODS

A systematic literature search was conducted on January 16, 2017 using the PubMed, Scopus, Cochrane Library, and CINAHL databases. Randomized controlled trials examining the efficacy of Tai Chi or qigong for stroke prevention and stroke risk factors were included. Risk of bias was assessed using the Cochrane Risk of Bias tool.

RESULTS

Twenty-one trials with n = 1604 patients with hypertension, hyperlipidaemia, diabetes, overweight or obesity, or metabolic syndrome were included. No trials were found that examined the effects of Tai Chi/qigong on stroke incidence. Meta-analyses revealed significant, but not robust, benefits of Tai Chi/qigong over no interventions for hypertension (systolic blood pressure: -15.55 mm Hg (95% CI: -21.16; -9.95); diastolic blood pressure: -10.66 mm Hg (95% CI: -14.90, -6.43); the homeostatic model assessment (HOMA) index (-2.86%; 95% CI: -5.35, -0.38) and fasting blood glucose (-9.6 mg/dL; 95% CI: -17.28, -1.91), and for the body mass index compared with exercise controls (-1.65 kg/m; 95% CI: -3.11, -0.20). Risk of bias was unclear or high for the majority of trials and domains, and heterogeneity between trials was high. Only 6 trials adequately reported safety. No recommendation for the use of Tai Chi/qigong for the prevention of stroke can be given.

CONCLUSION

Although Tai Chi and qigong show some potential more robust studies are required to provide conclusive evidence on the efficacy and safety of Tai Chi and qigong for reducing major stroke risk factors.

Traditional Chinese Exercise for Cardiovascular Diseases: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background

Traditional Chinese exercise (TCE) has widespread use for the prevention and treatment of cardiovascular disease; however, there appears to be no consensus about the benefits of TCE for patients with cardiovascular disease. The objective of this systematic review was to determine the effects of TCE for patients with cardiovascular disease.

Methods and Results

Relevant studies were searched by PubMed, Embase, Web of Science, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, and the China National Knowledge Infrastructure. We covered only published articles with randomized controlled trials. The outcome measures included physiological outcomes, biochemical outcomes, physical function, quality of life, and depression. A total of 35 articles with 2249 cardiovascular disease patients satisfied the inclusion criteria. The pooling revealed that TCE could decrease systolic blood pressure by 9.12 mm Hg (95% CI −16.38 to −1.86, P=0.01) and diastolic blood pressure by 5.12 mm Hg (95% CI −7.71 to −2.52, P<0.001). Patients performing TCE also found benefits compared with those in the control group in terms of triglyceride (standardized mean difference −0.33, 95% CI −0.56 to −0.09, P=0.006), 6‐minute walk test (mean difference 59.58 m, 95% CI −153.13 to 269.93, P=0.03), Minnesota Living With Heart Failure Questionnaire results (mean difference −17.08, 95% CI −23.74 to −10.41, P<0.001), 36‐Item Short Form physical function scale (mean difference 0.82, 95% CI 0.32–1.33, P=0.001), and Profile of Mood States depression scale (mean difference −3.02, 95% CI −3.50 to −2.53, P<0.001).

Conclusions

This study demonstrated that TCE can effectively improve physiological outcomes, biochemical outcomes, physical function, quality of life, and depression among patients with cardiovascular disease. More high‐quality randomized controlled trials on this topic are warranted.

Effects of Qigong Exercise on Biomarkers and Mental and Physical Health in Adults With at Least One Risk Factor for Coronary Artery Disease

Current medical technology permits the early detection of risk factors for coronary artery disease (CAD) in adults, and interventions are available to prevent CAD-related morbidity and mortality. The goal of this study was to determine the effectiveness of a Qigong exercise intervention in improving biomarker levels and mental and physical health outcomes in community-dwelling adults diagnosed with CAD risk factors, in a southern Taiwanese city. Participants were randomly assigned to an experimental ( n = 84) group that participated in a 60-min Qigong group session 3 times per week for 3 months or a control ( n = 61) group that did not receive the intervention. Self-perceived mental and physical health assessed with the Chinese Health Questionnaire-12, and body fat percentage were measured at baseline and 6, 12, and 16 weeks. Blood samples were collected at baseline and 12 weeks for analysis of lipid profiles, high-sensitivity C-reactive protein (hs-CRP), glycated hemoglobin (HbA1c), and fasting plasma sugar. Linear mixed model analyses revealed that experimental participants had significantly improved perceived mental and physical health and body fat percentage compared to the control group at 6 and 12 weeks but not 16 weeks. The lipid profiles were significantly more improved in the Qigong group than in the control group at 12 weeks. Qigong exercise, however, had no significant effects on hs-CRP, HbA1c, or fasting plasma sugar. Findings suggest that Qigong exercise improves a limited number of CAD risk factors in community-dwelling adults aged 40 years and over.

Qigong for the primary prevention of cardiovascular disease

BACKGROUND

Two major determinants of cardiovascular disease (CVD) are a sedentary lifestyle and stress. Qigong involves physical exercise, mind regulation and breathing control to restore the flow of Qi (a pivotal life energy). As it is thought to help reduce stress and involves exercise, qigong may be an effective strategy for the primary prevention of CVD.

OBJECTIVES

To determine the effectiveness of qigong for the primary prevention of CVD.

SEARCH METHODS

We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (November 2014, Issue 10 of 12); MEDLINE (Ovid) (1946 to 2014 October week 4); EMBASE Classic + EMBASE (Ovid) (1947 to 2014 November 4); Web of Science Core Collection (1970 to 31 October 2014); Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database and Health Economics Evaluations Database (November 2014, Issue 4 of 4). We searched several Asian databases (inception to July 2013) and the Allied and Complementary Medicine Database (AMED) (inception to December 2013), as well as trial registers and reference lists of reviews and articles; we also approached experts in the field and applied no language restrictions in our search.

SELECTION CRITERIA

Randomised controlled trials lasting at least three months involving healthy adults or those at high risk of CVD. Trials examined any type of qigong, and comparison groups provided no intervention or minimal intervention. Outcomes of interest included clinical CVD events and major CVD risk factors. We did not include trials that involved multi-factorial lifestyle interventions or weight loss.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected trials for inclusion. Two review authors extracted data from included studies and assessed the risk of bias.

MAIN RESULTS

We identified 11 completed trials (1369 participants) and one ongoing trial. Trials were heterogeneous in participants recruited, qigong duration and length of follow-up periods. We were unable to ascertain the risk of bias in nine trials published in Chinese, as insufficient methodological details were reported and we were unable to contact the study authors to clarify this.We performed no meta-analyses, as trials were small and were at significant risk of bias. Clinical events were detailed in subsequent reports of two trials when statistically significant effects of qigong were seen for all-cause mortality, stroke mortality and stroke incidence at 20 to 30 years after completion of the trials. However, these trials were designed to examine outcomes in the short term, and it is not clear whether qigong was practised during extended periods of follow-up; therefore effects cannot be attributed to the intervention. None of the included studies reported other non-fatal CVD events.Six trials provided data that could be used to examine the effects of qigong on blood pressure. Reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were seen in three and two trials, respectively. Three trials examined the effects of qigong on blood lipids when favourable effects were seen in one trial for total cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides, and two trials showed favourable effects on high-density lipoprotein (HDL) cholesterol. The only trial considered at low risk of selection and detection bias did not demonstrate statistically significant effects on CVD risk factors with qigong, but this study was small and was underpowered. None of the included studies reported incidence of type 2 diabetes (T2D), adverse events, quality of life or costs.

AUTHORS' CONCLUSIONS

Currently, very limited evidence is available on the effectiveness of qigong for the primary prevention of CVD. Most of the trials included in this review are likely to be at high risk of bias, so we have very low confidence in the validity of the results. Publication of the ongoing trial will add to the limited evidence base, but further trials of high methodological quality with sufficient sample size and follow-up are needed to be incorporated in an update of this review before the effectiveness of qigong for CVD prevention can be established.

Sit, breathe, smile: effects of single and weekly seated Qigong on blood pressure and quality of life in long-term care

Long-term care (LTC) facilities house individuals with diverse combinations of cognitive and physical impairments, and the practice of Seated Qigong eliminates common exercise barriers. This study hypothesized: 1) a single session would lower blood pressure (BP) and improve quality of life (QOL) in a generalized LTC population, and 2) these responses would be attenuated with chronic (weekly) Seated Qigong practice. Ten residents (6 female; 86 ± 7 years) participated in 1X/week Seated Qigong sessions for 10-weeks. BP and QOL were assessed pre- and post-session at baseline and following 5- and 10-weeks of Qigong. Systolic BP was significantly reduced immediately post-session after 10-weeks of Qigong (P = 0.03), yet unchanged at baseline and after 5-weeks (all P > 0.05). Diastolic BP and QOL remained unchanged (P > 0.05). A session of Seated Qigong elicits a hypotensive response with exposure, supporting the notion that repeated sessions may provide advantageous health benefits.

Psychological, immunological and physiological effects of a Laughing Qigong Program (LQP) on adolescents

OBJECTIVES

One objective of this study was to assess the effects of laughter on the psychological, immunological and physiological systems of the body. Another objective was to introduce the Laughing Qigong Program (LQP), as a method of standardization for simulated laughter interventions.

DESIGN

A randomized, prospective, experimental study of the LQP was conducted in a group of adolescents (n=67) in Taiwan. During study-hall sessions, experimental subjects (n=34) attended the LQP for eight-weeks. Simultaneously, control subjects (n=33) read or did their homework. All subjects were tested before and after the intervention on the following: Rosenberg Self-Esteem scale (RSE), Chinese Humor Scale (CHS) and Face Scale (FS) as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR), and heart rate variability (HRV) as physiological markers of the body's response to stress. Mood states (FS) were measured before/after each LQP session.

RESULTS

Mood states (p=.00) and humor (p=.004; p=.003) improved in the experimental group; no significant changes were found in the controls (p=69; p=60). The immunological marker of stress, cortisol levels, decreased significantly for those who participated in the LQP (p=.001), suggesting lower levels of stress after completion of the program.

CONCLUSIONS

The LQP is a non-pharmacological and cost-effective means to help adolescents mitigate stresses in their everyday life.

Evidence-based chinese medicine for hypertension

Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM). Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go.

The treatment of depressed chinese americans using qigong in a health care setting: a pilot study

Background. This pilot study examined the feasibility and efficacy of providing Qigong treatment in a health center to Chinese Americans with major depressive disorder (MDD). Methods. Fourteen Chinese Americans with MDD were enrolled, and they received a 12-week Qigong intervention. The key outcome measurement was the 17-item Hamilton Rating Scale for Depression (HAM-D₁₇); the Clinical Global Impressions-Severity (CGI-S) and -Improvement (CGI-I), the Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form (Q-LES-Q-SF), and the Multidimensional Scale of Perceived Social Support (MSPSS) were also administered. Positive response was defined as a decrease of 50% or more on the HAM-D₁₇, and remission was defined as HAM-D₁₇ ≤ 7. Patients' outcome measurements were compared before and after the Qigong intervention. Results. Participants (N = 14) were 64% female, with a mean age of 53 (±14). A 71% of participants completed the intervention. The Qigong intervention resulted in a positive treatment-response rate of 60% and a remission rate of 40% and statistically significant improvement, as measured by the HAM-D₁₇, CGI-S, CGI-I, Q-LES-Q-SF, and the family support subscale of the MSPSS. Conclusions. The Qigong intervention provided at a health care setting for the treatment of primary care patients with MDD is feasible. Further studies with larger sample sizes are warranted.

Effects of qigong on depression: a systemic review

Physical exercises and relaxation have been found to be beneficial for depression. However, there is little evidence on the use of Qigong, a mind-body practice integrating gentle exercise and relaxation, in the management of depression. The aim of this paper is to evaluate the effects of Qigong on depression. The paper examined clinical trials measuring the effect of Qigong on depression within six large-scale medical research databases (PubMed, Medline, ProQuest, Science Direct, EMBASE, and PsycInfo) till October 2011. Key words “Qigong,” “depression,” and “mood” were used. Ten studies were identified as original randomized controlled trial (RCT) studies investigating the effect of Qigong on depression as primary (n = 2) or secondary outcome (n = 8). Four studies reported positive results of the Qigong treatment on depression; two reported that Qigong effect on depression was as effective as physical exercise. One study reported that Qigong was comparable to a conventional rehabilitation program, but the remaining three studies found no benefits of Qigong on depression. While the evidence suggests the potential effects of Qigong in the treatment of depression, the review of the literature shows inconclusive results. Further research using rigorous study designs is necessary to investigate the effectiveness of Qigong in depression.

The effects of qigong on anxiety, depression, and psychological well-being: a systematic review and meta-analysis

Introduction. The effect of Qigong on psychological well-being is relatively unknown. This study systematically reviewed the effects of Qigong on anxiety, depression, and psychological well-being. Methods. Using fifteen studies published between 2001 and 2011, a systematic review was carried out and meta-analyses were performed on studies with appropriate homogeneity. The quality of the outcome measures was also assessed. Results. We categorized these studies into three groups based on the type of subjects involved as follows: (1) healthy subjects, (2) subjects with chronic illnesses, and (3) subjects with depression. Based on the heterogeneity assessment of available studies, meta-analyses were conducted in three studies of patients with type II diabetes in the second group, which suggested that Qigong was effective in reducing depression (ES = −0.29; 95% CI, −0.58–0.00) and anxiety (ES = −0.37; 95% CI, −0.66–0.08), as measured by Symptom Checklist 90, and in improving psychological well-being (ES = −0.58; 95% CI, −0.91–0.25) as measured by Diabetes Specific Quality of Life Scale. Overall, the quality of research methodology of existing studies was poor. Conclusions. Preliminary evidence suggests that Gigong may have positive effects on psychological well-being among patients with chronic illnesses. However the published studies generally had significant methodological limitations. More high-quality studies are needed.

Relaxation practice and physiologic regulation in a national sample of older Taiwanese

OBJECTIVES

To compare the effects of relaxation practice and other exercise on a multisystem measure of physiologic dysregulation in a national sample of older Taiwanese.

DESIGN

The study was a cross-sectional survey.

SETTINGS/LOCATION

The study was conducted in Taiwan.

SUBJECTS

A population-based sample of 1036 adults aged 53 and older completed an in-home interview and in-hospital physical examination. The final model is based on 934 respondents with complete data.

OUTCOME MEASURES

The outcome measures were overall dysregulation, based on 26 biomarkers, and subscores for cardiovascular/metabolic risk factors and inflammatory markers.

RESULTS

After adjustment for age and sex, overall dysregulation is 0.35 of a standard deviation (SD) lower for practitioners of relaxation techniques compared with nonpractitioners. The effect of exercise is smaller: 0.19 SD difference between those who exercise regularly and those who do not exercise. Similar effects of relaxation practice and regular exercise were found on inflammation, but smaller effects for cardiovascular/metabolic risk factors. In the presence of controls for sociodemographic characteristics, medication use, and a wide range of self-reported and interviewer-assessed health indicators, the effect of relaxation practice is attenuated but remains sizable (-0.19 of a SD for overall dysregulation); regular exercise has a comparable effect (-0.16 of a SD). The effects are similar for the inflammation subscore, but not significant for cardiovascular/metabolic risk factors after adjusting for health status.

CONCLUSIONS

The physiologic benefits of relaxation practice that have been demonstrated in small experimental studies are also evident in the general population of older Taiwanese who practice these techniques in everyday life. Relaxation practice is associated with lower levels of physiologic dysregulation, particularly with respect to inflammation. Among this sample of older adults, the effect appears to be at least as large as that for exercise. Older people with limited ability to engage in vigorous exercise may especially welcome such information.

Qigong Exercise with Concentration Predicts Increased Health

Regular physical activity has many positive health effects. Despite this, approximately 50% of all adults are not exercising enough to enjoy better health and may, therefore, need an alternative to vigorous physical exercise. Qigong offers a gentle way to exercise the body. A questionnaire sample of 253 participants was collected and correlations with the variable health-now were analyzed. Results showed that health-now was positively correlated with number of completed qigong courses ( p < 0.05), with level of concentration ( p < 0.01), session-time ( p < 0.01), and years of practice ( p < 0.05). Among these variables, concentration predicts an increased feeling of health ( R 2 = 0.092). Qigong exercise thereby seems to offer a viable alternative to other more vigorous physical activities when wellness is the primary goal. When interpreted using self-determination theory, qigong seems to satisfy needs related to autonomy, competence and relatedness, thereby, primarily attracting individuals who are intrinsically motivated.

A critical review of the effects of medical Qigong on quality of life, immune function, and survival in cancer patients

BACKGROUND

Due to the limitations and side effects of conventional cancer treatment, especially in relation to quality of life (QOL), patients are increasingly utilizing complementary and alternative medicine (CAM) to supplement health-related outcomes. However, evidence for the safety and efficacy of such treatments is lacking. The purpose of the current review was to investigate evidence for the role of one CAM, medical Qigong (MQ), in supportive care.

METHODS

The literature was searched for reported effects of MQ in improving QOL, immune function, and survival in cancer patients.

RESULTS

Although many studies possessed methodological limitations and small sample sizes, encouraging evidence was found for the effects of MQ on these health-related outcomes. More robust evidence in the form of randomized controlled trials with larger sample sizes also reflected positive results for the role of MQ in improving QOL, mood and fatigue parameters, and reducing inflammation.

CONCLUSION

Given such encouraging results, further research is recommended in methodologically sound approaches to further delineate the action of MQ. These findings support the utilization of MQ by cancer patients and the place for such programs in comprehensive cancer care.

A comprehensive review of health benefits of qigong and tai chi

OBJECTIVE

Research examining psychological and physiological benefits of Qigong and Tai Chi is growing rapidly. The many practices described as Qigong or Tai Chi have similar theoretical roots, proposed mechanisms of action, and expected benefits. Research trials and reviews, however, treat them as separate targets of examination. This review examines the evidence for achieving outcomes from randomized controlled trials (RCTs) of both.

DATA SOURCES

The key words Tai Chi, Taiji, Tai Chi Chuan, and Qigong were entered into electronic search engines for the Cumulative Index for Allied Health and Nursing (CINAHL), psychological literature (PsycINFO), PubMed, Cochrane database, and Google Scholar. STUDY INCLUSION CRITERIA: RCTs reporting on the results of Qigong or Tai Chi interventions and published in peer-reviewed journals from 1993 to 2007.

DATA EXTRACTION

Country, type and duration of activity, number/type of subjects, control conditions, and reported outcomes were recorded for each study.

SYNTHESIS

Outcomes related to Qigong and Tai Chi practice were identified and evaluated.

RESULTS

Seventy-seven articles met the inclusion criteria. The nine outcome category groupings that emerged were bone density (n = 4), cardiopulmonary effects (n = 19), physical function (n = 16), falls and related risk factors (n = 23), quality of life (n = 17), self-efficacy (n = 8), patient-reported outcomes (n = 13), psychological symptoms (n = 27), and immune function (n = 6).

CONCLUSIONS

Research has demonstrated consistent, significant results for a number of health benefits in RCTs, evidencing progress toward recognizing the similarity and equivalence of Qigong and Tai Chi.

Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial

Background: Substantial numbers of cancer patients use complementary medicine therapies, even without a supportive evidence base. This study aimed to evaluate in a randomized controlled trial, the use of Medical Qigong (MQ) compared with usual care to improve the quality of life (QOL) of cancer patients.

Patients and methods: One hundred and sixty-two patients with a range of cancers were recruited. QOL and fatigue were measured by Functional Assessment of Cancer Therapy—General and Functional Assessment of Cancer Therapy—Fatigue, respectively, and mood status by Profile of Mood State. The inflammatory marker serum C-reactive protein (CRP) was monitored serially.

Results: Regression analysis indicated that the MQ group significantly improved overall QOL (t₁₄₄ = −5.761, P < 0.001), fatigue (t₁₅₃ = −5.621, P < 0.001), mood disturbance (t₁₂₂ =2.346, P = 0.021) and inflammation (CRP) (t₉₉ = 2.042, P < 0.044) compared with usual care after controlling for baseline variables.

Conclusions: This study indicates that MQ can improve cancer patients’ overall QOL and mood status and reduce specific side-effects of treatment. It may also produce physical benefits in the long term through reduced inflammation.

Serum cytokines, mood and sleep after a qigong program: is qigong an effective psychobiological tool?

Qigong is an ancient Chinese psychosomatic exercise that integrates movement, breathing and meditation into a single multifaceted practice. The present study was designed to assess the effects of qigong practice on serum cytokines, mood and subjective sleep quality. Experimental participants underwent a qigong training program for one month. Blood samples for the quantification of TNF-alpha and IFN-gamma, and several instruments to assess anxiety and depression symptoms as well as SSQ, were obtained before and after the program. Our findings revealed that while the practice of qigong for one month did not alter serum cytokines, it enhanced psychological well-being, including sleep duration.

Medical Qigong for cancer patients: pilot study of impact on quality of life, side effects of treatment and inflammation

Quality of life (QOL) of cancer patients is often diminished due to the side effects of treatment and symptoms of the disease itself. Medical Qigong (coordination of gentle exercise and relaxation through meditation and breathing exercise based on Chinese medicine theory of energy channels) may be an effective therapy for improving QOL, symptoms and side effects, and longevity of cancer patients. In this pilot study, the feasibility, acceptability, and impact of Medical Qigong (MQ) were evaluated on outcomes in cancer patients. Thirty patients diagnosed with heterogeneous cancers, were randomly assigned to two groups: a control group that received usual medical care and an intervention group who participated in a MQ program for 8 weeks in addition to receiving usual medical care. Randomization was stratified by completion of cancer treatment (n = 14) or under chemotherapy (n = 16). Patients completed measures before and after the program. Quality of life and symptoms were measured by the EORTC QLQ-C 30 and progress of disease by the inflammation biomarker (CRP: c-reactive protein) via a blood test was assessed. The MQ intervention group reported clinically significant improved global QOL scores pre- and post-intervention. The MQ intervention also reduced the symptoms of side effects of cancer treatment and inflammation biomarker (CRP) compare to the control group. Due to the small sample size, however, the results were not statistically significant between treatment and the control groups. Data from the pilot study suggest that MQ with usual medical treatment can enhance the QOL of cancer patients and reduce inflammation. This study needs a further investigation with a larger sample size.

Menopause, the metabolic syndrome, and mind-body therapies

Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health.

Relaxation therapies for the management of primary hypertension in adults

BACKGROUND

Lifestyle interventions are often recommended as initial treatment for mild hypertension, but the efficacy of relaxation therapies is unclear.

OBJECTIVES

To evaluate the effects of relaxation therapies on cardiovascular outcomes and blood pressure in people with elevated blood pressure.

SEARCH STRATEGY

We searched the Cochrane Library, MEDLINE, EMBASE, Science Citation Index, ISI Proceedings, ClinicalTrials.gov, Current Controlled Trials and reference lists of systematic reviews, meta-analyses and randomised controlled trials (RCTs) included in the review.

INCLUSION CRITERIA

RCTs of a parallel design comparing relaxation therapies with no active treatment, or sham therapy; follow-up >/=8 weeks; participants over 18 years, with raised systolic blood pressure (SBP) >/=140 mmHg or diastolic blood pressure (DBP) >/=85 mmHg); SBP and DBP reported at end of follow-up.

EXCLUSION CRITERIA

participants were pregnant; participants received antihypertensive medication which changed during the trial.

DATA COLLECTION AND ANALYSIS

Two reviewers independently extracted data and assessed trial quality. Disagreements were resolved by discussion or a third reviewer. Random effects meta-analyses and sensitivity analyses were conducted.

MAIN RESULTS

29 RCTs, with eight weeks to five years follow-up, met our inclusion criteria; four were excluded from the primary meta-analysis because of inadequate outcome data. The remaining 25 trials assessed 1,198 participants, but adequate randomisation was confirmed in only seven trials and concealment of allocation in only one. Only one trial reported deaths, heart attacks and strokes (one of each). Meta-analysis indicated that relaxation resulted in small, statistically significant reductions in SBP (mean difference: -5.5 mmHg, 95% CI: -8.2 to -2.8, I2 =72%) and DBP (mean difference: -3.5 mmHg, 95% CI: -5.3 to -1.6, I2 =75%) compared to control. The substantial heterogeneity between trials was not explained by duration of follow-up, type of control, type of relaxation therapy or baseline blood pressure. The nine trials that reported blinding of outcome assessors found a non-significant net reduction in blood pressure (SBP mean difference: -3.2 mmHg, 95% CI: -7.7 to 1.4, I(2) =69%) associated with relaxation. The 15 trials comparing relaxation with sham therapy likewise found a non-significant reduction in blood pressure (SBP mean difference: -3.5 mmHg, 95% CI: -7.1 to 0.2, I(2) =63%).

AUTHORS' CONCLUSIONS

In view of the poor quality of included trials and unexplained variation between trials, the evidence in favour of causal association between relaxation and blood pressure reduction is weak. Some of the apparent benefit of relaxation was probably due to aspects of treatment unrelated to relaxation.

Qigong for hypertension: a systematic review of randomized clinical trials

OBJECTIVES

To assess systematically the clinical evidence of qigong for hypertension.

METHODS

Databases were searched up to August 2006. All randomized clinical trials (RCTs) testing qigong in patients with hypertension of any origin and assessing clinically relevant outcomes were considered. Trials using any type of control intervention were included. The selection of studies, data extraction and quality assessment were performed independently by at least two reviewers. Methodological quality was evaluated using the Jadad score.

RESULTS

A total of 121 potentially relevant articles were identified and 12 RCTs were included. Seven RCTs tested qigong in combination with antihypertensive drugs compared with antihypertensive drugs alone. The meta-analysis of two trials reporting adequate data suggested beneficial effects in favour of qigong [weighted mean difference, systolic blood pressure (SBP) -12.1 mmHg, 95% confidence interval (CI) -17.1 to -7.0; diastolic blood pressure -8.5 mmHg, 95% CI -12.6 to -4.4]. Qigong was compared with waiting list control in two RCTs and was found to reduce SBP significantly (weighted mean difference -18.5 mmHg, 95% CI -23.1 to -13.9). In three further RCTs the comparisons made were: qigong combined with conventional therapy versus muscle relaxation combined with conventional therapy; qigong as a sole treatment versus exercise. All reported positive results in at least some of the relevant outcome measures. The methodological quality of the studies was low.

CONCLUSION

There is some encouraging evidence of qigong for lowering SBP, but the conclusiveness of these findings is limited. Rigorously designed trials are warranted to confirm these results.

Qigong ameliorates symptoms of chronic fatigue: a pilot uncontrolled study

Traditional Chinese Medicine practitioners consider that chronic fatigue reflects a disharmony and depletion in the supply of qi in the body. Qigong is one of the traditional complementary interventions used to strengthen qi through self-practice, and to manage the state of qi to prevent and cure disease. The aim of this study is to assess whether qigong could be used to manage the symptoms of chronic fatigue. Eighteen Caucasian, British female participants were recruited, taught a qigong routine during weekly classes over 6 months, and asked to practice it daily for 15 min. Participants completed the core set of the RAND Medical Outcomes Study questionnaire (RAND MOS) and a sleep diary during the 2-week baseline control period, and at 3 and 6 months following the start of the trial. The qigong intervention resulted in significant changes in sleep rate score and in the following subscales of the RAND MOS: SF36 Vitality, Sleep Problems, Social Activity, Social Activity Limitation due to Health, Health Distress, Mental Health Index and Psychological Well-being. Qigong seems to improve factors related to chronic fatigue such as sleep, pain, mental attitude and general mobility after 3 and 6 months. Qigong's positive effects indicate that it represents a potentially safe method of treatment for chronic fatigued patients. However, we cannot completely discount the possible influence of placebo effects, and more objective clinical measures are needed to reproduce our findings with long-term follow-up in a randomized, controlled study involving a larger number of subjects.