A Systematic Review and Meta-Analysis of Mindfulness-Based (Baduanjin) Exercise for Alleviating Musculoskeletal Pain and Improving Sleep Quality in People with Chronic Diseases

PT-IN-MIND: study protocol for a multisite randomised feasibility trial investigating physical therapy with integrated mindfulness (PT-IN-MIND) for patients with chronic musculoskeletal pain and long-term opioid treatment who attend outpatient physical therapy

INTRODUCTION

Many individuals receiving outpatient physical therapy have musculoskeletal pain and up to one-third use prescription opioids. The impact of physical therapist-led mindfulness-based interventions integrated with evidence-based physical therapy (I-EPT) to manage patients with chronic musculoskeletal pain and long-term opioid treatment has not been elucidated. This project evaluates the feasibility of conducting a cluster randomised trial to test the effectiveness of I-EPT.

METHODS AND ANALYSIS

Study 1 aim: Refine and manualise the I-EPT treatment protocol. Our approach will use semistructured interviews of patients and physical therapists to refine an I-EPT training manual. Study 2 aim: Evaluate different intensities of physical therapist training programmes for the refined I-EPT treatment protocol. Physical therapists will be randomised 1:1:1 to high-intensity training (HighIT), low-IT (LowIT) training and no training arms. Following training, competency in the provision of I-EPT (LowIT and HighIT groups) will be assessed using standardised patient simulations. Study 3 aim: Evaluate the feasibility of the I-EPT intervention across domains of the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework. The refined I-EPT treatment protocol will be tested in two different health systems with 90 patients managed by the randomised physical therapists. The coprimary endpoints for study 3 are the proportions of the Pain, Enjoyment of Life and General Activity Scale and the Timeline Followback for opioid use/dose collected at 12 weeks.

ETHICS AND DISSEMINATION

Ethics approval for the study was obtained from the University of Utah, University of Florida and Florida State University Institutional Review Boards. Informed consent is required for participant enrolment in all phases of this project. On completion, study data will be made available in compliance with NIH data sharing policies.

TRIAL REGISTRATION NUMBER

NCT05875207.

Efficacy of Daoyin combined with lower limb robot as a comprehensive rehabilitation intervention for stroke patients: a randomized controlled trial

OBJECTIVE

To assess the effectiveness of a comprehensive rehabilitation approach combining Traditional Chinese Medicine Daoyin with lower limb robotics during the recovery phase of stroke patients.

METHODS

Stroke patients meeting the specified criteria were randomly assigned to one of four groups using a random number table: Control group, Daoyin group, lower limb robot group (LLR group), and Daoyin and lower limb robot group (DLLR group). Each group received distinct treatments based on conventional rehabilitation training. The treatment duration spanned two weeks with two days of rest per week. Pre- and post-intervention assessments included various scales: Fugl-Meyer Assessment (FMA), Berg balance scale (BBS), Barthel index (BI), Fatigue Scale-14 (FS-14), Pittsburgh sleep quality index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD).

RESULTS

Statistically significant differences were observed in the lower limb function measured by FAM between the Control group (15 ± 5) and the DLLR group (18 ± 5) (P = 0.049). In the Barthel index, a statistically significant difference was noted between the Control group (54 ± 18) and the DLLR group (64 ± 11) (P = 0.041). Additionally, significant differences were found in the Berg balance scale between the Control group (21 ± 10) and the DLLR group (27 ± 8) (P = 0.024), as well as between the Control group (21 ± 10) and the LLR group (26 ± 10) (P = 0.048).

CONCLUSION

The findings of this study suggest that the combined use of Daoyin and robotics not only enhances motor function in stroke patients but also has a positive impact on fatigue, sleep quality, and mood. This approach may offer a more effective rehabilitation strategy for stroke patients.

The effect of sitting baduanjin in patients with ST-segment elevation acute myocardial infarction after percutaneous coronary intervention: A quasi-experimental study

BACKGROUND

Early cardiac rehabilitation plays a crucial role in the recovery of patients with ST-segment elevation acute myocardial infarction (STEMI) following percutaneous coronary intervention (PCI). This study sought to determine the effect of a program of sitting Baduanjin exercises on early cardiac rehabilitation.

OBJECTIVE

The goal of this study was to investigate the effects of sitting Baduanjin exercises on cardiovascular and psychosocial functions in patients with STEMI following PCI.

METHODS

This quasi-experimental study employed a randomized, non-equivalent group design. Patients in the intervention group received daily sitting Baduanjin training in addition to a series of seven-step rehabilitation exercises, whereas those in the control group received only the seven-step rehabilitation training, twice daily. Differences in heart rate variability (HRV) indicators, exercise capacity (Six-Minute Walking Distance; 6-MWD), anxiety (Generalized Anxiety Disorder-7; GAD-7), and depression (Patient Health Questionnaire-9; PHQ-9) between the two study groups during hospitalization were analyzed.

RESULTS

Patients in the intervention group exhibited lower rates of abnormalities in the time domain and frequency domain parameters of HRV. The median scores of GAD-7 and PHQ-9 in both groups were lower than those at the time of admission, with the intervention group exhibiting lower scores than the control group (P < 0.001; P < 0.001, respectively). The 6-MWD after the intervention was greater in the intervention group compared to the control group (P = 0.014).

CONCLUSIONS

We found that sitting Baduanjin training has the potential to enhance HRV, cardiac function, and psychological well-being in patients with STEMI after PCI. This intervention can potentially improve the exercise capacity of a patient before discharge.

Non-Pharmacological Strategies for Managing Sarcopenia in Chronic Diseases

This article focuses on a range of non-pharmacological strategies for managing sarcopenia in chronic diseases, including exercise, dietary supplements, traditional Chinese exercise, intestinal microecology, and rehabilitation therapies for individuals with limited limb movement. By analyzing multiple studies, the article aims to summarize the available evidence to manage sarcopenia in individuals with chronic diseases. The results strongly emphasize the role of resistance training in addressing chronic diseases and secondary sarcopenia. Maintaining the appropriate frequency and intensity of resistance training can help prevent muscle atrophy and effectively reduce inflammation. Although aerobic exercise has limited ability to improve skeletal muscle mass, it does have some positive effects on physical function. Building upon this, the article explores the potential benefits of combined training approaches, highlighting their helpfulness for overall quality of life. Additionally, the article also highlights the importance of dietary supplements in combating muscle atrophy in chronic diseases. It focuses on the importance of protein intake, supplements rich in essential amino acids and omega-3, as well as sufficient vitamin D to prevent muscle atrophy. Combining exercise with dietary supplements appears to be an effective strategy for preventing sarcopenia, although the optimal dosage and type of supplement remain unclear. Furthermore, the article explores the potential benefits of intestinal microecology in sarcopenia. Probiotics, prebiotics, and bacterial products are suggested as new treatment options for sarcopenia. Additionally, emerging therapies such as whole body vibration training, blood flow restriction, and electrical stimulation show promise in treating sarcopenia with limited limb movement. Overall, this article provides valuable insights into non-pharmacological strategies for managing sarcopenia in individuals with chronic diseases. It emphasizes the importance of a holistic and integrated approach that incorporates exercise, nutrition, and multidisciplinary interventions, which have the potential to promote health in the elderly population. Future research should prioritize high-quality randomized controlled trials and utilize wearable devices, smartphone applications, and other advanced surveillance methods to investigate the most effective intervention strategies for sarcopenia associated with different chronic diseases.

Gender-specific link between sleep quality and body composition components: a cross-sectional study on the elderly

Sleep duration has been associated with overweight/obesity. Since sleep quality and body composition alter during aging, we conducted this study to determine if sleep quality is linked to body composition components in elderly people. This is a cross-sectional study conducted on 305 Iranian community-dwelling elderly aged ≥ 65 years. Sleep quality and body composition components were evaluated using Pittsburgh sleep quality index and bioelectric impedance analysis, respectively. The association of sleep quality and body composition components was examined using linear regression analysis. The prevalence of poor sleep quality and overweight/obesity was 48.9% and 54.4% in men and 77.0% and 79.3% in women, respectively. Women had significantly higher scores in most PSQI items than men, indicating their worse sleep quality compared to men. Women also had significantly higher body mass index (BMI), body fat percentage, and visceral adipose tissue and lower skeletal muscle and fat-free mass percentages than men. In the adjusted regression model, men showed positive associations between the third tertile of poor sleep quality and BMI (B = 1.35; 95% CI 0.08-2.61) and waist circumference (B = 4.14; 95% CI 0.39-7.89), but they did not demonstrate an association between sleep quality and body composition components. In the adjusted regression model for women, there were positive associations for BMI (B = 1.21; 95% CI 0.34-2.07), waist circumference (B = 2.95; 95% CI 0.99-4.91), body fat percentage (B = 2.75; 95% CI 1.06-4.45), and visceral adipose tissue (B = 7.80; 95% CI 1.73-13.87); also there were negative associations for skeletal muscle (B =  - 1.40; 95% CI - 2.39 - - 0.41) and fat-free mass (B =  - 2.76; 95% CI - 4.46 - -1.07) percentages. Except for waist circumference, other variables differed between men and women (P < 0.001). Weight management, prevention of muscle wasting, and improvement of sleep quality should be considered in a consortium when designing healthcare strategies for the elderly.

Insomnia and anxiety among COVID-19 patients in China: the chain mediating effect of psychological capital and self-esteem

BACKGROUND

The outbreak of Corona Virus Disease (COVID-19) in 2019 has continued until now, posing a huge threat to the public's physical and mental health, resulting in different degrees of mental health problems. As a vulnerable segment of the public, anxiety is one of the most common mental health problems among COVID-19 patients. Excessive anxiety aggravates the physical and psychological symptoms of COVID-19 patients, which is detrimental to their treatment and recovery, increases financial expenditure, affects family relations, and adds to the medical burden.

OBJECTIVE

This study aimed to explore the role of psychological capital and self-esteem in the relationship between insomnia and anxiety, thereby shedding light on the mechanism of the effect of insomnia on anxiety in COVID-19 patients.

METHODS

A cross-sectional study was conducted from April to May 2022 in Fangcang hospital in Shanghai, China. The self-administered questionnaires were distributed to 718 COVID-19 patients via cell phone using the Internet platform "Questionnaire Star", which included Athens Insomnia Scale, Psychological Capital Questionnaire, Self-esteem Scale, Self-Rating Anxiety Scale, gender, age, marital status, education. Data analysis was performed using descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analysis, ordinary least-squares regression, and bootstrap method.

RESULTS

Education background had significant impact on anxiety in COVID-19 patients (F = 7.70, P < 0.001). Insomnia, psychological capital, self-esteem and anxiety were significantly correlated, respectively (P < 0.001). And Regression analysis showed that insomnia had a direct negative predictive effect on psychological capital (β = -0.70, P < 0.001) and self-esteem (β = -0.13, P < 0.001). Psychological capital had a direct positive predictive effect on self-esteem (β = 0.12, P < 0.001). Insomnia had a direct positive predictive effect on anxiety (β = 0.61, P < 0.001). Both psychological capital and self-esteem had significant negative predictive effects on anxiety (β = -0.06, P < 0.05; β = -0.72, P < 0.001). The results showed that the mediating effect of psychological capital and self-esteem was significant, and the mediating effect value was 0.21. First, the indirect effect consisting of insomnia - psychological capital - anxiety was 0.04, showing that psychological capital had a significant mediating effect. Second, the indirect effect consisting of insomnia-self-esteem-anxiety had a value of 0.10, indicating that self-esteem had a significant mediating effect. Third, the indirect effect consisting of insomnia-psychological capital-self-esteem-anxiety had a value of 0.06, suggesting that psychological capital and self-esteem had a significant chain mediating effect between insomnia and anxiety.

CONCLUSIONS

Insomnia had a significant positive predictive effect on anxiety. Insomnia was first associated with a decrease in psychological capital, followed by a sequential decrease in self-esteem, which in turn was associated with increased anxiety symptoms in COVID-19 patients. Therefore, focusing on improving the psychological capital and self-esteem of patients can help alleviate the anxiety caused by insomnia in COVID-19 patients. It is recommended that patients and health care professionals increase the psychological capital and Self-esteem of COVID-19 patients through various methods to counter the effects of insomnia on anxiety.

Effects of mind-body exercise on body constitution and circadian rhythm in people with suboptimal health status

BACKGROUND

Suboptimal health status (SHS) is a dynamic state in which people have not been diagnosed with a disease but tend to develop diseases. People with SHS are more prone to conditions such as cardiovascular disease and metabolic syndrome. Suitable interventions in people with SHS can prevent disease development. SHS is correlated with traditional Chinese medicine (TCM)-based constitutions, including Yang-Xu (yang deficiency), Yin-Xu (yin deficiency), and stasis types. The circadian rhythm is a potential biomarker of health and metabolism. Baduanjin exercise, a kind of mind-body exercise, has been regarded to adjust body constitution and metabolism, but few studies have evaluated the effects of Baduanjin exercise on body constitution and circadian rhythms. Therefore, this randomized controlled trial investigated the effects of Baduanjin exercise on body constitution and circadian rhythms in people with SHS.

METHODS

Seventy-six participants with SHS were divided into the Baduanjin exercise and control groups (watching a Baduanjin video), with the interventions lasting 12 weeks. The Body Constitution Questionnaire (BCQ), SHS Questionnaire-25 (SHSQ-25), and actigraphy for circadian rhythm measurement were conducted.

RESULTS

The scores of SHSQ-25, Yang-Xu, Yin-Xu, and BCQ stasis decreased significantly after 12 weeks in the Baduanjin exercise group, but not in the control group. Interdaily stability of the circadian rhythm increased significantly in the Baduanjin exercise group but not in the control group.

CONCLUSION

This is the first report of improved health status, modulated body constitution, and increased interdaily stability of the circadian rhythm in participants with SHS who practiced Baduanjin exercise.

Effect of Baduanjin Qigong on Sleep Quality and Hyperarousal State in Adults With Chronic Insomnia: Protocol for a Randomized Controlled Trial

BACKGROUND

Chronic insomnia (CI) is a mind-body disease that is commonly defined as a state of having disturbed daytime activities due to poor nighttime sleep quality. Baduanjin qigong (BDJQG) is widely used for CI in China. However, there is little scientific evidence to evaluate its effects on the hyperarousal state, which is closely associated with improved sleep quality.

OBJECTIVE

The objective of the trial is to assess the therapeutic effects of BDJQG on sleep quality in patients with CI.

METHODS

A randomized controlled trial will be conducted on 86 patients, who will be divided into a BDJQG group and a cognitive behavioral therapy for insomnia group at a ratio of 1:1. Interventions in both groups will be given to the participants 7 times a week for 8 weeks, and the participants will be followed up for 4 weeks. The primary outcome is the change in the Pittsburgh Sleep Quality Index from baseline to week 8. The secondary outcomes are the changes in the Hyperarousal Scale, Insomnia Severity Index, Fatigue Scale-14, wrist actigraphy, salivary cortisol level, and functional magnetic resonance imaging from baseline to week 8. All main analyses will be carried out on the basis of the intention-to-treat principle.

RESULTS

This study was funded from January 2023. As of the submission of the manuscript, there were 86 participants. Data collection began in April 2023 and will end in January 2024. Data analysis is expected to begin in January 2024, with the publication of results expected in February 2024.

CONCLUSIONS

This study will present data concerning the clinical effects of BDJQG on CI. The results will help to demonstrate whether BDJQG is an effective therapy for improving sleep quality in association with a decreased hyperarousal level as a possible underlying mechanism. This study will provide much-needed knowledge for complementary and alternative therapy for patients with CI.

TRIAL REGISTRATION

China Clinical Registration Agency ChiCTR2300069241; https://chictr.org.cn/bin/project/ChiCTR2300069241.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/53501.

Baduanjin exercise for chronic non-specific low back pain: protocol for a series of N-of-1 trials

INTRODUCTION

Chronic non-specific low back pain (CNLBP) is one of the most common health problems worldwide. According to the clinical guideline released by the American College of Physicians, exercise has been recommended for the treatment of chronic LBP. In recent years, traditional Chinese medicine (TCM) is becoming increasingly popular for the management of chronic LBP. Baduanjin exercise is one of the exercise therapies in TCM. N-of-1 trial is a randomised cross-over self-controlled trial suitable for patients with this chronic disease. A series of similar N-of-1 trials can be pooled to estimate the overall and individual therapeutic effects synchronously by hierarchical Bayesian analysis. And N-of-1 trials are considered as a good tool for evaluating the therapeutic effect of TCM. Therefore, this study aims to conduct a series of N-of-1 trials with hierarchical Bayesian analysis for assessing whether Baduanjin exercise is effective and safe for CNLBP.

METHODS AND ANALYSIS

This study conducts a series of N-of-1 trials on Baduanjin exercise for the management of CNLBP. Fifty participants will receive 1-3 treatment cycles. They will be randomised into a Baduanjin exercise or waiting list group for a week during the two periods of each treatment cycle. The primary outcome is the 10-point Visual Analogue Scale. The secondary outcomes include the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and the Short Form Health Survey 12. Statistical analysis will be conducted with WinBUGS V.1.4.3 software. Overall and individual therapeutic effects will be estimated synchronously by hierarchical Bayesian analysis.

ETHICS AND DISSEMINATION

This study is approved by the Medical Ethics Committee of Tianjin University of TCM (reference number TJUTCM-EC20220005). Our findings will be published in a peer-reviewed journal or international conference.

TRIAL REGISTRATION NUMBER

ChiCTR2200063307.

Traditional Chinese exercises on pain and disability in middle-aged and elderly patients with lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials

Background

Traditional Chinese exercises (TCEs) have played a significant role in treating various diseases. However, there is limited research assessing the efficacy of TCEs in treating Lumbar disc herniation (LDH). This study aimed to systematically evaluate the effects of four commonly used TCEs (Baduanjin, Yijinjing, Taichi, and Wuqinxi) on pain and disability in elderly patients with LDH.

Objectives

To assess the quality of relevant randomized controlled trials (RCTs) to provide evidence support for the treatment of LDH.

Methods

RCTs were identified through eight databases. Meta-analysis and trial sequence analysis (TSA) were conducted using RevMan 5.4, Stata 17.0, and TSA 0.9.

Results

A total of 22 RCTs, involving 1931 patients, were included in the analysis. TCEs exhibited a superior effectiveness in treating LDH compared to the control group. However, the TSA analysis suggested the possibility of false positives, indicating the need for more high-quality RCT evidence. Nevertheless, TCEs showed reliable results in significantly improving the VAS score and JOA score of LDH patients.

Conclusion

Current evidence indicates that the four TCEs have advantages in treating LDH in middle-aged and elderly individuals. However, considering the limitations of this study, we need to exercise caution in drawing conclusions, and further research is required to validate these findings.

Systematic Review Registration

http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023431633].

The Effect of Sleep on Metabolism, Musculoskeletal Disease, and Mortality in the General US Population: Analysis of Results From the National Health and Nutrition Examination Survey

BACKGROUND

Sleep is an important physiological behavior in humans that is associated with the occurrence and development of various diseases. However, the association of sleep duration with health-related outcomes, including obesity-related factors, musculoskeletal diseases, and mortality because of different causes, has not been systematically reported.

OBJECTIVE

This study aims to systematically investigate the effect of sleep duration on health-related outcomes.

METHODS

Overall, 54,664 participants with sleep information from 8 survey cycles of the National Health and Nutrition Examination Survey (2005-2020) were included in the analysis. Health-related outcomes comprised obesity-related outcomes (ie, BMI, obesity, waist circumference, and abdominal obesity), metabolism-related outcomes (ie, uric acid, hyperuricemia, and bone mineral density [BMD]), musculoskeletal diseases (ie, osteoarthritis [OA] and rheumatoid arthritis [RA]), and mortality because of different causes. The baseline information of participants including age, sex, race, educational level, marital status, total energy intake, physical activity, alcohol consumption, smoking, hypertension, and diabetes was also collected as covariates. Information about the metabolism index, disease status, and covariates was acquired from the laboratory, examination, and questionnaire data. Survival information, including survival status, duration, and cause of death, was obtained from the National Death Index records. Quantile regression models and Cox regression models were used for association analysis between sleep duration and health-related outcomes. In addition, the threshold effect analysis, along with smooth curve fitting method, was applied for the nonlinear association analysis.

RESULTS

Participants were divided into 4 groups with different sleep durations. The 4 groups showed significant differences in terms of baseline data (P<.001). The quantile regression analysis indicated that participants with increased sleep duration showed decreased BMI (β=-.176, 95% CI -.220 to -.133; P<.001), obesity (odds ratio [OR] 0.964, 95% CI 0.950-0.977; P<.001), waist circumference (β=-.219, 95% CI -.320 to -.117; P<.001), abdominal obesity (OR 0.975, 95% CI 0.960-0.990; P<.001), OA (OR 0.965, 95% CI 0.942-0.990; P=.005), and RA (OR 0.940, 95% CI 0.912-0.968; P<.001). Participants with increased sleep duration also showed increased BMD (β=.002, 95% CI .001-.003; P=.005), as compared with participants who slept <5.5 hours. A significant saturation effect of sleep duration on obesity, abdominal obesity, and hyperuricemia was detected through smooth curve fitting and threshold effect analysis (sleep duration>inflection point). In addition, a significant threshold effect of sleep duration on BMD (P<.001); OA (P<.001); RA (P<.001); and all-cause (P<.001), cardiovascular disease-cause (P<.001), cancer-cause (P=.005), and diabetes-cause mortality (P<.001) was found. The inflection point was between 6.5 hours and 9 hours.

CONCLUSIONS

The double-edged sword effect of sleep duration on obesity-related outcomes, embolism-related diseases, musculoskeletal diseases, and mortality because of different causes was detected in this study. These findings provided epidemiological evidence that proper sleep duration may be an important factor in the prevention of multisystem diseases.

Effects of Linpan nature therapy on health benefits in older women with and without hypertension

Background

Nature therapy can significantly benefit the physiology and psychology of middle-aged and older people, but previous studies have focused on forest environments. The restoration potential of rural environments in urban fringe areas, which are more accessible to older people on a daily basis, has not been fully studied. This study assessed the effects of nature therapy on the physical and mental health of older women in a rural setting (locally known as Linpan) in the urban fringe area of Chengdu, China.

Methods

We recruited a total of 60 older women (65.3 ± 5.5 years old) living in cities for 3 days of nature therapy in the winter (30 subjects) and spring (30 subjects), including 20 hypertensive patients.

Results

The results showed that the overall blood pressure, pulse and sleep dysfunction rating scores of the participants were significantly lower than the pretest levels, and the finger blood oxygen saturation, mid-day salivary alpha-amylase and cortisol were increased post-treatment. Increases in these biomarker indicates and increase in stress. There were significant differences in the changes in systolic blood pressure between the hypertension group (HTN) and the normal group (normal) (HTN decreased by 8.8%, normal decreased by 5.4%), salivary alpha-amylase content (HTN decreased by 0.3%, normal increased by 16.9%), and sleep dysfunction rating scores (HTN decreased by 59.6%, normal decreased by 54%). The decreases in systolic blood pressure and pulse in the winter group were higher than those in the spring group by 1.8 and 4.4%, respectively, while the increases in salivary alpha-amylase content and salivary cortisol content were lower than those in the spring group by 11.7 and 11.2%, respectively, and the decrease in sleep dysfunction rating scores was lower than that in the spring group by 7.1%.

Conclusion

Our study concluded that nature therapy based on various health activities in the Linpan has significant health effects on older women. It can regulate blood pressure and pulse in older women, relieve cardiovascular disease, improve sleep quality. Meanwhile, older women with high blood pressure experienced a more significant effect than the healthy group.

Effects of Baduanjin exercise on patients with chronic nonspecific low back pain and surface electromyography signs of erector spinal muscle: A randomized controlled trial

BACKGROUND

Chronic nonspecific low back pain (CNLBP) is a common disease usually with lower back muscle fatigue and injuries that may contribute to lumbar muscle imbalance and pain recurrence. This study aimed to examine the effectiveness of Baduanjin exercise on patients of CNLBP and to assess its impact on the surface electromyographic signals of the lumbar erector spinae muscle.

METHODS

A total of 60 patients diagnosed with CNLBP were admitted from the Hubei Provincial Hospital of Traditional Chinese Medicine from March 2022 to December 2022. Those patients were randomly allocated into the Baduanjin group (n = 30) or the walking group (n = 30). Both groups received a 4-week intervention, with 5 training sessions per week. The numeric pain rating scale (the minimal clinically important difference = 2.4) and Oswestry Disability Index (the minimal clinically important difference = 13.4), electromyogram signals during lumbar flexion (FLEXAEMG), lumbar extension (EXTAEMG), and maximum lumbar flexion (MAEMG), the ratios of FLEXAEMG to MAEMG and EXTAEMG to MAEMG were collected at Baseline and posttreatment and compared using the Wilcoxon signed-rank test or Mann-Whitney U test.

RESULTS

After treatment, the numeric pain rating scale score in the Baduanjin group exhibited a significant decrease compared to baseline (P < .05) and was found to be lower than that of the Walking group (mean difference 2.36; CI 95% -2.323 to -1.742; P = .001). Similarly, the Oswestry disability index in the Baduanjin group demonstrated a reduction compared to baseline (P < .05) and was lower than that of the Walking group (the mean difference 7.59; CI 95% -8.861 to -6.312; P = .001). The FLEXAEMG and EXTAEMG of both groups had a significant increase (P < .05), with the Baduanjin group demonstrating higher levels compared to the Walking group (P < .05). Conversely, the MAEMG of both groups displayed a significant decrease (P < .05), with the Baduanjin group exhibiting lower levels than the Walking group (P < .05). The FLEXAEMG to MAEMG and EXTAEMG to MAEMG in the Baduanjin group increased (P < .05) and were significantly higher than the Walking group (P < .05).

CONCLUSION

Baduanjin exercise has shown to be highly effective in reducing low back pain and in promoting lumber dysfunction, due to its ability to improve the strength and flexibility of the lumbar erector spinae muscle.

Efficacy of Baduanjin for treatment of fatigue: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Numerous studies have suggested that Baduanjin, a traditional Chinese exercise, can alleviate fatigue symptoms in patients with various illnesses. The aim of this review was to evaluate the efficacy of Baduanjin in reducing fatigue symptoms.

METHODS

A comprehensive literature search was conducted using several databases, including PubMed, Web of Science, Embase, Medline, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang, from inception to June 2023. Relevant studies reporting on the effects of Baduanjin on fatigue symptoms were included. A random-effects meta-analysis model with standardized mean differences was used to estimate the treatment effects. Moderator analyses were conducted using continuous variables and meta-regression. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023411532). Grading of recommendations, assessment, development and evaluations framework was used to assess the certainty of evidence.

RESULTS

Ten randomized controlled trials with patients diagnosed with 9 different diseases were included in the meta-analysis. The Baduanjin intervention groups showed significant improvements in total fatigue intensity (standard mean difference = -0.49, 95% confidence interval = -0.69 to -0.30, P = .000; I2 = 56%, P = .009). The statistically significant differences in the subgroup analyses, including intervention durations, age of participants, fatigue types, and practice location, remained unchanged. Meta-regression showed that practice place might have significant effect on the results. The certainty of the evidence was moderate for participants 55-year younger or in hospital training. However, fatigue, different groups, participants 55-year or older, training at home, and different fatigue types had lower evidence certainty.

CONCLUSION

Baduanjin can effectively alleviate fatigue symptoms with relatively flexible requirements. However, studies investigating the same disease types and including non-Chinese populations are scarce. Therefore, further studies with long-term interventions, larger sample sizes, and well-designed methodologies are warranted.

Econometric evaluation of implementing a behavioral health integration intervention in primary care settings

Integrated behavioral health (IBH) is an approach to patient care that brings medical and behavioral health providers (BHPs) together to address both behavioral and medical needs within primary care settings. A large, pragmatic, national study aimed to test the effectiveness and measure the implementation costs of an intervention to improve IBH integration within primary care practices (IBH-PC). Assess the time and cost to practices of implementing a comprehensive practice-level intervention designed from the perspective of clinic owners to move behavioral service integration from co-location toward full integration as part of the IBH-PC study. IBH-PC program implementation costs were estimated in a representative sample of 8 practices using standard micro-econometric evaluation of activities outlined in the implementation workbook, including program implementation tasks, remote quality improvement coaching services, educational curricula, and learning community activities, over a 24-month period. The total median cost of implementing the IBH-PC program across all stages was $20,726 (range: $12,381 - $60,427). The median cost of the Planning Stage was $10,258 (range: $4,625 - $14,840), while the median cost of the Implementation Stage was $9,208 (range: $6,017 - 49,993). There were no statistically significant differences in practice or patient characteristics between the 8 selected practices and the larger IBH-PC practice sample (N=34). This study aimed to quantify the relative costs associated with integrating behavioral health into primary care. Although the cost assessment approach did not include all costs (fixed, variable, operational, and opportunity costs), the study aimed to develop a replicable and pragmatic measurement process with flexibility to adapt to emerging developments in each practice environment, providing a reasonable ballpark estimate of costs associated with implementation to help guide future executive decisions.

The relationship between physical activity and depression among community-dwelling adults in Wuhan, China

Background

While the association between physical activity (PA) and depression has been established, there is limited research on the effect of PA on the risk of depression among Chinese individuals. Thus, this study aimed to investigate the relationship between PA and depression among Chinese individuals.

Methods

We used a stratified random sampling approach to recruit participants from five urban districts in Wuhan, China. A total of 5,583 permanent residents aged 18 years or older completed questionnaires, which included the International Physical Activity Questionnaire Short Form (IPAQ-SF) to measure PA, and the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. To control for potential confounders, multiple logistic regression was employed to assess the association of PA with depression.

Results

The depression group had significantly lower weekly PA levels, measured in metabolic equivalent of task-minutes per week (MET-min/w), compared to the non-depression group [1,770 (693-4,200) MET-min/w vs. 2,772 (1,324-4,893) MET-min/w, p < 0.001]. In the fully adjusted model, the moderate and high PA level groups had lower odds ratios (ORs) for depressive symptoms compared to the low PA level group [OR (95% confidence interval (CI)) = 0.670 (0.523-0.858), 0.618 (0.484-0.790), respectively]. Among males, moderate and high levels of PA were associated with lower risk of depression compared to low PA levels [OR (95% CI) = 0.417 (0.268-0.649), 0.381 (0.244-0.593), respectively]. However, this association was not observed in females [OR (95% CI) = 0.827 (0.610-1.121), 0.782 (0.579-1.056), respectively]. The study found a significant interaction between PA levels and gender in relation to depression (P for interaction = 0.019).

Conclusion

The findings suggest a negative association between PA and risk of depressive symptoms, indicating that moderate to high levels of PA may serve as a protective factor against depressive symptoms.

Analysis of the effect of mini-nutrition nursing plus Baduanjin rehabilitation exercise on fracture healing, mobility and nutritional status of elderly patients with vertebral or hip fractures

Hip fractures (VOHF) are a type of bone fracture that occurs in the hip bone, typically affecting older adults. Recovery from hip fractures in older adults can be challenging due to factors such as decreased mobility, weakened bones, and other health issues. This paper intends to determine the effect of mini-nutrition nursing plus Baduanjin rehabilitation exercise on postoperative rehabilitation of elderly patients with vertebral or hip fractures (VOHF). 106 senile VOHF patients were chosen for the study between May 2020 and May 2022. The research group (RG) consisted of 60 patients who received mini-nutrition nursing + Baduanjin rehabilitation exercise, while the control group (CG) had 46 patients who received mini-nutrition nursing + routine rehabilitation training. The study compared the fracture healing effect, MAMC, CC, and MNA-SF scores. The rehabilitation status of patients was evaluated using FMA, BI, BBS, and VAS. Adverse reactions during hospitalization and SF-36 scores were also recorded. Better fracture healing efficacy and higher MAMC, CC, and MNA-SF scores were determined in RG versus CG (P < 0.05). Elevated FMA, BI and BBS scores were observed in both groups after rehabilitation training, with more evident elevations in RG; while the VAS score reduced markedly and was lower in RG compared with CG (P < 0.05). In addition, RG was observed with fewer adverse reactions and higher SF-36 scores (P < 0.05). Mini-nutrition nursing + Baduanjin rehabilitation exercise can effectively accelerate the postoperative rehabilitation of elderly patients with VOHF, improve mobility, and enhance their quality of life.

Dismantling the Component-Specific Effects of Yogic Breathing: Feasibility of a Fully Remote Three-Arm RCT with Virtual Laboratory Visits and Wearable Physiology

Despite the growing research base examining the benefits and physiological mechanisms of slow-paced breathing (SPB), mindfulness (M), and their combination (as yogic breathing, SPB + M), no studies have directly compared these in a "dismantling" framework. To address this gap, we conducted a fully remote three-armed feasibility study with wearable devices and video-based laboratory visits. Eighteen healthy participants (age 18-30 years, 12 female) were randomized to one of three 8-week interventions: slow-paced breathing (SPB, N = 5), mindfulness (M, N = 6), or yogic breathing (SPB + M, N = 7). The participants began a 24-h heart rate recording with a chest-worn device prior to the first virtual laboratory visit, consisting of a 60-min intervention-specific training with guided practice and experimental stress induction using a Stroop test. The participants were then instructed to repeat their assigned intervention practice daily with a guided audio, while concurrently recording their heart rate data and completing a detailed practice log. The feasibility was determined using the rates of overall study completion (100%), daily practice adherence (73%), and the rate of fully analyzable data from virtual laboratory visits (92%). These results demonstrate feasibility for conducting larger trial studies with a similar fully remote framework, enhancing the ecological validity and sample size that could be possible with such research designs.

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.

Efficacy of basic body awareness therapy on functional outcomes: A systematic review and meta-analysis of randomized controlled trials

PURPOSE

This study examined the efficacy of basis body awareness therapy (BBAT) on functional outcomes and quality of life (QoL) in patients with mental health problems and long-lasting conditions including musculoskeletal disorders, chronic and psychosomatic pain, and neurological conditions.

MATERIAL AND METHODS

Randomized controlled trials (RCTs) were obtained from MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro from inception to April 1st, 2022. A random effects meta-analysis was performed to explore the efficacy of BBAT versus non-active and active control conditions.

RESULTS

Eight RCTs (n BBAT = 307, n controls = 428) were included. There was no evidence for reductions in anxiety (standardized mean difference [SMD] = -1.42, 95% confidence interval [CI] = -3.30 to 0.46, p = 0.14), depression (SMD = -0.82, 95% CI = -1.85 to 0.21, p = 0.12), and no improvements in global assessment of functioning for functioning (GAF-F) (SMD = 0.58, 95% CI = -0.03 to 1.19, p = 0.06) or for symptoms (GAF-S) (SMD = 0.76, 95% CI = -0.44 to 1.96, p = 0.21) in BBAT versus non-active control conditions. BBAT reduced anxiety significantly more than active interventions (SMD = -0.84, 95% CI = -1.17 to -0.51, p < 0.001). No significant differences between BBAT and active control conditions were found for reduction in depression (SMD = -1.16, 95% CI = -2.74 to 0.41, p = 0.15) or in self-reported pain (SMD = 0.08, 95% CI = -0.25 to 0.40, p = 0.65). Active control conditions were superior in improving QoL (SMD = 0.83, 95% CI = 0.49 to 1.17, p < 0.001), GAF-F (SMD = 1.58, 95% CI = 0.29 to 2.86, p = 0.016) and GAF-S (SMD = 1.19, 95% CI = 0.85 to 1.53, p < 0.001).

CONCLUSIONS

Physiotherapists should be cautious in adopting BBAT, noting there is no high-quality evidence to support its' use to improve functionality and QoL in patients with mental health problems and/or long-lasting conditions.

Effects of pharmacotherapy on sleep-related outcomes in adults with chronic low back pain: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Adults with chronic low back pain (CLBP) suffer impaired sleep. Medications for CLBP can impact sleep which in turn may influence treatment outcomes. This systematic review and meta-analysis examined the effects of pharmacotherapy (any type) on sleep in adults with CLBP.

METHODS

In this systematic review and meta-analysis, we searched PubMed, CINAHL, SPORTDiscus, PsycINFO, EMBASE, and CENTRAL from inception to 10 July 2022. Randomised controlled trials that investigated the effects of pharmacotherapy on sleep in adults with CLBP were included. Manual citation search of relevant systematic reviews and included studies were also conducted. Mean change from baseline for sleep outcomes (e.g., sleep quality, total sleep time, wake after sleep onset) was the effect of interest. Pairwise inverse-variance random effect meta-analysis was performed to impute pooled estimates (Hedges' g or risk ratios). The Hartung-Knapp-Sidik-Jonkman method was used where there were ≤5 studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for evaluating the certainty of evidence. This study was registered with PROSPERO (CRD42022309419).

FINDINGS

Assessment of 3959 records resulted in nine studies (n = 2927) being included. Pharmacotherapy for CLBP management had a small, yet unlikely clinically significant, effect on improving sleep in adults with CLBP, when compared to placebo (g [95% CI]: -0.23 [-0.37, -0.09], p = .0009; I ²  = 30.1%; n = 1433; studies: n = 8; GRADE: low). Notably, no eligible studies investigated the effect of sleep medications in this population, despite being within the scope of this review.

INTERPRETATION

Pharmacotherapy used to manage CLBP provided improvements in sleep in adults with CLBP. Given that these effects were small and unlikely clinically significant, clinicians could consider alternative treatments (e.g., non-pharmacological interventions) for managing sleep in adults with CLBP. However, low to very low certainty of evidence precluded strong conclusions. To improve certainty of evidence and confidence in the effect estimates, future research needs to use robust method to minimise bias. Additional research evaluating multiple sleep characteristics, using both validated objective and subjective measures, is also warranted to further investigate the influence of distinct sleep parameters.

FUNDING

The Summer Research Scholarship from the Appleton Institute, Central Queensland University, Australia.

Remotely monitored Baduanjin exercise in moderate-to-severe chronic obstructive pulmonary disease patients (BROCADE): A study protocol

BACKGROUND

Baduanjin is a traditional Chinese exercise regimen used to treat various chronic illnesses and is associated with both psychological and physical benefits. However, its benefits for patients suffering from chronic obstructive pulmonary disease (COPD) are unclear. This study aims to assess the efficacy, safety, and underlying mechanisms of Baduanjin exercise in patients with moderate-to-severe COPD (BROCADE) by remote monitoring.

METHODS

This study protocol describes a multicenter, open-label, prospective randomized computed tomography. A total of 150 individuals who meet the inclusion criteria after the screening and consent processes will take part in the study. All participants will be provided routine medication and lifestyle interventions. They will be randomly assigned to a control group, a classical pulmonary rehabilitation group, or a Baduanjin group, which will undergo remotely monitored Baduanjin exercises for a cumulative duration of 1 hour per day, three times per week for 12 weeks. The participants will be followed for 24 weeks. The primary outcomes will be a 6-minutes walking distance and St. George's Respiratory Questionnaire index. The secondary outcomes will be lung function, cross-sectional area of the pectoralis major and subcutaneous fat, modified Medical Research Council score, COPD assessment test questionnaire results, extremity muscle strength, and quality of life. Any adverse events that may occur will be monitored and recorded.

RESULTS

This study is ongoing and will be submitted to a peer-reviewed journal for publication once completed.

CONCLUSION

A novel neutrophil-related inflammatory mechanism will potentially be identified. In addition, the study results will provide a safe, effective, simple and operational Baduanjin exercise protocol for moderate-to-severe COPD patients aimed at improving prognosis and quality of life.

The effect of Baduanjin exercise on health-related physical fitness of college students: A randomized controlled trial

Background

The continuous decline in the physical fitness of college students has become a serious social problem worldwide. Therefore, it is necessary to explore the effective method improving college students' physique. Previous studies have shown that Baduanjin exercise is beneficial in improving sleeping quality, mental health, body flexibility, and body physique. However, the evidence is unclear whether Baduanjin exercise can be recommended as an effective exercise to promote health-related physical fitness of college students.

Methods

A total of 130 college students were recruited and randomly allocated to either the Baduanjin training or the control group at a ratio of 1:1. The students in the Baduanjin training group received a 12-week supervised Baduanjin exercise training intervention with a frequency of 1 h each day and 4 days per week, while those in the control group did not receive any specific exercise intervention and were informed to maintain their original lifestyle for 12 weeks. The outcomes of health-related physical fitness involving measurements of body flexibility, muscular strength, cardiopulmonary fitness, and body endurance were measured at baseline and after the 12-week intervention period. Mixed linear model was used to analyze the effect of the Baduanjin exercise intervention.

Results

Mixed linear model analyses showed that the Baduanjin training group had a significant increase in the composite scores of health-related physical fitness compared to the control group from baseline to 12-week post-intervention with a medium effect size (d = 0.68, P = 0.006). Moreover, there were significant improvements in vital capacity, physical flexibility, 800/1,000 m endurance running, and body composition (measured by body mass index (BMI), fat mass and body fat ratio) at end of 12-week intervention in the Baduanjin training group. No adverse events were observed in this trial.

Conclusion

Regular Baduanjin training may be an effective, safe exercise form to promote the health-related physical fitness of young adults.

Trial registration

Chinese Clinical Trial Registry, ChiCTR-IOR-17013011. http://www.chictr.ogr.cn.

An exercise prescription for patients with lung cancer improves the quality of life, depression, and anxiety

Introduction

Lung cancer has the highest rates of morbidity and mortality among all cancers. Patients with lung cancer inevitably confront psychosocial discomforts and progressively experience depression and anxiety that potentially impact the clinical outcomes [e.g., quality of life (QoL)]. These mental disorders in patients with lung cancer may effectively be alleviated with prescribed Chinese traditional mind-body exercises. This study aimed to determine the effect of the exercise prescription containing Chinese traditional mind-body exercise on QoL, depression, and anxiety in patients with lung cancer.

Methods

In this study, 52 patients with non-small cell lung cancer (NSCLC) recruited from the China-Japan Friendship Hospital were divided into two groups, namely, the experimental group (N = 26) and the control group (N = 26). The experimental group was treated with an 8-week exercise prescription containing aerobic and resistance training. The control group received the usual care during the study period. The QoL, depression, and anxiety were separately investigated using EORTC QLQ-C30, EORTC QLQ-LC13, the Self-Rating Depression Scale (SDS), and the Self-Rating Anxiety Scale (SAS) at baseline and post-intervention. The scores of questionnaires were analyzed using the paired sample and independent sample t-tests to explore the intragroup and intergroup differences, respectively.

Results

The EORTC QLQ-C30 scores for physical functioning, role functioning, emotional functioning, and global QoL in the experimental group at post-intervention were significantly higher than those at baseline. The EORTC QLQ-C30 scores for fatigue, pain, dyspnea, and insomnia in the experimental group at post-intervention were significantly lower than those at the baseline. The SDS scores (baseline: 57.74 ± 8.77 vs. post-intervention: 51.42 ± 7.31, p < 0.05) and the SAS scores (baseline: 56.63 ± 9.39 vs. post-intervention: 49.16 ± 7.83, p < 0.05) in the experimental group at post-intervention were significantly lower than those at baseline.

Conclusions

The 8-week exercise prescription containing moderate-intensity Baduanjin (5 days per week) can effectively alleviate QoL, depression, and anxiety in patients with NSCLC. Our exercise prescription is an effective supportive treatment for lung cancer patients with depression and anxiety.

Clinical trial registration

Chinese Clinical Trial Registry (ChiCTR1900025121).

A randomized controlled trial of Baduanjin exercise to reduce the risk of atherosclerotic cardiovascular disease in patients with prediabetes

To investigate the effectiveness of long-term Baduanjin and aerobic training on the 10-year risk of atherosclerotic cardiovascular disease in prediabetic patients. This study was single-blind randomized controlled trial. A total of 98 participants with prediabetes were randomly divided into three groups: the BDJ (n = 34), AT (n = 32), and control (n = 32) groups. Participants in the BDJ and AT groups underwent one year of supervised group exercise, consisting of 60 min/session every other day. The primary outcomes were metabolic control and the 10-year risk of ASCVD. The secondary outcome was a change in blood glucose status. After the intervention, various metabolic indexes were significantly improved in the two exercise groups relative to the control group and baseline measurements (p < 0.05). Compared with no exercise, BDJ and AT had significant preventive and protective effects against the risk of ASCVD in patients with prediabetes (p < 0.001). The overall effects of the two exercise groups were similar (p > 0.05). Long-term BDJ training can effectively reduce the risk of type 2 diabetes mellitus (T2DM) and its cardiovascular complications in prediabetic patients. The effect of BDJ is similar to that of moderate-intensity aerobic exercise.

The effects of forest therapy on public mental health and circular economy: A policy support model in Japan

Background

Forest therapy has gained popularity in Japan and even other nations/regions due to its health benefits. In addition, forest therapy has contributed to the development of circular economy and industrial upgrading. Japanese successful practice can serve as a model for other countries in the Asia-Pacific region. To this end, the aim of this study was to determine whether forest therapy can improve the whole well-being of the participants and has a positive effect on the development of circular economy in the region.

Methods

Both empirical and inductive research methods were used; empirical approach was conducted to perform comparative analysis of regional data that was retrieved from the research project of Japanese Forestry Agency in 2015. Specifically, the efficacy of forest therapy on physical (blood glucose, blood pressure, body weight) and mental (sleep quality e.g.,) health outcomes among 815 participants was investigated. Regional data are from the statistics of Iiyama City from 1990 to 2005. After the concept of forest therapy became popular in the late 1990s, this element had a great positive impact on the economic benefits of Ishiyama City and other major forest scenic areas. We summarize and analyze a series of policies made by relevant departments of the Japanese government in the years from 2019 to 2021 to promote forest therapy and related circular industry development.

Results

Significant (pre-to-post participation) changes in physical measure was observed. Firstly, mean weight of those overweight participants decreased across three different time points (pre-test/enrollment = 79.7 kg, 3-month participation = 77.2, and 6-month participation = 76.8 kg), while overall mean weight of the participants decreased to 61, 60.5, and 60.4 kg, respectively. Secondly, Participant with normal weight showed a decrease on mean HbA1C (from 6.09 to 6.06) at Week 24, while overweight participants demonstrated a slight change 6.03-6.01 after 6 months the average HOMA-IR for overweight participants decreased from 3.5 to 2.5 at Week 24, while participants with normal weight demonstrated a decrease from 2.2 to 1.7 at Week 24. Forest Therapy has emerged in Japan since Mid-1990s and has attracted a large number of tourists all over the world due to its unique health benefits.

Conclusion

Forest therapy in Japan has positive effects on whole well-being of Japanese residents and it has helped public mental health promotion and economic growth. Under the guidance and support of government policies, it can promote the development of circular economy and industrial transformation and set a model of Japanese forest therapy development for other countries in the Asia-Pacific region.

The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review

Background

Increasing lines of evidence indicate that traditional Chinese exercise (TCE) has potential benefits in improving chronic low back pain (CLBP) symptoms. To assess the clinical efficacy of TCE in the treatment of CLBP, we performed a systematic review of existing randomized controlled trials (RCTs) of CLBP and summarized the neural mechanisms underlying TCE in the treatment of CLBP.

Methods

A systematic search was conducted in four electronic databases: PubMed, Embase, the Cochrane Library, and EBSCO from January 1991 to March 2022. The quality of all included RCTs was evaluated by the Physiotherapy Evidence Database Scale (PEDro). The primary outcomes included pain severity and pain-related disability.

Results

A total of 11 RCTs with 1,256 middle-aged and elderly patients with CLBP were included. The quality of all 11 included RCTs ranged from moderate to high according to PEDro. Results suggested that TCE could considerably reduce pain intensity in patients with CLBP. Overall, most studies did not find any difference in secondary outcomes (quality of life, depression, and sleep quality).

Conclusion

The neurophysiological mechanism of TCE for treating CLBP could be linked to meditation and breathing, posture control, strength and flexibility training, and regulation of pain-related brain networks. Our systematic review showed that TCE appears to be effective in alleviating pain in patients with CLBP.

Protocol for mindfulness-oriented recovery enhancement (MORE) in the management of lumbosacral radiculopathy/radiculitis symptoms: A randomized controlled trial

Introduction

Lumbosacral radiculopathy/radiculitis (LR) or "sciatica" is a commonly intractable sequelae of chronic low back pain (LBP), and challenges in the treatment of LR indicate that persistent pain may have both mechanical and neuropathic origins. Mindfulness-based interventions have been demonstrated to be effective tools in mitigating self-reported pain in LBP patients. This paper describes the protocol for a randomized controlled trial (RCT) evaluating the effects of the specific mindfulness-based intervention Mindfulness-Oriented Recovery Enhancement (MORE) on LR symptoms and sequelae, including mental health and physical function.

Methods

Participants recruited from the Portland, OR area are screened before completing a baseline visit that includes a series of self-report questionnaires and surface electromyography (sEMG) of the lower extremity. Upon enrollment, participants are randomly assigned to the MORE (experimental) group or treatment as usual (control) group for 8 weeks. Self-reported assessments and sEMG studies are repeated after the intervention is complete for pre/post-intervention comparisons. The outcome measures evaluate self-reported pain, physical function, quality of life, depression symptoms, trait mindfulness, and reinterpretation of pain, with surface electromyography (sEMG) findings evaluating objective physical function in patients with LR. To our knowledge, this is the first trial to date using an objective measure, sEMG, to evaluate the effects of a mindfulness-based intervention on LR symptoms.

Hypotheses

We hypothesize that MORE will be effective in improving self-reported pain, physical function, quality of life, depression symptoms, mindfulness, and reinterpretation of pain scores after 8 weeks of mindfulness training as compared to treatment as usual. Additionally, we hypothesize that individuals in the MORE group with abnormal sEMG findings at baseline will have improved sEMG findings at their 8-week follow-up visit.

Research on the Protection of Extensor and Flexor Muscles in the Waist and Back of Competitive Athletes

In the past, in the study of special sports quality of heavy antagonistic sports events, the study of strength quality training was emphasized. The transformation of athletes' strength quality to special strength was highlighted, and the special exercises which tended to be consistent with the characteristics of wrestling events were added. However, in competition and training, athletes' spine bears a heavy load. Long-term static contraction of lumbar muscles can lead to excessive local load and injury of lumbar muscles. In this paper, the test results of athletes' joints are analyzed, and the waist protection scheme for athletes' strength training is obtained. First of all, solve the problem of athletes' action mode and improve athletes' muscle endurance. All special sports quality evaluation can reach a good level. Then, enhance athletes' explosive power. Thus, all special sports quality evaluations can reach an excellent level. It is concluded that the waist and back are the key parts to support their participation in various sports, maintain body balance, and realize power transmission. Through the study, it is found that there are significant differences in the muscle strength indexes of the maximum strength of the waist and back of athletes of different levels, which fully proves the characteristics of the maximum strength of the waist and back. Through the test, we can understand the flexion and extension strength, range, speed, force, and flexion and extension ratio of athletes' joints and take timely optimization measures according to the test results to avoid sports injuries in training. It has a key guiding significance for the measurement, analysis, and evaluation of athletes' joint muscle strength, as well as rehabilitation training after injury and prevention of reinjury.

Changes in satisfaction with female genital self-image and sexual function after a Qigong exercise intervention in Spanish postmenopausal women: a randomized-controlled trial

OBJECTIVE

To analyze the effectiveness of a Qigong exercise program on satisfaction with female genital self-image and female sexual function in postmenopausal Spanish women.

METHODS

A total of 49 women were randomly assigned to an experimental group (n = 22) that carried out training based on Qigong exercises for 12 weeks and a control group (n = 27) that did not carry out any type of intervention. Female genital self-image was measured through the Female Genital Self-Image Scale and female sexual function through the Female Sexual Function Index; both variables were measured before and just after the intervention.

RESULTS

Results showed that women who participated in the Qigong exercise program showed significant improvements with respect to female genital self-image, as well as in the domains of desire, arousal, lubrication, satisfaction, and pain and the total score of the Female Sexual Function Index, but, on the contrary, were not found in the orgasm domain.

CONCLUSIONS

Our results suggest that Qigong has the potential to improve female genital self-image and female sexual function among postmenopausal Spanish women.

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.

Embodied Learning for Well-Being, Self-Awareness, and Stress Regulation: A Randomized Trial with Engineering Students Using a Mixed-Method Approach

The continuous changes in our society require adapted training that encompasses both technical and competency knowledge. There is a high level of demand, especially in areas such as engineering, which can affect the mental health of students, producing high levels of stress and psychological distress, hindering self-efficacy and academic performance. Embodied learning working on self-awareness, stress reduction and self-knowledge can help to generate healthier environments. Creative therapies can be a tool to promote the prevention of health problems in this group of the population. In particular, Dance Movement Therapy has demonstrated its effectiveness in improving health in clinical and non-clinical settings. In this work, a body awareness program based on Dance Movement Therapy is developed and implemented in engineering students. Through a mixed pre-post methodology, its impact is evaluated and analyzed in an experimental group of engineering students. Psychometric tests, physiological variables and reflective diaries are used as data sources. The results show that the experimental group, compared with the control group, increased their levels of body awareness and connectedness, well-being and life satisfaction and reduced their stress levels. The results were supported by cortisol measures. Likewise, the students acknowledged having increased their levels of self-awareness and self-knowledge and considered the inclusion of these bodily approaches in higher education to be necessary.

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.

Reductions in anxiety, depression and insomnia in health care workers using a non-pharmaceutical intervention

The COVID-19 pandemic has caused significant medical and psychological challenges worldwide, and not only exceeded the capacity of hospitals and intensive care units but also an individuals' ability to cope with life. Health-care workers have continued to provide care for patients despite exhaustion, fear of transmission to themselves and their family, illness or death of friends and colleagues, and losing many patients. They have also faced additional stress and anxiety due to long shifts combined with unprecedented population restrictions, including personal isolation. In this study, we study the effect of an app-based Yoga of Immortals (YOI) intervention on mental health of healthcare workers. In this study, the health care workers were digitally recruited, and their psychological parameters were measured using validated questionaries. The participants were randomly grouped into control and test groups. The validated psychological measures were the Patient Health Questionnaire-8 (PHQ-8), Insomnia Severity Index (ISI) and generalized anxiety disorder (GAD-7) scales. The digital YOI intervention significantly reduced the anxiety, depression symptoms, and insomnia in healthcare workers of all age groups. In contrast, there was no improvement in the control group. This study details the effectiveness of an app-based YOI intervention in healthcare workers.

Effectiveness of Baduanjin Exercise on Quality of Life and Psychological Health in Postoperative Patients With Breast Cancer: A Systematic Review and Meta-analysis

Background:

Baduanjin exercise is a traditional Chinese Qigong exercise. This study aimed to investigate the effects of Baduanjin exercise on the quality of life and psychological status of postoperative patients with breast cancer.

Methods:

A systematic review and meta-analysis were conducted. Eight databases were searched from inception to December 15, 2021, restricting the language to English and Chinese. RevMan5.3 software was employed for data analysis. This study was registered in PROSPERO, number CRD 42020222132.

Results:

A total of 7 randomized controlled trials (RCTs) with 450 postoperative breast cancer patients with or without Baduanjin exercise were collected. Compared with the group without Baduanjin, those who practiced Baduanjin showed significant improvement in quality of life (WMD = 5.70, 95% CI 3.11-8.29, P < .0001). Subgroup analysis showed significant improvement in physical (WMD = 1.83, 95% CI 1.13-2.53, P < .00001) and functional well-being (WMD = 1.58, 95% CI 0.77-2.39, P = .0001), which were measured by the functional assessment of cancer therapy-breast (FACT-B). Subgroup analysis also showed that role-physical (WMD = 11.49, 95% CI 8.86-14.13, P < .00001) and vitality (WMD = 8.58, 95% CI 5.60-11.56, P < .00001) were significantly increased, as measured by a 36-item Short Form survey (SF-36). In terms of psychological health, Baduanjin exercise reduced patients’ anxiety (WMD = −8.02, 95% CI −9.27 to −6.78, P < .00001) and depression (WMD = −4.45, 95% CI −5.62 to −3.28, P < .00001).

Conclusions:

Baduanjin is an effective exercise, which can significantly improve the quality of life and psychological health of breast cancer patients after operation.

A Systematic Review of the Effectiveness of Tai Chi Exercises for Improving Balance and Lower Limb Muscle Strength of the Elderly in the Community

BACKGROUND: Balance disorders are the primary cause of falls, a significant health concern for the elderly. Tai Chi (TC) improves the balance and strength of the lower limb muscles that focus on centering the mind, bodywork, and breathing exercises. AIM: A systematic review was conducted to search for evidence of the effects of Thai Chi in balancing and strengthening of lower extremities among the elderly in the community. METHODS: According to the preferred reporting items for systematic reviews and meta-analyses guidelines, a systematic review was conducted. Databases included Science Direct, ProQuest, and PubMed, from 2015 to 2020, with research articles being original studies. The quality of research articles was assessed using the Physiotherapy Evidence Database scale. Systematically analyses were used for results syntheses. RESULTS: Six articles were included in this review. TC exercises effectively improve the balance and muscle strength of the lower limbs among the elderly in the community. TC has a beneficial effect on evaluation in the short (8 weeks) and long (12 weeks) term to prevent falls among the elderly in the community. CONCLUSION: TC exercises are beneficial for improving balance and muscle strength of the lower limb among the elderly in the community with Selected TC, Traditional TC, and Modified Chen-style TC.

Effects of Low Back Pain Exercises on Pain Symptoms and Activities of Daily Living: A Systematic Review and Meta-Analysis

Our objective in this paper was to systematically review evaluations of the effects of exercises on pain symptoms and activities of daily living (ADL) in middle-aged and elderly patients with low back pain (LBP). We searched Web of Science, PubMed, EBSCO, and China National Knowledge Internet (CNKI) databases for randomized controlled trials (RCTs) on this topic. We evaluated the methodological quality of included articles using the Physiotherapy Evidence Database (PEDro) scale, and we statistically analyzed these studies using RevMan software. We reviewed 18 RCTs (23 comparison groups) with a total of 910 participants, and our meta-analysis confirmed that exercises significantly improved both pain and ADLs measured on visual analog scales (VAS) (SMD = -0.91, 95% CI: [-1.3, -0.52], p < 0.00001) and on the Oswestry Disability Index (ODI) (SMD = -2.07, 95% CI: [-3.19, -0.96], p < 0.00001). We conclude that exercises can reduce pain severity and improve ADL capacity in middle-aged and elderly persons with LBP, confirming that exercise can serve as a medical intervention for these indivdiuals. However, given the high heterogeneity of responses among individual participants, there remains a need for further study.

Effect of exercise on bone mineral density among patients with osteoporosis and osteopenia: A systematic review and network meta-analysis

AIMS AND OBJECTIVES

To systematically review and compare the efficacy of different exercise interventions on bone mineral density (BMD, g/cm² ) in patients with osteoporosis and osteopenia.

BACKGROUND

It is vitally important to prevent and treat bone loss in patients with osteoporosis and osteopenia. Exercise can effectively increase bone density and slow down bone loss in middle-aged and older people. However, it is still unclear which type of exercise intervention is the most effective on bone mineral density.

DESIGN

Systematic review and network meta-analysis (NMA) according to PRISMA.

METHODS

Randomised controlled trials of different exercise treatments for osteopenia and primary osteoporosis were included. A Frequentist network meta-analysis was conducted to appraise the efficacy of different types of exercise. The outcome was bone mineral density of different parts of the body.

RESULTS

Ninety-seven studies were included. The network meta-analysis showed that combined exercise, resistance exercise, aerobic exercise and mind-body exercise had a significant effect in improving the bone density of lumbar spine. The surface under the cumulative ranking area (SUCRA) values for mind-body exercise was 0.99 and ranked first. For BMD of the femoral neck, all kinds of exercise interventions increased the bone density significantly compared with no exercise and the optimal type was mind-body exercise (SUCRA = 0.99). In terms of the total hip bone mineral density, aerobic exercise and resistance exercise could improve hip bone density, with the resistance exercise (SUCRA = 0.95) ranking as first.

CONCLUSIONS

This NMA demonstrated the mind-body exercise might be the optimal exercise type to increase the BMD of the lumbar spine and femoral neck and resistance exercise is the most promising type for total hip BMD.

BADUANJIN EXERCISE TO TREAT FOR LUMBAR DISC HERNIATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

This study aimed to systematically evaluate the effectiveness of Baduanjin in the treatment of lumbar disc herniation (LDH). We searched PubMed, the Cochrane Library, EMBASE, Web of Science (WOS), CNKI, and Wanfang Databases from their inception until August 1, 2021, to collect the randomized controlled trials (RCTs) of Baduanjin in the treatment of LDH. After literature screening, data extraction, and quality evaluation by two independent researchers, the RevMan 5.4 software was used for meta-analysis. A total of 13 studies, involving 853 patients were finally included. The results showed that compared with the control group, the Baduanjin group showed remarkably improved treatment efficiency ([Formula: see text], 95% CI (1.05, 1.23), [Formula: see text]), JOA score ([Formula: see text], 95% CI (0.56, 4.68), [Formula: see text]), and VAS score ([Formula: see text], 95% CI ([Formula: see text], [Formula: see text]), [Formula: see text]). The Baduanjin group exhibited higher VAS scores than the control group in different intervention times (within 1 month, 1–2 months, and more than two months) ([Formula: see text]). Moreover, the JOA score of the Baduanjin was better than that of the control group in the presence of intervention for more than two months ([Formula: see text], 95% CI (1.05, 7.30), [Formula: see text]). In the comparison of exercise therapy, Baduanjin has more advantages than traditional rehabilitation training, as manifested by the improved VAS score ([Formula: see text], 95% CI ([Formula: see text], [Formula: see text]), [Formula: see text]) and JOA score ([Formula: see text], 95% CI (1.63, 3.09), [Formula: see text]). Conclusion: Baduanjin can significantly improve the rehabilitation evaluation scores of LDH patients and the treatment efficiency, and its curative effect was more obvious in a long time.

Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity

Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19.

METHOD

Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety.

RESULTS

The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms.

CONCLUSIONS

These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise.

Effect of qigong for sleep disturbance-related symptom clusters in cancer: a systematic review and meta-analysis

OBJECTIVES

To examine the effects of qigong interventions on sleep disturbance-related symptom clusters for cancer patients and to explore the possible mediating role of fatigue and depression in affecting sleep.

METHODS

In this systematic review and meta-analysis, a systematic search was conducted through October 2020 by searching multiple English and Chinese databases. Inclusion was limited to randomized controlled trials that measured the effect of qigong on sleep and fatigue/depressive symptoms in cancer patients. Eleven studies involving 907 cancer patients were included in the systematic review, whereas the meta-analysis included ten studies with 851 cancer patients.

RESULTS

The most commonly investigated form of qigong was Taichi, and the intervention length ranged from 10 days to 6 months. All studies employed self-reported measurements. Overall, qigong significantly improved sleep (SMD = -1.28, 95% CI: -2.01, -0.55) and fatigue (SMD = -0.89, 95% CI: -1.59, -0.19) in cancer patients post-intervention, but not depressive symptoms (SMD = -0.69, 95% CI: -1.81, 0.42). Notably, the benefits on sleep and fatigue became non-significant after 3 months. Qigong's effect on sleep was significantly mediated by its effect on fatigue (β = 1.27, SE = 0.24, p = 0.002), but not depressive symptoms (β = 0.53, SE = 0.26, p = 0.106).

CONCLUSIONS

Qigong can be recommended for improving sleep disturbance-fatigue symptom clusters in the cancer population, while qigong's benefit on sleep is likely based on its effect on reducing fatigue. Future qigong studies should adopt more rigorous design and employ strategies to maintain longevity of intervention benefits.

Observational Study of Qigong as a Complementary Self-Care Practice at a Tertiary-Care Pain Management Unit

Qigong, which can be characterized in many different ways, is offered as a complementary self-care practice at a tertiary-care pain management unit in Halifax, Nova Scotia. This report provides a quantitative and qualitative assessment of two groups engaged in qigong practice in this context as part of two Research in Medicine (RIM) projects (2014-15, 2016-17). It includes assessments of pain, mood, quality of life, sleep, and fatigue, considers outcomes in relation to the amount of practice, and considers whether health attitudes would help determine who might benefit from the practice. There were 43 participants (28 ongoing practitioners, 15 new to qigong). The ongoing practice group in RIM2 had significant benefits over time in pain, mood, quality of life, and fatigue in quantitative scores, but changes were not significant in RIM 1. There were no differences in any measures in those new to qigong. Qualitative comments in core and other domains reflected good or better outcomes in 16 subjects in the ongoing group who practiced consistently. In those who practiced less, results were more variable. In most of those new to qigong, the practice was limited and comments indicate minimal changes. Those engaged in qigong have a stronger internal health locus of control than control subjects. Diligent qigong practice provides multiple health benefits for those with chronic pain, and qualitative assessments are essential for documenting these effects. For those new to qigong, factors needed to effectively engage practice need to be explored further to optimize program delivery. The trial is registered with http://www.clinicaltrials.gov (NCT04279639).

Effects of Baduanjin on postoperative rehabilitation of patients with breast cancer: A protocol for systematic review and meta-analysis

BACKGROUND

Baduanjin, as an ancient Chinese exercise, is beneficial to both physical and mental health. Moreover, researchers discovered that Baduanjin has effects on the recovery of postoperative breast cancer patients. Yet, nobody focused on the systematic review, which can provide convincing evidence to verify the effect of Baduanjin in breast cancer patients. Therefore, our study will conduct a systematic review to fill in the blank, besides we will offer new evidence for clinical workers.

METHODS

PubMed, Embase.com, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and SinoMed will be used for literature search, retrieve time is up to June 1, 2021. We will include randomized controlled trials that evaluate the effects of Baduanjin on postoperative rehabilitation for breast cancer patients. Two independent researchers will perform study selection and data extraction. The risk of bias will be assessed by the Cochrane bias assessment tool. We will use funnel plot and Egger test to evaluate publication bias. Stata 13.0, as a necessary software, will be used to perform statistical analysis. Also, we will utilize subgroup analyses and sensitivity analyses to explore the sources of heterogeneity.

RESULTS

The results of this study will be published in a peer-reviewed journal.

CONCLUSION

Evidence that adequately assesses the effect of Baduanjin in the recovery of breast cancer patients will be confirmed through this systematic review. Our study will offer a guideline for clinical workers, besides we will supply a new way for the rehabilitation of breast cancer patients.

The effects on pain, physical function, and quality of life of quadriceps strengthening exercises combined with Baduanjin qigong in older adults with knee osteoarthritis: a quasi-experimental study

BACKGROUND

Exercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA). However, the best choice for an optimal exercise program able to promote long-term compliance in KOA patients is not clear. This study aims to compare the effect of combined exercise (CE: quadriceps strengthening exercises (QSE) and Baduanjin qigong training (BDJ)) versus QSE alone and BDJ alone on older adults with KOA.

METHODS

A three-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from three community centers were assigned respectively to QSE group, BDJ group and CE group. We assessed pain intensity, physical function, self-efficacy, and health-related quality-of-life (HRQoL) using standardized instruments at baseline, 3 months and 6 months follow-up.

RESULTS

One hundred and twenty-eight participants with KOA aged over 60 completed the study. Over the 6 months, there were significant group interaction effects on pain intensity (F = 28.888, P < 0.001), physical function (F = 26.646, P < 0.001), and self-efficacy (F = 22.359, P < 0.001), and, based on a short form-12 item health survey questionnaire (SF-12), physical component summary (F = 7.470, P < 0.001), and mental component summary (F = 10.207, P < 0.001). Overall, the CE group exhibited significantly greater improvement in all outcomes when compared to the QSE group and the BDJ group.

CONCLUSIONS

CE treatment is more effective than QSE and BDJ in pain relief, increasing physical function, improving self-efficacy, and raising quality-of-life in community-dwelling KOA older adults. Moreover, it promotes long-term compliance in KOA community patients.

TRIAL REGISTRATION

Chinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020.

The effect of dance-based mind-motor activities on the quality of life in the patients recovering from COVID-19: A protocol for systematic review and meta-analysis

BACKGROUND

Since the outbreak of coronavirus disease 2019 (COVID-19), with the improvement of diagnosis and treatment level in various countries, more and more patients have been discharged after systematic treatment. In order to effectively promote the overall recovery of patients' physical and mental function and quality of life (QOL), the focus of clinical work should be gradually shifted to rehabilitation treatment. Dance-based mind-motor activities were defined as coordinated upright mind-motor movements that emphasize dynamic balance, structured through music or an inner rhythm (e.g., breathing) and distinctive instructions or choreography, and that involve social interaction. It has positive effects on motor function, lung function, psychological mood and other aspects, so it can be used as a safe alternative therapy for patients recovering from COVID-19. At present, there are no relevant articles for systematic review.

METHODS

From its inception until March 2021, we will conduct a comprehensive electronic search, including Cochrane Library, MEDLINE, PubMed, Springer, EMBASE, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, Wan-fang database. Two independent researchers will conduct article retrieval, screening, quality assessment, and data analysis through the Review Manager (V. 5.3.5).

RESULTS

The results of this study will evaluate the effectiveness and safety of dance-based mind-motor activities for the improvement of QOL in COVID-19 patients during the recovery period.

CONCLUSION

The conclusion of the study will provide an evidence to judge whether dance-based mind-motor activities is effective and safe for COVID-19 in recovery period.

ETHICS AND DISSEMINATION

This protocol will not evaluate individual patient information or infringe patient rights and therefore does not require ethical approval.

PROSPERO REGISTRATION NUMBER

CRD42021232995.

Clinical application of mindfulness-oriented meditation in children with ADHD: a preliminary study on sleep and behavioral problems

OBJECTIVE

High incidence of sleep problems in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) has been described. Mindfulness meditation has emerged as a novel approach to sleep disturbances and insomnia remediation. This preliminary study tested the efficacy of Mindfulness-Oriented Meditation (MOM) training on sleep quality and behavioral problems in children with ADHD.

DESIGN

Twenty-five children with ADHD aged 7-11 years underwent two programs three times per week for eight-weeks: the MOM training (15 children) and an Active Control Condition (10 children).

MAIN OUTCOME MEASURES

Objective and subjective measures of sleep quality and behavioral measures were collected before and after the programs.

RESULTS

Positive effects on sleep and behavioral measures were found only in the MOM group.

CONCLUSION

Although they are preliminary, our results indicate that MOM training is a promising tool for ameliorating sleep quality and behavioral manifestations in ADHD.

Effects of Baduanjin on patients with chronic nonspecific low back pain: A randomized controlled trial

BACKGROUND

Chronic low back pain (CLBP) is 1 of the common clinical diseases, and many treatment methods can only improve the symptoms of pain in the short term. Traditional Chinese sports - Baduanjin has been proven to have a positive effect on chronic low back pain. However, the quality of the research is low, the sample size is small, and safety observations are lacking. We describe the protocol of a randomized controlled trial to study the efficacy and safety of Baduanjin chronic low back pain.

METHODS

This randomized, controlled, evaluator-blind, two-arm, parallel clinical trial will include 90 outpatients with chronic low back pain recruited from the First Hospital of Nanping City, Fujian Province. The patients were randomly assigned to the intervention group (Baduanjin exercise training) and the control group (not receiving any special exercise training) at a ratio of 1:1. Patients in the intervention group will receive Baduanjin exercise training 3 times a week for 24 weeks. The 2 groups received a 4- week follow-up observation at 24 weeks. The main result from the intervention before intervention to 24 weeks later, and the follow-up of 4 changes the visual analog scale score at weeks, and by independent t are tested groups. It will also review the Pain-related disability index, The Quebec Back Pain Disability Scale, Health-related quality of life, Roland Morris (Roland Morris) Disability Questionnaire, Overall Perceived Effect (OPE) and safety Compare. Cost data for cost-benefit and cost-benefit analysis will be collected.

DISCUSSION

This will be the first study to compare the effectiveness and safety of Baduanjin for patients with chronic low back pain. The results may help healthcare professionals make clinical decisions and may reduce the cost of treatment for this disease.

TRIAL REGISTRATION

ChiCTR2000033908.