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Recent publications in Qigong and Taiji studies.

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  • qigong4us
    Research Updates Health benefits of Tai Chi for older patients with type 2 diabetes: the Move It for Diabetes study --a randomized controlled trial. Clin
    Message 1 of 1 , Dec 3, 2007
      Research Updates

      Health benefits of Tai Chi for older patients with type 2 diabetes:
      the "Move It for Diabetes study"--a randomized controlled trial.
      Clin Interv Aging. 2007; 2(3):429-39.
      Tsang T, Orr R, Lam P, Comino EJ, Singh MF. (School of Exercise and
      Sport Science, Faculty of Health Sciences, University of Sydney,
      Lidcombe, NSW, Australia. ttsa6920@... )
      Older adults with type 2 diabetes have mobility impairment and
      reduced fitness. This study aimed to test the efficacy of the "Tai
      Chi for Diabetes" form, developed to address health-related problems
      in diabetes, including mobility and physical function. Thirty-eight
      older adults with stable type 2 diabetes were randomized to Tai Chi
      or sham exercise, twice a week for 16 weeks. Outcomes included gait,
      balance, musculoskeletal and cardiovascular fitness, self-reported
      activity and quality of life. Static and dynamic balance index (-5.8
      +/- 14.2; p = 0.03) and maximal gait speed (6.2 +/- 11.6%; p = 0.005)
      improved over time, with no significant group effects. There were no
      changes in other measures. Non-specific effects of exercise testing
      and/or study participation such as outcome expectation,
      socialization, the Hawthorne effect, or unmeasured changes in health
      status or compliance with medical treatment may underlie the modest
      improvements in gait and balance observed in this sham-exercise-
      controlled trial. This Tai Chi form, although developed specifically
      for diabetes, may not have been of sufficient intensity, frequency,
      or duration to effect positive changes in many aspects of physiology
      or health status relevant to older people with diabetes.

      An evaluation of the effects of Tai Chi Chuan and Chi Kung training
      in patients with symptomatic heart failure: a randomised controlled
      pilot study. Postgrad Med J. 2007 Nov; 83(985):717-21.
      Barrow DE, Bedford A, Ives G, O'Toole L, Channer KS. (Department of
      Cardiology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10
      2JF, UK.)
      OBJECTIVE: To study the effect of Tai Chi on exercise tolerance in
      patients with moderate heart failure. DESIGN: Randomised parallel
      group study balanced for baseline variables. SETTING: Cardiology
      Department, Royal Hallamshire Hospital. PATIENTS AND METHODS: 52
      patients (42 men, mean age (68.9 years), range (46-90 years), and 10
      women, mean age (70.0 years), range (58-82)) with chronic heart
      failure (New York Heart Association symptom class II-III) were
      studied. Patients were randomised to Tai Chi Chuan twice a week for
      16 weeks or to standard medical care without exercise rehabilitation.
      MAIN OUTCOME MEASURES: The primary outcome measure was the change in
      the distance walked in the shuttle walk test. Secondary outcome
      measures were changes in symptom scores and quality of life indices.
      RESULTS: Objective measures of exercise tolerance did not improve
      significantly with Tai Chi, but patients having Tai Chi exercise had
      an improvement in symptom scores of heart failure measured by the
      Minnesota Living with Heart Failure Questionnaire (comparison of
      deltas, -2.4 control vs -14.9; p = 0.01), and depression scores
      measured by the SCL-90-R questionnaire (-2.9 vs -6.8; p = 0.12)
      compared with those patients in the control group. CONCLUSION: In
      patients with chronic heart failure, 16 weeks of Tai Chi training was
      safe, with no adverse exercise related problems. It was enjoyed by
      all taking part and led to significant improvements in symptoms and
      quality of life.

      Mind/body techniques for physiological and psychological stress
      reduction: Stress management via Tai Chi training - a pilot study.
      Med Sci Monit. 2007 Nov;13(11):CR488-497.
      Esch T, Duckstein J, Welke J, Braun V. (Division of Integrative
      Health Promotion, Coburg University of Applied Sciences, Coburg,
      Germany and Institute for Integrative Medicine and Health Research,
      Potsdam, Germany.)
      Background: Stress can affect health. There is a growing need for the
      evaluation and application of professional stress management options,
      i.e, stress reduction. Mind/body medicine serves this goal, e.g, by
      integrating self-care techniques into medicine and health care. Tai
      Chi (TC) can be classified as such a mind/body technique, potentially
      reducing stress and affecting physical as well as mental health
      parameters, which, however, has to be examined further.
      Material/Methods: We conducted a prospective, longitudinal pilot
      study over 18 weeks for the evaluation of subjective and objective
      clinical effects of a Yang style TC intervention in young adults
      (beginners) by measuring physiological (blood pressure, heart rate,
      saliva cortisol) and psychological (SF-36, perceived stress,
      significant events) parameters, i.e, direct or indirect indicators of
      stress and stress reduction, in a non-randomised/-controlled, yet non-
      selected cohort (n=21) by pre-to-post comparison and in follow-up. SF-
      36 values were also compared with the age-adjusted norm population,
      serving as an external control. Additionally, we measured diurnal
      cortisol profiles in a cross-sectional sub-study (n=2+2, pre-to-
      post), providing an internal random control sub-sample. Results: Only
      nine participants completed all measurements. Even so, we found
      significant (p<0.05) reductions of saliva cortisol (post and follow-
      up), which seems to be an indicator of general stress reduction. A
      significant decrease in perceived mental stress (post) proved even
      highly significant (p<0.01) in the follow-up, whereas physical stress
      perception declined to a much lesser degree. Significant improvements
      were also detected for the SF-36 dimensions general health
      perception, social functioning, vitality, and mental
      health/psychological well-being. Thus, the summarized mental health
      measures all clearly improved, pointing towards a predominantly
      psychological impact of TC. Conclusions: Subjective health increased,
      stress decreased (objectively and subjectively) during TC practice.
      Future studies should confirm this observation by rigorous
      methodology and by further combining physical and psychological
      measurements with basic research, thereby also gaining knowledge of
      autoregulation and molecular physiology that possibly underlies
      mind/body medicine.

      Breathing exercises with vagal biofeedback may benefit patients with
      functional dyspepsia. Scand J Gastroenterol. 2007 Sep; 42(9):1054-
      Hjelland IE, Svebak S, Berstad A, Flatabø G, Hausken T. (Institute of
      Medicine, University of Bergen, Division of Gastroenterology, Medical
      Dept, Haukeland University Hospital, Bergen, Norway.
      OBJECTIVE: Many patients with functional dyspepsia (FD) have
      postprandial symptoms, impaired gastric accommodation and low vagal
      tone. The aim of this study was to improve vagal tone, and thereby
      also drinking capacity, intragastric volume and quality of life,
      using breathing exercises with vagal biofeedback. MATERIAL AND
      METHODS: Forty FD patients were randomized to either a biofeedback
      group or a control group. The patients received similar information
      and care. Patients in the biofeedback group were trained in breathing
      exercises, 6 breaths/min, 5 min each day for 4 weeks, using specially
      designed software for vagal biofeedback. Effect variables included
      maximal drinking capacity using a drink test (Toro clear meat soup
      100 ml/min), intragastric volume at maximal drinking capacity,
      respiratory sinus arrhythmia (RSA), skin conductance (SC) and
      dyspepsia-related quality of life scores. RESULTS: Drinking capacity
      and quality of life improved significantly more in the biofeedback
      group than in the control group (p=0.02 and p=0.01) without any
      significant change in baseline autonomic activity (RSA and SC) or
      intragastric volume. After the treatment period, RSA during breathing
      exercises was significantly correlated to drinking capacity (r=0.6,
      p=0.008). CONCLUSIONS: Breathing exercises with vagal biofeedback
      increased drinking capacity and improved quality of life in FD
      patients, but did not improve baseline vagal tone.

      The effects of vigorous exercise training on physical function in
      children with arthritis: a randomized, controlled, single-blinded
      trial. Arthritis Rheum. 2007; 57(7):1202-10.
      Singh-Grewal D, Schneiderman-Walker J, Wright V, Bar-Or O, Beyene J,
      Selvadurai H, et al. (The Hospital for Sick Children, Toronto,
      Ontario, Canada.)
      OBJECTIVE: To examine the effectiveness of high-intensity aerobic
      training compared with low-intensity training in terms of energy cost
      of locomotion, peak oxygen uptake, peak power, and self-reported
      physical function in children with juvenile idiopathic arthritis
      (JIA). METHODS: Eighty children with JIA, ages 8-16 years, were
      enrolled in a randomized, single-blind controlled trial. Both groups
      participated in a 12-week, 3-times-weekly training program consisting
      of high-intensity aerobics in the experimental group and qigong in
      the control group. Subjects underwent exercise testing measuring
      submaximal oxygen uptake at 3 km/hour (VO(2submax)) as the primary
      outcome, maximal oxygen uptake, and peak power at the beginning and
      end of the program. Physical function was measured using the Child
      Health Assessment Questionnaire (C-HAQ). RESULTS: The exercise
      program was well tolerated in both groups. There was no difference in
      VO(2submax) or any other exercise testing measures between the groups
      through the study period and no indication of improvement. Both
      groups showed significant improvements in C-HAQ with no difference
      between the groups. Adherence was higher in the control group than
      the experimental group. CONCLUSION: Our findings suggest that
      activity programs with or without an aerobic training component are
      safe and may result in an important improvement in physical function.
      The intensity of aerobic training did not seem to provide any
      additional benefits, but higher adherence in the qigong program may
      suggest that less intensive regimens are easier for children with JIA
      to comply with, and provide a degree of benefit equivalent to more
      intensive programs.

      Tai chi for osteoarthritis: a systematic review. Clin Rheumatol. 2007
      Sep 14;
      Lee MS, Pittler MH, Ernst E. (Complementary Medicine, Peninsula
      Medical School, Universities of Exeter & Plymouth, 25 Victoria Park
      Road, Exeter, EX2 4NT, UK, myeong.lee@....)
      The aim of this study was to evaluate data from controlled clinical
      trials testing the effectiveness of tai chi for treating
      osteoarthritis. Systematic searches were conducted on MEDLINE, AMED,
      British Nursing Index, CINAHL, EMBASE, PsycInfo, The Cochrane Library
      2007, Issue 2, the UK National Research Register and
      ClinicalTrials.gov, Korean medical databases, the Qigong and Energy
      database and Chinese medical databases (until June 2007). Hand
      searches included conference proceedings and our own files. There
      were no restrictions regarding the language of publication. All
      controlled trials of tai chi for patients with osteoarthritis were
      considered for inclusion. Methodological quality was assessed using
      the Jadad score. Five randomised clinical trials (RCTs) and seven non-
      randomised controlled clinical trials (CCTs) met all inclusion
      criteria. Five RCTs assessed the effectiveness of tai chi on pain of
      osteoarthritis (OA). Two RCTs suggested significant pain reduction on
      visual analog scale or Western Ontario and McMaster Universities
      Osteoarthritis Index (WOMAC) compared to routine treatment and an
      attention control program in knee OA. Three RCTs did not report
      significant pain reduction on multiple sites pain. Four RCTs tested
      tai chi for physical functions. Two of these RCTs suggested
      improvement of physical function on activity of daily living or WOMAC
      compared to routine treatment or wait-list control, whilst two other
      RCTs failed to do so. In conclusion, there is some encouraging
      evidence suggesting that tai chi may be effective for pain control in
      patients with knee OA. However, the evidence is not convincing for
      pain reduction or improvement of physical function. Future RCTs
      should assess larger patient samples for longer treatment periods and
      use appropriate controls.

      Biopsychosocial effects of qigong as a mindful exercise for people
      with anxiety disorders: a speculative review. J Altern Complement
      Med. 2007 Oct; 13(8):831-9.
      Chow YW, Tsang HW. (Department of Rehabilitation Sciences, The Hong
      Kong Polytechnic University, Hung Hom, Hong Kong.)
      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.
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