Carol E. Rogers

A Comprehensive Review of Health Benefits of Qigong and Tai Chi

Objective. Research examining psychological and physiological benefits of Qigong and Tai Chi is growing rapidly. The many practices described as Qigong or Tai Chi have similar theoretical roots, proposed mechanisms of action, and expected benefits. Research trials and reviews, however, treat them as separate targets of examination. This review examines the evidence for achieving outcomes from randomized controlled trials (RCTs) of both. Data Sources. The key words Tai Chi, Taiji, Tai Chi Chuan, and Qigong were entered into electronic search engines for the Cumulative Index for Allied Health and Nursing (CINAHL), psychological literature (PsycINFO), PubMed, Cochrane database, and Google Scholar. Study Inclusion Criteria. RCTs reporting on the results of Qigong or Tai Chi interventions and published in peer-reviewed journals from 1993 to 2007. Data Extraction. Country, type and duration of activity, number/type of subjects, control conditions, and reported outcomes were recorded for each study. Synthesis. Outcomes related to Qigong and Tai Chi practice were identified and evaluated. Results. Seventy-seven articles met the inclusion criteria. The nine outcome category groupings that emerged were bone density (n = 4), cardiopulmonary effects (n = 19), physical function (n = 16), falls and related risk factors (n = 23), quality of life (n = 17), self-efficacy (n = 8), patient-reported outcomes (n = 13), psychological symptoms (n = 27), and immune function (n = 6). Conclusions. Research has demonstrated consistent, significant results for a number of health benefits in RCTs, evidencing progress toward recognizing the similarity and equivalence of Qigong and Tai Chi.

A Review of Clinical Trials of Tai Chi and Qigong in Older Adults

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.

Roy's Adaptation Model to Promote Physical Activity among Sedentary Older Adults

T he aging population is rapidly increasing in size, and with this increase there is a growing need for age-appropriate physical activity (PA) programs to help older adults age successfully. Older adults face many challenges in adaptation to aging and related physical function, emphasizing the importance of developing interventions to promote adaptation to aging, such as increasing PA among older adults. A primary concern for the aging individual is the decline in physical function, compounded with the increased prevalence of sedentary behavior. In 2005, 47% of the young-old (those aged 65–74 years) reported no leisure-time activity, with 60% of the old-old (those aged over 75 years) reporting no leisure-time activity. These data indicate that the aging population is falling short of Healthy People 2010 goals and the American College of Sports Medicine/American Heart Association guidelines for PA in older adults. Those guidelines recommend at least 30 minutes of moderate-intensity PA at least 5 times per week, strength training and flexibility 2 times a week, and balance training. Further, they recommend that sedentary older adults begin with balance, flexibility, and strength training to build endurance before participating in moderateto vigorous-intensity aerobic PA. The interplay of mind-body theoretical concepts and PA has increased in popularity since the 1990s and makes up 30% of the exercise programs in fitness centers. Mind-body practices that blend physical movement or postures with a focus on the breath and mind to achieve deep states of relaxation include, but are not limited

Measurement Pilot Study of the Meditative Movement Inventory (MMI)

Background and Purpose: Mind–body practices that blend physical movement or postures with a focus on the breath and a meditative state to achieve deep states of relaxation have recently been characterized as a category of exercise called meditative movement and include practices such as Yoga, Tai Chi, and Qigong. Critical components of such practices have not been adequately assessed in research, leaving the fidelity of interventions in question; however, there is currently no set of relevant instruments. This article describes the development and preliminary validation of two subscales of the meditative movement inventory (MMI). Methods: Questionnaire items were generated with input from expert practitioners, and tested in the context of an intervention study (N = 87) comparing Qigong/Tai Chi Easy (QG/TCE) to sham Qigong (SQG). Results: Principal components analysis produced three substantively meaningful factors: breath focus (BF; e.g., “I was using my breathing to go into a relaxed state”; five items, α = .86), meditative connection (MC; e.g., “I was connected to something greater than myself”; four items, α = .90), and flowing motion (FM; e.g., “I moved in relaxed, fluid movements”; two items, α = .61, dropped from further analysis). Confirmatory factor analyses of the first two factors (BF and MC) to examine item reliabilities fit the data well providing positive results for construct composition and item reliabilities. Conclusions: The BF and MC subscales demonstrated initial strong properties for assessing the presence and strength of these factors in meditative movement intervention studies, whereas additional work is needed to further develop the FM subscale.

A randomized controlled trial to determine the efficacy of Sign Chi Do exercise on adaptation to aging.

Sedentary older adults are at risk of decreased physical function that may lead to loss of independence. In addition, low spirituality is associated with all-cause mortality for older adults. Published research studies have not evaluated the effects of spirituality following a meditative movement intervention such as Sign Chi Do (SCD). The Roy Adaptation Model guided the design of a 12-week intervention that tested the effects of SCD compared with a minimal education control group on physiological and self-concept adaptation. Sixty-seven sedentary, community-dwelling older adults were randomized to the SCD or control group. Final analysis included 49 participants after adjusting for dropouts and incomplete data. Measurement of physiological (Timed Up & Go [TUG], 6-minute walk [6-MW], and metabolic equivalent [MET]-minute/week) and self-concept (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12 and Exercise Self-Efficacy) adaptation were completed at baseline (Time 1), 6 (Time 2), and 12 (Time 3) weeks. TUG and MET-minute/week scores improved significantly from Time 1 to Time 3 for the intervention group, and 6-MW at Time 3 showed a significant between-group difference of 271.36 feet. Self-concept measures did not yield significant results. These results indicate that the theoretical factor of Roys physiological adaptation (balance and physical function) improved in response to the SCD intervention among sedentary older adults.

Maintenance of physical function in frail older adults

Inactivity leads to frailty and loss of function for older adults. Most older adults are sedentary. Participating in a regular routine of physical activity is recommended for maintaining physical function required to sustain quality of life and independence for older adults. Annual screening for level of physical activity is required to determine changes from year to year. Research shows older adults are more likely to initiate a regular routine of physical activity when a health care provider writes a prescription for physical activity including the type, frequency, and specific duration of physical activity sessions.

Mind–Body Therapies in Individuals With Dementia: An Integrative Review

Mind-body therapies frequently derive from Eastern philosophies and are becoming increasingly popular. These therapies, such as meditation, yoga, tai chi, qigong, biofield therapies, and guided imagery, have many reported benefits for improving symptoms and physiological measures associated with various chronic diseases. However, clinical research data concerning the effectiveness of these practices in individuals with dementia have not been evaluated using a synthesis approach. Thus, an integrative review was conducted to evaluate studies examining the efficacy of mind-body therapies as supportive care modalities for management of symptoms experienced by individuals with dementia. Findings from the studies reviewed support the clinical efficacy of mind-body practices in improving behavioral and psychological symptoms exhibited by individuals with dementia. [Res Gerontol Nurs. 2017; 10(6):288-296.].

Sign Chi Do and physical function: A pilot study

Participating in strength, balance, and flexibility training reduces the risk for decreased physical function for older adults. This pilot study tested the effect of an exercise intervention on physical function. A pretest/posttest single-group design was used to test the effect of a 12-week Sign Chi Do (SCD) exercise intervention on upper body strength (arm curls) and lower body strength (chair stands); balance (Timed Up & Go and one-leg stance), and flexibility (back scratch). Five community-dwelling older adults not participating in strength, flexibility, or balance training completed the study. Strength scores improved by at least 2 arm curls or chair stands for those at risk for loss of physical function. Timed Up & Go scores improved by an average of 3.83 (range 1.98-4.98) seconds for those at risk for falls. All flexibility scores remained in the upper 75th percentile. Continued practice of SCD has the potential to improve physical function for older adults.