Physical and Psychological Health Outcomes of Qigong Exercise in Older Adults: A Systematic Review and Meta-Analysis

Relationship between physical activities and mental health in older people: a bibliometric analysis

Objective

To summarize the general situation and focal points of research on the physical activity and mental health of older people over the past 15 years and provide references for future research.

Methods

Literature published between January 1, 2009, and December 31, 2023, was retrieved from the Web of Science core database. A bibliometric visualization analysis of countries/regions, institutions, authors, keywords, and references was conducted using CiteSpace6.1.R6.

Results

A total of 4,329 articles were included, and the annual number of articles published over the past 15 years showed an upward trend. The articles were primarily from 65 countries/regions and 626 institutions. The most represented country and institution were the USA and the University of Pittsburgh, respectively. Among the authors identified, Schuch and Callow were the most influential. The research focuses on four areas: the psychological effects of physical activity in older people; physical activity intervention approaches to the mental health of older people; physical activity and mental health assessment questionnaires; and the impact of physical activity on multidimensional aging. Research frontiers involve emerging topics such as the assessment and intervention of mental health in older people and the relationship between their physical activity and cognitive function.

Conclusion

This study conducted a comprehensive, objective, and visual analysis of publications and revealed the status of relevant studies, trending topics, and trends concerning the physical activity and mental health of older people from 2009 to 2023. We hope that this work will help researchers identify new perspectives on potential collaborators, important topics, and research frontiers.

Integrative Therapies in Cancer Care: An Update on the Guidelines

INTRODUCTION

ASCO and the Society for Integrative Oncology have collaborated to develop guidelines for the application of integrative approaches in the management of anxiety, depression, fatigue and use of cannabinoids and cannabis in patients with cancer. These guidelines provide evidence-based recommendations to improve outcomes and quality of life by enhancing conventional cancer treatment with integrative modalities.

METHODS

All studies that informed the guideline recommendations were reviewed by an Expert Panel which was made up of a patient advocate, an ASCO methodologist, oncology providers, and integrative medicine experts. Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations.

RESULTS

Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong. Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils. The strongest recommendation in the guideline is that MBIs should be offered to people with cancer, both during active treatment and post-treatment, to address depression.

CONCLUSION

The evidence for integrative interventions in cancer care is growing, with research now supporting benefits of integrative interventions across the cancer care continuum.

The effects of mind-body exercise on anxiety and depression in older adults: a systematic review and network meta-analysis

Background

Limited research directly compares the clinical effects of different types of mind-body exercises on anxiety and depression in older adults. Therefore, we conducted a systematic review and network meta-analysis of randomized controlled trials that meet the inclusion criteria to explore the intervention effects of five different types of mind-body exercises in improving anxiety and depression in older adults.

Methods

We followed the PRISMA-NMA guidelines and conducted searches in the Web of Science, PubMed, the Cochrane Library, and Embase databases up to July 28, 2023. The language was limited to English. Two independent reviewers conducted literature screening and data extraction. Review Manager 5.4 was used to perform Pairwise meta-analysis and risk assessment, while STATA version 15 software was used for network meta-analysis.

Result

A total of 42 studies, involving 2974 participants, were included. The results of the traditional meta-analysis showed that mind-body exercises were superior to the control group in alleviating anxiety (SMD: -0.87, 95% CI: -1.43, -0.31, p<0.05, I2 = 95%) and depressive (SMD: -0.52, 95% CI: -0.71, -0.34, p<0.05, I2 = 80%). In the network meta-analysis, the ranking of treatment effects for anxiety showed that Tai Chi > Qigong > Yoga > Dance > control group, while for depression, the ranking showed Tai Chi > Pilates > Yoga > Qigong > Dance > control group.

Conclusion

This study found that mind-body exercises have positive effects on improving anxiety and depression in older adults. Among the five different types of mind-body exercise interventions, Tai Chi was considered an effective approach for improving anxiety and depression. However, we encourage older adults to choose exercise modalities that suit their interests to enhance adherence.

Systematic review registration

http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023464296.

Effects of qigong exercise on physical fitness and patient-reported health outcomes in lung cancer survivors

PURPOSE

The aim of this study was to investigate the effects of a three-month Guolin Qigong (GQ) intervention on physical fitness and patient-reported health outcomes among patients with lung cancer.

METHODS

This pilot study was a non-randomized controlled trial. Eligible participants who were over 18 years of age and diagnosed with stage I-IV lung cancer were enrolled in the study and received either the GQ intervention or usual care (UC). Participants in the GQ group performed GQ at least twice a week (one hour per session) for three months. Physical fitness (chair stand, arm curl, sit and reach, back scratch, 8-foot up and go, 6-min walk test) was assessed at baseline, post-intervention, six months, and 12 months. Self-reported quality of life and sleep (European Organization for Research and Treatment of Cancer Quality of Life questionnaire and Pittsburgh Sleep Quality Index) were assessed at baseline, post-intervention, and six months.

RESULTS

Forty-nine participants (65% females, 59.1 ± 7.0 years old, ranging from 39 to 71 years old) were enrolled in the study, and 25 participants completed all tests at 12-month follow-up (13 in GQ vs. 12 in UC; 68% females, 59.3 ± 5.5 years old). Compared to the UC group, results for the chair stand and arm curl tests improved significantly in the GQ group from baseline to post-intervention (P = 0.024 and P = 0.041, respectively). Similarly, the 8-foot up and go test improved in the GQ group from baseline to post-intervention and 12 months (P = 0.004 and P = 0.008, respectively) when compared to the UC group. Between-group analyses also revealed a statistically significant improvement in global health status/quality of life from baseline to six months (P = 0.018) and quality of sleep from baseline to post-intervention (P = 0.034) in favor of the GQ group.

CONCLUSION

GQ had a beneficial effect on lower and upper body strength, locomotor performance (speed, agility, and balance while moving), quality of sleep, and quality of life among lung cancer survivors, but further randomized controlled trials are warranted to confirm these findings.

TRIAL REGISTRATION

The trial has been registered in the Chinese Clinical Trial Registry (ChiCTR2200059145).

An RCT-reticulated meta-analysis of six MBE therapies affecting college students' negative psychology

The positive impact of mind-body movement therapy on mental health has been confirmed, but the current effect of various mind-body movement-specific therapies on improving the negative psychology of college students is controversial. This study compared the effects of six mind-body exercise (MBE) therapies on improving negative psychological symptoms in college students. The study found that Tai Chi (standardized mean difference [SMD] = -0.87, 95% confidence interval [CI] (-1.59, -0.15), p < 0.05), yoga (SMD = -0.95, 95% CI (-1.74, -0.15), p < 0.05), Yi Jin Jing (SMD = -1.15, 95% CI (-2.36, -0.05), p=<0.05), Five Animal Play (SMD = -1.1, 95% CI (-2.09, -0.02), p < 0.05), and Qigong Meditation (SMD = -1.31, 95% CI (-2.2, -0.4), p < 0.05) improved depressive symptoms in college students (p < 0.05). Tai Chi (SMD = -7.18, 95% CI (-13.18, -1.17), p = 0.019), yoga (SMD = -6.8, 95% CI (-11.79, -1.81), p = 0.008), and Yi Jin Jing (SMD = -9.21, 95% CI (-17.55, -0.87), p = 0.03) improved college students' anxiety symptoms. It shows that the six MBE therapies are effective in improving anxiety and depression in college students.

The effectiveness of mind-body approaches for enhancing resilience in older adults: A systematic review and network meta-analysis

BACKGROUND

Resilience in older adults is associated with good well-being and resilience training has been shown to be beneficial. Mind-body approaches (MBAs) combine physical and psychological training in age-appropriate exercise programs.This study aims to evaluate the comparative effectiveness of different modes of MBAs in enhancing resilience in older adults.

METHOD

Electronic databases and a manual search were searched to identify randomized controlled trials of different MBA modes. Data from the included studies were extracted for fixed-effect pairwise meta-analyses. Quality and risk were assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Cochrane's Risk of Bias tool, respectively. Pooled effect sizes with a standardized mean difference (SMD) and a 95% confidence interval (CI) were used to quantify the impact of MBAs in enhancing resilience in older adults. Network meta-analysis was employed to evaluate the comparative effectiveness of different interventions. The study was registered in PROSPERO (Registration No. CRD42022352269).

RESULTS

Nine studies were included in our analysis. Pairwise comparisons indicated that MBAs, regardless of whether they were related to yoga, could significantly enhancing resilience in older adults (SMD: 0.26, 95% CI 0.09-0.44). With strong consistency, a network meta-analysis showed that physical and psychological programs and yoga-related programs were associated with resilience improvement (SMD: 0.44, 95% CI 0.01-0.88 and SMD: 0.42, 95% CI 0.06-0.79, respectively).

CONCLUSION

High quality evidence demonstrates that two MBA modes-physical and psychological programs and yoga-related programs-enhance resilience in older adults. However, long-term clinical verification is required to confirm our results.

Effectiveness of mind-body exercise via Baduanjin on physical and psychological outcomes in patients with pulmonary ground-glass nodules: A non-randomized controlled pilot study

BACKGROUND

With the increasing incidence and mortality of lung cancer, ground-glass nodules (GGNs) have become an ongoing public health concern. In clinical practice, the physical and psychological distress of GGN patients is easy to overlook during the follow-up after diagnosis. Such patients typically have limited medical options and few of these options involve mind-body exercises.

OBJECTIVE

The purpose of this pilot study was to explore the effectiveness of the mind-body exercise Baduanjin on physical and psychological outcomes among GGN patients.

DESIGN

We conducted a prospective, non-randomized, controlled, assessor-blinded trial (ClinicalTrials.gov: NCT03420885).

SETTING

This trial was conducted at three medical sites, both located in Shanghai, China, between April 2017 and January 2020.

PARTICIPANTS

Patients with GGN.

INTERVENTION

Sixty GGN participants were divided into a health education control group only receiving health education (n = 30) and a Baduanjin intervention group receiving health education plus a Baduanjin training program (n = 30). Both groups were treated for 16 weeks.

OUTCOME MEASUREMENTS

Outcomes were assessed at baseline and week 16. The primary outcomes included pulmonary function (FVC, FVC%, FEV₁, FEV₁/FVC, PEF) and psychological condition (SAS score, SDS score). The secondary outcome was quality of life (SF-36).

RESULTS

Compared with the health education control group, the Baduanjin intervention group had significant improvements in pulmonary function (FVC, FVC%, FEV₁), psychological outcomes (SAS score, SDS score), and quality of life (SF-36). The significant differences in pre-intervention and post-intervention between groups were as follows: FVC (MD = 0.21, 95%CI: 0.10 to 0.33, P = 0), FVC% (MD = 6.90, 95%CI: 3.10 to 10.70, P = 0.001), FEV₁ (MD = 0.18, 95%CI: 0.07 to 0.29, P = 0.001); SAS score (MD = -4.90, 95%CI: -8.28 to -1.52, P = 0.005), SDS score (MD = -5.83, 95%CI: -9.46 to -2.21, P = 0.002); physical component summary (PCS) of SF-36 (MD = 5.03, 95%CI: 2.54 to 7.51, P = 0), mental component summary (MCS) of SF-36 (MD = 5.78, 95%CI: 2.64 to 8.92, P = 0.001). Linear regression analysis was performed to study the influence of confounder variables on the improvements of primary outcomes, and no significant change was found. Moreover, Pearson correlation coefficient analysis demonstrated that ameliorations in lung function (FVC, FVC%, FEV₁, FEV₁/FVC, and PEF) were significantly associated with a decrease in anxious symptoms and depressive symptoms.

CONCLUSION

GGN patients in the Baduanjin intervention group showed greater benefits in pulmonary function and psychological outcomes than those in the health education control group, and the effectiveness was stable. The findings support Baduanjin as an effective, safe, enjoyable, and promising complementary intervention for management of GGN in patients with physical and psychological distress.

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.

Effects of qigong exercise on the physical and mental health of college students: a systematic review and Meta-analysis

BACKGROUND

Physical and mental health problems are becoming more serious among college students due to lifestyle changes and increased academic stress. Qigong exercise has been regarded as a potentially effective intervention to improve the physical and mental health of college students.

METHODS

Eleven databases were searched from their respective inception dates to April 2022. Relevant randomized controlled trials (RCTs) were included. Physical and psychological conditions, including limb muscle strength, flexibility, cardiorespiratory endurance, vital capacity, blood pressure and heart rate, as well as depression, anxiety and mood, were evaluated. The risk of bias was assessed with the Cochrane Collaboration tool.

RESULTS

Sixteen randomized controlled trials were included in the meta-analysis. Significant improvements in cardiorespiratory endurance (MD = 3.83, 95% CI: 0.99 to 6.67, P = 0.008) and flexibility (MD = 3.01, 95% CI: 1.21 to 4.81, P = 0.001) were observed. We also observed that Qigong exercise significantly reduced depression and anxiety symptoms (SMD=-0.89, 95% CI: -1.17 to -0.61, P < 0.00001; SMD=-0.78, 95% CI: -1.31 to -0.25, P = 0.004). Nevertheless, no significant effects on muscle strength, vital capacity, blood pressure, heart rate or mood were found.

CONCLUSION

Qigong exercise was advantageous for college students in terms of improving flexibility and cardiorespiratory endurance and alleviating depression and anxiety to some extent. However, due to the limited number of eligible trials and the low methodological quality, more well-designed RCTs are needed in the future.

The Associations between Meeting 24-Hour Movement Guidelines (24-HMG) and Self-Rated Physical and Mental Health in Older Adults-Cross Sectional Evidence from China

BACKGROUND

This study determined the prevalence of older adults (aged 60-80 years) meeting the Canadian 24-HMG alone and in combination, and their association with the self-rated physical health and mental health of older adults.

METHODS

Participants were drawn from 4134 older adults aged 60-80 years (age, 67.37 ± 0.08 years; 46.87% male) from the China Health and Nutrition Survey (CHNS) 2015 database. Mental health and physical health scores were obtained based on self-rated mental health questionnaires and physical health of older adults. The criteria for meeting the 24-HMG were: physical activity time ≥ 150 min/week, sedentary time ≤ 480 min/day, screen time ≤ 180 min/day, sleep time 7-9 h (60-64 years) and sleep time 7-8 h (65 years and above). Logistic regression models were used to examine the association between meeting the 24-HMG guidelines number and category and older adults' self-rated mental and physical health.

RESULTS

The proportion of older people meeting three of the 24-HMG guidelines was 1.16%, the proportion meeting two guidelines was 38.19% and the proportion meeting one guideline was 49.14%. The number of people meeting 24-HMG was closely related to the self-rated physical health and mental health of older people. The category meeting 24-HMG was closely related to the self-rated physical health and mental health of older people.

CONCLUSIONS

Meeting more guidelines in the 24-HMG was strongly associated with older people's self-rated mental health and physical health. However, only a small proportion of older people met all the recommendations, highlighting the need to promote and support adherence to these movement behaviours.

Qigong for mental health and sleep quality in postmenopausal women: A randomized controlled trial

BACKGROUND

Menopause is one of the stages in a woman's life that affects her psychological health, the most frequent being anxiety and depression. In addition, another problem related to this stage is the lack of sleep that causes a decrease in the quality of sleep. The purpose of this randomized controlled trial was to analyze the effectiveness of a Qigong exercise program on sleep quality, anxiety, and depression in Spanish postmenopausal women.

METHODS

A total of 125 women were randomly assigned to an experimental group (EG) (n = 63) that carried out a Qigong exercise program for 12 weeks, or a control group (CG) (n = 62), which did not perform any type of intervention. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS).

RESULTS

Women who underwent an intervention program experienced significant improvements for all measured variables, except for the use of sleeping medication and daytime dysfunctions that did not show any significant effect with respect to the group and group × time interaction.

CONCLUSIONS

After an intervention based on a BaDuanJin Qigong exercise program for 12 weeks, improvements were observed in sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, the total score of the PSQI, anxiety and depression in postmenopausal Spanish women.

Mental Health Benefits of a Traditional Vegetative Biofeedback Therapy Online Program during the COVID-19 Lockdown: A Controlled Trial

Mandatory lockdown resulting from a pandemic may be effective against the physical impact of the virus; however, the resulting mental strains can lead to the development of several mental disturbances. Taijiquan and Qigong are considered traditional vegetative biofeedback therapies that allow the practitioner to control the functions and processes of the body through specific movements or stances, breathing techniques, and meditative exercises. This study aims to understand if these techniques can be applied as an online distance therapeutic option to reduce the psychological impact of home confinement and social distancing. Sixty-four participants were recruited and allocated to three groups. The experienced and novice Taijiquan and Qigong participants' groups received the intervention for 8 weeks while the control group did not receive any intervention. The outcomes were psychological well-being and psychological distress levels and were assessed by the Mental Health Inventory and a written interview. The experienced Taijiquan and Qigong participants achieved significant improvements in psychological well-being and psychological distress. Novice Taijiquan and Qigong participants achieved a significant improvement in anxiety levels. Additionally, the control group showed a significant decrease in psychological well-being. This study suggests that this distance online program of Taijiquan and Qigong is feasible and may benefit the mental health of participants during a lockdown.

Examining the Delivery of a Tailored Chinese Mind-Body Exercise to Low-Income Community-Dwelling Older Latino Individuals for Healthy Aging: Feasibility and Acceptability Study

Background

Older Latino individuals are disproportionally affected by various chronic conditions including impairments in physical and cognitive functions, which are essential for healthy aging and independent living.

Objective

This study aimed to evaluate the feasibility and acceptability of FITxOlder, a 12-week mind-body exercise program, in community-dwelling low-income, predominantly older Latino individuals, and assess its preliminary effects on health parameters relevant to healthy aging and independent living.

Methods

This 12-week, single-arm, stage 1B feasibility study had a pre- and poststudy design. A total of 13 older adults (mean age 76.4, SD 7.9 years; 11/13, 85% Latino) of a congregate meal program in a senior center were enrolled. FITxOlder was a tailored Chinese mind-body exercise program using Five Animal Frolics led by a bilingual community health worker (CHW) participating twice a week at the senior center and facilitated by mobile health technology for practice at home, with incrementally increasing goals moving from once a week to at least 3 times a week. The feasibility and acceptability of the study were examined using both quantitative and qualitative data. Healthy aging–related outcomes (eg, physical and cognitive function) were assessed using paired 2-tailed t tests. Qualitative interview data were analyzed using thematic analysis.

Results

The attendance rate for the 24 exercise sessions was high (22.7/24, 95%), ranging from 93% (1.8/2) to 97% (1.9/2) over the 12 weeks. Participants were compliant with the incremental weekly exercise goals, with 69.2% (9/13) and 75.0% (9/12) meeting the home and program goals in the last 4 weeks, respectively. Approximately 83% (10/12) to 92% (11/12) of the participants provided favorable feedback on survey questions regarding the study and program implementation, such as program content and support, delivery by the CHW, enjoyment and appeal of the Five Animal Frolics, study burden and incentives, and safety concerns. The qualitative interview data revealed that FITxOlder was well accepted; participants reported enjoyment and health benefits and the desire to continue to practice and share it with others. The 5-time sit-to-stand test (mean change at posttest assessment=−1.62; P<.001; Cohen d=0.97) and 12-Item Short Form Health Survey physical component scores (mean change at post intervention=5.71; P=.01; Cohen d=0.88) exhibited changes with large effect sizes from baseline to 12 weeks; the other parameters showed small or medium effect sizes.

Conclusions

The research findings indicated that the CHW-led and mobile health–facilitated Chinese qigong exercise program is feasible and acceptable among low-income Latino older adults. The trending health benefits of the 12-week FITxOlder program suggest it is promising to promote physical activity engagement in underserved older populations to improve health outcomes for healthy aging and independent living. Future research with larger samples and longer interventions is warranted to assess the health benefits and suitability of FITxOlder.

Effects of tai chi and Qigong on cognition in neurological disorders: A systematic review and meta-analysis

OBJECTIVES

To explore whether tai chi and Qigong can improve cognitive function in patients with neurological disorders.

METHODS

The PubMed, Embase, Cochrane Central Register of Controlled Trials, SinoMed Database, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP) databases were searched from inception to December 24, 2021. The methodological quality of the included studies was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions criteria.

RESULTS

This study included 2,754 participants from 40 randomized controlled trials (RCT)s with low to high methodological quality. Analysis of active and non-active comparisons showed significant effects for tai chi/Qigong (P<0.05) on global cognitive function, executive function, memory, visuospatial ability, and cognitive processing speed.

CONCLUSIONS

Tai chi and Qigong were effective interventions to improve cognition in patients with Parkinson's disease, stroke, mild cognitive impairment, dementia, and traumatic brain injury; however, no RCTs were performed for other neurological disorders.

The effectiveness of traditional Chinese medicine-based exercise on physical performance, balance and muscle strength among older adults: a systematic review with meta-analysis

BACKGROUND

Traditional Chinese medicine (TCM) based exercises have been widely used in the prevention and treatment of balance, cardiopulmonary, and other related diseases in older adults. However, there seems to be no consensus on the improvement and comparison of physical performance, balance, and muscle strength in the elderly population.

OBJECTIVES

To systematically examine the impact of different TCM-based exercises on physical performance, balance, and muscle strength outcomes in the elderly.

METHODS

We searched PubMed, EMBASE, Scopus, and Cochrane Center, CNKI and Wan Fang between their date of inception and March 2021. This meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCT) or controlled clinical trials (CCT) were considered in TCM-based exercises (Tai Chi, Ba Duan Jin, Qigong). The overall mean difference (MD) or standardized mean difference (SMD), and its 95% confidence interval (CI) were calculated.

MAIN RESULTS

A total of 27 studies with 2580 older adults met the inclusion criteria. The pooled analysis indicated that Tai Chi could be more effective in Times up and go (TUG) (MD = - 2.62, 95% CI - 4.00 to - 1.24, P = 0.0002), 5 times sit-stand (MD = - 1.89; 95%CI - 3.38 to - 0.40; P = 0.01), and handgrip strength outcomes (SMD = 0.69; 95%CI 0.52-0.86; P < 0.0001) compared to Ba Duan Jin and Qigong. The older adults performing Qigong could have a better benefit in Single-bed balance (SLB) with eyes closed compared to Tai Chi and Ba Duan Jin (MD = 3.42; 95%CI 1.55 to 5.29; P = 0.0003). Tai Chi also had benefits in terms of balance outcomes compared to those in the control group: Berg Balance scale (BBS) (MD = 1.41; 95% CI 0.03-2.85; P = 0.05), Functional reach test (FRT) (MD = 1.57; 95%CI 1.22-1.93; P < 0.0001). The Tai Chi study meta-analysis demonstrated significant effects on lower limb strength: knee extension (SMD = 0.56; 95%CI 0.26-0.86; P = 0.0003), ankle dorsiflexion (SMD = 0.67; 95%CI 0.02-1.31; P = 0.04) compared to the controls.

CONCLUSION

This systematic review reveals that TCM-based exercises can effectively improve physical performance outcomes, balance outcomes, and muscle strength in the elderly population. While there is limited evidence on the efficacy of other TCM-based lifestyle interventions, more high-quality clinical trials on this topic are warranted.

Impact of Qigong exercises on the severity of the menopausal symptoms and health-related quality of life: a randomized controlled trial

ABSTRACTThe aim of the present study was to analyze the effects of a Qigong exercise program on the severity of the menopausal symptoms and health-related quality of life (HRQoL) of community-dwelling postmenopausal women. This was done by means of a randomized clinical trial with a sample of 125 women who were assigned to either a control (n = 62) or an experimental group (n = 63). The severity of their menopause-related symptoms and HRQoL were assessed through the Menopause Rating Scale (MRS) and the 36-item Short-Form Health Survey (SF-36) respectively, before and after the intervention period. The main findings of our study reveal significant improvement in the severity of menopausal symptoms at the somatic, psychological, and urogenital levels, as well as in the total score of the MRS. Additionally, participants assigned to the Qigong group experienced improvement in the general health, physical functioning, role-physical, bodily pain, vitality, and mental health domains of the 36-item Short-Form Health Survey, as well as in its physical component and mental component summaries. We can therefore conclude that, among Spanish postmenopausal women, a twelve-week Qigong exercise program has beneficial effects on the severity of menopausal symptoms and HRQoL.Trial registration: ClinicalTrials.gov identifier: NCT03989453..

Effect of different conditioning methods of traditional Chinese health exercise on lung function in healthy middle-aged and elderly people: study protocol for a randomized controlled trial

Background

Lung function is highly age-dependent as it decreases in varying degrees with age, even in healthy people. Decreased lung function results in less elastic lung tissue, reduced chest wall compliance, reduced area for gas exchange, and even a variety of chronic diseases. Traditional Chinese health exercise (TCHE) has three components: “breath regulation,” “body regulation,” and “heart regulation,” which play an important role in the improvement of lung function. However, which component has the most significant effect on lung functioning remains unclear. Therefore, depending on the modality of conditioning, TCHEs will be divided into three exercise intervention groups: breath regulation group, body regulation group, and heart regulation group, in order to explore the magnitude of the effect of the different modalities of conditioning on the improvement of lung function.

Methods

The prospective, parallel, single-blind, randomized controlled trial will evaluate the effects of different conditioning methods of TCHE on lung function in middle-aged and elderly people. The study subjects are healthy middle-aged and elderly adults, who will be randomly divided into the “breath regulation group,” “body regulation group,” “heart regulation group,” and “control group.” The control group will receive health education. Health education and exercise intervention in the three intervention groups will be provided for 6 months, 5 times a week, with each session lasting 60 min. The outcomes of interest include changes in the pulmonary function tests measured at baseline and 3 and 6 months after the beginning of the intervention. The primary outcome is the forced vital capacity (FVC), while the secondary outcomes include forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio, vital capacity (VC), and maximal voluntary ventilation (MVV).

Discussion

This study will assess the effects of different conditioning methods of TCHE on lung function in middle-aged and elderly people. The final findings of this study will validate the effectiveness and safety of TCHE on lung function interventions in middle-aged and elderly people.

Trial registration

China Clinical Trial Registry ChiCTR2100052687. Registered on November 3, 2021

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05980-5.

Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map

Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.

Qigong for Muscle Strength and Static Postural Control in Middle-Aged and Older Postmenopausal Women: A Randomized Controlled Trial

In the present study, we aimed to determine the effects of a Qigong exercise program on the muscle strength and postural control in middle-aged and older postmenopausal women. This is a randomized clinical trial (https://clinicaltrials.gov/ct2/show/NCT03989453) conducted on 125 women who were initially assigned to either an experimental group (n = 63) that performed a Qigong exercise program for 12 weeks or to a control group (n = 62) that did not receive any intervention. Muscle strength (dynamometer) and postural control (stabilometric platform) were evaluated before and immediately after an intervention period. The main findings of this study suggest that the women in the experimental group had improvements in muscle strength, mean velocity of the displacement of the center of pressure (CoP) with both eyes open and closed, and the surface sway area covered by the CoP, as well as the mediolateral and anteroposterior oscillations of the CoP, only with eyes open. The results of the present study determined that a 12 week Qigong exercise program has beneficial effects on muscle strength and postural control of middle-aged and older postmenopausal Spanish women.

The Effects of Tai Chi and Qigong Exercise on Psychological Status in Adolescents: A Systematic Review and Meta-Analysis

Background: The purpose of this study was to systematically review the effectiveness of Tai Chi and Qigong exercise on adolescents' symptoms of depression and anxiety, and psychological status based on clinical evidences, and to calculate the pooled results using meta-analysis. Methods: A systematic search using seven English and three Chinese databases was initiated to identify randomized controlled trials (RCT) and non-randomized comparison studies (NRS) assessing the effect of Tai Chi and Qigong exercise on psychological status among adolescents. Standardized mean differences (SMD) and their 95% confidence intervals (CI) were used to determine the pooled effect of the intervention. Study quality was evaluated using a Checklist to Evaluate a Report of a Non-pharmacological Trial (CLEAR-NPT) designed for non-pharmacological trials. Results: Four RCTs and six NRS were identified, including 1,244 adolescents. The results suggested a potential beneficial effect of Tai chi and Qigong exercise on reducing anxiety (SMD = 0.386, 95 CI% [0.233, 0.538]) and depression (SMD = 1.937 [95 CI%, 1.392-2.546]) symptoms, and reducing cortisol level (SMD = 0.621 [95 CI%, 0.18-1.062]) in adolescents. Conversely, non-significant effects were found for stress, mood, and self-esteem. Conclusions: The findings of this review suggest Qigong appears to be an effective therapeutic modality to improve psychological well-being in adolescents. Hope future studies will have rigorously designed, well-controlled randomized trials with large sample sizes in order to confirm these findings.

Effects of Pilates Training on Physiological and Psychological Health Parameters in Healthy Older Adults and in Older Adults With Clinical Conditions Over 55 Years: A Meta-Analytical Review

This meta-analytical review aimed at comparing the impact of Pilates interventions (PIs) on physiological and psychological health parameters in healthy older adults and older adults with a clinical condition aged 55 years and older. The literature search was conducted in three databases (PubMed, Web of Science, SPORTDiscus). Randomized controlled trials that aimed at improving physiological and psychological health parameters in adults aged 55 years and older using Pilates as an intervention were screened for eligibility. The included data was extracted and assigned based on participants' health condition (clinical vs. non-clinical), as well as the respective control condition used in the study [inactive (IC) vs. active control group (AC)]. Statistical analyses were computed using a random-effects inverse-variance model. Fifty-one studies with a total of 2,485 participants (mean age: 66.5 ± 4.9 years) were included. Moderate effects (SMD: 0.55; 0.68) were found for physiological health parameters (muscle strength, balance, endurance, flexibility, gait, and physical functioning) in both experimental (clinical and non-clinical) conditions when compared to ICs (p < 0.003; p = 0.0001), and small to moderate effects (SMD: 0.27; 0.50) when compared to ACs (p = 0.04; p = 0.01). Moderate to large effects (SMD: 0.62; 0.83) were documented for psychological health parameters (quality of life, depression, sleep quality, fear of falling, pain, and health perception) in both conditions when compared to ICs (p < 0.001, p < 0.001). PIs induce small to large effects in physiological and psychological health parameters in older adults, regardless of their health condition. The substantial heterogeneity within the included studies complicated standardized comparison of the training modalities between the two target groups. Nonetheless, Pilates seems to be a safe, adaptable, and promising exercise approach for a heterogenous population of older adults.

Effectiveness of horticultural therapy on physical functioning and psychological health outcomes for older adults: A systematic review and meta-analysis

AIMS AND OBJECTIVES

To systematically determine the effectiveness of horticultural therapy (HT) on the physical functioning and psychological health of older people.

BACKGROUND

With advancing age and increased chronic diseases, older adults are vulnerable to physical deterioration and psychological problems. There is evidence that horticultural therapy (HT) has positive effect among older adults. However, less attention has been devoted to systematically evaluating the physical functioning and psychological health effects of HT in older adults.

DESIGN

Systematic review and meta-analysis were conducted based on the checklist for PRISMA.

METHODS

The searches were conducted in PubMed, EMBASE, CINAHL, PsycINFO, Cochrane, China Network Knowledge Infrastructure, Wan Fang, and China Science and Technology Journal Database, from their inception until June 2021. Randomised controlled trials published in either English or Chinese were reviewed. The Review Manager 5.4 software was used for meta-analyses. The quality of included studies was evaluated using the Cochrane risk of bias tool by two independent researchers.

RESULTS

Ten studies involving 884 participants were included. Compared with the control group, HT can significantly improve upper body flexibility and aerobic endurance in older adults with cancer. Besides, HT was found to be more effective for promoting emotional functioning and well-being, subjective social functioning, and quality of life among the elderly. The attendance rate for HT was 66%-100%, and no negative events were found.

CONCLUSION

Horticultural therapy has potentially positive effects on the physical functioning and psychological health of older adults. However, more rigorous randomised controlled trials with larger populations are required to confirm the findings.

RELEVANCE TO CLINICAL PRACTICE

As a safe and promising nonpharmacological intervention, healthcare professionals may consider the HT intervention when caring for older adults with cancer, dementia and frailty.

Pathophysiologic Role of Neurotransmitters in Digestive Diseases

Neurotransmitters are special molecules that serve as messengers in chemical synapses between neurons, cells, or receptors, including catecholamines, serotonin, dopamine, and other neurotransmitters, which play an important role in both human physiology and pathology. Compelling evidence has indicated that neurotransmitters have an important physiological role in various digestive diseases. They act as ligands in combination with central or peripheral receptors, and transmits signals through chemical synapses, which are involved in regulating the physiological and pathological processes of the digestive tract organs. For instance, neurotransmitters regulate blood circulation and affect intestinal movement, nutrient absorption, the gastrointestinal innate immune system, and the microbiome. In this review, we will focus on the role of neurotransmitters in the pathogenesis of digestive tract diseases to provide novel therapeutic targets for new drug development in digestive diseases.

Mind-Body Interventions for Anxiety Disorders: A Review of the Evidence Base for Mental Health Practitioners

Mind-body interventions have gained increasing popularity for use with anxiety symptoms; however, it is unclear what role they play in the treatment of anxiety disorders, such as generalized anxiety disorder, panic disorder, and social anxiety disorder. Although psychopharmacology and psychotherapy treatment interventions are available, mind-body interventions may be low-stigma options that can serve as effective alternatives. The goal of this review is to provide clinicians with an overview of high-quality studies for the most well researched mind-body interventions. This review involved a search of the primary literature, including meta-analyses, systematic reviews, and randomized controlled trials (RCTs), that evaluated mind-body interventions for the treatment of anxiety disorders. When published evidence was limited, lower-quality studies were reviewed. Overall, data were limited on the efficacy of most mind-body modalities for anxiety disorders. The highest-quality data existed for yoga, mindfulness-based interventions, and applied relaxation for anxiety disorders. However, findings were sometimes inconsistent across studies, and some studies were limited by small sample sizes, poorly defined randomization and blinding procedures, and inadequate control groups. Although not enough data exist to recommend mind-body interventions as primary treatment options, they may be considered as part of a larger treatment plan given their relatively low levels of risk. Future steps for researchers include conducting additional RCTs with adequate control groups, comparing mind-body treatments with existing treatments, and examining long-term effects of mind-body interventions.

Effects of Qigong Exercise on Physical and Psychological Health among African Americans

Interventions are needed to address physical and psychological health in middle-aged and older African Americans (AAs). The purpose of this pilot study was to evaluate the feasibility and potential benefits of an eight-week Qigong exercise on physical ability and function, balance, frailty, depression and anxiety, and spiritual well-being in AAs using a single-group design. Fifteen AAs with a mean age of 64 years received Qigong exercise over 16 semi-weekly, one-hour sessions. The majority were female (93.3%) and college-level educated (53.3%). Repeat chair stands, physical function, and spiritual well-being improved significantly (p < .05) with effect sizes ranging from .45 to .87. Over 52% of participants showed improved depression scores, fast gait speed, and standing balance. Nearly 42% demonstrated some frailty improvement over baseline. No adverse events were reported. Qigong exercise potentially improves the physical ability and function, and spiritual well-being of AAs and needs further testing in a randomized clinical trial.

Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind-Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology

Women have been reported to be more vulnerable to the development, prognosis and mortality of cardiovascular diseases, yet the understanding of the underlying mechanisms and strategies to overcome them are still relatively undeveloped. Studies show that women's brains are more sensitive to factors affecting mental health such as depression and stress than men's brains. In women, poor mental health increases the risk of cardiovascular disease, and conversely, cardiovascular disease increases the incidence of mental illness such as depression. In connection with mental health and cardiovascular health, the presence of gender differences in brain activation, cortisol secretion, autonomic nervous system, vascular health and inflammatory response has been observed. This connection suggests that strategies to manage women's mental health can contribute to preventing cardiovascular disease. Mind-body interventions, such as meditation, yoga and qigong are forms of exercise that strive to actively manage both mind and body. They can provide beneficial effects on stress reduction and mental health. They are also seen as structurally and functionally changing the brain, as well as affecting cortisol secretion, blood pressure, heart rate variability, immune reactions and reducing menopausal symptoms, thus positively affecting women's cardiovascular health. In this review, we investigate the link between mental health, brain activation, HPA axis, autonomic nervous system, blood pressure and immune system associated with cardiovascular health in women and discuss the effects of mind-body intervention in modulating these factors.

The efficacy and safety of health qigong for anti-aging: Protocol for a systematic review and meta-analysis

BACKGROUND

Aging is a phenomenon that human's physiology and psychology is progressive decline for natural environment. Health Qigong, as a convenient and effective exercise therapy,is widely used for anti-aging. However, there are no systematic reviews or meta-analysises to evaluate the efficacy and safety of Health Qigong on anti-aging.

METHODS

We will systematically search for 7 English databases(PubMed, Excerpta Medica Database, MEDLINE, Web of Science, Cochrane Library, SpringerLink, and WHO International Clinical Trials Registry Platform) and 4 Chinese databases(namely the China National Knowledge Infrastructure Database, the Wanfang Database, the Chinese Scientific Journal Database, and the Chinese BioMedical Literature Database) from their inceptions to August 2020. Randomized controlled trials (RCTs) using Health Qigong to anti-aging will be included. After the selection and extraction of eligible studies, a meta-analysis will be undertaken to assess the efficacy and safety of Health Qigong on anti-aging. Moreover, study selection, data extraction, and the evaluation of the methodological quality of trials will each be independently completed by at least 2 researchers. The Review Manager Software V.5.3 will be employed for meta-analysis to assess the risk of bias, data synthesis, and subgroup analysis.

RESULTS

This review will provide the latest knowledge and evidence on the efficacy and safety of Health Qigong for anti-aging through the analysis of various evaluation scales.

CONCLUSION

The conclusion of this review will help clinicians provide effective exercise therapy for anti-aging.

REGISTRATION NUMBER

INPLASY202090017.

Traditional Chinese exercise for COVID-19: A protocol for systematic review and meta-analysis

BACKGROUND

A new type of coronavirus (COVID-19), is spreading all over the world. Under the background of the comprehensive medical treatment and strict prevention and control in China, the number of discharged patients increased substantially. By the end of July, more than 80,000 patients had been cured and discharged from hospital in China. In order to effectively promote the full recovery of the patient's physical and mental functions and quality of life, gradually shift the emphasis of clinical work to convalescence therapy is very important, thus Chinese experts draw up Expert Consensus on Rehabilitation of Chinese Medicine for COVID-19. This systematic review and meta-analysis will assess studies of the effects of traditional Chinese exercise (TCE) for COVID-19 patients.

METHODS AND ANALYSIS

We will search 6 English and 4 Chinese databases by 01, December 2020. After a series of screening, Randomized Clinic Trials (RCTs) will be included related to TCE for COVID-19. Two assessors will use the Cochrane bias risk assessment tool to assess the RCTs. Finally, the evidence grade of the results will be evaluated.

RESULTS

This study will provide a reliable evidence for the selection of TCE therapies for COVID-19.

CONCLUSION

The results of this study will provide references for the selection of TCE treatment for COVID-19, and provide decision making references for clinical research.

PROSPERO REGISTRATION NUMBER

CRD42020179095.

Effects of Mind-Body Interventions Involving Meditative Movements on Quality of Life, Depressive Symptoms, Fear of Falling and Sleep Quality in Older Adults: A Systematic Review with Meta-Analysis

Background: The aim of the present systematic meta-analytical review was to quantify the effects of different mind–body interventions (MBI) involving meditative movements on relevant psychological health outcomes (i.e., quality of life (QoL), depressive symptoms, fear of falling (FoF) and sleep quality) in older adults without mental disorders. Methods: A structured literature search was conducted in five databases (Ovid, PsycINFO, PubMed, SPORTDiscus, Web of Science). Inclusion criteria were: (i) the study was a (cluster) randomized controlled trial, (ii) the subjects were aged ≥59 years without mental illnesses, (iii) an intervention arm performing MBI compared to a non-exercise control group (e.g., wait-list or usual care), (iv) psychological health outcomes related to QoL, depressive symptoms, FoF or sleep quality were assessed and (v) a PEDro score of ≥5. The interventions of the included studies were sub-grouped into Tai Chi/Qigong (TCQ) and Yoga/Pilates (YP). Statistical analyses were conducted using a random-effects inverse-variance model. Results: Thirty-seven randomized controlled trials (RCTs) (comprising 3224 participants) were included. Small to moderate-but-significant overall effect sizes favoring experimental groups (Hedges’ g: 0.25 to 0.71) compared to non-exercise control groups were observed in all outcomes (all p values ≤ 0.007), apart from one subdomain of quality of life (i.e., social functioning, p = 0.15). Interestingly, a significant larger effect on QoL and depressive symptoms with increasing training frequency was found for TCQ (p = 0.03; p = 0.004). Conclusions: MBI involving meditative movements may serve as a promising opportunity to improve psychological health domains such as QoL, depressive symptoms, FoF and sleep quality in older adults. Hence, these forms of exercise may represent potential preventive measures regarding the increase of late-life mental disorders, which need to be further confirmed by future research.

Effects of Wuqinxi in the Patients with Chronic Low Back Pain: A Randomized Controlled Trial

Low back pain (LBP) is one of the major concerns of the current health care. The guidelines for chronic LBP recommend traditional Chinese exercise as an effective treatment. As one of the representatives of traditional Chinese exercise, Wuqinxi has been famous in China for its effects on improving health and treating chronic diseases for thousands of years. The objectives of the study were to assess the effects of Wuqinxi in the patients with chronic LBP on pain intensity, trunk muscle strength, and quality of life. The primary outcome measure was assessed by the Short-Form McGill Pain Questionnaire (SF-MPQ), including the Visual Analog Scale (VAS) and Present Pain Intensity (PPI) as the subtables. The effects of Wuqinxi on the quality of life were also assessed by the Short-Form Health Survey (SF-36) and the Pittsburgh Sleep Quality Index (PSQI) from physical component summary (PCS), mental component summary (MCS), and sleep quality. Besides, the electrical activities of the rectus abdominis (RA), obliquus externus abdominis (OEA), lumbar erector spinae (ES), and multifidus (MF) were assessed by integrated electromyogram (iEMG) after the end of the intervention. Both the groups showed statistically significant improvement in SF-MPQ, SF-36, PSQI, and iEMG at 12 weeks and 24 weeks when compared with baseline (P < 0.05). However, Wuqinxi demonstrated better effects in SF-MPQ and MCS after 24 weeks of intervention compared with the general exercise (P < 0.05). The patients in the Wuqinxi group (WQXG) also showed a significantly higher iEMG on OEA than the general exercise group (GEG) in 30°/s and 90°/s (P < 0.05). Our results showed that Wuqinxi had better effects on chronic LBP for a long time compared with general exercise, including pain intensity and quality of life. Thus, Wuqinxi should be recognized as a possible standalone therapy and self-management skill in chronic LBP, which is suitable for long-term practice.

Qigong for the Prevention, Treatment, and Rehabilitation of COVID-19 Infection in Older Adults

The elderly are at high risk of contracting respiratory infectious diseases, including COVID-19 infection. The recent pandemic has the potential to cause significant physical and mental damage in older adults. Similarly to other mind-body exercises in Traditional Chinese medicine, Qigong features regulation of breath rhythm and pattern, body movement and posture, and meditation. Given these traits, Qigong has the potential to play a role in the prevention, treatment, and rehabilitation of respiratory infections, such as COVID-19. Potential mechanisms of action include stress reduction, emotion regulation, strengthening of respiratory muscles, reduction of inflammation, and enhanced immune function. Three forms of Qigong; abdominal breathing, Ba Duan Jin and Liu Zi Jue, all of which are gentle, smooth, and simple for the elderly to practice, are recommended in this context.

Analysis of Traditional Chinese Medicine Diagnosis and Treatment Strategies for COVID-19 Based on "The Diagnosis and Treatment Program for Coronavirus Disease-2019" from Chinese Authority

In December 2019, coronavirus disease-2019 (COVID-19) broke out in Wuhan and other places. Seven versions of the Diagnosis and Treatment Program for Coronavirus Disease-2019 successively issued by the Chinese government have designated traditional Chinese medicine (TCM) as a necessary medical strategy. Based on the changes in TCM diagnosis and treatment strategies in these seven versions of Diagnosis and Treatment Program for Coronavirus Disease-2019, this paper collected data reported by the Chinese government media; analyzed the understanding of the etiology, pathogenesis, syndrome differentiation, treatment methods, and prescriptions of COVID-19 by TCM and evaluated the clinical efficacy of TCM strategies. COVID-19 is associated with TCM disease of pestilence, and its pathogenesis can be summarized as an "epidemic pathogen invading the body, followed by entering the internal organs and transforming into heat, resulting in pathogen trapping in the interior and healthy qi collapsing, and deficiency of qi and yin". Pathological processes should be emphasized in syndrome differentiation. The manifestations of qi deficiency and yin deficiency are exhibited during the recovery period. TCM strategies represented by Qing Fei Pai Du Tang have shown apparent advantages in improving symptoms, promoting virus clearance, and shortening hospitalization, as well as surprising efficacy of zero patient progressing from mild to severe cases in a TCM cabin hospital. Clinical data illustrate the effectiveness of TCM strategies proposed by the Chinese government. This major epidemic may bring new opportunities for TCM development.

Qigong and Musculoskeletal Pain

PURPOSE OF REVIEW

Musculoskeletal pain is a widespread symptom that commonly produces considerable disability, particularly in later life. This brief review strove to summarize and critically review the recent research base concerning the use of Qigong as a possible strategy for alleviating longstanding or chronic musculoskeletal pain states.

METHODS

Research reports and literature reviews specifically focusing on Qigong and its impact on various forms of musculoskeletal pain between 2015 and 2019 were sought and analyzed, along with related data.

RESULTS

Collectively, these data reveal that while more research is indicated, Qigong practice may help to attenuate pain in varying degrees among adults with different forms of chronic pain with few side-effects.

CONCLUSION

More research is needed to ensure health professionals working with adults who have chronic unrelenting musculoskeletal pain may safely recommend these exercises as one possible remedy for reducing intractable musculoskeletal pain.