Qigong for hypertension: a systematic review of randomized clinical trials.

Lee MS, Pittler MH, Guo R, Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK. drmslee@gmail.com

Abstract

OBJECTIVES: To assess systematically the clinical evidence of qigong for hypertension.

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

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

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

PMID: 17620944 [PubMed - indexed for MEDLINE]

Spontaneous respiratory modulation improves cardiovascular control in essential hypertension.

[Article in English, Portuguese]

Pinheiro CH, Medeiros RA, Pinheiro DG, Marinho Mde J.

Laboratório de Cardiopneumologia e Fisiologia do Exercício, Escola de Saúde Pública do Estado do Ceará, Universidade de Fortaleza, Fortaleza, CE, Brasil. fisiologia_carlos@yahoo.com.br

Erratum in:

• Arq Bras Cardiol. 2007 Aug;89(2):138.

Abstract

BACKGROUND: Recent studies show that controlled breathing improves baroreflex and heart rate variability and lowers blood pressure in hypertensive patients.

OBJECTIVE: To evaluate the effects of slow breathing training on cardiorespiratory system modulation of patients (n=10, men and women, ages ranging from 45 to 60) with essential hypertension seen in an outpatient setting.

METHODS: According to the study design, each patient was used as his/her own control, and data were collected before and after the intervention. The following parameters were assessed: heart rate variability (HRV), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), respirometry, chest expansion measurement, and statistical data analysis. Respiratory training was performed in 30-minute sessions held twice a week over one month using slow breathing exercises.

RESULTS: Our results were as follows: a reduction in SBP, DPB, and MAP (p <>

CONCLUSION: Respiratory retraining using the slow breathing technique appears to be a useful adjunctive for cardiorespiratory control in hypertensive patients.

PMID: 17664992 [PubMed - indexed for MEDLINE]Free Article

External qigong for pain conditions: a systematic review of randomized clinical trials.

Lee MS, Pittler MH, Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, United Kingdom. myeong.lee@pms.ac.uk

Abstract

The aim of this systematic review was to assess the clinical evidence of external qigong as a treatment option for pain conditions. Databases were searched up to January 2007. Randomized, clinical trials (RCTs) testing external qigong in patients with pain of any origin assessing clinical outcomes were considered. Trials using any type of control group were included. The selection of studies, data extraction, and validation were performed independently by at least 2 reviewers. One hundred forty-one potentially relevant studies were identified and 5 RCTs could be included. All RCTs of external qigong demonstrated greater pain reductions in the qigong groups compared with control groups. Meta-analysis of 2 RCTs showed a significant effect of external qigong compared with general care for treating chronic pain (Pain 100 mm VAS; weighted main differences, 36.3 mm; 95% CI, 22.8 to 49.8; P < .001; heterogeneity: chi(2) = 1.79, P = .18, I(2) = 44.0%, n = 80). The evidence from RCTs testing the effectiveness of external qigong for treating pain is encouraging. Further studies are warranted. PERSPECTIVE: This review of clinical studies focused on the efficacy of qigong, an energy-healing intervention used to prevent and cure ailments. A meta-analysis shows that evidence for the effectiveness of external qigong is encouraging, though further studies are warranted.

PMID: 17690012 [PubMed - indexed for MEDLINE]

Effects of a Taiji and Qigong intervention on the antibody response to influenza vaccine in older adults.

Yang Y, Verkuilen J, Rosengren KS, Mariani RA, Reed M, Grubisich SA, Woods JA.

Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA. yyang5@uiuc.edu

Abstract

Previous studies have suggested that Taiji practice may improve immune function. This study was intended to examine whether 5 months of moderate Taiji and Qigong (TQ) practice could improve the immune response to influenza vaccine in older adults. Fifty older adults (mean age 77.2 +/- 1.3 years) participated in this study (TQ N = 27; wait-list control [CON] N = 23). Baseline pre-vaccine blood samples were collected. All subjects then received the 2003-2004 influenza vaccine during the first week of the intervention. Post-vaccine blood samples were collected 3, 6 and 20 weeks post-intervention for analysis of anti-influenza hemagglutination inhibition (HI) titers. We found a significant (p <> 40HI) antibody response (37% TQ vs. 20% CON for the H1N1 strain and 56% TQ vs. 45% CON for the H3N2 strain), but the differences between groups were not statistically significant. Traditional TQ practice improves the antibody response to influenza vaccine in older adults, but further study is needed to determine whether the enhanced response is sufficient to provide definitive protection from influenza infection.

PMID: 17708626 [PubMed - indexed for MEDLINE]

The effect of Qigong on fibromyalgia (FMS): a controlled randomized study.

Haak T, Scott B.

Department of Clinical Psychology, University of Uppsala, Sweden.

Abstract

PURPOSE: To evaluate the effect of a 7-week Qigong intervention on subjects with Fibromyalgia Syndrome (FMS).

METHODS: The study was a controlled randomized study with repeated measures. Fifty-seven FMS female subjects were randomly assigned to an intervention group (n = 29) or a waiting-list control group (n = 28). After completion of the experimental part, the control group received the same intervention. Collection of data was made at pre- and post-treatment and at 4-month follow-up for both groups.

RESULTS: During the experimental part of the study, significant improvements were found for the intervention group, at posttreatment, regarding different aspects of pain and psychological health and distress. Almost identical results were found for the combined group. At 4-month follow-up, the majority of these results were either maintained or improved.

CONCLUSION: The overall results show that Qigong has positive and reliable effects regarding FMS. A high degree of completion, 93%, and contentment with the intervention further support the potential of the treatment. The results of the study are encouraging and suggest that Qigong intervention could be a useful complement to medical treatment for subjects with FMS.

PMID: 17852292 [PubMed - indexed for MEDLINE]

Concentrative meditation enhances preattentive processing: a mismatch negativity study.

Srinivasan N, Baijal S.

Centre for Behavioural and Cognitive Sciences, University of Allahabad, Allahabad, India. ammuns@yahoo.com

Abstract

The mismatch negativity (MMN) paradigm that is an indicator of preattentive processing was used to study the effects of concentrative meditation. Sudarshan Kriya Yoga meditation is a yogic exercise practiced in an ordered sequence beginning with breathing exercises, and ending with concentrative (Sahaj Samadhi) meditation. Auditory MMN waveforms were recorded at the beginning and after each of these practices for meditators, and equivalently after relaxation sessions for the nonmeditators. Overall meditators were found to have larger MMN amplitudes than nonmeditators. The meditators also exhibited significantly increased MMN amplitudes immediately after meditation suggesting transient state changes owing to meditation. The results indicate that concentrative meditation practice enhances preattentive perceptual processes, enabling better change detection in auditory sensory memory.

PMID: 17921873 [PubMed - indexed for MEDLINE]

Related citations

Biopsychosocial effects of qigong as a mindful exercise for people with anxiety disorders: a speculative review.

Chow YW, Tsang HW.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.

Abstract

In view of the inadequacies of mainstream treatments for anxiety disorders, we suggest that qigong, an ancient oriental mindful exercise, may be a useful adjunctive treatment. We base this on a biopsychosocial model for health. Evidence suggests that the benefits of exercise on personal well-being can be explained using six theories: cognitive behaviour; distraction; social interaction; cardiovascular fitness; amine; and endorphin theories. To date, not much has been done to employ these theories to analyze the benefits of mindful exercises. We try here to reorganize these theories into psychosocial and physiologic perspectives and integrate them with the "mind regulation," "body regulation," and "breath regulation" components of qigong. We propose, because of its potential therapeutic effects, that qigong can be considered as an alternative therapy to help meet the increasing demand of nonpharmacologic modalities in achieving biopsychosocial health for those suffering from anxiety in the general population.

PMID: 17983339 [PubMed - indexed for MEDLINE]

Biochemical changes after a qigong program: lipids, serum enzymes, urea, and creatinine in healthy subjects.

Vera FM, Manzaneque JM, Maldonado EF, Carranque GA, Cubero VM, Blanca MJ, Morell M.

Department of Psychobiology and Methodology, Faculty of Psychology, University of Malaga, Campus de Teatinos, Malaga, Spain. pvera@uma.es

Abstract

BACKGROUND: The aim of the present study was to analyze the effects of a qigong training program on blood biochemical parameters.

MATERIAL/METHODS: Twenty-nine healthy subjects participated in the study of whom 16 were randomly assigned to the experimental group and 13 to the control. The experimental subjects underwent daily qigong training for one month. Blood samples for the quantification of biochemical parameters (total cholesterol, HDL, LDL, triglycerides, phospholipids, GOT, GPT, GGT, urea, creatinine) were taken before and after the training program. As statistical analysis, ANCOVA was performed.

RESULTS: Statistically significant differences were found showing that the experimental group had lower serum levels of GOT (glutamic-oxaloacetic transaminase), GPT (glutamic-pyruvic transaminase), and urea and that there was a trend towards significance in GGT (gamma-glutamyltransferase).

CONCLUSIONS: This study demonstrates that after practicing qigong for the short period of one month, noteworthy changes in several blood biochemical parameters were induced. While it is tempting to speculate on the relevance and implications of these biochemical variations, further investigation is needed to elucidate the scope of these findings.

PMID: 18049436 [PubMed - indexed for MEDLINE]

External Qi of Yan Xin Qigong induces G2/M arrest and apoptosis of androgen-independent prostate cancer cells by inhibiting Akt and NF-kappa B pathways.

Yan X, Shen H, Jiang H, Zhang C, Hu D, Wang J, Wu X.

Institute of Chongqing Traditional Chinese Medicine, Chongqing, China.

Abstract

Long-term clinical observations and ongoing studies have shown antitumor effects of external Qi of Yan Xin Qigong (YXQG-EQ) that originated from traditional Chinese medicine (TCM). In order to understand the molecular mechanisms underlying the antitumor effects of YXQG-EQ, we investigate the effects of YXQG-EQ on growth and apoptosis in androgen-independent prostate cancer PC3 cells. We found that exposure to YXQG-EQ led to G2/M arrest associated with reduced cyclin B1 expression and apoptosis in PC3 cells. YXQG-EQ treatment inhibited constitutive and epidermal growth factor-induced Akt phosphorylation, basal and TNF-alpha-induced NF-kappaB activation, and downregulated anti-apoptotic Bcl-2 and Bcl-xL expression. In contrast, exposure to YXQG-EQ increased phosphorylation of Akt and Erk1/2 in human umbilical vein endothelial cells (HUVEC), and had no cytotoxic effect on either HUVEC or peripheral blood mononuclear cells (PBMC). These results indicate that YXQG-EQ has profound effects on growth and apoptosis of prostate cancer cells by targeting survival pathways including the Akt and NF-kappa B pathways.

PMID: 18080802 [PubMed - indexed for MEDLINE]

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Qigong and exercise therapy in patients with long-term neck pain: a prospective randomized trial.

Lansinger B, Larsson E, Persson LC, Carlsson JY.

Göteborg University, Institute of Neuroscience and Physiology/Physiotherapy, Göteborg, Sweden. birgitta.lansinger@neurophys.gu.se

Abstract

STUDY DESIGN: A randomized, controlled, multicenter trial: 1-year follow-up.

OBJECTIVE: To compare the effectiveness of qigong and exercise therapy in subjects with long-term nonspecific neck pain.

SUMMARY OF BACKGROUND DATA: The evidence for the benefit of treatment programs focusing on persons with long-term, nonspecific neck pain is conflicting. Several studies have shown support for exercise therapy, but the efficacy of qigong has not been scientifically evaluated.

METHODS: A total of 122 patients were randomly assigned to receive either qigong (n = 60) or exercise therapy (n = 62). Most of them were women (70%), and the mean age was 44 years. A maximum of 12 treatments were given over a period of 3 months. Neck pain frequency and intensity, neck disability (NDI), grip strength, and cervical range of motion were recorded before and immediately after, at 6 months, and at 12 months after the treatment period. Changes in outcome variables were analyzed and dichotomized as improved or unchanged/deteriorated.

RESULTS: Clinical and demographic characteristics were similar among groups at baseline. No differences were found between the 2 interventions: qigong and exercise therapy. Both groups significantly improved immediately after treatment and this was maintained at the 6- and 12-month follow-ups in 5 of 8 outcome variables: average neck pain in the most recent week, current neck pain (with exception for immediately after treatment period), neck pain diary, NDI, and cervical range of motion in rotation.

CONCLUSION: These results indicate that treatments including supervised qigong or exercise therapy resulting in reduced pain and disability can be recommended for persons with long-term nonspecific neck pain.

PMID: 18090079 [PubMed - indexed for MEDLINE]

Effects of yoga and the addition of Tui Na in patients with fibromyalgia.

da Silva GD, Lorenzi-Filho G, Lage LV.

Rheumatology Division and Pulmonary Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. ge.daddio@ig.com.br

Abstract

OBJECTIVES: This study aimed to verify whether techniques of yoga with and without the addition of Tui Na might improve pain and the negative impact of fibromyalgia (FMS) on patients' daily life.

DESIGN: Forty (40) FMS women were randomized into two groups, Relaxing Yoga (RY) and Relaxing Yoga plus Touch (RYT), for eight weekly sessions of stretching, breathing, and relaxing yogic techniques. RYT patients were further submitted to manipulative techniques of Tui Na.

OUTCOME MEASURE: Outcome measures comprised the Fibromyalgia Impact Questionnaire (FIQ), pain threshold at the 18 FMS tender points, and a verbal graduation of pain assessed before treatment and on the followup. The visual analog scale (VAS) for pain was assessed before and after each session and on the follow-up.

RESULTS: Seventeen (17) RYT and 16 RY patients completed the study. Both RY and RYT groups showed improvement in the FIQ and VAS scores, which decreased on all sessions. The RYT group showed lower VAS and verbal scores for pain on the eighth session, but this difference was not maintained on the follow-up. Conversely, RY VAS and verbal scores were significantly lower just on the follow-up.

CONCLUSIONS: These study results showed that yogic techniques are valid therapeutic methods for FMS. Touch addition yielded greater improvement during the treatment. Over time, however, RY patients reported less pain than RYT. These results suggest that a passive therapy may possibly decrease control over FMS symptoms.

PMID: 18166122 [PubMed - indexed for MEDLINE]

fMRI study of pain reaction in the brain under state of "Qigong".

Yu WL, Li XQ, Tang WJ, Li Y, Weng XC, Chen YZ.

Shanghai Qigong Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Abstract

In this study, 4 male Qigong masters (aged 60 +/- 12) who had Qigong practicing experience for more than 30 years were tested. By using the technique of fMRI, the change of brain function under the state of Qigong was observed through the peripheral pain stimulation generated by potassium penetrating method. The fMRI examination was running on a GE signa VH/3.0 T MRI machine and block design was used. The test was repeated several times, which was carried out before and 15 min after Qigong practicing. The heart and respiration rate of these 4 Qigong masters were monitored during the whole test. SPM2 was used for the data analysis, and the result showed that before Qigong practicing, besides SI and SII-insula regions, many other Brodmann areas, the cigulate cortex, the thalamus, and the cerebellum were all activated, while 15 min after that, the activated areas were decreased obviously, which were mainly at the SII-insula region and some other Brodmann areas. Since the SII-insula region was activated in both of these two states, further analysis of the response curve was focused on it. Its response amplitude under the state of Qigong (3.5%) was greater than that before Qigong (1.2%). Our result indicated that the main manifestation of brain functional change under Qigong was functional suppressing, but in some particular regions such as SII-insula region in our study, the response amplitude was increased. Further study of the exact physiological mechanism of Qigong is needed.

PMID: 18186580 [PubMed - indexed for MEDLINE]

Clinical effect of qigong practice on essential hypertension: a meta-analysis of randomized controlled trials.

Guo X, Zhou B, Nishimura T, Teramukai S, Fukushima M.

National DME Training Center, Guangzhou University of Traditional Chinese Medicine, Guangzhou, People's Republic of China. drguoguo@gmail.com

Abstract

OBJECTIVES: This study was designed to quantitatively assess the effectiveness of self-practiced qigong for treatment of essential hypertension.

METHODS: Six major electronic databases were searched up to July 2006 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of self-practiced qigong for essential hypertension reported in any language, with main outcome measures as systolic blood pressure (SBP) and diastolic blood pressure (DBP). The quality of included studies were assessed with the Jadad Scale and a customized standard quality assessment scale.

RESULTS: Ninety-two (92) studies were identified. Nine (9) of these studies qualified for meta-analysis, comprising a total of 908 cases. Results were as follows: (1) The mean decrease of SBP in those practicing qigong was a 17.03 mm Hg reduction (95% confidence interval (CI) 11.53-22.52) compared with nonspecific intervention controls, but not superior to that in drug controls (1.19 mm Hg, 95% CI -5.40-7.79) and conventional exercise controls (-1.51 mm Hg, 95% CI -6.98-3.95). (2) Mean decrease of DBP in those practicing qigong was 9.98 mm Hg (95% CI 2.55-17.41) compared with nonspecific intervention controls, but not superior to that in drug controls (2.49 mm Hg, 95% CI -0.16-5.13) and conventional exercise controls (-1.59 mm Hg, 95% CI -4.91-1.74). (3) No obvious side effects were identified.

CONCLUSIONS: Self-practiced qigong for less than 1 year is better in decreasing BP in patients with essential hypertension than in no-treatment controls, but is not superior to that in active controls. More methodologically strict studies are needed to prove real clinical benefits of qigong, and to explore its potential mechanism.

PMID: 18199012 [PubMed - indexed for MEDLINE]

Cardiorespiratory and metabolic changes during yoga sessions: the effects of respiratory exercises and meditation practices.

Danucalov MA, Simões RS, Kozasa EH, Leite JR.

Unidade de Medicina Comportamental, Depto. de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, CEP 04024-002 Sao Paulo, Brazil.

Abstract

The novelty of this study was to investigate the changes in cardiorespiratory and metabolic intensity brought about by the practice of pranayamas (breathing exercises of yoga) and meditation during the same hatha-yoga session. The technique applied was the one advocated by the hatha-yoga system. Nine yoga instructors-five females and four males, mean age of 44+/-11, 6, were subjected to analysis of the gases expired during three distinct periods of 30 min: rest, respiratory exercises and meditative practice. A metabolic open circuit computerized system was applied (VO2000, MedGraphics-USA). The oxygen uptake (VO(2)) and the carbon dioxide output (VCO(2)) were statistically different (P

PMID: 18317923 [PubMed - indexed for MEDLINE]

Improving quality of life using compound mind-body therapies: evaluation of a course intervention with body movement and breath therapy, guided imagery, chakra experiencing and mindfulness meditation.

Fernros L, Furhoff AK, Wändell PE.

Karolinska Institutet/Stockholm County Council's Center for Family and Community Medicine, Huddinge, Sweden. lotta.fernros@sll.se

Abstract

OBJECTIVE: Assess changes in quality of life and in sense of coherence (SOC), after an intervention involving a self-development course using mind-body medicine (MBM) activities.

DESIGN: A questionnaire study using a health-related quality of life (HRQOL) instrument, the SWEDQUAL, with 13 subscales and scores ranging from 0 to 100, combined with the SOC-13 scale, healthcare utilisation, medication and sick listing data.

SETTING: A training centre for MBM. Eligible course attendants (study group, SG, n = 83) assessed their HRQOL before and 6 months after a 1-week course. A control group (CG) of individuals who had previously attended the course (n = 69), matched for age, sex and length of course time to the SG, also made assessments.

MAIN OUTCOME: Changes in HRQOL and SOC in SG and CG.

RESULTS: Of the 13 HRQOL subscales, eight showed clinically significant improvement in the SG (>9%, p <>

CONCLUSIONS: This group of men and women (SG), starting from a clinically significant low health assessment, had improved their HRQOL and SOC after the course intervention.

PMID: 18324479 [PubMed - indexed for MEDLINE]

Treating the climacteric symptoms in Indian women with an integrated approach to yoga therapy: a randomized control study.

Chattha R, Raghuram N, Venkatram P, Hongasandra NR.

Swami Vivekananda Yoga Research Foundation, Bangalore, India. chattha.ritu@yahoo.com

Comment in:

• Menopause. 2008 Sep-Oct;15(5):827-9.

Abstract

OBJECTIVE: To study the effect of yoga on the climacteric symptoms, perceived stress, and personality in perimenopausal women.

DESIGN: One hundred twenty participants (ages 40-55 y) were randomly divided into two study arms, ie, yoga and control. The yoga group practiced an integrated approach to yoga therapy comprising surya namaskara (sun salutation) with 12 postures, pranayama (breathing practices), and avartan dhyan (cyclic meditation), whereas the control group practiced a set of simple physical exercises under supervision of trained teachers for 8 weeks (1 h daily, 5 days per week). The assessments were made by Greene Climacteric Scale, Perceived Stress Scale, and Eysenck's Personality Inventory before and after the intervention.

RESULTS: Of the three factors of the Greene Climacteric Scale, the Mann-Whitney test showed a significant difference between groups (P < p =" 0.06)" size =" 0.43)" size =" 0.21)">

CONCLUSIONS: Eight weeks of an integrated approach to yoga therapy decreases climacteric symptoms, perceived stress, and neuroticism in perimenopausal women better than physical exercise.

PMID: 18463543 [PubMed - indexed for MEDLINE]

Effects of a traditional Taiji/Qigong curriculum on older adults' immune response to influenza vaccine.

Yang Y, Verkuilen J, Rosengren KS, Mariani RA, Reed M, Grubisich SA, Woods JA, Schlagal B.

Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801, USA. yyang5@uiuc.edu

Abstract

Previous studies have suggested that Taiji (T'ai Chi) practice may improve immune function. The current study examined whether 5 months of moderate traditional Taiji and Qigong (TQ) practice could improve the immune response to influenza vaccine in older adults. Fifty older adults participated in this study. Baseline pre-vaccine blood samples were collected. Subjects received the 2003-2004 influenza vaccine during the 1st week of the intervention. Post-vaccine blood samples were collected 3, 6 and 20 weeks after intervention for analysis of anti-influenza hemagglutination inhibition titers. Findings indicated a significant increase in the magnitude and duration of the antibody response to influenza vaccine in TQ participants when compared to controls. There was a significant between-group difference at 3 and 20 weeks after vaccine, and at 20 weeks the TQ group had significantly higher titers compared to the pre-vaccine time point, whereas the controls did not. A higher percentage of TQ subjects also responded to the influenza A strains with a protective antibody response, but differences between groups were not statistically significant. Traditional TQ practice improves the antibody response to influenza vaccine in older adults, but further study is needed to determine whether the enhanced response is sufficient to provide definitive protection from influenza infection.

PMID: 18487887 [PubMed - indexed for MEDLINE]

Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure.

Pullen PR, Nagamia SH, Mehta PK, Thompson WR, Benardot D, Hammoud R, Parrott JM, Sola S, Khan BV.

Department of Kinesiology and Health, Georgia State University, Atlanta, Georgia, USA.

Abstract

BACKGROUND: Despite recent advances in pharmacologic and device therapy, morbidity and mortality from heart failure (HF) remain high. Yoga combines physical and breathing exercises that may benefit patients with HF. We hypothesized that an 8-week regimen of yoga in addition to standard medical therapy would improve exercise capacity, inflammatory markers, and quality of life (QoL) in patients with HF.

METHODS AND RESULTS: New York Heart Association Class I-III HF patients were randomized to yoga treatment (YT) or standard medical therapy (MT). Measurements included a graded exercise test (GXT) to V O(2Peak) and the following serum biomarkers: interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), and extracellular superoxide dismutase (EC-SOD). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was administered to assess changes in QoL. A total of 19 patients were enrolled after the initial screening. Of the 19 patients, 9 were randomized to YT and 10 to MT. Patients had a mean EF of 25%. GXT time and V O(2Peak) were significantly improved in the YT versus MT groups (+18% in the YT and -7.5% in MT; P = .03 vs. control and +17 in YT and -7.1 in MT; P = .02, respectively). There were statistically significant reductions in serum levels of IL-6 and hsCRP and an increase in EC-SOD in the YT group (all P < .005 vs. MT). MLHFQ scores improved by 25.7% in the YT group and by 2.9% in the MT group.

CONCLUSIONS: Yoga improved exercise tolerance and positively affected levels of inflammatory markers in patients with HF, and there was also a trend toward improvements in QoL.

PMID: 18514933 [PubMed - indexed for MEDLINE]

Mind-body interventions: applications in neurology.

Wahbeh H, Elsas SM, Oken BS.

Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code CR120, Portland, OR 97239, USA.

Abstract

OBJECTIVE: Half of the adults in the United States use complementary and alternative medicine with mind-body therapy being the most commonly used form. Neurology patients often turn to their physicians for insight into the effectiveness of the therapies and resources to integrate them into their care. The objective of this article is to give a clinical overview of mind-body interventions and their applications in neurology.

METHODS: Medline and PsychInfo were searched on mind-body therapies and neurologic disease search terms for clinical trials and reviews and published evidence was graded.

RESULTS: Meditation, relaxation, and breathing techniques, yoga, tai chi, and qigong, hypnosis, and biofeedback are described. Mind-body therapy application to general pain, back and neck pain, carpal tunnel syndrome, headaches, fibromyalgia, multiple sclerosis, epilepsy, muscular dysfunction, stroke, aging, Parkinson disease, stroke, and attention deficit-hyperactivity disorder are reviewed.

CONCLUSIONS: There are several conditions where the evidence for mind-body therapies is quite strong such as migraine headache. Mind-body therapies for other neurology applications have limited evidence due mostly to small clinical trials and inadequate control groups.

PMID: 18541886 [PubMed - indexed for MEDLINE]PMCID: PMC2882072Free PMC Article

Acute psychological responses to Qigong exercise of varying durations.

Johansson M, Hassmén P.

School of Health and Medical Sciences, Orebro University, SE-701 82 Orebro, Sweden. mattias.johansson@oru.se

Abstract

Qigong exercise has been shown to induce acute psychological changes of a positive nature; but whether longer durations have greater effects than shorter ones is not known. Forty-one regular qigong practitioners therefore engaged in either 30 or 60 min of qigong exercise within a randomized cross-over design. Measures of mood, anxiety, activation, and hedonic tone were obtained pre- and post-exercise. Results showed benefits of the same magnitude in the two conditions: more positive mood states, reduced state anxiety, and enhanced perceived pleasure. Thirty minutes of qigong exercise thereby seems to be sufficient to provide psychological benefits, and with no additional benefits detected after 60 min. This finding is important for those having little time or motivation to engage in activities of longer durations. In addition, health professionals prescribing exercise for health benefits can prescribe shorter exercise sessions with confidence knowing that positive psychological effects can also occur after a shorter exercise bout.

PMID: 18543380 [PubMed - indexed for MEDLINE]

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

Oh B, Butow P, Mullan B, Clarke S.

School of Public Health, Faculty of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia. bsoh@med.usyd.edu.au

Abstract

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

PMID: 18543381 [PubMed - indexed for MEDLINE]

Effects of external qigong therapy on osteoarthritis of the knee. A randomized controlled trial.

Chen KW, Perlman A, Liao JG, Lam A, Staller J, Sigal LH.

UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ, USA. kchen@compmed.umm.edu

Abstract

The objective of our study was to assess the efficacy of external qigong therapy (EQT), a traditional Chinese medicine practice, in reducing pain and improving functionality of patients with knee osteoarthritis (OA). One hundred twelve adults with knee OA were randomized to EQT or sham treatment (control); 106 completed treatment and were analyzed. Two therapists performed EQT individually, five to six sessions in 3 weeks. The sham healer mimicked EQT for the same number of sessions and duration. Patients and examining physician were blinded. Primary outcomes were Western Ontario MacMaster (WOMAC) pain and function; other outcomes included McGill Pain Questionnaire, time to walk 15 m, and range of motion squatting. Results of patients treated by the two healers were analyzed separately. Both treatment groups reported significant reduction in WOMAC scores after intervention. Patients treated by healer 2 reported greater reduction in pain (mean improvement -25.7 +/- 6.6 vs. -13.1 +/- 3.0; p <>

PMID: 18654733 [PubMed - indexed for MEDLINE]PMCID: PMC2582590Free PMC Article

Effect of short-term intensive yoga program on pain, functional disability and spinal flexibility in chronic low back pain: a randomized control study.

Tekur P, Singphow C, Nagendra HR, Raghuram N.

Division of Yoga and Life Sciences, Swami Vivekananda Yoga Research Foundation (SVYASA), Bangalore, India. p_tekur@yahoo.co.in

Abstract

OBJECTIVE: The aim of this study was to compare the effect of a short-term intensive residential yoga program with physical exercise (control) on pain and spinal flexibility in subjects with chronic low-back pain (CLBP).

DESIGN: This was a wait-list, randomized controlled study.

SETTING: The study was conducted at a residential integrative health center in Bangalore, South India.

SUBJECTS: Eighty (80) subjects (females, n = 37) with CLBP, who consented were randomly assigned to receive yoga or physical exercise if they satisfied the selection criteria. Intervention: The intervention consisted of a 1-week intensive residential yoga program comprised of asanas (physical postures) designed for back pain, pranayamas (breathing practices), meditation, and didactic and interactive sessions on philosophical concepts of yoga. The control group practiced physical exercises under a trained physiatrist and also had didactic and interactive sessions on lifestyle change. Both of the groups were matched for time on intervention and attention.

OUTCOME MEASURES: Pain-related outcomes were assessed by the Oswestry Disability Index (ODI) and by spinal flexibility, which was assessed using goniometer at pre and post intervention. Data were analyzed using repeated measures analysis of variance (RMANOVA).

RESULTS: Data conformed to a Gaussian distribution. There was a significant reduction in ODI scores in the yoga group compared to the control group (p = 0.01; effect size 1.264). Spinal flexibility measures improved significantly in both groups but the yoga group had greater improvement as compared to controls on spinal flexion (p = 0.008; effect size 0.146), spinal extension (p = 0.002; effect size 0.251), right lateral flexion (p = 0.059; effect size 0.006); and left lateral flexion (p = 0.006; effect size 0.171).

CONCLUSIONS: Seven (7) days of a residential intensive yoga-based lifestyle program reduced pain-related disability and improved spinal flexibility in patients with CLBP better than a physical exercise regimen.

PMID: 18673078 [PubMed - indexed for MEDLINE]

Effect of alternate nostril breathing exercise on cardiorespiratory functions.

Upadhyay Dhungel K, Malhotra V, Sarkar D, Prajapati R.

Department of Physiology, Nepal Medical College, Kathmandu, Nepal. kistiz2003@yahoo.com

Abstract

Pranayama (breathing exercise), one of the yogic techniques can produce different physiological responses in healthy individuals. The responses of Alternate Nostril Breathing (ANB) the Nadisudhi Pranayama on some cardio-respiratory functions were investigated in healthy young adults. The subjects performed ANB exercise (15 minutes everyday in the morning) for four weeks. Cardio-respiratory parameters were recorded before and after 4-weeks training period. A significant increment in Peak expiratory flow rate (PEFR L/min) and Pulse pressure (PP) was noted. Although Systolic blood pressure (SBP) was decreased insignificantly, the decrease in pulse rate (PR), respiratory rate (RR), diastolic blood pressure (DBP) were significant. Results indicate that regular practice of ANB (Nadisudhi) increases parasympathetic activity.

PMID: 18700626 [PubMed - indexed for MEDLINE]

Menopause, the metabolic syndrome, and mind-body therapies.

Innes KE, Selfe TK, Taylor AG.

Center for the Study of Complementary and Alternative Therapies, University of Virginia Health Systems, Charlottesville, VA 22908-0905, USA. kei6n@virginia.edu

Abstract

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

PMID: 18779682 [PubMed - indexed for MEDLINE]PMCID: PMC2810543Free PMC Article

Qigong stress reduction in hospital staff.

Griffith JM, Hasley JP, Liu H, Severn DG, Conner LH, Adler LE.

Department of Psychiatry, VISN 19 MIRECC, and University of Colorado Denver School of Medicine, Denver, CO, USA. jaymgriffithmd@aol.com

Abstract

OBJECTIVE: The aim of this study was to investigate the effectiveness of a qigong training program in reducing stress in hospital staff.

METHODS: Subjects were randomly assigned to a 6-week intervention of either qigong practice (n = 16) or a waiting list (n = 21). The primary measure of stress was the Perceived Stress Scale. Secondary measures included the Short Form 36 (SF-36) quality-of-life measure and a 100-mm analog pain scale.

RESULTS: The qigong group demonstrated a statistically significant reduction of perceived stress compared to the control group (p = 0.02). On the Social Interaction subscale of the SF-36, the qigong group demonstrated greater improvement compared to controls (p = 0.04). Within-groups analyses demonstrated that the qigong group (p = 0.03), but not the control group, experienced a significant reduction of pain intensity. A regression analysis demonstrated an association between higher baseline stress levels and greater improvement within the qigong group (R(2) = 0.34; p = 0.02).

CONCLUSIONS: These results suggest that short-term exposure to qigong was effective in reducing stress in hospital staff. Further studies are needed to evaluate the possible effectiveness of qigong in reducing pain and in improving quality of life.

PMID: 18823261 [PubMed - indexed for MEDLINE]

A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose.

Liu X, Miller YD, Burton NW, Brown WJ.

University of Queensland, St Lucia Queensland, Australia.

Abstract

OBJECTIVES: To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose.

DESIGN, SETTING, AND PARTICIPANTS: A single group pre-post feasibility trial with 11 participants (3 male and 8 female; aged 42-65 years) with elevated blood glucose.

INTERVENTION: Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home.

MAIN OUTCOME MEASURES: Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms.

RESULTS: There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference -1.05,>

CONCLUSIONS: The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.

PMID: 18927159 [PubMed - in process]

Intrinsically motivated qigong exercisers are more concentrated and less stressful.

Jouper J, Hassmén P.

School of Health and Medical Sciences, Orebro University, Sweden. john.jouper@oru.se

Abstract

Low-intensity qigong exercise has been suggested as an alternative to more vigorous exercise when striving for health benefits. The purpose of this study was to investigate whether self-determined motivation and perceived stress are related to concentration during exercise, and to the amount of exercise carried out. Leisure-time qigong exercisers (n = 279) were assessed by using the Sport Motivation Scale, Stress and Energy Scale, and by self-rated Concentration. Exercise sessions per week, Session time, and ability to Set a time for exercise, and perceived Disturbance during exercise were also recorded. Participants who were in a Calm energy mood (low-stress, high-energy, able to set a time for exercise), displayed an increased Concentration on qi-flow (R(2) = 0.13) during exercise. An elevated stress-level correlated negatively with Health, Energy, Concentration, Sessions per week, Session time, Sessions performed during the previous week, ability to Set a time for exercise, and feeling Undisturbed during exercise (all p <>

PMID: 19051335 [PubMed - indexed for MEDLINE]

Breathing exercises for asthma: a randomised controlled trial.

Thomas M, McKinley RK, Mellor S, Watkin G, Holloway E, Scullion J, Shaw DE, Wardlaw A, Price D, Pavord I.

Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen, UK. mikethomas@doctors.org.uk

Comment in:

* J Physiother. 2010;56(1):60.
* Thorax. 2009 Sep;64(9):824; author reply 824.

Abstract

BACKGROUND: The effect of breathing modification techniques on asthma symptoms and objective disease control is uncertain.

METHODS: A prospective, parallel group, single-blind, randomised controlled trial comparing breathing training with asthma education (to control for non-specific effects of clinician attention) was performed. Subjects with asthma with impaired health status managed in primary care were randomised to receive three sessions of either physiotherapist-supervised breathing training (n = 94) or asthma nurse-delivered asthma education (n = 89). The main outcome was Asthma Quality of Life Questionnaire (AQLQ) score, with secondary outcomes including spirometry, bronchial hyper-responsiveness, exhaled nitric oxide, induced sputum eosinophil count and Asthma Control Questionnaire (ACQ), Hospital Anxiety and Depression (HAD) and hyperventilation (Nijmegen) questionnaire scores.

RESULTS: One month after the intervention there were similar improvements in AQLQ scores from baseline in both groups but at 6 months there was a significant between-group difference favouring breathing training (0.38 units, 95% CI 0.08 to 0.68). At the 6-month assessment there were significant between-group differences favouring breathing training in HAD anxiety (1.1, 95% CI 0.2 to 1.9), HAD depression (0.8, 95% CI 0.1 to 1.4) and Nijmegen (3.2, 95% CI 1.0 to 5.4) scores, with trends to improved ACQ (0.2, 95% CI 0.0 to 0.4). No significant between-group differences were seen at 1 month. Breathing training was not associated with significant changes in airways physiology, inflammation or hyper-responsiveness.

CONCLUSION: Breathing training resulted in improvements in asthma-specific health status and other patient-centred measures but not in asthma pathophysiology. Such exercises may help patients whose quality of life is impaired by asthma, but they are unlikely to reduce the need for anti-inflammatory medication.

PMID: 19052047 [PubMed - indexed for MEDLINE]

Effects of Qigong exercises on 3 different parameters of human saliva.

Bayat-Movahed S, Shayesteh Y, Mehrizi H, Rezayi S, Bamdad K, Golestan B, Mohamadi M.

Sports Medicine Research Center, Medical Sciences/University of Tehran, Tehran, Iran. swt_f@yahoo.com

Abstract

OBJECTIVE: To analyze the effects of a Qigong program on various parameters of unstimulated saliva, including volume, pH and secretory immunoglobulin A (S-IgA) level.

METHODS: Twice a day from the beginning of Fall 2005, twenty-three healthy volunteers aged 22-24 did special Qigong exercises and massage of acupuncture points which stimulated the energy cycle and increased body water energy. The unstimulated saliva volume and pH were recorded every week in Spring (April, May, June) 2005 before the volunteers started to learn and exercise Qigong, and after Qigong intervention in Spring (April, May, June) 2006. During the period of study, saliva was collected in the same location and on similar dates at the Dental Faculty of Tehran University of Medical Sciences. The S-IgA levels of the last samples of the last week of Spring 2005 and 2006 were measured.

RESULTS: The unstimulated saliva volume after Qigong exercises (2.94 + or - 0.20 mL/5min) was significantly higher as compared to the pre-Qigong phase (1.65 + or -0.102 mL/5min>

CONCLUSIONS: The application of Qigong is beneficial for increasing salivary volume and other parameters. Moreover, the results suggest that Qigong may be a useful medication for patients with salivary hyposecretion. Further research is recommended in examining the long-term effects of Qigong on improving salivary volume and other parameters in individuals with salivary hyposecretion.

PMID: 19082797 [PubMed - indexed for MEDLINE]

Commentary on the AHRQ report on research on meditation practices in health.

Orme-Johnson DW.

Maharishi University of Management Fairfield, Iowa, USA. davidoj@earthlink.net

Abstract

The Agency for Healthcare Research and Quality (AHRQ) report is a major reference point for establishing where the research on meditation stands and where it should go from here. This commentary argues that double blinding, a major component of the report's evaluation criteria, is not an appropriate control for placebo in meditation research. A viable alternative is to make the treatment and control groups equivalent on nonspecific therapeutic attention factors and expectation. High quality meditation research must also use qualified instructors, have high compliance levels, insure proficient practice, use state-of-the-art measurement methodology, and make sure control subjects are not inadvertently practicing the same or another form of meditation. None of these determinants of research quality was assessed by the AHRQ report. It is noteworthy that whereas randomized controlled trials have their place in demonstrating clinical efficacy, few if any of the major ideas in the basic or behavioral sciences have come from randomized trails. A wide range of study designs have demonstrated that the traditional goal of meditation, a state of inner silence called "transcendental consciousness," has unique physiological characteristics with far ranging implications for health, cognition, and behavior. Such studies need to be included in future reviews of meditation techniques.

PMID: 19123876 [PubMed - indexed for MEDLINE]

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

Manzaneque JM, Vera FM, Rodriguez FM, Garcia GJ, Leyva L, Blanca MJ.

Department of Psychobiology and Methodology, Faculty of Psychology, University of Malaga, Spain. manzaneque@uma.es

Abstract

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

PMID: 19129338 [PubMed - indexed for MEDLINE]

Psychophysiological outcomes of health qigong for chronic conditions: a systematic review.

Ng BH, Tsang HW.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.

Abstract

We aimed to unravel the clinical benefits and the plausible underlying psychophysiological mechanism based on available randomized controlled trials (RCTs). Meta-analysis of 26 RCTs shortlisted from electronic databases from 1997 to 2006 shows that qigong had some effects on increasing the numbers of white blood cells and lymphocytes, stroke volume, peak early transmitral filling velocity, peak late transmitral filling velocity, forced vital capacity, and forced expiratory volume, and, conversely, lowering of total cholesterol, systolic blood pressure, diastolic blood pressure, and depressive mood scores. Explanatory pathways may pertain to stress reduction via nervous, endocrine, and immune systems. Limitations on methodology are discussed and directions for further studies are suggested. Because of its safety, minimal cost, and clinical benefit, health qigong can be advocated as an adjunctive exercise therapy for older people with chronic conditions.

PMID: 19170945 [PubMed - indexed for MEDLINE]

A review of clinical trials of tai chi and qigong in older adults.

Rogers CE, Larkey LK, Keller C.

Arizona State University, USA. carol.rogers@asu.edu

Abstract

Initiation and maintenance of physical activity (PA) in older adults is of increasing concern as the benefits of PA have been shown to improve physical functioning, mood, weight, and cardiovascular risk factors. Meditative movement forms of PA, such as tai chi and qigong (TC & QG), are holistic in nature and have increased in popularity over the past few decades. Several randomized controlled trials have evaluated TC & QG interventions from multiple perspectives, specifically targeting older adults. The purpose of this report is to synthesize intervention studies targeting TC & QG and identify the physical and psychological health outcomes shown to be associated with TC & QG in community dwelling adults older than 55. Based on specific inclusion criteria, 36 research reports with a total of 3,799 participants were included in this review. Five categories of study outcomes were identified, including falls and balance, physical function, cardiovascular disease, and psychological and additional disease-specific responses. Significant improvement in clusters of similar outcomes indicated interventions utilizing TC & QG may help older adults improve physical function and reduce blood pressure, fall risk, and depression and anxiety. Missing from the reviewed reports is a discussion of how spiritual exploration with meditative forms of PA, an important component of these movement activities, may contribute to successful aging.

PMID: 19179544 [PubMed - indexed for MEDLINE]PMCID: PMC2810462Free PMC Article

Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial.

Carson JW, Carson KM, Porter LS, Keefe FJ, Seewaldt VL.

Department of Anesthesiology and Peri-operative Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA. carsonja@ohsu.edu

Abstract

GOAL OF WORK: Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA-IIB).

MATERIALS AND METHODS: Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat.

MAIN RESULTS: At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance.

CONCLUSIONS: This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.

PMID: 19214594 [PubMed - indexed for MEDLINE]

Scientific and holistic therapy perspectives on Qigong practice for elders with cardiovascular disease risk factors

[Article in Chinese]

Hung HM, Chen KM.

Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Kaohsiung, Taiwan, ROC.

Abstract

The ratio of older adults with chronic illnesses has increased due to increased average life spans. The incidence of cardiovascular diseases among older adults has reached 33.26%, becoming the leading chronic disease and second most significant cause of mortality among older adults. Statistics show that the largest proportion of expenditures on prescription pharmaceuticals in the National Health Insurance goes toward the treatment of cardiovascular diseases. In addition, complications resulting from cardiovascular diseases result in burdens of care that impact seriously on the individual, their family, and society. Studies have supported physical activity as the most important behavior in reducing cardiovascular disease risk factors. Qigong, a traditional Chinese therapeutic activity, uses gentle movements of extremities and control of breathing to improve health, enhance vitality and enable bodies, emotion, and spirit to reach optimal performance. Evidence-based research supports the argument that Qigong improves cardiovascular-respiratory function and lipid profile, decreases blood sugar, and relieves anxiety and depression. We suggest developing a safe, convenient, and simple Qigong exercise regimen for older adults at higher risk of cardiovascular diseases to extend their life expectancy and quality of life.

PMID: 19222003 [PubMed - indexed for MEDLINE]

Exercise intervention in brain injury: a pilot randomized study of Tai Chi Qigong.

Blake H, Batson M.

University of Nottingham School of Nursing, Midwifery & Physiotherapy, Queen's Medical Centre, Nottingham NG7 2AH, UK. Holly.Blake@nottingham.ac.uk

Abstract

OBJECTIVE: To examine the effects of a brief Tai Chi Chuan Qigong ('Qigong') exercise intervention on individuals with traumatic brain injury.

DESIGN: A single-centre randomized controlled trial pilot study.

SETTING: A registered charity day centre in the community.

SUBJECTS: Twenty individuals with traumatic brain injury.

INTERVENTION: Intervention participants attended a Qigong exercise session for one hour per week over eight weeks. Control participants engaged in non-exercise-based social and leisure activities for the same intervention period.

MEASURES: Outcome was assessed at baseline and post intervention using the General Health Questionnaire-12, the Physical Self-Description Questionnaire and the Social Support for Exercise Habits Scale, to measure perceived mood, self-esteem, flexibility, coordination, physical activity and social support.

RESULTS: Groups were comparable at baseline. After the intervention, mood was improved in the exercise group when compared with controls (U = 22.0, P =0.02). Improvements in self-esteem (Z = 2.397, P =0.01) and mood (Z = -2.032, P =0.04) across the study period were also evident in the exercise group only. There were no significant differences in physical functioning between groups. In view of the sample size, these findings are inconclusive.

CONCLUSIONS: This study provides preliminary evidence that a brief Qigong exercise intervention programme may improve mood and self-esteem for individuals with traumatic brain injury. This needs to be tested in a large-scale randomized trial.

PMID: 19237436 [PubMed - indexed for MEDLINE]

Immediate effect of slow pace bhastrika pranayama on blood pressure and heart rate.

Pramanik T, Sharma HO, Mishra S, Mishra A, Prajapati R, Singh S.

Department of Physiology, Nepal Medical College, Kathmandu, Nepal. drpramanik@hotmail.com

Abstract

OBJECTIVES: The objective of this study was to evaluate the immediate effect of slow pace bhastrika pranayama (respiratory rate 6/min) for 5 minutes on heart rate and blood pressure and the effect of the same breathing exercise for the same duration of time (5 minutes) following oral intake of hyoscine-N-butylbromide (Buscopan), a parasympathetic blocker drug.

SUBJECTS AND METHODS: Heart rate and blood pressure of volunteers (n = 39, age = 25-40 years) was recorded following standard procedure. First, subjects had to sit comfortably in an easy and steady posture (sukhasana) on a fairly soft seat placed on the floor keeping head, neck, and trunk erect, eyes closed, and the other muscles reasonably loose. The subject is directed to inhale through both nostrils slowly up to the maximum for about 4 seconds and then exhale slowly up to the maximum through both nostrils for about 6 seconds. The breathing must not be abdominal. These steps complete one cycle of slow pace bhastrika pranayama (respiratory rate 6/min). During the practice the subject is asked not to think much about the inhalation and exhalation time, but rather was requested to imagine the open blue sky. The pranayama was conducted in a cool, well-ventilated room (18-20 degrees C). After 5 minutes of this breathing practice, the blood pressure and heart rate again were recorded in the aforesaid manner using the same instrument. The other group (n = 10) took part in another study where their blood pressure and heart rate were recorded following half an hour of oral intake of hyoscine-N-butylbromide 20 mg. Then they practiced the breathing exercise as stated above, and the abovementioned parameters were recorded again to study the effect of parasympathetic blockade on the same pranayama.

RESULTS: It was noted that after slow bhastrika pranayamic breathing (respiratory rate 6/min) for 5 minutes, both the systolic and diastolic blood pressure decreased significantly with a slight fall in heart rate. No significant alteration in both blood pressure and heart rate was observed in volunteers who performed the same breathing exercise for the same duration following oral intake of hyoscine-N-butylbromide.

DISCUSSION: Pranayama increases frequency and duration of inhibitory neural impulses by activating pulmonary stretch receptors during above tidal volume inhalation as in Hering Bruer reflex, which bring about withdrawal of sympathetic tone in the skeletal muscle blood vessels, leading to widespread vasodilatation, thus causing decrease in peripheral resistance and thus decreasing the diastolic blood pressure. After hyoscine-N-butylbromide, the parasympathetic blocker, it was observed that blood pressure was not decreased significantly as a result of pranayama, as it was observed when no drug was administered.

CONCLUSIONS: Vagal cardiac and pulmonary mechanisms are linked, and improvement in one vagal limb might spill over into the other. Baroreceptor sensitivity can be enhanced significantly by slow breathing (supported by a small reduction in the heart rate observed during slow breathing and by reduction in both systolic and diastolic pressure). Slow pace bhastrika pranayama (respiratory rate 6/min) exercise thus shows a strong tendency to improving the autonomic nervous system through enhanced activation of the parasympathetic system.

PMID: 19249921 [PubMed - indexed for MEDLINE]

The effect(s) of a six-week home-based exercise program on the respiratory muscle and functional status in ankylosing spondylitis.

Ortancil O, Sarikaya S, Sapmaz P, Basaran A, Ozdolap S.

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.

Abstract

BACKGROUND: Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. Involvement of costovertebral and costotransverse joints results in rigidity of the chest wall and inability to expand the chest fully on inspiration. Also significant reduction in exercise capacity in the AS patients was reported.

OBJECTIVES: To determine the effects of a 6-week home-based exercise program on the respiratory muscle and energy cost in AS.

METHODS: Twenty-two AS patients were included. Chest expansion, tragus-wall distance, modified Schober test, maximal inspiratory pressure, maximal expiratory pressure, 6-minute walking distance, physiologic cost index and functional status Bath Ankylosing Spondylitis Functional Index of patients were measured at baseline and repeated at the end of an open 6-week home-based exercise program. Breathing exercises and upper extremity exercises were taught to all the patients. The patients were then asked to practice these exercises at home individually for 6 weeks.

RESULTS: Chest expansion, maximal inspiratory pressure, and maximal expiratory pressure values and Bath Ankylosing Spondylitis Functional Index scores of patients significantly increased after 6 weeks (P <> 0.05).

CONCLUSIONS: A home-based exercise program can have an effect on some measures respiratory muscle and functional status. Greater emphasis should be placed on maintaining cardiorespiratory fitness as well as spinal mobility to encourage patients with AS.

PMID: 19265348 [PubMed - indexed for MEDLINE]

Efficacy and tolerability of yoga breathing in patients with chronic obstructive pulmonary disease: a pilot study.

Pomidori L, Campigotto F, Amatya TM, Bernardi L, Cogo A.

Sports Biomedical Studies Centre, University of Ferrara, Ferrara, Italy. analisa.cogo@unife.it

Abstract

PURPOSE: Yoga-derived breathing has been reported to improve gas exchange in patients with chronic heart failure and in participants exposed to high-altitude hypoxia. We investigated the tolerability and effect of yoga breathing on ventilatory pattern and oxygenation in patients with chronic obstructive pulmonary disease (COPD).

METHODS: Patients with COPD (N = 11, 3 women) without previous yoga practice and taking only short-acting beta2-adrenergic blocking drugs were enrolled. Ventilatory pattern and oxygen saturation were monitored by means of inductive plethysmography during 30-minute spontaneous breathing at rest (sb) and during a 30-minute yoga lesson (y). During the yoga lesson, the patients were requested to mobilize in sequence the diaphragm, lower chest, and upper chest adopting a slower and deeper breathing. We evaluated oxygen saturation (SaO2%), tidal volume (VT), minute ventilation (E), respiratory rate (i>f), inspiratory time, total breath time, fractional inspiratory time, an index of thoracoabdominal coordination, and an index of rapid shallow breathing. Changes in dyspnea during the yoga lesson were assessed with the Borg scale.

RESULTS: During the yoga lesson, data showed the adoption of a deeper and slower breathing pattern (VTsb L 0.54[0.04], VTy L 0.74[0.08], P = .01; i>fsb 20.8[1.3], i>fy 13.8[0.2], P = .001) and a significant improvement in SaO2% with no change in E (SaO2%sb 91.5%[1.13], SaO2%y 93.5%[0.99], P = .02; Esb L/min 11.2[1.1], Ey L/min 10.2[0.9]). All the participants reported to be comfortable during the yoga lesson, with no increase in dyspnea index.

CONCLUSION: We conclude that short-term training in yoga is well tolerated and induces favorable respiratory changes in patients with COPD.

PMID: 19305239 [PubMed - indexed for MEDLINE]