WISSENSCHAFTLICHE ARBEITEN UND STUDIEN
Qigong exercise for the symptoms of Parkinson's disease: a randomized, controlled pilot study.
Schmitz-Hubsch T, Pyfer D, Kielwein K, Fimmers R, Klockgether T, Wullner U.
Department of Neurology, University of Bonn, Germany.
Irrespective of limited evidence, not only traditional physiotherapy, but also a wide array of complementary methods are applied by patients with Parkinson's disease (PD). We evaluated the immediate and sustained effects of Qigong on motor and nonmotor symptoms of PD, using an add-on design. Fifty-six patients with different levels of disease severity (mean age/standard deviation [SD], 63.8/7.5 years; disease duration 5.8/4.2 years; 43 men [76%]) were recruited from the outpatient movement disorder clinic of the Department of Neurology, University of Bonn. We compared the progression of motor symptoms assessed by Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) in the Qigong treatment group (n = 32) and a control group receiving no additional intervention (n = 24). Qigong exercises were applied as 90-minute weekly group instructions for 2 months, followed by a 2 months pause and a second 2-month treatment period. Assessments were carried out at baseline, 3, 6, and 12 months. More patients improved in the Qigong group than in the control group at 3 and 6 months (P = 0.0080 at 3 months and P = 0.0503 at 6 months; Fisher's exact test). At 12 months, there was a sustained difference between groups only when changes in UPDRS-III were related to baseline. Depression scores decreased in both groups, whereas the incidence of several nonmotor symptoms decreased in the treatment group only. Copyright 2005 Movement Disorder Society.
Yang KH, Kim YH, Lee MS.
Department of Nursing, Wonkwang Health Science College, Iksan, Republic of Korea.
To test the efficacy of Qi-therapy (external Qigong) in improving symptoms of pain and mood states in elderly peoples with chronic pain. Forty-three elderly people with chronic pain were randomly assigned either to an intervention or a general care group. The intervention group was given four weeks of Qi-therapy whereas the control group was given standard care. Compared with the control group, Qi-therapy participants experienced improvements in positive mood and psychological variables over the four-week program. Compared with baseline values, pain and psychological benefits remained significantly improved after two weeks of follow-up. These findings suggest that Qi-therapy may help the elderly cope with pain and associated mood disturbances.
Qi-training (qigong) enhanced immune functions: what is the underlying mechanism?
Lee MS, Kim MK, Ryu H.
Center for Integrative Medicine, Institute of Medical Science, Wonkwang University, Iksan, Republic of Korea. [email protected]
The authors observed that Qi-training enhances immune function and modulates neurohormone concentrations. The exact signal and priming mechanism for enhanced neutrophil function by Qi-training has not yet been demonstrated. This study investigated the effect of Qi-training on intracellular signaling leading to the enhancement of immune function. The growth hormone (GH) concentrations and O2- production by neutrophils (PMNs) was significantly increased after 1 h of Qi-training compared with the basal state. To verify that endogenous GH mediates the priming of PMNs, serum obtained from elderly subjects in the basal state and after Qi-training was incubated with neutrophils isolated from young subjects for 60 min and triggered with N-formyl-1-methionyl-1-leucyl-1-phenylalanine (fMLP). Significant O2- production was observed in the PMNs incubated with serum collected after a Qi-training (p < .05). On the other hand, the priming effect on the PMNs was abolished in Qi-training sera depleted of endogenous GH with anti-human GH polyclonal antibody (p < .01) and the tyrosine kinase inhibitor, genistein (p < .01). The authors suggest that the endogenous GH released during and immediately after Qi-training mediates the priming events through tyrosine kinase activation in PMNs.
Qigong for schoolchildren: a pilot study.
Witt C, Becker M, Bandelin K, Soellner R, Willich SN.
Institute of Social Medicine, Epidemiology, and Health Economics, Charite University Medical Center, Berlin, Germany. [email protected]
OBJECTIVE: To evaluate the effects of qigong lessons on schoolchildren in terms of their achievements at school, social behavior, and general health. DESIGN: A controlled intervention pilot study was conducted with children in two second-grade classes at an elementary school and in two eighth-grade classes at a high school. SETTING/LOCATION AND INTERVENTION: One class from each school received qigong lessons for 20 minutes at least twice weekly over a period of 6 months, while the control class from the same school received no intervention. Two additional classes at two elementary schools participated in the qualitative analysis only. MEASURES: Teachers, parents, and students answered standardized questionnaires at the beginning of the study and after 6 months, covering complaints, concentration, creativity, grades, quality of life (QOL) (assessed by the KINDL questionnaire), and social behavior. In addition to this quantitative study, we conducted in-depth, semi-structured interviews with all participating teachers at the end of the project to evaluate individual effects. RESULTS: Of a total of 90 participants in the study (52% boys and 48% girls), 40 students attended elementary school (20 per class, mean age 7.4 +/- 0.5 years) and 50 high school (25 per class, mean age 13 +/- 0.8 years). Factor analysis yielded three scales for the teacher questionnaire (learning process, social behavior, appropriate behavior) and four scales for the parent questionnaire (creativity, concentration, well-being, restlessness). The qigong group showed significantly better results in the teacher questionnaire (especially for appropriate behavior) and in grades in comparison to the control group, but no effect was found in the parent questionnaire, medical complaints, sick days, or in the children's assessment of QOL. Qualitative analyses indicated a relevant decrease of individual complaints for some children in the qigong group. CONCLUSIONS: The feasibility of integrating qigong in school lessons was shown. Six months after starting qigong lessons, schoolchildren improved in social behavior and showed stable grades, while inappropriate behavior decreased, compared to the control. Combining quantitative and qualitative research methods appeared to be useful to detect the effects of qigong in individuals. Due to the limitations of our pilot study, further studies with larger sample sizes and long-term follow-up are needed.
· Clinical Trial
Cardiac rehabilitation for the elderly: Qi Gong and group discussions.
Stenlund T, Lindstrom B, Granlund M, Burell G.
Heart Centre, University Hospital, SE-901 85 Umea, Sweden. [email protected]
BACKGROUND: Over the last decade several studies have shown that patients with coronary artery disease even above the age of 70 can be successfully treated with advanced medical and surgical methods. Unfortunately, rehabilitation programmes for this group are rarely offered. It is important to develop forms of rehabilitation that are adapted to the specific needs of this increasing group of elderly patients. The aim of this randomized study was to investigate whether the combination of Qi Gong and group discussions would increase physical ability for elderly patients > or =73 years with coronary artery disease. METHODS: A total of 95 patients (66 men and 29 women), with documented coronary artery disease, were randomized to an intervention group (n=48) mean age 77+/-3 (73-82) or to a control group (n=47) mean age 78+/-3 (73-84). The intervention groups met weekly over 3 months. The control group got usual care. Physical ability was assessed at baseline and after the intervention. RESULTS: Patients in the intervention group increased their self-estimated level of physical activity (P=0.011), and their performance in the one-leg stance test for the right leg (P=0.029), co-ordination (P=0.021) and the box-climbing test for right leg (P=0.035). CONCLUSION: A combination of Qi Gong and group discussions appear to be a promising rehabilitation for elderly cardiac patients in terms of improving self-reported physical activity, balance and co-ordination. This could be an option for elderly patients who do not participate in the ordinary cardiac rehabilitation.
Effects of Qi-training (Qigong) on forearm blood gas concentrations.
Lee MS, Ryu H, Song J, Moon SR.
Center for Integrative Medicine, Institute of Medical Science, Wonkwang University, Iksan, Korea.
Using an ABA' design, the authors investigated the effects of Qi-training on blood gas concentrations with a 20 min control rest period (A), 1 h of Qi-training (B), and a 20-min rest period (A'). The blood partial pressures of oxygen (PO2) and carbon dioxide (PCO2), and oxygen content, oxygen saturation, and pH were significantly altered. The mean PO2 value increased significantly during Qi-training by 14 mmHg (about 24%, p < .01) compared with control A. During Qi-training, the mean decrease in PCO2 was 3 mmHg (about 10%). These results suggest that the practical application of Qi-training may exert a positive regulatory function on physiological status.
Effect of qi training on neutrophil function in young and elderly males.
Lee MS, Kang CW, Ryu H.
Center for Integrative Medicine, Institute of Medical Science, Wonkwang University, Iksan, Republic of Korea. [email protected]
OBJECTIVES: To examine the effect of qi training on neutrophil bactericidal function (superoxide generation and adhesion). METHODS: We studied the effects of one session of qi training on superoxide generation and adhesion of neutrophils immediately after (Post I), and 2 hours after qi training (Post II), in nine young and nine elderly male subjects. RESULTS: The qi training significantly enhanced the superoxide generation and adhesion of neutrophils, and there were significant differences at Post I compared to before qi training (Pre) in both groups. CONCLUSION: Our current observations show that qi training enhances superoxide generation and adhesion of neutrophils. It is supposed that qi training may increase the resistance of trained individuals against common infection and inflammation.
Effects of qigong on blood pressure, high-density lipoprotein cholesterol and other lipid levels in essential hypertension patients.
Lee MS, Lee MS, Kim HJ, Choi ES.
Department of Nursing, Mokpo Catholic University, Mokpo, Korea.
This study investigated the effectiveness of Qigong on blood pressure and several blood lipids, such as high-density lipoprotein (HDL) cholesterol, Apolipoprotein A1 (APO-A1), total cholesterol (TC), and triglycerides (TG) in hypertensive patients. Thirty-six patients were randomly divided into either the Qigong group, or a wait-listed control group. Blood pressures decreased significantly after eight weeks of Qigong. The levels of TC, HDL, and APO-A1 were changed significantly in the Qigong group post-treatment compared with before treatment. In summary. Qigong acts as an antihypertensive and may reduce blood pressure by the modulation of lipid metabolism. Copyright Taylor and Francis Inc.
Randomized Controlled Trial
Standing balance after vestibular stimulation in Tai Chi-practicing and nonpracticing healthy older adults.
Tsang WW, Hui-Chan CW.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China.
OBJECTIVE: To compare the effects of vestibular stimulation on standing balance control between Tai Chi practitioners and older subjects. DESIGN: Cross-sectional study. SETTING: University-based rehabilitation center. PARTICIPANTS: Tai Chi practitioners (n=24; age +/- standard deviation, 69.3+/-5.0y) and control subjects (n=24; age, 71.6+/-6.1y) were recruited. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjects stood on a force platform with eyes closed before and after stimulation of their horizontal semicircular canals, applied by means of whole head-and-body rotation at 80 degrees /s for 60 seconds, with subjects seated in a rotational chair. Body sway during stance was measured as total sway path, peak amplitudes, and mean velocities of sway in both anteroposterior (AP) and mediolateral (ML) directions. RESULTS: After head-and-body rotation, significant within-group increases were found in all measures in both AP and ML directions during stance with eyes closed in older control subjects but not in Tai Chi practitioners along the AP direction. In fact, significantly smaller increases in total sway path, peak amplitude, and mean velocity of body sway in the AP direction were found in the Tai Chi practitioners when compared with those of control subjects. CONCLUSIONS: Our results show that long-term Tai Chi practitioners had better AP standing balance control after vestibular stimulation than older control subjects.
The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults.
Wolf SL, O'Grady M, Easley KA, Guo Y, Kressig RW, Kutner M.
Department of Rehabilitation Medicine, Emory University School of Medicine, 212 C Rehabilitation Center, 1441 Clifton Rd. NE, Atlanta, GA 30322, USA. [email protected]
BACKGROUND: Few data exist to evaluate whether Tai Chi (TC) training improves physical performance and hemodynamic outcomes more than a wellness education (WE) program does among older fallers transitioning to frailty. METHODS: This 48-week randomized clinical trial was provided at 10 matched pairs of congregate living facilities in the Atlanta metropolitan area to 291 women and 20 men, who were transitionally frail, >or=70 years old, and had fallen at least once within the past year. Pairs of facilities were randomized to either TC exercise (n = 158) or WE (control) interventions (n = 153) over 48 weeks. Physical performance (freely chosen gait speed, reach, chair-rises, 360 degrees turn, picking up an object from the floor, and single limb support) and hemodynamic outcomes (heart rate and blood pressure) were obtained at baseline and after 4, 8, and 12 months. RESULTS: Mean percent change (baseline to 1 year) for gait speed increased similarly in both cohorts (TC: 9.1% and WE: 8.2%; p =.78). However, time to complete three chair-rises decreased 12.3% for TC and increased 13.7% for WE (p =.006). Baseline to 1 year mean percent change decreased among TC and increased within WE cohorts for: body mass index (-2.3% vs 1.8%; p <.0001), systolic blood pressure (-3.4% vs 1.7%; p =.02), and resting heart rate (-5.9% vs 4.6%; p <.0001). CONCLUSIONS: TC significantly improved chair-rise and cardiovascular performance. Because TC training reduced fall occurrences in this cohort, factors influencing functional and cardiovascular improvements may also favorably impact fall events
Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults.
Sattin RW, Easley KA, Wolf SL, Chen Y, Kutner MH.
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. [email protected]
OBJECTIVES: To determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education (WE) program in older adults who had fallen previously and meet criteria for transitioning to frailty. DESIGN: Cluster-randomized, controlled trial of 48 weeks' duration. SETTING: Ten matched pairs of congregate living facilities in the greater Atlanta area. PARTICIPANTS: Sample of 291 women and 20 men, aged 70 to 97. MEASUREMENTS: Activity-related fear of falling using the Activities-Specific Balance Confidence Scale (ABC) and the Fall Efficacy Scale at baseline and every 4 months for 1 year. Demographics, time to first fall and all subsequent falls, functional measures, Centers for Epidemiologic Studies Depression Scale, medication use, level of physical activity, comorbidities, and adherence to interventions. RESULTS: Mean ABC was similar in both cohort groups at the time of randomization but became significantly higher (decreased fear) in the tai chi cohort at 8 months (57.9 vs 49.0, P<.001) and at study end (59.2 vs 47.9, P<.001). After adjusting for covariates, the mean ABC after 12 months of intervention was significantly greater in the tai chi group than in the WE group, with the differences increasing with time (mean difference at 12 months=9.5 points, 95% confidence interval=4.8-14.2, P<.001). CONCLUSION: Tai chi led to a significantly greater reduction in fear of falling than a WE program in transitionally frail older adults. The mean percentage change in ABC scores widened between tai chi and WE participants over the trial period. Tai chi should be considered in any program designed to reduce falling and fear of falling in transitionally frail older adults.
Tai Chi and fall reductions in older adults: a randomized controlled trial.
Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, Wilson NL.
Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, USA. [email protected]
BACKGROUND: The authors' objective was to evaluate the efficacy of a 6-month Tai Chi intervention for decreasing the number of falls and the risk for falling in older persons. METHODS: This randomized controlled trial involved a sample of 256 physically inactive, community-dwelling adults aged 70 to 92 (mean age, 77.48 years; standard deviation, 4.95 years) who were recruited through a patient database in Portland, Oregon. Participants were randomized to participate in a three-times-per-week Tai Chi group or to a stretching control group for 6 months. The primary outcome measure was the number of falls; the secondary outcome measures included functional balance (Berg Balance Scale, Dynamic Gait Index, Functional Reach, and single-leg standing), physical performance (50-foot speed walk, Up&Go), and fear of falling, assessed at baseline, 3 months, 6 months (intervention termination), and at a 6-month postintervention follow-up. RESULTS: At the end of the 6-month intervention, significantly fewer falls (n=38 vs 73; p=.007), lower proportions of fallers (28% vs 46%; p=.01), and fewer injurious falls (7% vs 18%; p=.03) were observed in the Tai Chi group compared with the stretching control group. After adjusting for baseline covariates, the risk for multiple falls in the Tai Chi group was 55% lower than that of the stretching control group (risk ratio,.45; 95% confidence interval, 0.30 to 0.70). Compared with the stretching control participants, the Tai Chi participants showed significant improvements (p<.001) in all measures of functional balance, physical performance, and reduced fear of falling. Intervention gains in these measures were maintained at a 6-month postintervention follow-up in the Tai Chi group. CONCLUSIONS: A three-times-per-week, 6-month Tai Chi program is effective in decreasing the number of falls, the risk for falling, and the fear of falling, and it improves functional balance and physical performance in physically inactive persons aged 70 years or older.
· Clinical Trial
A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women.
Chan K, Qin L, Lau M, Woo J, Au S, Choy W, Lee K, Lee S.
Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong.
OBJECTIVE: To evaluate the potential benefits of programmed Tai Chi Chun (TCC) exercise on the weight-bearing bones of early postmenopausal women. DESIGN: Age-matched and randomized prospective intervention. SETTING: University medical school. PARTICIPANTS: One hundred thirty-two healthy postmenopausal women (mean age, 54.0+/-3.5y) within 10 years of menopause onset were recruited and randomized into the TCC exercise group (n=67) or the sedentary control group (n=65). INTERVENTION: Supervised TCC exercise was performed by the TCC group for 45 minutes a day, 5 days a week, for 12 months; control subjects retained a sedentary life style.Main outcome measures Bone mineral density (BMD) was measured in the lumbar spine and proximal femur by using dual-energy x-ray absorptiometry and in the distal tibia by using multislice peripheral quantitative computed tomography (pQCT). All BMD measurements were repeated after 12 months in both groups. Fracture rate was also documented. RESULTS: Baseline measurements showed homogeneity in age, anthropometric variables, and menstruation status between the TCC and control groups. Exactly 81.6% of the subjects in the TCC group and 83.1% of subjects in the control group completed the 12-month follow-up study. BMD measurements revealed a general bone loss in both TCC and sedentary control subjects at all measured skeletal sites, but with a reportedly slower rate in the TCC group. A significant 2.6- to 3.6-fold retardation of bone loss (P<.01) was found in both trabecular and cortical compartments of the distal tibia in the TCC group as compared with the controls, as measured by pQCT. A total of 4 fracture cases were documented during follow-up, including 3 subjects in the control group and 1 in the TCC group. CONCLUSIONS: This is the first prospective and randomized study to show that a programmed TCC exercise intervention is beneficial for retarding bone loss in weight-bearing bones in early postmenopausal women. Long-term follow-up is needed to substantiate the role of TCC exercise in the prevention of osteoporosis and its related fracture.
· Clinical Trial
Health benefits of Tai Chi exercise: improved balance and blood pressure in middle-aged women.
Thornton EW, Sykes KS, Tang WK.
Department of Psychology, University of Liverpool, UK. [email protected]
Tai Chi has been widely practiced as a Chinese martial art that focuses on slow sequential movements, providing a smooth, continuous and low intensity activity. It has been promoted to improve balance and strength and to reduce falls in the elderly, especially those 'at risk'. The potential benefits in healthy younger age cohorts and for wider aspects of health have received less attention. The present study documented prospective changes in balance and vascular responses for a community sample of middle-aged women. Seventeen relatively sedentary but healthy normotensive women aged 33-55 years were recruited into a three times per week, 12-week Tai Chi exercise programme. A further 17 sedentary subjects matched for age and body size were recruited as a control group. Dynamic balance measured by the Functional Reach Test was significantly improved following Tai Chi, with significant decreases in both mean systolic (9.71 mmHg) and diastolic (7.53 mmHg) blood pressure. The data confirm that Tai Chi exercise can be a good choice of exercise for middle-aged adults, with potential benefits for ageing as well as the aged.
Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial.
Song R, Lee EO, Lam P, Bae SC.
Department of Nursing, Soonchunhyang University, Chon An, South Korea.
OBJECTIVE: Twelve forms of Sun-style tai chi exercise have been developed specifically to reduce the symptoms and improve the physical functioning of arthritic patients, and this randomized study examined the changes in symptoms and physical characteristics in older women with osteoarthritis (OA) at the completion of a 12-week tai chi exercise program. METHODS: Seventy-two patients with OA were randomly assigned into 2 groups. Due to a 41% overall dropout rate, 22 experimental subjects and 21 controls completed pre- and post-test measures over a 12 week interval. Outcome variables were physical symptoms and fitness, body mass index, cardiovascular functioning, and perceived difficulties in physical functioning. The independent t test was used to examine group differences. RESULTS: The homogeneity test confirmed that there were no significant group differences in demographic data and pretest measures. Mean comparisons of the change scores revealed that the experimental group perceived significantly less pain (t = -2.19, p = 0.034) and stiffness (t = -2.13, p = 0.039) in their joints, and reported fewer perceived difficulties in physical functioning (t = -2.81, p = 0.008), while the control group showed no change or even deterioration in physical functioning after 12 weeks. In the physical fitness test, there were significant improvements in balance (t = 3.34, p = 0.002) and abdominal muscle strength (t = 2.74, p = 0.009) for the tai chi exercise group. No significant group differences were found in flexibility and upper-body or knee muscle strength in the post-test scores. CONCLUSION: Older women with OA were able to safely perform the 12 forms of Sun-style tai chi exercise for 12 weeks, and this was effective in improving their arthritic symptoms, balance, and physical functioning. A longitudinal study with a larger sample size is now needed to confirm the potential use of tai chi exercise in arthritis management.