Qigong Exercises for the Management of Type 2 Diabetes Mellitus
Abstract
:1. Introduction
2. Medical Qigong Terminology
2.1. The History and Development of Medical Qigong
2.2. Definitions of Internal Medical Qigong
2.3. Yi Ren Medical Qigong
2.4. Yi Ren Medical Qigong Exercises for Healing T2DM
3. Traditional Chinese Medicine, Medical Qigong Etiology and Pathophysiology
3.1. Pancreas
3.2. Liver
3.3. Liver and Pancreas Disharmony
3.4. The Kidneys
3.5. Pancreas Qi and Kidney Yin Deficiency
3.6. The Autonomic Nervous System
4. Effects of Medical Qigong in Adults with Type 2 Diabetes Mellitus
4.1. Possible Mechanisms of Action
5. Designing Adequate Randomized Controlled Clinical Trials
5.1. Description of Qigong Exercises, Frequency and Duration
5.2. Criteria for Enrollment
5.3. Selection of Appropriate Control Groups
6. Limitations of Review
7. Conclusions
Supplementary Materials
Supplementary File 1Author Contributions
Conflicts of Interest
References
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Systematic Review | Discussion on Internal Qigong Variation |
---|---|
Xin (2007) A qualitative review of the role of qigong in the management of diabetes [11] | The included studies were of different styles of static and/or dynamic qigong and varied in duration (from 10 days to more than three years) and frequency. “The quality of reporting of studies of the effect of qigong on diabetes management in the published literature requires improvement, including more explicit description of the type of training used (static versus dynamic, duration, frequency, pre-dominant movements, etc.), to allow replication and comparability of effects between studies.” |
Chen (2009) An Analytical Review of the Chinese Literature on Qigong Therapy for Diabetes Mellitus [14] | “Qigong comes in many forms. Not all forms are equally effective in treating diabetes… Many investigations of qigong therapy for DM even do not specify what form of qigong was used or how it differs from others, making reviews and evaluations even more difficult.” |
Lee (2009) Qigong for type 2 diabetes care: A systematic review Complementary Therapies in Medicine [13] | “There are significant differences between the numerous forms of qigong, which poses difficulties in establishing quality standards for this treatment.28 In future trials, clear description of the qigong intervention should be provided together with a description of the level of expertise of the instructors.” |
Freire (2013) Therapeutic Chinese exercises (qigong) in the treatment of type 2 diabetes mellitus: A systematic review [15] | “It can be seen that all the studies that identified the types of exercises practiced by the patients performed different qigong sequences with their patients. Therefore, regarding qigong research, not only the efficiency of qigong exercises in the treatment of the diabetic patients in the study, but also the efficiency of these specific qigong exercises in the treatment of diabetic patients.” |
Study (Year) Location Review article cited | Nature of Practice | Amount of Practice | Study Results, Attributes and Limitations |
---|---|---|---|
TSUJIUCHI et al. (2002) [46] Japan/Tokyo Xin 2007 Lee 2009 Friere 2013 | Qi-Gong relaxing consists of "controlled synchronized breathing with slow body movements as an aerobic exercise and relaxation". | 4 months Weekly 2 h Qi-Gong group sessions held by a Chinese Qi-Gong doctor; all requested to practice at home | Compared with the Control period of Group 2, Group 1 demonstrated significant improvement of HbA1c level (p < 0.01) Combination of Chinese Qi-Gong doctor led group practice and at home individual practice |
FANG (2008) [47] Japan/Tokyo Friere 2013 | Eight-Section Brocade practice is a movement of limbs combined with breathing and mind concentration. | 4 months Practice 1 ×/day at home for about 1 h Both groups given 2-month practice period Intervention group continued for another 2 months | HbA1c pre = 7.7 ± 1.55 HbA1c post = 6.9 ± 1.49; (p < 0.05) Unable to compare intervention to control group since control group was exposed to qigong for 2 months. Little known about medications, diet and additional exercise in subjects. Detailed information regarding the exercises at end of article. |
SUN et al. (2010) [32] USA/Seattle, WA Friere 2013 | Yi Ren Medical Qigong (YRMQ) defines qigong as traditional Chinese energy medicine practice combining breathing, movement, and meditation. "The term 'qi' (or 'chi') meaning 'vital energy of the body' and 'gong' meaning the skill and achievement cultivated through regular and disciplined practice." | 12 weeks Weekly Qigong or PRT group sessions for 60 min/wk with certified instructors and practiced at least twice a week at home for 30 min following a DVD | All qigong intervention participants showed reduction in FBG in contrast to the control and PRT groups; YRMQ group showed significant reductions in FBG, slight reduction in weight and a trend toward reversing insulin resistance. Specific exercise descriptions lacking from publications making it difficult to replicate study. Combination of Certified Qigong Instructor led group practice and at home DVD led individual practice. |
LIU et al. (2011) [48] Australia/Queensland Friere 2013 | KaiMai-style qi-gong: 28 min warm-up 30 min practice 6–28 min cool-down intensity varied; length of time increased through duration of study | 12 weeks 3 group sessions/week led by qigong expert Participants received DVD to practice at home 1–1.5 h/day on days group sessions did not meet | Between-group differences in favor of intervention in Weight (p < 0.01); Effect of qigong on improved IR was mediated by reduced weight Combination of qigong expert led group practice and at ome DVD led individual practice. Qigong practice fluctuated throughout the study. |
YOUNGWANICHSETHA et al. (2013) [49] Southern Thailand | Tai Chi Qigong Group protocol: 1. warm-up with 25 movements 2. tai chi qigong following set one of Lin Housheng’s style comprising 18 movements for 30 min 3. cooling-down with 5 qigong movements for 5 min | 12 weeks Intervention Group: 50 min tai chi qigong exercise program 3 ×/wk for 12 weeks plus 5 ×/wk at home –6 months postpartum Control Group: usual care | Statistically significant reduction in FPG, HbA1c and BP in intervention when compared with the Control Group (p < 0.05). No significant between group differences in body-weight or BMI at 12 weeks. Subjects all post-partum younger women making study not generalizable, but helpful for this population. Combination of group and individual practice. |
XIAO (2017) [50] China/Bejing | Ba duan jin Qigong (BDJ) – 60 min training 10 min warming-up BDJ exercise 45 min 5 min cool-down | 24 weeks (5) 1–2 h sessions/week | HbA1c (p = 0.034) at baseline and week 24 Little known about medications, diet and additional exercise in subjects. Published photos to demonstrate qigong exercises along with step-by-step procedures. |
Study (Year) Location Review article cited | Nature of Practice | Amount of Practice | Study Results, Attributes and Limitations |
---|---|---|---|
IWAO et al. (1999) [51] Japan/Kyoto uncontrolled observational study | Qigong walking = mild and slow walking using all muscles in body Conventional walking = normal walking | Evaluated 90 min post lunch on 3 different days Qigong walking (30–40 min) Conventional walking (30 min) | Plasma glucose decreased in both exercise groups Conventional = 228 to 205 mg/dL; Qigong = 223 to 216 mg/dL Compared with no exercise, 229 mg/dL (p < 0.025) Very short-duration study where subjects served as their own controls. Little information known about subjects. |
LIU et al. (2010) [52] Australia/Queensland Pre-post feasibility trial uncontrolled observational study | Kai/Mai Tai Chi/Qigong style - defines qigong as "mind-body movement therapy…most involve combined training of movement, breathing, and mind, with a strong focus on the mind“ | 12 weeks 1–1.5 h 3×/wk with Tai Chi/Qigong instructor; also encouraged to practice at home | Good adherence and high acceptability; Significant reductions with BMI, HbA1c and IR No subjects were taking medications. Combination of group and individual practice. |
HUANG et al. (2012) [53] Taiwan/Kaohsiung quasi-experimental | Defines qigong as breathing training. Qi meaning breath and gong meaning to train. Five Element Gymnastics (FEG) consolidates Qigong, Xiang Gong & Martial Arts with Gymnastics. | 16 weeks FEG practiced following DVD 2 ×/day for 20 min each session for 16 weeks with 2 sessions in first week taught by certified fitness instructor and group education sessions at weeks 3, 7, 11 and 14; Control group maintained usual activities | HbA1C change -6.77 (p < 0.01) Included insulin-dependent subjects; however, medications remained same. Combination of instructor led group practice and DVD led at home individual practice. |
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Putiri, A.L.; Close, J.R.; Lilly, H.R.; Guillaume, N.; Sun, G.-C. Qigong Exercises for the Management of Type 2 Diabetes Mellitus. Medicines 2017, 4, 59. https://doi.org/10.3390/medicines4030059
Putiri AL, Close JR, Lilly HR, Guillaume N, Sun G-C. Qigong Exercises for the Management of Type 2 Diabetes Mellitus. Medicines. 2017; 4(3):59. https://doi.org/10.3390/medicines4030059
Chicago/Turabian StylePutiri, Amy L., Jacqueline R. Close, Harold Ryan Lilly, Nathalie Guillaume, and Guan-Cheng Sun. 2017. "Qigong Exercises for the Management of Type 2 Diabetes Mellitus" Medicines 4, no. 3: 59. https://doi.org/10.3390/medicines4030059