Qi Research Update -- many new RCTs
- Tai Chi is effective in treating knee osteoarthritis: A randomized controlled trial. Arthritis Rheum. 2009 Nov 15;61(11):1545-53. by Wang C, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, McAlindon T. ( Tufts Medical Center , Tufts University School of Medicine, Boston , Massachusetts .)
OBJECTIVE: To evaluate the effectiveness of Tai Chi in the treatment of knee osteoarthritis (OA) symptoms. METHODS: We conducted a prospective, single-blind, randomized controlled trial of 40 individuals with symptomatic tibiofemoral OA. Patients were randomly assigned to 60 minutes of Tai Chi (10 modified forms from classic Yang style) or attention control (wellness education and stretching) twice weekly for 12 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score at 12 weeks. Secondary outcomes included WOMAC function, patient and physician global assessments, timed chair stand, depression index, self-efficacy scale, and quality of life. We repeated these assessments at 24 and 48 weeks. Analyses were compared by intent-to-treat principles. RESULTS: The 40 patients had a mean age of 65 years and a mean body mass index of 30.0 kg/m(2). Compared with the controls, patients assigned to Tai Chi exhibited significantly greater improvement in WOMAC pain (mean difference at 12 weeks -118.80 mm [95% confidence interval (95% CI) -183.66, -53.94; P = 0.0005]), WOMAC physical function (-324.60 mm [95% CI -513.98, -135.22; P = 0.001]), patient global visual analog scale (VAS; -2.15 cm [95% CI -3.82, -0.49; P = 0.01]), physician global VAS (-1.71 cm [95% CI -2.75, -0.66; P = 0.002]), chair stand time (-10.88 seconds [95% CI -15.91, -5.84; P = 0.00005]), Center for Epidemiologic Studies Depression Scale (-6.70 [95% CI -11.63, -1.77; P = 0.009]), self-efficacy score (0.71 [95% CI 0.03, 1.39; P = 0.04]), and Short Form 36 physical component summary (7.43 [95% CI 2.50, 12.36; P = 0.004]). No severe adverse events were observed. CONCLUSION: Tai Chi reduces pain and improves physical function, self-efficacy, depression, and health-related quality of life for knee OA.
Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Annals of Oncology Advance Access published online on Oct 30, 2009. by Oh B, Butow P, Mullan B, Clarke S, Beale P, Pavlakis N, Kothe E, Lam L, Rosenthal D. (Department of Medicine, Concord Repatriation General Hospital , University of Sydney , Concord .)
BACKGROUND: Substantial numbers of cancer patients use complementary medicine therapies, even without a supportive evidence base. This study aimed to evaluate in a randomized controlled trial, the use of Medical Qigong (MQ) compared with usual care to improve the quality of life (QOL) of cancer patients. PATIENTS AND METHODS: One hundred and sixty-two patients with a range of cancers were recruited. QOL and fatigue were measured by Functional Assessment of Cancer Therapy-General and Functional Assessment of Cancer Therapy-Fatigue, respectively, and mood status by Profile of Mood State. The inflammatory marker serum C-reactive protein (CRP) was monitored serially. RESULTS: Regression analysis indicated that the MQ group significantly improved overall QOL (t(144) = -5.761, P < 0.001), fatigue (t(153) = -5.621, P < 0.001), mood disturbance (t(122) =2.346, P = 0.021) and inflammation (CRP) (t(99) = 2.042, P < 0.044) compared with usual care after controlling for baseline variables. CONCLUSIONS: This study indicates that MQ can improve cancer patients' overall QOL and mood status and reduce specific side-effects of treatment. It may also produce physical benefits in the long term through reduced inflammation.
Effects of Qigong in patients with burnout: a randomized controlled trial. Journal of rehabilitation Medicine, 2009, 41(9):761-7. by Stenlund T, Birgander LS, Lindahl B, Nilsson L, Ahlgren C. (Dept. of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University , Umeå , Sweden . therese.stenlund@... )
OBJECTIVE: To evaluate the efficacy of Qigong in rehabilitation for patients with burnout. DESIGN: Prospective, randomized controlled trial. SUBJECTS: Eighty-two patients (68 women and 14 men, mean age 44.3 (standard deviation 9.1) years) diagnosed with burnout. METHODS: Basic care was offered to both the intervention and the control group. Patients in the intervention group received basic care and, in addition, performed Qigong twice a week for 12 weeks. Psychological variables, health-related quality of life, perceived relaxation and physical measurements were assessed at baseline and after the intervention period. RESULTS: No significant difference in treatment efficacy between the groups was found by either intention-to-treat or per-protocol analyses. Both groups improved significantly over time, with reduced levels of burnout, fatigue, anxiety and depression, and increased dynamic balance and physical capacity. CONCLUSION: In this study, a Qigong intervention twice a week for 12 weeks had no additional effect beyond basic care for patients with burnout.
Qigong massage treatment for sensory and self-regulation problems in young children with autism: a randomized controlled trial. Am J Occup Ther. 2009 Jul-Aug;63(4):423-32. by Silva LM, Schalock M, Ayres R, Bunse C, Budden S. (Teaching Research Institute, Western Oregon University , PO Box 688 , Salem , OR 97308 , USA. lmtsilvaqigong@...)
Autism is commonly associated with sensory and self-regulatory disturbances. This article presents a randomized controlled study evaluating the effect of a 5-month intervention directed toward improving sensory impairment, digestion, and sleep in 46 children with autism < age 6. The intervention, Qigong Sensory Training (QST), is a qigong massage intervention based in Chinese medicine. It is two-pronged: Trainers work with children directly 20 times over 5 months, and parents give the massage daily to their children. Improvement was evaluated in two settings--preschool and home--by teachers (blind to group) and parents. Teacher evaluations showed that treated children had significant classroom improvement of social and language skills and reduction in autistic behavior compared with wait-list control participants. These findings were confirmed by parent data, indicating that the gains had generalized across contexts. A model and supporting data for understanding and treating sensory and self-regulation problems in autism is presented.
Effect of 12-week tai chi chuan exercise on peripheral nerve modulation in patients with type 2 diabetes mellitus. J Rehabil Med. 2009 Nov;41(11):924-9. by Hung JW, Liou CW, Wang PW, Yeh SH, Lin LW, Lo SK, Tsai FM. (Department of Rehabilitation Medicine, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University, Kaohsiung Hsiang, Taiwan.)
OBJECTIVE: To examine the effect of tai chi chuan exercise on peripheral nerve modulation in patients with type 2 diabetes mellitus. DESIGN: Parallel group comparative study with a pre- and post- design. SUBJECTS: Twenty-eight participants with diabetes mellitus and 32 healthy adult controls from communities in Kaohsiung , Taiwan . METHODS: Cheng's tai chi chuan, 3 times a week for 12 weeks. Fasting blood glucose levels, insulin resistance index and nerve conduction studies were measured. RESULTS: A 12-week tai chi chuan programme significantly improved fasting blood glucose (p = 0.035) and increased nerve conduction velocities in all nerves tested (p = 0.046, right; p = 0.041, left) in diabetic patients. Tai chi chuan exercise did not advance the nerve conduction velocities of normal adults; however, it significantly improved the motor nerve conduction velocities of bilateral median and tibial nerves, and distal sensory latencies of bilateral ulnar nerves in diabetic patients. Tai chi chuan exercise had no significant effect on amplitudes of all nerves tested in diabetic patients. CONCLUSIONS: Results from this study suggest that fasting blood glucose and peripheral nerve conduction velocities in diabetic patients can be improved by 12 weeks tai chi chuan exercise. A further larger randomized controlled clinical trial with longer follow-up time is needed.
A systematic review of neurobiological and clinical features of mindfulness meditations. Psychol Med. 2009 Nov 27:1-14. by Chiesa A, Serretti A. ( Institute of Psychiatry , University of Bologna , Italy .)
BACKGROUND: Mindfulness meditation (MM) practices constitute an important group of meditative practices that have received growing attention. The aim of the present paper was to systematically review current evidence on the neurobiological changes and clinical benefits related to MM practice in psychiatric disorders, in physical illnesses and in healthy subjects.MethodA literature search was undertaken using Medline, ISI Web of Knowledge, the Cochrane collaboration database and references of retrieved articles. Controlled and cross-sectional studies with controls published in English up to November 2008 were included. RESULTS: Electroencephalographic (EEG) studies have revealed a significant increase in alpha and theta activity during meditation. Neuroimaging studies showed that MM practice activates the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC) and that long-term meditation practice is associated with an enhancement of cerebral areas related to attention. From a clinical viewpoint, Mindfulness-Based Stress Reduction (MBSR) has shown efficacy for many psychiatric and physical conditions and also for healthy subjects, Mindfulness-Based Cognitive Therapy (MBCT) is mainly efficacious in reducing relapses of depression in patients with three or more episodes, Zen meditation significantly reduces blood pressure and Vipassana meditation shows efficacy in reducing alcohol and substance abuse in prisoners. However, given the low-quality designs of current studies it is difficult to establish whether clinical outcomes are due to specific or non-specific effects of MM.DiscussionDespite encouraging findings, several limitations affect current studies. Suggestions are given for future research based on better designed methodology and for future directions of investigation.
Increased theta and alpha EEG activity during nondirective meditation. J Altern Complement Med. 2009 Nov;15(11):1187-92. by Lagopoulos J, Xu J, Rasmussen I, Vik A, Malhi GS, Eliassen CF, Arntsen IE, Saether JG, Hollup S, Holen A, Davanger S, Ellingsen Ø. (Discipline of Psychological Medicine and Northern Clinical School , University of Sydney , Sydney , New South Wales , Australia. jlagopoulos@...)
OBJECTIVES: In recent years, there has been significant uptake of meditation and related relaxation techniques, as a means of alleviating stress and maintaining good health. Despite its popularity, little is known about the neural mechanisms by which meditation works, and there is a need for more rigorous investigations of the underlying neurobiology. Several electroencephalogram (EEG) studies have reported changes in spectral band frequencies during meditation inspired by techniques that focus on concentration, and in comparison much less has been reported on mindfulness and nondirective techniques that are proving to be just as popular. DESIGN: The present study examined EEG changes during nondirective meditation. The investigational paradigm involved 20 minutes of acem meditation, where the subjects were asked to close their eyes and adopt their normal meditation technique, as well as a separate 20-minute quiet rest condition where the subjects were asked to close their eyes and sit quietly in a state of rest. Both conditions were completed in the same experimental session with a 15-minute break in between. RESULTS: Significantly increased theta power was found for the meditation condition when averaged across all brain regions. On closer examination, it was found that theta was significantly greater in the frontal and temporal-central regions as compared to the posterior region. There was also a significant increase in alpha power in the meditation condition compared to the rest condition, when averaged across all brain regions, and it was found that alpha was significantly greater in the posterior region as compared to the frontal region. CONCLUSIONS: These findings from this study suggest that nondirective meditation techniques alter theta and alpha EEG patterns significantly more than regular relaxation, in a manner that is perhaps similar to methods based on mindfulness or concentration.
Mindfulness meditation for substance use disorders: a systematic review. Substance Abuse. 2009 Oct-Dec; 30(4): 266-94. by Zgierska A, Rabago D, Chawla N, Kushner K, Koehler R, Marlatt A. (Department of Family Medicine, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, USA.)
Relapse is common in substance use disorders (SUDs), even among treated individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for SUDs. The comprehensive search for and review of literature found over 2000 abstracts and resulted in 25 eligible manuscripts (22 published, 3 unpublished: 8 randomized controlled trials, 7 controlled nonrandomized, 6 noncontrolled prospective, and 2 qualitative studies, and 1 case report). When appropriate, methodological quality, absolute risk reduction, number needed to treat, and effect size were assessed. Overall, although preliminary evidence suggests MM efficacy and safety, conclusive data for MM as a treatment of SUDs are lacking. Significant methodological limitations exist in most studies. Further, it is unclear which persons with SUDs might benefit most from MM. Future trials must be of sufficient sample size to answer a specific clinical question and should target both assessment of effect size and mechanisms of action.