What is Qigong ( 氣功 )?

Transcription

1 Health Qigong Baduanjin ( 八段錦 ) Evidence-based Practice 2 nd March, 2019 Dr Bacon Ng Occupational Therapists and Health Qigong Practitioners Members of the Hong Kong Occupational Therapy Association, SIG, National Traditional Sports Research Group Certified Health Qigong Coach (Baduanjin) issued by The Chinese Health Qigong Association of General Administration of Sports in China What is Qigong ( 氣功 )? Ø A term for a large range of different form of Ancient art of self-healing exercise of Traditional Chinese Medicine (TCM) Harmonious flow of energy to regulate Þ Mind ( 調心 ) Þ Body ( 調身 ) Þ Breath ( 調息 ) Qi ( 氣 ) is our vital energy and Gong ( 功 ) refers to the practice Simple activity within patient s ability Cultural relevant 2 1

2 Qigong History Ancient martial arts with roots in Þ Taoism 道 - 行氣 (Flow of qi) Þ Buddhism 釋 - 坐禪 (Dhyana) Introspection Þ Confucianism 儒 - 心齋 (Minimize distraction) Þ KungFu 武 內功 (Internal Strength) Þ Chinese Medicine 醫 - 導引 (Guide the flow) Þ Ayurveda 阿育吠陀 - 瑜珈療法 (Yoga) Definition ( 定義 ) Health Qi-gong ( 健身氣功 ) ( 健身 ) Health promotion ( 真氣能量 ) Vital life energy ( 功法 ) Practice Strategies A national-traditional sport combining body movement, breathing techniques and mental regulation 健身氣功是以自身形體活動 呼吸吐納 心理調節相結合爲主要運動形式的民族傳統體育項目, 是中華悠久文化的組成部分 The General Administration of Sport in China enacted The Provisional Regulations for the Management of Health Qigong in 2000 國家體育總局第 4 號令 健身氣功管理暫行辦法 2

3 Qi ( 氣 ) 天氣 (Seasons) 元氣 - 父母所傳 (Genes from parents ) 地氣 (Environment) 真氣 (Vital energy) 精氣 (Body energy) 神氣 (Spiritual energy) 營氣 ( 脈中 )( 清 ) (Digestive & cardiovascular system) 宗氣 (Lung function) 衛氣 ( 脈外 )( 濁 ) (Immune system) 正氣 (Dynamic balance of energy) 5 經絡分類 經脈 12 經脈 奇經八脈 雜脈 11 絡 12 經筋 12 經別 13 別絡 ( 脾 x 2) 督脈的別絡 任脈的別絡 孫絡 14 經皮 ( 浮絡 ) 365 穴 和孫絡 6 3

4 Mechanism of Qigong Corticotrophin ( 促腎上線皮質激素 ) & aldosterone ( 醛固酮 ) C-reactive protein (inflammation) Cholesterol, BP IFNγ : IL10 (Type 1 vs 2 Cytokines ratio, ie. favour cell-mediated immunity) Adiponectin ( 脂聯素 ) Telomerase activity ( 端粒酶 ) HPA Axis activity ( 下視丘 / 腦下垂體 / 腎上腺 的軸線 ) Parasympathetic Nervous System Activity ( 副交感神經系統 ) Meridian and Baduanjin Form Triple Warmer Meridian 1 Pericardium Meridian 1 Bladder Meridian 1 Large Intestine Meridian 1, 2 Small Intestine Meridian 1 Lung Meridian 2, 4 Liver Meridian 2, 4, 7 Ren Meridian 3 Stomach Meridian 3 Gall Bladder Meridian 3 Spleen Meridian 3, 4 Heart Meridian 4, 5 Kidney Meridian 4, 6, 8 Du Meridian 8 8 Bacon Ng at ngfl@ha.org.hk 4

5 Systematic Reviews of Qigong (15 meta-analysis) 9 1) Stress (Qigong SR) One SR (Wang et al. 2014) performed meta-analysis â Perceived stress (3 RCTs) â Anxiety (4 RCTs) Qigong Type: Baduanjin and Chan Mi Gong - Modified 1. Wang, C. W., Chan, C. H. Y., Ho, R. T. H., Chan, J. S. M., Ng, S. M., & Chan, C. L. W. (2014). 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, 14, 8. (7 RCTs) 2. Lee, M. S., Oh, B., & Ernst, E. (2011). Qigong for healthcare: an overview of systematic reviews. JRSM Short Reports, 2(2), 7. (10 RCTs) 3. Ng, B. H. P., & Tsang, H. W. H. (2009). Psychophysiological outcomes of health qigong for chronic conditions: a systematic review. Psychophysiology, 46(2), (26 RCTs) 4. Rogers, C., Larkey, L., & Keller, C. (2009). A Review of Clinical trials of tai chi and qigong in older adults. Western Journal of Nursing Research, 31(2), (36 RCTs)6 10 5

6 2) Fall Prevention (Tai chi SR) One SR (Huang al al., 2017) performed meta-analysis â No. of fallers by 20% (16 RCTs) â Incident rate of falls by 30% (15 RCTs) >3/wk (RR 0.36) vs 3/wk (RR 0.62) vs 2/week (RR 0.83) vs 1/week (RR 0.95) Yang Style Taichi (RR 0.61) > Sun Style Taichi (RR 0.88) 1. Huang, Z.-G., Feng, Y.-H., Li, Y.-H., & Lv, C.-S. (2017). Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open, 7(2), e (18 RCTs) 2. Wu, Y., MacDonald, H. V., & Pescatello, L. S. (2016). Evaluating Exercise Prescription and Instructional Methods Used in Tai Chi Studies Aimed at Improving Balance in Older Adults: A Systematic Review. Journal of the American Geriatrics Society, 64(10), (27 RCTs) 11 3) SR on Hypertension and Cardiac Rehab. Guo et al. (2008) meta-analysis â SBP 7.32 mm Hg (2 RCTs) (qigong+ drug vs drug therapy) â SBP/DBP 17.03/9.98 mm Hg (3 RCTs) (qigong vs no treatment) Lee et al. (2007 & 2008) meta-analysis â SBP 18.5 mm Hg (2 RCTs) (qigong vs wait-list) â SBP/DBP 12.1/8.5 mm Hg (2 RCTs) (qigong+ drug vs drug therapy) Xiong et al. (2015) meta-analysis â SBP/DBP 17.4/10.15 mm Hg (3 RCTs) (qigong vs no) â SBP 6.51 mm Hg (2 RCTs) (qigong inferior than exercise) â DBP 6.08 mm Hg (4 RCTs) (qigong vs drug therapy) â SBP/DBP 11.99/5.28 mm Hg (5 RCTs) (qigong+ drug vs drug therapy) Qigong Type: Qubingyangsheung, Guolin, Shuxinpingzue, Dayan 1. Chan, C. L.-W., Wang, C.-W., Ho, R. T.-H., Ho, A. H.-Y., Ziea, E. T.-C., Taam Wong, V. C.-W., & Ng, S.-M. (2012). A systematic review of the effectiveness of qigong exercise in cardiac rehabilitation. The American Journal of Chinese Medicine, 40(2), (7 RCTs) 2. Hartley, L., Ms, L., Jsw, K., Flowers, N., Todkill, D., Ernst, E., & Rees, K. (2015). Qigong for the primary prevention of cardiovascular disease ( Review ), (6). (11 RCTs) 3. Guo, X., Zhou, B., Nishimura, T., Teramukai, S., & Fukushima, M. (2008). Clinical effect of qigong practice on essential hypertension: a meta-analysis of randomized conrolled trials. The Journal of Alternative and Complement Medicine, 14(1), (9 RCTs) 4. Lee, M. S., Pitter, M. H., Guo, R., & Ernst, E. (2008). Qigong for hypertension: a systematic review of randomized clinical trials. Journal of Alternative and Complementary Medicine, 25(8), (12 RCTs) 5. Lee, M. S., Pittler, M. H., Guo, R., & Ernst, E. (2007). Qigong for hypertension: a systematic review of randomized clinical trials. Journal of Hypertension, 25(8), (12 RCTs) 6. Xiong, X., Wang, P., Li, X., & Zhang, Y. (2015). Qigong for Hypertension: A Systematic Review. Medicine, 94(e352), (20 RCTs) 12 6

7 4) SR on Cancer QoL Zeng et al. (2014) meta-analysis l á cancer-specific QOL WMD 7.99 (5 RCTs) (Baseline vs 12 weeks F/U) l â Fatigue SSD (2RCTs) (Baseline vs 12 weeks F/U) l á Vitality WMD 1.5 (3 RCTs) l Qigong type: Tai Chi, Guolin, medical qigong 1. Chan CL, Wang CW, Ho RT, Ng SM, Chan JS, Ziea ET, et al. (2012). A systematic review of the effectiveness of qigong exercise in supportive cancer care. Supportive Care in Cancer, 20, (23 RCTs) (11 RCTs) 2. Klein, P. J., Schneider, R., Rhoads, C. J., & Schneider, R. (2016). Qigong in cancer care : a systematic review and construct analysis of effective Qigong therapy. Supportive Care in Cancer, 24, (11 RCTs) 3. Lee, M. S., Chen, K. W., Sancier, K. M., & Ernst, E. (2007). Qigong for cancer treatment: a systematic review of controlled clinical trials. Acta Oncologica (Stockholm, Sweden), 46(6), (9 RCTs) 4. Oh, B., Butow, P., Mullan, B., Hale, A., Lee, M. S., Guo, X., & Clarke, S. (2012). A critical review of the effects of medical Qigong on quality of life, immune function, and survival in cancer patients. Integrative Cancer Therapies, 11(2), (8 RCTs) 5. Zeng, Y., Luo, T., Xie, H., Huang, M., & Cheng, A. S. K. (2014). Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complementary Therapies in Medicine, 22(1), (13 RCTs) 5) SR Diabetes Mellitus Huang & Yeh (2013) meta-analysis â HbA1C (7 RCTs) â Fasting Glucose (5 RCTs) Recommend Twice/ day with min or once with an hour duration with 3-5 times per week for 24 weeks Qigong Type: TaiChi, Baduanjin, Liuzijue 1. Freire, M. D. M., & Alves, C. (2013). Therapeutic Chinese exercises (Qigong) in the treatment of type 2 diabetes mellitus: a systematic review. Diabetes & Metabolic Syndrome, 7(1), (5 RCTs) 2. Huang, J. P., & Yeh, M.-L. (2013). The Qigong Effect on Blood Glucose Control in People With Type 2 Diabetes: A Systematic Review and Meta-Analysis. Journal of Nursing & Healthcare Research, 9(3), (11 RCTs) 3. Lee, M. S., Chen, K. W., Choi, T.-Y., & Ernst, E. (2009). Qigong for type 2 diabetes care: a systematic review. Complementary Therapies in Medicine, 17(4), RCTs) 4. Xin, L., Miller, Y. D., & Brown, W. J. (2007). A qualitative review of the role of qigong in the management of diabetes. Journal of Alternative and Complementary Medicine, 13(4), (Not mention) Free video 14 /subpage.php?mid=72&id=275 7

8 6) SR Pain Lee, Pittler & Ernst (2006 & 2007) external qigong meta-analysis â WMD 36.3mm VAS pain (100mm) (2 RCTs) Qigong Type: External Qi- therapy Bai (2015) meta-analysis SMD of 1.17 (3-month) (6-month) Internal qigong (2 RCTs) SMD Internal qigong 6-month vs waitlist (3 RCTs) SMD External qigong vs general care (2 RCTs) SMD External qigong vs placebo (3 RCTs) Qigong Type: Qi- therapy & non-specific internal qigong 1. Lee, M. S., Pittler, M. H., & Ernst, E. (2009). Internal qigong for pain conditions: a systematic review. The Journal of Pain : Official Journal of the American Pain Society, 10(11), e14. (4 RCTs + 3 CT) 2. Lee, M. S., Pittler, M. H., & Ernst, E. (2007). External qigong for pain conditions: a systematic review of randomized clinical trials. The Journal of Pain : Official Journal of the American Pain Society, 8(11), (5 RCTs) 3. Lee, M., Pittler, M., & Ernst, E. (2006). Qigong for pain conditions: a systematic review of randomised clinical trials. Focus on Alternative and Complementary Therapies, 11, (11 RCTs) 4. Bai, Z., Guan, Z., Fan, Y., Liu, C., Yang, K., Ma, B., & Wu, B. (2015). The Effects of Qigong for Adults with Chronic Pain: Systematic Review and Meta-Analysis. The American Journal of Chinese Medicine, 43(8), (10 RCTs) SR 15 had meta-analysis SR Client Outcome Qigong Type Wang, C.W. et al., 2014 Huang & Yeh, 2013 Bai, et al Lee, et al 2006&7 Healthy Adults Type II Diabetes â Perceived stress & anxiety â HbA1c & Fasting glucose Baduanjin Chan Mi Gong + Modified Baduanjin, Liuzijue, Tai Chi Pain â Chronic pain Internal qigong (Charité department ) External qigong (Qi Therapy) Zeng, et al., 2014 Cancer á QOL vitality, â Fatigue and cortisol level Tai Chi, Guolin Qigong Lee, et al., 2007&2008; Guo, et al., 2008; Xiong et al., 2014 Wang F. et al., 2013 Liu, et al Ding, et al., 2014; Ng, et al., 2012; Ng, et al., 2014 Hypertension, cardiovascula r rehab. Depressive Symptoms Pulmonary Rehab. â Systolic BP ( mmhg) â Diastole BP ( mmhg) â Depressive symptoms á Psychological health á Lung fx., physical state â Dyspnea Shuxinpingxue Gong ( 舒心平血功 ) Wuxing Qigong ( 五行氣功 ) Dayan Qigong ( 大雁養生功 ) Qubingyangsheng Gong ( 去病養生功 ) Dejian Mind-Body Intervention (DMBI) Baduanjin, Wuqinxi, Wu Xing Ping Xing Gong ( 五行平衡功 ) Yan Chai Ten-section Brocades, Liuzijue, Baduanjin, Health Qigong from the 4 types 8

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