Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials

BMC Complementary and Alternative Medicine

Cecilia LW Chan²  Siu-Man Ng²  Jessie SM Chan¹  Rainbow TH Ho²  Celia HY Chan²  Chong-Wen Wang¹ 

[1] Centre on Behavioral Health, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong, China;Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam Road, Hong Kong, China

关键词: meta-analysis;    systematic review;    qigong;    anxiety;    stress;   

Others  :  1220391
DOI  :  10.1186/1472-6882-14-8

 received in 2013-09-16, accepted in 2014-01-06,  发布年份 2014

【 摘 要 】

Background

An increasing number of studies have documented the effectiveness of qigong exercise in helping people reduce psychological stress and anxiety, but there is a scarcity of systematic reviews evaluating evidence from randomized controlled trials (RCTs) conducted among healthy subjects.

Methods

Thirteen databases were searched for RCTs from their inception through June 2013. Effects of qigong exercise were pooled across trials. Standardized mean differences (SMDs) were calculated for the pooled effects. Heterogeneity was assessed using the I² test. The risk of bias was assessed using the Cochrane criteria.

Results

Seven RCTs met the inclusion criteria. Two RCTs suggested that qigong exercise immediately relieved anxiety among healthy adults, compared to lecture attendance and structured movements only. Four RCTs suggested qigong exercise relieved anxiety (pooled SMD = -0.75; 95% CI, -1.11 to -0.40), and three RCTs suggested that qigong exercise reduced stress (pooled SMD = -0.88; 95% CI, -1.22 to -0.55) among healthy subjects following one to three months of qigong practice, compared to wait-list controls.

Conclusions

The available evidence suggests that qigong exercise reduces stress and anxiety in healthy adults. However, given the limited number of RCTs and their methodological flaws, further rigorously designed RCTs are needed.

【 授权许可】

   
2014 Wang et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]American Psychological Association: 2010 Stress in America Report. http://www.apa.org/news/press/releases/stress/national-report.pdf webcite Accessed January 14, 2013
• [2]Centre for Health Protection, Department of Health, Government of Hong Kong Special Administrative Region: Statistics on behavioral risk factors: stress coping method. http://www.chp.gov.hk/en/data/1/10/280/760.html webcite. Accessed January 14, 2013
• [3]Centers for Disease Control and Prevention: Managing stress. http://www.cdc.gov/Features/HandlingStress/ webcite. Accessed January 14, 2013
• [4]Arnetz BB, Ekman R: Stress in Health and Disease. Weinheim, Germany: Wiley-VCH; 2006.
• [5]National Center for Health Statistics: Healthy People 2000 Final Review. Hyattsville, Maryland: Public Health Service; 2001.
• [6]Tsang HW, Cheung L, Lak DC: Qigong as a psychosocial intervention for depressed elderly with chronic physical illnesses. Int J Geriatr Psychiatry 2002, 17(12):1146-1154.
• [7]Chan CL, Wang CW, Ho RT, Ng SM, Chan JS, Ziea ET, Wong VC: A systematic review of the effectiveness of qigong exercise in supportive cancer care. Support Care Cancer 2012, 20(6):1121-1133.
• [8]Lee MS, Pittler MH, Guo R, Ernst E: Qigong for hypertension: a systematic review of randomized clinical trials. J Hypertens 2007, 25(8):1525-1532.
• [9]Lee MS, Chen KW, Choi TY, Ernst E: Qigong for type 2 diabetes care: a systematic review. Complement Ther Med 2009, 17(4):236-242.
• [10]Chan CL, Wang CW, Ho RT, Ho AH, Ziea ET, Taam Wong VC, Ng SM: A systematic review of the effectiveness of qigong exercise in cardiac rehabilitation. Am J Chin Med 2012, 40(2):255-267.
• [11]Chan CL, Wang CW, Ho RT, Ng SM, Ziea ET, Wong VT: Qigong exercise for the treatment of fibromyalgia: a systematic review of randomized controlled trials. J Altern Complement Med 2012, 18(7):641-646.
• [12]Lee MS, Ernst E: Qigong for movement disorders: a systematic review. Mov Disord 2009, 24(2):301-303.
• [13]Wang CW, Chan CL, Ho RT, Tsang HW, Chan CH, Ng SM: The effect of qigong on depressive and anxiety symptoms: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med 2013, 2013:716094.
• [14]Higgins JPT, Green S: Cochrane Handbook for Systematic Reviews of Interventions. Chichester, UK: Wiley-Blackwell; 2008.
• [15]Borenstein M: Effect sizes for continuous data. In The Handbook of Research Synthesis and Meta-Analysis. 2nd edition. Edited by Cooper H, Hedges LV, Valentine JC. New York, NY: Russell Sage Foundation; 2009.
• [16]Cohen J: Statistical Power Analysis in the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.; 1988.
• [17]Johansson M, Hassmén P, Jouper J: Acute effects of qigong exercise on mood and anxiety. Int J Stress Manag 2008, 15(2):199-207.
• [18]Lee MS, Kang CW, Lim HJ, Lee MS: Effects of qi-training on anxiety and plasma concerntrations of cortisol, ACTH, and aldosterone: a randomized placebo-controlled pilot study. Stress and Health 2004, 20:243-248.
• [19]Chow YWY, Dorcas A, Siu AMH: The effects of qigong on reducing stress and anxiety and enhancing body-mind well-being. Mindfulness 2012, 3(1):51-59.
• [20]Griffith JM, Hasley JP, Liu H, Severn DG, Conner LH, Adler LE: Qigong stress reduction in hospital staff. J Altern Complement Med 2008, 14(8):939-945.
• [21]Hwang EY, Chung SY, Cho JH, Song MY, Kim S, Kim JW: Effects of a brief Qigong-based stress reduction program (BQSRP) in a distressed Korean population: a randomized trial. BMC Complement Altern Med 2013, 13:113. BioMed Central Full Text
• [22]Liu H, An H, Meng F, Hu B, Wei Y, Meng F: A survey about the effect of eight-section brocade to the mental health of students in medical college. Medicine Society 2008, 21:63-64.
• [23]Manzaneque JM, Vera FM, Rodriguez FM, Garcia GJ, Leyva L, Blanca MJ: Serum cytokines, mood and sleep after a qigong program: is qigong an effective psychobiological tool? J Health Psychol 2009, 14(1):60-67.
• [24]Wang C, Bannuru R, Ramel J, Kupelnick B, Scott T, Schmid CH: Tai Chi on psychological well-being: systematic review and meta-analysis. BMC Complement Altern Med 2010, 10:23. BioMed Central Full Text
• [25]Chong CSM, Tsunaka M, Tsang HWH, Chan EP, Cheung WM: Effects of yoga on stress management in healthy adults: a systematic review. Altern Ther Health Med 2011, 17(1):32-38.
• [26]Chiesa A, Serretti A: Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med 2009, 15(5):593-600.
• [27]Johansson M, Hassmén P: Acute psychological responses to qigong exercise of varying durations. Am J Chin Med 2008, 36(3):449-458.
• [28]Skoglund L, Josephson M, Wahlstedt K, Lampa E, Norback D: Qigong training and effects on stress, neck-shoulder pain and life quality in a computerised office environment. Complement Ther Clin Pract 2011, 17(1):54-57.
• [29]Sibbald B, Roberts C: Understanding controlled trials. Crossover trials. BMJ 1998, 316(7146):1719.
• [30]Sousa CM, Goncalves M, Machado J, Efferth T, Greten T, Froeschen P, Greten HJ: Effects of qigong on performance-related anxiety and physiological stress functions in transverse flute music schoolchildren: a feasibility study. J Chin Integr Med 2012, 10(8):858-865.
• [31]Skoglund L, Jansson E: Qigong reduces stress in computer operators. Complement Ther Clin Pract 2007, 13(2):78-84.
• [32]Terjestam Y, Jouper J, Johansson C: Effects of scheduled qigong exercise on pupils’ well-being, self-image, distress, and stress. J Altern Complement Med 2010, 16(9):939-944.
• [33]Lee MS, Jeong SM, Oh SW, Ryu H, Chung HT: Effects of chundosunbup Qi-training on psychological adjustments: a cross-sectional study. Am J Chin Med 1998, 26(2):223-230.
• [34]Lee MS, Ryu H, Chung HT: Stress management by psychosomatic training: effects of ChunDoSunBup Qi-training on symptoms of stress: a cross-sectional study. Stress and Health 2000, 16(3):161-166.
• [35]Tsang HW, Fung KM: A review on neurobiological and psychological mechanisms underlying the anti-depressive effect of qigong exercise. J Health Psychol 2008, 13(7):857-863.