Peer-Reviewed Research: Physical and Psychological Health Outcomes of Qigong Exercise in Older Adults
The systematic review and meta-analysis conducted by Chang et al. (2019) investigates the physical and psychological health outcomes of Qigong exercise in older adults. The authors address the need for alternative, low-impact exercise interventions for individuals aged 60 and above who often experience physical and psychological health challenges due to aging and chronic conditions. By focusing on 14 randomized controlled trials (RCTs), this review evaluates the effects of Qigong on physical ability, functional ability, balance, depression, and anxiety among older adults.
Study Selection and Methods
The review included 14 RCTs involving 1,282 participants aged 62–83 years. The inclusion criteria focused on studies that:
Evaluated the effects of Qigong using randomized controlled designs.
Included participants with a mean age of 60 years or older.
Measured physical or psychological health outcomes. The authors excluded studies on Tai Chi Qigong, external Qigong, and Qigong massage due to their differing mechanisms and influences.
Key databases such as CINAHL, PubMed, AMED, and Scopus were searched, and the studies were assessed for risk of bias using Cochrane’s tool. Data analysis involved standardized mean differences (SMDs) for outcomes like the 6-minute walk test (6MWT), depression scales, and balance measures.
Key Findings
Physical Ability: Qigong demonstrated significant improvements in physical ability, particularly in the 6MWT. Studies comparing Qigong to active controls (e.g., walking or yoga) showed moderate effects, while comparisons with non-active controls (e.g., newspaper reading) yielded even larger effect sizes.
Functional Ability: Similar trends were observed for functional ability, with Qigong groups outperforming control groups in evaluations such as the Monitored Functional Task Evaluation (MFTE). However, heterogeneity among studies reduced the statistical strength of these findings.
Balance: Although some individual studies reported improvements in balance, the pooled analysis did not show statistically significant results. The authors attributed this to variations in Qigong styles and durations across studies.
Psychological Outcomes: Depression and anxiety were assessed in several studies, with mixed results. While some studies showed significant reductions in depressive symptoms (e.g., using the Geriatric Depression Scale [GDS]), the overall effect was not statistically significant compared to controls. Anxiety outcomes, although less frequently assessed, showed potential benefits in certain populations, such as cancer patients.
Safety: Qigong was reported as a safe exercise intervention with minimal adverse events, including mild nausea and muscle aches in a few participants.
Discussion
The findings support Qigong as a feasible and beneficial exercise for improving physical and functional abilities in older adults. However, the evidence for psychological benefits remains inconclusive due to high heterogeneity and limited methodological rigor in some studies. The review also highlights an optimal intervention dosage of 1,500–2,000 minutes over three months, practiced three times weekly, for achieving meaningful physical health outcomes.
The authors discuss cultural factors influencing psychological outcomes, such as differing expressions of mood among participants from various backgrounds. Additionally, they note that methodological weaknesses, including inadequate randomization and lack of allocation concealment, may inflate effect sizes in low-quality studies.
Strengths of the Review
Comprehensive Inclusion Criteria: By focusing exclusively on RCTs, the authors ensured a high standard of evidence quality.
Detailed Subgroup Analysis: The subgroup analyses shed light on variables such as intervention frequency, duration, and Qigong style, which help guide future research and clinical applications.
Focus on Older Adults: The review addresses a crucial demographic often underrepresented in exercise research.
Limitations
High Heterogeneity: Significant variability in study designs, outcome measures, and Qigong interventions reduced the precision of pooled results. For instance, studies utilized different forms of Qigong (e.g., Baduanjin, Liuzijue), each with unique characteristics.
Limited Psychological Measures: While depression was frequently measured, anxiety assessments were sparse, leading to an incomplete understanding of Qigong’s psychological effects.
Geographic and Cultural Bias: Most studies were conducted in Asia, limiting generalizability to Western populations. Furthermore, the exclusion of non-English studies may have omitted relevant data.
Methodological Shortcomings: Many studies lacked blinding and adequate randomization, which could bias results.
Implications for Practice and Research
The findings emphasize the potential of Qigong as a low-risk, accessible intervention for older adults with physical limitations or chronic conditions. Clinicians and therapists may incorporate Qigong into rehabilitation programs, particularly for enhancing physical functioning. However, the review underscores the need for high-quality RCTs with standardized protocols to confirm these benefits and explore Qigong’s psychological effects in greater depth.
Future research should:
Include larger, more diverse populations, including Western participants.
Standardize Qigong interventions to reduce variability and enhance reproducibility.
Employ robust methodologies, including blinded assessments and detailed reporting of randomization and allocation processes.
Conclusion
Chang et al. (2019) provide valuable insights into the potential benefits of Qigong for older adults, particularly for physical and functional abilities. While the findings for psychological health are promising, they are limited by methodological weaknesses and heterogeneity across studies. The review highlights the need for more rigorous research to establish Qigong as a mainstream intervention for promoting healthy aging.
Reference
Chang, P. S., Knobf, T., Oh, B., & Funk, M. (2019). Physical and psychological health outcomes of Qigong exercise in older adults: A systematic review and meta-analysis. The American Journal of Chinese Medicine, 47(02), 301–322
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