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Research updates on Qigong and Tai chi...

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  • Kevin W Chen
    [Research Update] Guo X, Zhou B, Nishimura T, Teramukai S, Fukushima M “Clinical Effect of Qigong Practice on Essential Hypertension: A Meta-Analysis of
    Message 1 of 1 , Mar 29, 2008
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      [Research Update]
      Guo X, Zhou B, Nishimura T, Teramukai S, Fukushima M  “Clinical Effect of Qigong Practice on Essential Hypertension: A Meta-Analysis of Randomized Controlled Trials.” J Altern Complement Med. 2008 Jan 16 [Epub ahead of print]
               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.

      Yu ML, Li XQ, Tang WJ, LI Y, Weng XC, Chen YZ, fMRI study of pain reaction in the brain under state of "Qigong".  Am J Chin Med. 2007; 35(6):937-45

               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.

      Da Silva GD,  Lorenzi-Filho G, Lage LV. Effects of yoga and the addition of Tui Na in patients with fibromyalgia.    J Altern Complement Med. 2007 Dec;13(10):1107-13
               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.

      Yan X,  Shen H, Jiang H, Zhang C, Hu D,  Wang J, Wu X. External Qi of Yan Xin Qigong induces G2/M arrest and apoptosis of androgen-independent prostate cancer cells by inhibiting Akt and NF-kappaB pathways.  Mol Cell Biochem. 2008 Mar; 310(1-2):227-34.
               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-kappaB pathways.

      Reid MC, Papaleontiou M, Ong A, Breckman R, Wethington E, Pillemer K,  Self-Management Strategies to Reduce Pain and Improve Function among Older Adults in Community Settings: A Review of the Evidence. Pain Med. 2008 Mar 11 [Epub ahead of print]
               Context. Self-management strategies for pain hold substantial promise as a means of reducing pain and improving function among older adults with chronic pain, but their use in this age group has not been well defined. Objective. To review the evidence regarding self-management interventions for pain due to musculoskeletal disorders among older adults. Design. We searched the Medline and Cumulative Index to Nursing and Allied Health Literature databases to identify relevant articles for review and analyzed English-language articles that presented outcome data on pain, function, and/or other relevant endpoints and evaluated programs/strategies that could be feasibly implemented in the community. Abstracted information included study sample characteristics, estimates of treatment effect, and other relevant outcomes when present. Results. Retained articles (N = 27) included those that evaluated programs sponsored by the Arthritis Foundation and other programs/strategies including yoga, massage therapy, Tai Chi, and music therapy. Positive outcomes were found in 96% of the studies. Proportionate change in pain scores ranged from an increase of 18% to a reduction of 85% (median = 23% reduction), whereas change in disability scores ranged from an increase of 2% to a reduction of 70% (median = 19% reduction). Generalizability issues identified included limited enrollment of ethnic minority elders, as well as non-ethnic elders aged 80 and above. Conclusions. Our results suggest that a broad range of self-management programs may provide benefits for older adults with chronic pain. Research is needed to establish the efficacy of the programs in diverse age and ethnic groups of older adults and identify strategies that maximize program reach, retention, and methods to ensure continued use of the strategies over time.

      Yang Y, et al.   Effects of a Taiji and Qigong intervention on the antibody response to influenza vaccine in older adults.  Am J Chin Med. 2007;35(4):597-607.

               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 < 0.05) increase in the magnitude and duration of the antibody response to influenza vaccine in TQ participants when compared to CON. The vaccination resulted in a 173, 130, and 109% increase in HI titer at 3, 6, and 20 weeks post-vaccine, respectively, in the TQ group compared to 58, 54, and 10% in CON. There was a significant between group difference at 3 and 20 weeks post-vaccine and at 20 weeks the TQ group had significantly higher titers compared to the pre-vaccine time point, whereas the CON group did not. A higher percentage of TQ subjects also responded to the influenza A strains with a protective (> 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.

      Smith BW, Shelley BM, Dalen J,  Wiggins K, Tooley E,  Bernard J.  A Pilot Study Comparing the Effects of Mindfulness-Based and Cognitive-Behavioral Stress Reduction. .  J Altern Complement Med. 2008 Mar 27 [Epub ahead of print]
               ABSTRACT Objectives: The objective of this pilot study was to compare the effects of two mind-body interventions: mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR). Subjects: Fifty (50) subjects were recruited from the community and took part in MBSR (n = 36) and CBSR (n = 14) courses. Participants self-selected into MBSR or CBSR courses taught at different times. There were no initial differences between the MBSR and CBSR subjects on demographics, including age, gender, education, and income. Intervention: MBSR was an 8-week course using meditation, gentle yoga, and body scanning exercises to increase mindfulness. CBSR was an 8-week course using cognitive and behavioral techniques to change thinking and reduce distress. Design: Perceived stress, depression, psychological well-being, neuroticism, binge eating, energy, pain, and mindfulness were assessed before and after each course. Pre-post scores for each intervention were compared by using paired t tests. Pre-post scores across interventions were compared by using a general linear model with repeated measures. Settings/Locations: Weekly meetings for both courses were held in a large room on a university medical center campus. Results: MBSR subjects improved on all eight outcomes, with all of the differences being significant. CBSR subjects improved on six of eight outcomes, with significant improvements on well-being, perceived stress, and depression. Multivariate analyses showed that the MBSR subjects had better outcomes across all variables, when compared with the CBSR subjects. Univariate analyses showed that MBSR subjects had better outcomes with regard to mindfulness, energy, pain, and a trend for binge eating. Conclusions: While MBSR and CBSR may both be effective in reducing perceived stress and depression, MBSR may be more effective in increasing mindfulness and energy and reducing pain. Future studies should continue to examine the differential effects of cognitive behavioral and mindfulness-based interventions and attempt to explain the reasons for the differences.

      Singh NN,  Lancioni GE,  Winton AS, Singh AN, Adkins AD, Singh J.  Clinical and Benefit-Cost Outcomes of Teaching a Mindfulness-Based Procedure to Adult Offenders With Intellectual Disabilities. Behav Modif. 2008 Mar 24 [Epub ahead of print] 
               The effects of a mindfulness-based procedure, called Meditation on the Soles of the Feet, were evaluated as a cognitive-behavioral intervention for physical aggression in 6 offenders with mild intellectual disabilities. They were taught a simple meditation technique that required them to shift their attention and awareness from the precursors of aggression to the soles of their feet, a neutral point on their body. Results showed that physical and verbal aggression decreased substantially, no Stat medication or physical restraint was required, and there were no staff or peer injuries. Benefit-cost analysis of lost days of work and cost of medical and rehabilitation because of injury caused by these individuals in both the 12 months prior to and following mindfulness-based training showed a 95.7% reduction in costs. This study suggests that this procedure may be a clinically effective and cost-effective method of enabling adult offenders with intellectual disabilities to control their aggression.

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