The following information was presented during the Research Panel at the 2019 NQA Annual Conference on Diaphramgmatic Breathing. It includes a summary of current research on diaphragmatic breathing.

Diaphragmatic Breathing

Qigong for Insomnia

This systematic review and meta-analysis provided evidence that mind body therapies such as tai chi, qigong, yoga, and meditation could be effective in treating insomnia and improving the sleep quality of healthy subjects and clinical patients.

This paper examined the effects of a Tai Chi / Qigong intervention in four children between the ages of 6 and 10. The children were referred into the program due to difficult behavior and a diagnosis of ADHD. Consent was obtained from their parents.

The sessions took place over the course of a school-year (20 minutes, 30 sessions total - 1x/week). Tai Chi forms focused on regulation of breathing, mind focus and soft control of movements. The Qigong forms focused on clearance of mind and slow control of movements with muscle contraction-relaxation patterns synced with breathing.

This study suggested the protective role of long-term Tai Chi exercise at slowing gray matter atrophy, improving the emotional stability and achieving successful aging for elders.

Long-Term Tai Chi Experience Promotes Emotional Stability and Slows Gray Matter Atrophy for Elders

This study examined the effects of Tai Chi and Baduanjin on the Default Mode Network (DMN) in individuals between the ages of 50 and 70 years old. Participants were randomized into 3 groups: group 1 performed Tai Chi exercises based on Yang Style 24 form; group 2 performed exercises of Baduanjin; and group 3 was the control group and received a health education lecture at the beginning of the program and were instructed to continue with their routine activities over the next 12 weeks. Groups 1 and 2 performed their respective exercises for 60 minutes, 5 times/week, for 12 weeks. Pre and post outcome measures consisted of a standardized memory test and resting-state functional MRI’s.

The default mode network refers to a collection of areas in the brain that have shown age related decreases in neural activities related to goal-directed tasks. Two of these regions- the medial prefrontal cortex and the posterior cingulate cortex- have been implicated in the processing of cognitive, emotional, pain and other self-modulation. Abnormalities of the DMN have been detected in multiple age-related diseases, such as mild cognitive impairment (Gardini et al., 2015), Alzheimer’s disease (Brueggen et al., 2017), depression (Ho et al., 2015) and Parkinson’s disease (Mohan et al., 2016). In addition, studies have found that stress is also associated with alterations of the DMN.

This article shows the effects on healthy volunteers who are new to qigong  who did qigong for one month. The main finding of the present investigation is that Taoist qigong practice induces a significant modulation on the blood levels of ACTH in healthy subjects with no previous qigong experience.  There were no effects on other measures of well-being such as depression or anxiety or sleep issues, however, perhaps due to the very short time frame (only one month). Generally ACTH blood levels impact the feeling of well-being.

Abstract

Assessment of hormonal parameters and psychological well‐being in healthy subjects after a Taoist qigong program: An exploratory study

Francisca M. Vera, Juan M. Manzaneque , Francisco M. Rodríguez,  Miguel Vadillo , Federico Navajas , Ana I. Heiniger , Vidal Pérez , M. José Blanca

This study from the Sleep Disorders Center in Turkey provides strong evidence that a Tai Chi and Qigong program (three times per week for twelve weeks) can significantly improve breathing during sleep and improve the quality of sleep in patients with sleep apnea.

Fifty participants were equally randomized into an intervention group and a control group. The intervention group received Tai Chi and Qigong instruction for 1 hour, 3 times a week with self-practice on 2 additional days for 12 weeks. The control group received a home exercise program only, for 5 days/week for 12 weeks.

Effectiveness of t'ai chi and qigong on chronic obstructive pulmonary disease: a systematic review and meta-analysis.

This is a systematic review and meta-analysis, which means  it looks at all the other studies that were done on the topic of tai chi and qigong (TCQ) and Chronic Obstructive Pulmonary Disease (COPD) and assesses an overall evaluation of the evidence of benefit.  Unfortunately, the methodology for the chosen trials is not as rigorous as it needs to be in order to draw strong conclusions. Nonetheless, the evidence is positive.

This review found, out of a population of over 500 potential studies, only 10 met their strict criteria of randomized controlled trials with both exercise and non-exercise controls. The resulting 10 studies involved 718 subjects.

This study is significant because it showed for the first time Qigong can improve breathing function in people with COPD via instruction utilizing Qigong videos instead of an in-person program.

Participant adoption of the Meditative Movement (MM) practices showed a significant and moderately large correlation with overall health improvement for Flight Attendants with CPOD due to exposure to secondhand smoke. There were significant improvements in the 6-min walk test, the Multidimensional Assessment of Interoceptive Awareness (MAIA) score, and the COPD Assessment Test. Eighty one percent of respondents enjoyed the program. These results support the benefits of video-based qigong (MM) training for this population.

What Is the Molecular Signature of Mind–Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices

This systematic review of 18 studies investigated Mind-Body Interventions (MBI) and their effect on gene expression. MBIs included Qigong, yoga, breathing practices, Mindfulness Based Stress Reduction, Tai Chi, and meditation. In regards to Qigong, it was found that practitioners who had practiced Falun Qigong for an average of 1-5 years experienced  enhanced immunity, down-regulated cellular metabolism, and delayed cell death. Also, Tai Chi was studied for its effects on inflammation and sleep deprivation in breast cancer survivors. It was compared to a Cognitive Behavioral Intervention. It was found that IL-6 was marginally reduced and TNF (pro-inflammatory cytokines) was significantly reduced after Tai Chi, indicating that it can reduce cellular inflammatory responses. Similarly, gene expression analysis found a 9% reduction in expression of 19 pro-inflammatory genes and a 3.3% increase in expression of 34 genes involved in the production of proteins that regulate anti-viral response and tumor activity in the Tai Chi group relative to CBT-I.

Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomized controlled trial.

These findings indicate that Tai Chi offered greater and longer-term benefits than brisk walking in reducing modifiable CVD risk factors (especially blood pressure, obesity, blood glucose levels and psychosocial well-being). This study was a randomized control trial of  246 participants, randomized into three groups. Participants in the tai chi group attended a tai chi class for one hour twice a week for 3 months with 20 people per class. A follow up step showed that the results lasted 9 months after the study completed.

 Can Tai Chi and Qigong Postures Shape Our Mood? 

This Harvard University article gives a scientific basis for the importance of position as demonstrated by tai chi and qigong for people’s health.  According to Dr. Peter Wayne, the brain does not rule the body, the body rules the brain. Gait is a better predictor of health than heart rate, respiration rate, blood pressure or blood sugar. Qigong changes the body position and thus influences our health. Qigong can change your mood based on the shape you make.

Front. Hum. Neurosci., 01 May 2018 | https://doi.org/10.3389/fnhum.2018.00174

Tai Chi and Pulmonary Rehabilitation Compared for Patients With COPD.

 This study  shows that there is another beneficial treatment other than traditional pulmonary rehabilitation for people with COPD. It compared traditional pulmonary rehabilitation with a Tai Chi treatment. Tai Chi/Qigong was done five times weekly for 12 weeks. The improvements were the same during the study period but the main benefit was that after 3 months Tai Chi’s improvements remained while the pulmonary rehabilitation benefits declined.

The NQA Research and Education Committee is happy to provide qigong instructors with this handout to that describes what is qigong and some of its benefits. Revised 2018.

Handout to Download

This study utilized measurable biomarkers to demonstrate the impact of tai chi qigong. It was a relatively large study with a control group and found a statistically significant decrease in Hbq A1C (a pre-diabetes marker), a statistically significant increase in antioxidant markers, and a decrease in the oxidative stress score. The participants did Tai Chi Easy five days a week for six months. This is a impressive study.

Hypoglycemic and antioxidant effect of Tai chi exercise training in older adults with metabolic syndrome.

Clin Interv Aging. 2018 Apr 3;13:523-531. doi: 10.2147/CIA.S157584. eCollection 2018.

This high quality meta-analysis study review found that MB exercises (like Qigong) as an add-on treatment may potentially improve depression, activities of daily living, and mobility of these post-stroke patients. They limited the studies to those that were at least 5 weeks long, and they all showed positive results post stroke. This meta-analysis demonstrated a very high level of rigor (using the PRISMA checklist), and is the combined work of Chinese and American Researchers.

“To our knowledge, this is the first meta-analysis that included the rehabilitative effects of tai chi and qigong among stroke survivors. The main findings from this systematic review are of great significance for the public health sector since many stroke survivors have varying degrees of depression and loss of functional capacity—both of which affect their mood, functioning, and quality of life. MB exercises can be employed as safe and inexpensive complementary treatments to offer these patients more favorable outcomes.”

Encouraging results were found in this meta-study review of research on people with Heart Failure. Twenty-four Random Control studies were reviewed with a total of 1,314 participants. Qigong is included in the Tai chi studies.

Harvard Researcher Peter Wayne Meta-analysis on Qigong and Cancer

A very interesting article about the benefits of qigong during cancer challenges was recently published. Peter Wayne of Harvard University published a meta study review of 22 studies, of which 15 were randomized control research studies with 1,283 participants. He found that TCQ shows promise in addressing cancer-related symptoms and QOL in cancer survivors.

Qigong exercise has shown promising results in clinical experience and in randomized, controlled pilot studies for affecting aspects of Type 2 Diabetes Mellitus (T2DM) including blood glucose, triglycerides, total cholesterol, weight, BMI and insulin resistance.

Qigong Exercises for the Management of Type 2 Diabetes Mellitus

Amy L. Putiri, Jacqueline R. Close, Harold Ryan Lilly, Nathalie Guillaume, and Guan-Cheng Sun, Wen Liu, Academic Editor

Qigong and Memory - Preventing memory deficits and cognitive decline

Objectively using MRI imaging, this study showed that Qigong and Tai Chi can increase gray matter in the brain in older adults. It showed that there truly are physical changes in the brain with qigong, when practiced for twelve weeks.   The first article’s results demonstrate the potential of Tai Chi Chuan and Baduanjin exercise for the prevention of memory deficits in older adults. The second article’s findings demonstrate the potential of Tai Chi Chuan and Baduanjin exercises in preventing cognitive decline.