Cheng: The traditional Chinese Baduanjin exercise for the enhancements in health of older adults: a narrative review

The traditional Chinese Baduanjin exercise for the enhancements in health of older adults: a narrative review

Abstract

Health debilitation negatively impacts the physical and psychiatric states of ageing persons, consequently increasing individual, familial, and social burdens. Physical exercise is an effective measure to cope with this problem, and Baduanjin, a traditional Chinese exercise, is one of the choices. This narrative review analyses 58 clinical studies, which indicate the efficacy of Baduanjin for the health of old adults, including in physiological refinement, bone diseases, cardiovascular and cardio-pulmonary illnesses, metabolic disorders, digestive sicknesses, cognitive impairment, and mental disorders. The results not only reveal the rehabilitative and preventive functions of Baduanjin, but also suggest health promotion through this physical activity for the ageing population. It also proposes improvements in methodological design and practical implications for the well being of seniors and successful ageing.





Introduction

Population ageing has become a global issue. Demographic studies predict that the number of individuals aged over 60 will exceed the number of adolescents by about 2047,1 challenging social economics,2 organizational productivity,3 and individual health.4

Physiological changes are inevitable during the ageing process, which diminishes the functional status of older adults. About 81% of people who are 65 years old or older complain of having at least one chronic illness.5 Age-related impairments are prevalent, particularly hearing6 and visual7 deficits that will cause them to misperceive the world around them and miscommunicate with others.8 An increase in neuro-degenerative diseases,9 such as Alzheimer’s disease, increases their vulnerability. Non-communicable illnesses10 devastate mobility of the ageing population; for example, hypertension, and diabetes. Risks of falling increase due to sarcopenia and dynapenia, which refer to age-associated loss of muscle mass11 and muscle strength12,13 respectively. More harmfully, older adults always suffer from emotional disorders,14 especially with depression.15 These ailments intensify disabilities, and thus obstruct normal daily activities,16 resulting not only in social isolation17 and unfavorable quality of life18 but also expanded private and public medical expenses.19

Physical activity20 is a critical strategy21 benefiting physical function, as well as cognitive and mental health for seniors. It includes a variety of resistance exercise training22,23 and aerobic exercises,24 such as rowing,25 swimming,26 walking,27 dancing,28 pilates,29 yoga,30 and conventional fitness exercises.

Traditional Chinese exercise is one of the effective approaches,31 and includes Qigong and Taiji (Tai Chi Quan), which benefit physical and psychological health for the aged.32,33 Ameliorated conditions encompass such items as reductions in knee osteoarthritis incurred pain and stiffness,34 and enhancement in motor function induced by Parkinson’s disease.35 Qigong is an umbrella term, covering a spectrum of exercises such as Baduanjin, Tuna (a kind of breathing method), and Xianggong. Based on traditional Chinese medicinal theory36 and the IChing principle37 (related to the yin-yang principle), Baduanjin, also known as the eight-brocade exercise, eight-section brocades or eight-treasured exercise, was used for health training in the form of a martial art, and has recently been adopted for community- based health promotion by the General Administration of Sport of China.38 A set of eight sequential movements is stipulated39 involving body-trunk, limb and eye movements that are matched with breathing: holding the hands high with palms up to regulate the internal organs (雙手托天理三焦), posing as an archer shooting both left-andright- handed (左右開弓似射鵰), holding one arm aloft to regulate the functions of the spleen and stomach (調理脾胃須單舉), looking backwards to prevent sickness and strain (五勞七傷向後瞧), swinging the head lowering the body to relieve stress (搖 頭擺尾去心火), moving the hands down the back and legs and touching the feet to strengthen the kidneys (兩手攀足固腎腰), thrusting the fists and making the eyes glare to enhance strength (攢拳怒目增氣力), and raising and lowering the heels to cure disease (背後七顛百病消).

In additional to the principal standing form, Baduanjin also has sitting and lying modes. The sitting form focuses on meditation, oral and auricular proliferation, and upper limb training, while the lying method inclines towards self-massaging for facial organs (eyes, ears, mouth, and nose), limbs, and the trunk. These forms are adaptable for practitioners with different movement capabilities and disparate ages,40 being both flexible and safe.41 Therefore, they are suitable for not only healthy older adults but also older people with Parkinson’s disease, 42 cardiovascular autonomic balance,43 cognitive impairment44 or blood lipid levels.45 Baduanjin is beneficial to gait and balance for stroke rehabilitation,46 fall prevention, and emotional health.47

This narrative review investigates the effectiveness of Baduanjin, a body-mind intervention,48 on the biological and psychological health of old adults. Its analysis offers an overview of the research results and highlights encouraging indicators that are favorable for health promotion among seniors, from which medical professionals can integrate this low-intensity exercise into available treatments for geriatric care.

Research Method

This narrative review utilized ProQuest to search potential studies, in which there are 27 prominent electronic databases, including British Nursing Index, Medical Database, MEDLINE, ProQuest Medical Library, PsycARTICLES, and PsycINFO. Inputting the keywords Baduanjin and aged OR elderly OR elders OR old OR senior resulted in 45 references. Additionally, the China National Knowledge Infrastructure (CNKI) and Taiwan Electronic Periodical Services (TEPS) were searched using the keywords 八段錦and 老年人, retrieving 85 Chinese works.

A two-tiered selection process was performed under the following eligibility criteria: they were required to be empirical studies (quantitative, qualitative or mixed inquiries) published in peer-reviewed, scholarly journals prior to October 2017. Non-resultant trials, duplicates, literature reviews, book reviews, dissertations, editorials, letters to the editor, and commentaries were excluded. First, 75 (n=30 in English, n=45 in Chinese) out of 130 potential articles were selected (Figure 1) according to the exclusion criteria; second, 58 (n=10 in English, n=48 in Chinese) studies were chosen for further analysis in light of the inclusion criteria.

Findings and Discussion

The reviewed 58 projects (Table 1)49-106 involved 5084 participants, most of whom were aged 60-84. This narrative review analyzed how Baduanjin can benefit older adults, initially detailing its contribution to physiological refinement, and subsequently enumerating its efficacy on ageing problems, including bone diseases, cardiovascular and cardio-pulmonary illnesses, metabolic disorders, digestive sicknesses, cognitive impairment, and mental health.

Physiological refinement

Baduanjin positively influences antioxidant capacity and immune cells, achieving anti-ageing.85 It indicates a range of health enhancements, with the aid of measurements, for instance, Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36), Chinese Version of the Personal and Social Performance Scale (PSP-CHN), Chronic Disease Self- Management Study Measures, and tests for arithmetic, figure recognition, reaction time, digit width, and digit symbol. It delays hypophrenia (connected to intelligence recession) and metabolic oxygen consumption, and regulates the endocrine system, hemodynamics, hemorheology, cardiac functions, and nervous system.106 It is conducive to the reduction of bodily pain, and the increase of vitality, general health perception, health transition, physical functioning, physical-role functioning, emotionalrole functioning, social functioning and mental health.105 Also, this exercise alleviates retirement syndrome58 and therefore strengthens self-awareness, attention, emotion coping, sense of well being linked to self-care, and social relationships, resulting in self-efficacy84 even among older adults with chronic illnesses.

Sixty-two elderly males (aged 60-69) who practiced Baduanjin regularly over three years enhanced their body quality, balance ability and cardiovascular capability.49 Managing obesity with better body weight, body fat mass, waist-hip ratio, body total moisture, and protein quality, they improved their balance, showing amelioration of issues with muscle strength, seat body flexion, hand grip, and standing on one leg while closing their eyes. Their vital capacity, systolic blood pressure, diastolic blood pressure, and resting pulse became more acceptable. According to evidence from another 139 women,67 Baduanjin produced refinements in the respiratory system and body anteflexion in the sitting position, increased lower limb strength, decreased waist circumference, hip circumference, and thickness of abdominal skinfold, the upper arm and the scapular. Overall improvements were attained in body shape, body composition, physical fitness, nervous response, immune function, sex hormone level, and free radical scavenging ability,81,98 as supported by pertinent research.72,79

Bone disease and arthritis

Osteoporosis is a common disease among older adults, causing fractures, disability, and pain.107 Pain alleviation was reported by 60 patients with primary osteoporosis51 who also experienced better mental states after undertaking eight weeks of Baduanjin training, such as vitality, emotional role functioning and social role functioning. Consistent outcomes were delivered by Peng and team in their research.77

Although osteoarthritis may be avoidable within the ageing population, degenerative joint condition is attributable to this disease,108 particularly with knee osteoarthritis,109 for which various treatments are provided.110 An and colleagues88 offered a one-year program to 22 patients who suffered from knee osteoarthritis. The participants saw significant easing of pain, stiffness, and disability, probably caused by a decrease in body-mass index when practicing 30 minutes of Baduanjin daily, five times a week, which enhanced knee extensors, flexor strength, and aerobic ability. Their earlier research also reported enhanced quadriceps strength.103 The effectiveness of Baduanjin on this illness has been ostensive.65 Similarly, patients with chronic neck pain benefited from 30-minute daily sessions for six months.86

Falling and fear of falling disturbs this frail population, especially for those with osteoporosis111 or osteoarthritis,112 giving rise to threats such as hip and vertebral fractures,113 and limb function limitations. 114 Recent studies illustrated that Baduanjin practitioners are capable of preventing falls,55,63 as a result of boosting balance50,64 and coping with the fear of falling.76 A reduction in fall risk not only satisfactorily adjusts functional behavior,62 but also more importantly provided a better quality of life.59

Cardiovascular and cardio-pulmonary diseases

Cardiovascular and cardio-pulmonary diseases weaken heart function and the respiratory system of seniors115 who suffer from hypertension, coronary artery disease, or obstructive pulmonary disease.

The effects of Baduanjin on hypertension82,93 include improvements in heart rate68 and blood pressure: showing a decrease in systolic blood pressure but an increase in diastolic blood pressure,73 along with a reduction in serum endothelia levels,54 improved sleep quality, sleep duration and sleep efficiency.71 Consequently, this exercise diminishes the risk of heart failure, stroke, and arteriosclerosis.75

Supported by 50 patients with coronary artery disease, a randomized controlled trial showed reductions in angina attacks and their duration after three months of Baduanjin exercise.65 Furthermore, improved rehabilitation was observed from another 60 patients with coronary artery bypass grafting who completed 23 weeks of training in which they performed 30-minute daily practice sessions.95

Interaction between hypertension, heart sickness, and stroke has been unveiled,116,117 for the management of which Baduanjin plays a positive role.118 This exercise is suitable for stroke rehabilitation,100 and is related to physical and psychological health. In addition to 30 minutes of daily practice, 83.3% of 60 older patients who underwent acupoint (a specific point for acupuncture) massage 2-3 times every day saw relief from constipation during the post-stroke period.91

An estimated 14% of individuals aged 65 or over suffer from chronic obstructive pulmonary disease due to ageing respiratory systems.119 Baduanjin may represent an optional intervention.120 With the aid of an XXG-D cardiovascular function tester and a pneumometer, 48 elderly patients with cardio- pulmonary problems who practiced 30 minutes of Baduanjin daily for one year increased the compensatory force of the heart pump, cardiac contractility, cardiac output stroke volume, as well as pulmonary function, together with enhancements in myocardial oxygen supply, their bodies’ scavenging ability of oxygen free radicals, and respiratory endurance.104 Feng and team102 added that the efficacy of this exercise could increase the forced expiratory volume in one second (FEV1), and forced vital capacity (FVC). A positive correlation between the strength of lung function and emotional stability connects this exercise to such issues as depression and anxiety,61 and to quality of life.69

Metabolic syndrome

Metabolic abnormality is fatal in the ageing population.121 Baduanjin is a possible vehicle for combating this.

Comparing pre- and post-test outputs, a study of a 10-week Baduanjin training program74 discerned increases in levels of nitric oxide (with a lower level in patients with diabetes) and superoxide dismutase (which is a key component in anti-oxidative and anti-inflammatory activities), particularly in elderly males, and a decrease in malondialdehyde (a hazardous compound inducing oxidative stress), particularly in elderly females.

Serum lipid levels correlate to illnesses such as cardiovascular diseases and diabetes. 122 An investigation into the effectiveness of Baduanjin on blood lipid and antioxidant levels70,80 indicated decreases in triglyceride, total cholesterol, malonyldialdehyde, low-density lipoprotein, whole blood viscosity, low shear blood viscosity and plasma viscosity, in contrast to increases in high-density lipoprotein, superoxide dismutase and glutathione peroxidase. Thus, these are able to ameliorate problems in the respiratory system.89

A decrease in blood glucose among elderly individuals who carried out a 30- minute Baduanjin session twice a day for three months99 shows promise for dealing with diabetes. Such a reduction in glycosylated hemoglobin (HbA1c) together with this exercise is linked to better psychological health,87 including a decrease in depressive symptoms.96 In research carried out by Xiao and colleagues,60 Baduanjin was shown to be beneficial to balance, body flexibility and glucose metabolism among elderly people with diabetes who received 96 45-minute sessions; following which they exhibited stronger physical function, limb strength and flexibility of the joints, fortified nerves, and improved glucose and lipid parameters.

Digestive ailments

Age-related changes in intestinal microbiota increase the risks of illness, including inflammatory bowel disease, colon rectal cancer, and immune system deficiencies.123 Indicators presented advantageous effects of Baduanjin in positive changes in intestinal flora,97 decreasing the quantity of enterobacter and fusobacterium, while increasing the quantity of bifidobacterium, lactobacillus and the ratio of bifidobacterium and enteric bacilli.

Approximately 10-20% of elderly people experience irritable bowel syndrome,124 with pain, cramping, and other negative signs. Looking into the efficacy of Baduanjin on irritable bowel syndrome,101 60 patients saw improvements in abdominal pain, abdominal distension, constipation, and abnormal defecation.

Cognitive impairment

Age-directed cognitive decline deteriorates individual health, social connections, and social economy,125 for which both pharmaceutical and non-medication measures are given to combat this decline. Lin53 recruited 47 participants who suffered from mild cognitive impairment and who received Baduanjin with standard treatment (including diet control, psychoeducation, and counseling) for six months. The data marked significant improvements in memory, attention, association, and language. Another set of data56 inferred these benefits from a decrease in rsFC between the DLPFC and the left putamen and insula, whereas mental control enhancement is negatively associated with rsFC and DLPFC-putamen changes. Tao and team57 identified an evident increase in grey matter volume in the insula, medial temporal lobe, and putamen among their informants who participated in 60 30-minute Baduanjin sessions. As a result, practicing this exercise positively correlates to mental control, recognition, touch, cognition and comprehensive memory.

Mental health

The detrimental effects of psychotic disorders consist of personal ill-being and social deprivation126 among older people, for which the scope of traditional and innovative approaches pinpoint Baduanjin127 as an effective countermeasure.128 One study, which interviewed 20 informants who practiced Baduanjin 40 minutes daily for 12 weeks, reiterated that they felt relaxed physically and psychologically due to self-tranquility, pleasure, and relief from emotional symptoms.78 Another 180 participants saw improvements in somatization, obsession and interpersonal sensitivity, and lessened depression, anxiety, hostility, phobia, paranoia and psychotic symptoms after 20 weeks, during which they received six onehour Baduanjin training sessions each week.90 In particular, these sessions favor housebound elderly people52 who are afterwards able to reconnect with society.

Practitioner calmness92 also helps abate sleep difficulties, accomplishing overall sleep quality,94 including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and controlled daytime dysfunction.

Methodological limitations and future research directions

This narrative review addresses methodological limitations among the reviewed articles, which arise from conducting randomized controlled research with small sample sizes and a cross-sectional design, particularly focusing on Chinese population and using mainly psychometric surveys. It also gives suggestions for future studies.

Despite there being 36 (62%) randomized controlled trials among the reviewed research, incomplete fulfillments are notable. While this method values evidence- based assessment,129 it requires strong reliability and validity, especially through randomization. However, most randomized controlled projects in this review failed to demonstrate random allocation, blinding, prevention of selection bias, and details of p-value. This study suggests the need for well-designed scientific research, such as through a proper randomization process, not only for convincing results but also for research replication.

Nineteen (32%) of the reviewed articles were carried out with less than 61 participants. A small sample size can potentially undermine data performance, cross-validation, and statistical power.130 In order to attain data confidence, this study proposes future research on the efficacy of Baduanjin in senior health with a larger number of informants, which would enable such studies to be more powerful.

The reviewed studies are cross-sectional inquiries: 16 (27%) were six-month programs, two (3%) were one-year projects, and the remainder was less than these or unspecified. This research strategy restricts the findings to within a specific time span, which offers insufficient cause-and-effect results, and is inappropriate for age-associated research.131 Instead, longitudinal studies would feasibly rectify these weaknesses and measure intra-individual changes:132 which is why they are usually utilized for age-oriented research.

All the reviewed projects involve only a Chinese population, which may engender sampling bias. Such a constraint leads to homogeneity and limits representativeness and generalization. It is therefore necessary to extend the research to non-Chinese elderly people in order to bolster the evaluation.

The reviewed studies are dominated by self-administered psychometric surveys and basic physiological measurements (for example, blood pressure, and forced vital capacity). However, they tend to refrain from elaborating on the mechanisms of physiological changes that occur when practicing Baduanjin, such as on cardiac function and antioxidant capacity. It is advisable to adopt the medical tools necessary to measure the biomarkers that underpin clinical data for scientific research. Furthermore, this review proposes the use of evaluation tools, such as Performance Oriented Mobility Assessment (POMA), in future research to measure practical advantages of this exercise.

Despite positivist quantitative research acquiring a larger pool of data in a shorter time, there is a lack of qualitative inquiries (only one within the reviewed references) and therefore it is unable to represent the social reality experienced by the participants. This study recommends that qualitative or mixed research be conducted that allows informants (perhaps with case examples) to disclose their experience in practicing Baduanjin.

Practical implications

Owing to the presence of more promising results, combined therapy is not rare within the reviewed research: 14 (24%) projects demonstrate this; Baduanjin with varied instruments, such as cognitive behavioral therapy,52 medication,54 meditation, 58 dance,68 diet management,72 or massage. 91 An integrative model is therefore suggested, for instance, simultaneously using with music therapy,133 which may further enhance the physical and emotional health of the aged.

Although positive signals are exhibited, the findings do not suffice to confirm the curative effects of Baduanjin, owing to the methodological weaknesses explained previously. However, it is apparent that older patients with different illnesses show significant enhancements in health when practicing this exercise, demonstrating rehabilitative and preventive capabilities. Baduanjin likely contributes to health promotion through disease prevention, such as through the prevention of ischemic stroke,134 and relapse prevention.

A healthy state and long-term engagement in physical activity are positively correlated. 135 It is highly recommended that Baduanjin be practiced 30 minutes regularly either in an individual or group setting: the latter also promotes psychological health136 and social relationships.137

Despite the fact that Baduanjin is safe and learner-friendly, this review suggests to recruit a qualified instructor in order to maximize the benefits of this exercise, especially for the elderly. The General Administration of Sport of China provides a set of training programs for various levels of instructors, associated with development, theories and techniques of Baduanjin.

A sound lifestyle substantially determines life expectancy. Baduanjin cannot be the sole agent of older adults’ health and well-being. This study encourages active ageing138 or successful ageing139 that connects to holistic involvement, including healthy habits,140 nutrition,141 relaxation,142 religious participation,143 lifetime learning,144 volunteering,145 and leisure/recreation activities146 such as handicrafts,147 and travel.148

Conclusions

Baduanjin, a traditional Chinese exercise, is a body-mind, learning-friendly, safe, self-paced, cost-effective, convenient, non-intrusive, low-intensity exercise. Its anti-ageing capabilities rejuvenate the physical and psychological health of the older individuals. This narrative review reveals that this physical activity is conducive to health promotion due to its rehabilitative and preventive effectiveness, resulting in quality of life and well-being and a large population of people who age successfully.

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J Zhang, X Ma, X-Q Sun, J. Wang Effects of health-care qigong Baduanjin on the blood lipid level and antioxidant level of the middle-aged and aged people. Shandong Sports Sci Technol 2016;38:65-8.

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YQ Chen, RZ Liu, R. He Effect of Baduanjin on quality of sleep among the elderly with hypertension. Hunan J Tradit Chinese Med 2015;31:52-3, 82.

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Y He, HL Shi, MJ Zhao. 36 cases of using Baduanjin in sub-health among the elderly. J Extern Ther Tradit Chinese Med 2015;24:9-11.

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X He. Rehabilitation therapeutic effect of baduanjin training in aged patients with hypertension. Chinese J Cardiovasc Rehab Med 2015;24:252-4.

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T Huang, JD Chang. Influence of body building Qigong and eight-section brocade on the metabolisms of nitric oxide, malondialdehyde and superoxide dismutase in middle-aged and elderly people of different gender. Chinese J Clin Rehab. 2015;9:162-4.

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XM Lin, WZ Lin. 60 cases of using Baduanjin (lying form) in hypertension among the elderly. Fujian J Tradit Chinese Med 2015;46:75-6.

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X Liu, J Gao, D Bai. Study on influence of eight-sectioned exercise on falls efficacy in community elderly. Chinese Nursing Res 2015;29:90-3.

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G Zheng, Q Fang, B Chen. Qualitative evaluation of Baduanjin (traditional Chinese qigong) on health Promotion among an elderly community population at risk for ischemic stroke. Evid Based Complement Alternat Med 2015;2015:1-10.

79. 

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KP Gu, GX Hu. Effect of Baduanjin and Qigong on blood lipid among the elderly. Chinese Rural Health Serv Admin 2014;34:1027-8.

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F Lin, QX He. Effect of Baduanjin on stage one hypertension among the elderly. Chinese J Geriatric Care 2014;12: 25-6.

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Q Liu, DZ Peng, H Wang, FY Li. Effect of Baduanjin on self-efficacy among the elderly with chronic diseases. Chinese J Convalescent Med 2014;23:414-6.

85. 

WM Qiu, HS Pan, X Wen. Effect of Baduanjin on anti-ageing. J N Chinese Med 2014;46:82-4.

86. 

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87. 

Q Wei, Y. Wu Clinical study of Baduanjin on health status inpatients with type 2 diabetes. J Liaoning Univ Traditional Chinese Med. 2014;16: 103-5.

88. 

B-C An, Y Wang, X Jiang. Effects of Baduanjin exercise on knee osteoarthritis: A one-year study. Chin J Integr Med 2013;19:143-8.

89. 

LY Bao, Y Wang, JR Liu. Effect of Baduanjin on different levels of blood lipid and vital capacity among the elderly. Chinese J Gerontol 2013;33:1140-1.

90. 

W Chen. Effects of Baduanjin on mental health of urban-dwelling elders. Chinese J Gerontol 2013;33:3472-3.

91. 

HY Men, SX Li, CX Chen. Effect of Baduanjin with acupoint massage on constipation among patients with stroke. J Hebei United Univ Health Sci 2013;15:330-2.

92. 

H-J Shen, T Jing, Z-L Wang. Comparative study on five kinds of traditional health exercises for multidimensional psychological and immune function of elder adults. Chinese J Inf Tradit Chinese Med 2013;20:17-20.

93. 

JF Zhang, J. Ai Effects of stress reduction based Baduanjin with anti-hypertensive drugs on quality of life of the elderly with high blood pressure. Chinese J Truma Disab Med 2013;21:179-80.

94. 

M-C Chen, H-E Liu, H-Y Huang, A-F Chiou. The effect of a simple traditional exercise programme (Baduanjin exercise) on sleep quality of older adults: A randomised controlled trial. Int J Nurs Stud 2012;49:265-73.

95. 

X-L Lin, J-W Chen, G-Q Zhang. Effects of eight sections brocade (Ba Duan Jin) on quality of life for patients after coronary artery bypass grafting. J Nursing (China) 2012;19:63-5.

96. 

Y Liu, R Huo, Y Lai. Communitybased study on effects of Chinese Qigong-Baduanjin on depression symptoms and life quality of patients with type 2 diabetes mellitus. Chinese J Sports Med 2012;31:212-7.

97. 

H Sun. Beneficial influence on the breeding and growth of intestinal flora through gymnastic Qigong-Baduanjin exercise in the aged. Chinese J Sports Med 2012;31:973-7.

98. 

J-H He, L Yao, Z Chang, G-N Liu. The influence of new Ba Duan Jin on the physiological function in aged women of army. Acta Acad Med CPAF 2011;20:10-2.

99. 

JR Liu, YS Guo, RF Zhang. Effect of Baduanjin on glycemia among the middle-aged and older adults. Chinese J Gerontol 2011;31:3196-7.

100. 

W Cai. Influence of sitting Baduanjin on quality of life of cerebral apoplexy patients with sequela in community. Chinese Nursing Res 2010;24:2667-8.

101. 

Y-C Feng, B-G Bian, H-S Pan. Observation of the efficacy of Baduanjin exercise on the constipation- predominant irritable bowel syndrome of the elderly. Sport Sci Res 2010;31:89-91.

102. 

YC Feng, HS Pan, X Wen. Effect of Baduanjin on the stabilised period of elderly patients with chronic obstructive pulmonary disease. J N Chinese Med 2009;41:36-7.

103. 

B An, K Dai, Z Shu. Baduanjin alleviates the symptoms of knee osteoarthritis. J Alternat Complement Med 2008;14:167-74.

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HS Pan. Effect of Baduanjin on cardiopulmonary function among the elderly. J N Chinese Med 2008;40:55-7.

105. 

S-T Wang, H-X Zhu, Y Zhang. The effects of new Baduanjin on middle/ old aged people’s life quality. J Beijing Sport Univ 2007;30:203-5.

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S-T Wang. Effect of Baduanjin on physiological age of intelligence for old people. J Clin Rehab Tissue Engine Res 2007;11:7910-3.

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W-L Hsu, C-Y Chen, J-Y Tsauo, R-S Yang. Balance control in elderly people with osteoporosis. J Formos Med Assoc 2014;113:334-9.

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CT Ng, MP Tan. Osteoarthritis and falls in the older person. Age Ageing 2013;42:561-6.

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JA Cauley. Public health impact of osteoporosis. J Gerontol A Biol Sci Med Sci 2013;68:1243-51.

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CM McDonough, AM Jette. The contribution of osteoarthritis to functional limitations and disability. Clin Geriatr Med 2010;26:387-99.

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T Gunnoo, N Hasan, MS Khan. Quantifying the risk of heart disease following acute ischaemic stroke: A meta-analysis of over 50000 participants. BMJ Open 2016;6:1-8.

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TC Turin, T Okamura, AR Afzal. Hypertension and lifetime risk of stroke. J Hypertens 2016;34:116-22.

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EA El-Moselhy, AHIA Hay. Chronic obstructive pulmonary disease in the elderly. J Gerontol Geriatr Res 2016;5:e140.

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Figure 1.

Selection Process.

gc-4-2-7449-g001.jpg
Table 1.

Analysis of the reviewed 58 clinical projects.

Source Research objective Sample size Intervention Results
Cao and Shi49 To look into the effect of regular Baduanjin on health of older adults. 62 men, aged 60-69, who practiced Baduanjin 30 minutes daily, >3 times a week, >3 years. Assigned to the Baduanjin (n=32), and control (n=30) groups. Improvements in body weight, body fat mass, waist-hip ratio, muscle content, body total moisture, protein quality, systolic blood pressure, diastolic blood pressure, rested pulse, vital capacity, seat body flexion, grip, closed eyes standing with one leg, choice reaction, and balance ability.
Chen, Pei50 To investigate the effect of Baduanjin and balance pad on balance of older adults and fall prevention. 80 participants (n=34 males, n=46 females), aged 60-70. Randomly allocated to the Baduanjing (n=20; n=8 males, n=12 females), balance pad (n=20; n=7 males, n=13 females), combined (n=20; n=11 males, n=9 females), and non-treatment (n=20; n=8 males, n=12 females) groups. Baduanjin: 20-minute session, 6 times a week, 12 weeks. Balance pad: 20-minute session, 6 times a week, 12 weeks. Combined exercise: each 10 minutes for Baduanjin and balance pad, 6 times a week, 12 weeks. Significant improvements in balance ability in exercise groups, whereas best in combined exercise group, second in Baduanjin, and then in balance pad.
Chen, Xiong51 To look into the effect of Baduanjin on pain management and overall health among patients with primary osteoporosis. 60 patients with primary osteoporosis (n=15 males, n=45 females), aged 55-71. Randomly assigned to the Baduanjin with assorted treatment (n=30; n=8 males, n=22 females), and assorted treatment (n=30; n=7 males, n=23 females) groups. Baduanjin: 40-60 minutes a session, twice a day, 8 weeks. Medication: calcium carbonate and vitamin D3 tablets, twice a day, 8 weeks. Low-frequency impulse magnetic stimulation: 20-minute session, 5 times a week, 8 weeks. Much significant alleviation of pain in Baduanjin with ssorted treatment group than that in assorted treatment a group. Better improvements in mental state in Baduanjin with assorted treatment group than that in assorted treatment group, including vitality, general health perception, mental health, physical functioning, physical role functioning, emotional role functioning, and social role functioning.
Jin, Xing52 To compare the effect of Baduanjin and cognitive behavioural therapy on the housebound elderly. 118 participants (n=40 males, n=78 females), aged 60-97. Randomly assigned to the Baduanjin (n=39; n=11 males, n=28 females; aged 62-97), cognitive behavioural therapy (n=40; n=12 males, n=28 females; aged 60-95), and combined therapy (n=39; n=17 males, n=22 females; aged 60-87) groups. Baduanjin: 30 minutes daily, 5 times a week, 6 months. Cognitive behavioural therapy: 1-1.5 hours a session, once a week, 6 months. Significant reduction in housebound in combined therapy, then Baduanjing, and then cognitive behavioural therapy groups. Activity of Daily Living Scale: highest scores in combined therapy, then cognitive behavioural therapy, and then Baduanjin groups.
Lin53 To examine the effect of Baduanjin on mild cognitive impairment. 94 patients with mild cognitive impairment (n=58 males, n=36 females), aged 61-79. Randomly distributed to the Baduanjin plus standard treatment (n=47; n=28 males, n=19 females; aged 61-79), and standard treatment (including diet control, psychoeducation, counseling) (n=47; n=30 males, n=17 females; aged 63-78) groups. 6 times a week, 6 months. Significant improvements in memory, attention, association, language, depressive symptoms, and quality of life in Baduanjin plus standard treatment after 6 months, while enhancements began after 3 months.
Lin and Yan54 To examine the effect of Baduanjin and Amlodipine Besylate on hypertension among older adults. 116 patients with hypertension (n=62 males, n=54 females), average aged at 58. Randomly assigned to the Baduanjin and Amlodipine Besylate (drug) (n=58), and Amlodipine Besylate (n=58) groups. Baduanjin: 30-40 minutes daily, 5 times a week, 6 months. Amlodipine Besylate: 5mg daily. Better improvements in systolic blood pressure, diastolic blood pressure and heart rate, and a decrease in serum endothelin in the combined therapy group.
Shi55 To compare the effect of Baduanjin and walking on fall prevention. 104 participants (n=53 males, n=51 females), aged 55-75. Randomly distributed to the Baduanjin (n=52; n=25 males, n=27 females; aged 55-74), and walking (n=52; n=28 males, n=24 females; aged 56-75). Baduanjin: 30-40 minutes per session, 12 weeks. Walking: 40-60 minutes a day, 12 weeks. Better improvements in balance ability, fall prevention, and quality of life.
Tao, Chen56 To compare the effect of Taiji and Baduanjin on cognitive control network. 61 participants (n=20 males, 41 females), average aged at 62. Assigned to the Baduanjin (n=15; n=6 males, n=9 females), Taiji (n=21; n=8 males, n=13 females), and non-treatment (n=25; n=6 males, n=19 females) groups. 60-minute session, 5 times a week, 12 weeks. Both Taiji Chuan and Baduanjin groups demonstrated significant improvements in mental control function. The Tai Chi Chuan group showed a significant decrease in rsFC between the DLPFC and the left superior frontal gyrus (SFG) and anterior cingulate cortex. The Baduanjin group showed a significant decrease in rsFC between the DLPFC and the left putamen and insula. Mental control improvement was negatively associated with rsFC DLPFC-putamen changes across all subjects.
Tao, Liu57 To compare the effect of Taiji and Baduanjin on grey matter volume. 61 participants (n=20 males, n=41 females), average aged at 62. Assigned to Baduanjin (n=16; n=6 males, n=10 females), Taiji (Yang style 24-form) (n=21; n=8 males, n=13 females), and non-treatment (n=24; n=6 males, n=18 females) groups. 30-minute session, 5 times a week, 12 weeks. Both groups significantly increased grey matter volume (GMV) in the insula, medial temporal lobe, and putamen. No significant differences were observed in GMV between 2 groups. Taiji Chuan and Baduanjin significantly improved visual reproduction subscores on the WMS-CR. Baduanjin also improved mental control, recognition, touch, and comprehension memory subscores of the WMS-CR compared to the control group. Memory quotient and visual reproduction subscores were both associated with GMV increases in the putamen and hippocampus. Improvements in cognition and memory.
Wang, Hao58 To look into the effect of Baduanjin and meditation on retirement syndrome. 89 patients with retirement syndrome (n=56 males, n=33 females), aged 49-68. Randomly assigned to the Baduanjin and meditation (n=45; n=29 males, n=16 females; aged 49-68), and Baduanjin (n=44; n=27 males, n=17 females; aged 51-67) groups. Baduanjin: 1 hour daily, 3 months. Meditation: 1 hour daily, 3 months. More significant improvements in Baduanjin and meditation group than these in Baduanjin group, including self-awareness, social activities, attention, emotion coping, sense of well-being, social relationships, self-care, and disturbing behavior.
Wu, Xue59 To evaluate the effect of Baduanjin on fall prevention. 120 participants (n=36 males, n=84 females), aged 65-80. Randomly distributed to the Baduanjin (n=60; n=18 males, n=42 females, aged 65-80), and non-treatment (n=60; n=18 males, n=42 females, aged 65-80) groups. 2 times a day, 30 days. Significant improvements in fall prevention, mental health, and quality of life in Baduanjin group.
Xiao, Zhuang60 To assess the effects of Baduajin on balance and fitness ability in older adults with type 2 diabetes mellitus. 94 patients with type 2 diabetes mellitus (n=40 males, n=54 females), aged 60-70. Randomly allocated to the Baduanjin, and no treatment groups. 45-minute session, 4 times a week, 24 weeks. Improvements in arm curls right, 30-second chair stand, back scratch-right, right chair sit-and-reach, left chair sit-and-reach, 6-minute walk test, and Timed Up-and-Go, and a decrease in glycosylated haemoglobin (HbA1c ) in Baduanjin group.
Cao, Guo61 To compare the effect of Baduanjin and walking on lung function, depression, and anxiety among old adults with chronic obstructive pulmonary disease. 102 patients with chronic obstructive pulmonary disease (n=62 males, n=40 females), average aged at 70. Randomly allocated to the Baduanjin (n=52; n=31 males, n=21 females), and walking (n=50; n=31 males, n=19 females) groups. Better improvements in lung function, depressive and anxiety symptoms in Baduanjin group.
Chen, Xu62 To examine the effect of Baduanjin on fall risk and mental health among older adults. 100 participants (n=51 males, n=49 females) average aged at 67. Allocated to the Baduanjin (n=50; n=24 males, n=26 females), and walking (n=50; n=27 males, n=23 females) groups. Baduanjin: 30 minutes daily, 5 times a week, 24 weeks. Walking: 30-60 minutes daily, 24 weeks. Reduced fall risk, and improved mental health and quality of life in Baduanjin group. More significant improvements in function, functional behavior, environment, sensory loss in Baduanjin group.
Liu, Gao63 To investigate the effect of Baduanjin on balance ability of old people. 95 participants (n=20 males, n=75 females), averaged aged at 67. Distributed to the Baduanjin (n=47; n=9 males, n=38 females), and walking (n=48; n=11 males, n=37 females) groups. 40-minute session, 12 weeks. 30-40 minutes daily, 12 weeks. Better improvements in balance ability, and fall prevention in Baduanjin group.
Liu and Yi64 To assess the effect of Baduanjin on fall prevention. 47 participants, aged over 60. Unspecified sex ratio. 30-40 minutes daily, 12 weeks. Increases in balance ability, and fall prevention.
Wang, Guan65 To compare the effect of Baduanjin and medication on coronary artery disease. 50 patients with coronary artery disease (n=31 males, n=19 females), aged 60-70. Randomly assigned to the Baduanjin with standard care (n=25; n=15 males, n=10 females), and standard care (n=25; n=16 males, n=9 females) groups. 3 months. Significant and more decreases in angina attacks and its duration, anxiety and depression, and improvement in quality of life in combined therapy group.
Wang and Meng66 To compare the effect of Baduanjin and medication on knee osteoarthritis. 60 patients with knee osteoarthritis (n=27 males, n=33 females), aged over 60. Randomly distributed to the Baduanjin (n=30; n=14 males, n=16 females), and medication (n=30; n=13 males, n=17 females) groups. 30-minute session, 5 times a week, 3 months. Medication: Meloxicam, 7.5mg, twice daily, 3 months. Better improvements in Baduanjin group.
Wu, Fan67 To compare the effect of Baduanjin on women in different ages. 139 women, aged 45-65. Distributed to the middle aged (aged 45-55) (n=60), and senior (aged 56-65) (n=79) groups. 1 hour daily, 7 days a week, 90 days. Improvements in respiratory system, blood pressure, grip, pulmonary capacity, body anteflexion in sitting position, lower limb strength, body weight, waist circumference, hip circumference, waist-hip ratio, and thickness of abdominal skinfold, upper arm and scapular in both groups. No significant differences between the 2 groups.
Xu, Li68 To assess the effect of Baduanjin and dance on hypertension of older adults. 115 patients with hypertension (n=62 males, n=53 females), average aged at 65. Randomly assigned to the Baduanjin and dance (n=58; n=30 males, n=28 females), and non-treatment (n=57; n=32 males, n=25 females) groups. 50-60 minutes per session, 4 times a week, 12 weeks. Improvements in emotion, blood pressure and heart rate.
Ye69 To evaluate the effect of Baduanjin on quality of life among patients with chronic obstructive pulmonary disease. 80 patients with chronic obstructive pulmonary disease (n=51 males, n=29 females), average aged at 65. Randomly allocated to the Baduanjin with standard treatment (n=40; n=25 males, n=15 females), and standard treatment (n=40; n=26 males, n=14 females) groups. Baduanjin: 40-minute session, twice a day, 5 times a week, 4 weeks. Standard treatment: oxygenotherapy, abdominal breathing, half-closed lip respiratory training, diet control, drug. Better improvements in vitality, bodily pain, general health perception, mental health, physical functioning, physical role functioning, emotional role functioning, and social role functioning in Baduanjin group.
Zhang, Ma70 To investigate the effect of Baduanjin on blood lipid level and antioxidant level. 50 participants (n=22 males, n=28 females), aged 55-65. Randomly allocated to the Baduanjin (n=25), and non-treatment (n=25) groups. 40 minutes daily, 3 times a week, 6 months. Decreases in triglyceride, total cholesterol, malonyldialdehyde, low-density lipoprotein, whole blood viscosity, low shear blood viscosity and plasma viscosity, and increases in high-density lipoprotein, superoxide dismutase and glutathione peroxidise in Baduanjin group.
Chen, Liu71 To examine the effect of Baduanjin and psychoeducation on quality of sleep among older adults with hypertension. 60 patients with hypertension (n=31 males, n=29 females), aged 60-75. Distributed to the Baduanjin with psychoeducation (n=30; n=14 males, n=16 females; aged 60-75), and psychoeducation (n=30; n=17 males, n=13 females; aged 62-73) groups. 1-hour session, twice a day, 3-4 times a week, 12 weeks. Better improvements in blood pressure, quality of sleep, sleep duration, and sleep efficiency in combined therapy.
He, Shi72 To examine the effect of Baduanjin and diet control on sub-health among older adults. 72 participants, average aged at 65. Unspecified sex ratio. Randomly allocated to the Baduanjin with diet control (n=36), and diet control (n=36) groups. 30 minutes daily, 6 months. Better improvements in overall health state in Baduanjin with diet control group.
He73 To investigate the effect of Baduanjin (sitting form) and standard care on hypertension among older adults. 84 patients with hypertension (n=45 males, n=39 females), average aged at 69. Randomly distributed to the Baduanjin (sitting form) and standard care (n=42; n=22 males, n=20 females), and standard care (n=42; n=23 males, n=19 females) groups. 30 minutes daily, 5 days a week, 12 weeks. Greater decrease in systolic blood pressure and increase in diastolic blood pressure in Baduanjin group than in standard care group.
Huang and Chang74 To compare the effects of Baduanjin on the metabolism of nitric oxide, malondialdehyde, and superoxide dismutase on the middle-aged and older adults. 44 participants (n=21 males, n=23 females), aged 45-65. Assigned to the middle-aged (n=22; n=10 males, n=12 females; aged 45-55), and older adults (n=22; n=11 males, n=11 females; aged 56-65) groups. 50 minutes daily, 7 times a week, 10 weeks. Increases in levels of nitric oxide and superoxide dismutase, particularly in the male elderly. A decrease in malondialdehyde, particularly in the female elderly.
Lin and Lin75 To evaluate the effect of Baduanjin (lying form) and standard care on hypertension. 60 patients with hypertension (n=34 males, m=26 females), aged 65-82. Allocated to the Baduanjin (lying form) and standard care (n=30; n=18 males, n=12 females; aged 65-80), and standard care (n=30; n=16 males, n=14 females; aged 65-82) groups. 30 minutes daily. No cases of heart failure and stroke, and 1 case of arteriosclerosis in Baduanjin and standard care group, which showed significantly better than standard care group.
Liu, Gao76 To assess the effect of Baduanjin on fall prevention. 95 participants (n=20 males, n=75 females), average aged at 67. Assigned to the Baduanjin (n=47; n=9 males, n=38 females), and walking (n=48; n=11 males, n=37 females) groups. Baduanjin: 30-40 minutes a session, twice a day, 12 weeks. Walking: 40-60 minutes a day, 12 weeks. More significant increase in fall prevention and decrease in fear of fall.
Peng, Li77 To assess the effect of Baduanjin (sitting form) and Chinese medicine on osteoporosis. 91 patients with osteoporosis (n=43 males, n=48 females), average aged at 69. Randomly distributed to the Baduanjin (sitting form) and Chinese medicine (n=47; n=21 males, n=26 females), and Chinese medicine (n=44; n=22 males, n=22 females) groups. Much higher score in Baduanjin and Chinese medicine group than in Chinese medicine group.
Zheng, Fang78 To examine the effect of Baduanjin on physical and psychological benefits. 20 participants (n=11 males, n=9 females), aged 50-69. 40 minutes daily, 5 times a week, 12 weeks. Improvements in digestive function, circulatory system function, immunity and sleep quality, relaxed body and moods, and enhanced self-tranquillity, pleasure, and symptom relief.
Bai, Tien79 To compare the effect of Baduanjin and physical exercise on health among older females. 100 women, average aged at 61. Distributed to the Baduanjin (n=50), and physical activity (n=50) groups. Baduanjin: 90-minute session, 12 weeks. Physical activity: 90 minutes daily. More improvements in abdominal fat mass, and body weight in Baduanjin group.
Gu and Hu80 To investigate the effect of Baduanjin and Taiji on blood lipid among older adults. 93 participants (n=45 males, n=48 females), aged 45-70. Randomly assigned to the middle aged (n=43; n=20 males, n=23 females; aged 46-60), and elderly (n=50; n=25 males, n=25 females; aged 60-70) groups. Baduanjin: 1 hour daily, 6-7 times a week, 6 months. Taiji: 30-minute session, twice a daily, 6 months. Decreases in total cholesterol, and low-density lipoprotein, and increase in high-density lipoprotein in both groups.
Hu and Gu81 To assess the effect of Baduanjin on health of older adults. 109 participants (n=55 males, n=44 females), aged 53-70. Randomly distributed to the Baduanjin (n=55; n=25 males, n=20 females), and non-treatment (n=54; n=30 males, n=24 females) groups. 30-60 minutes daily, 4-7 times a week, 6 months. Significant improvements in bodily pain, vitality, general health perception, physical functioning, physical role functioning, social role functioning, and mental health in Baduanjin group. Decreases in systolic blood pressure and diastolic blood pressure, but increases in vital capacity, grip strength, leg balance ability in Baduanjin group. Improvements in the body shape, body composition, physical fitness, cardiovascular function, immune function, blood lipids, sex hormone level, free radical scavenging ability, and mental health level in Baduanjin group.
Lin and He82 To compare the effect of Baduanjin and medication on stage one hypertension. 55 patients with hypertension (n=26 males, n=29 females), average aged at 62. Randomly allocated to the Baduanjin (n=27; n=14 males, n=13 females), and medication (Amlodipine Besylate) (n=28; n=12 males, n=16 females) group. Baduanjin: 30 minutes per session, twice a day, 12 weeks. Medication: Amlodipine Besylate 5mg daily, 12 weeks. Effect rate: 85% in Baduanjin group, 89% in medication group.
Liu, Gao83 To assess the effect of Baduanjin on quality of life among older adults. 95 participants. Unspecified sex ratio, and age range. Randomly distributed to the Baduanjin (n=47), and walking (n=48) groups. Baduanjin: 30-40 minutes daily, 12 weeks. Walking: 40-60 minutes daily, 12 weeks. More significant improvements in Baduanjin group than in walking group, including bodily pain, general health, vitality, social functioning, role-emotional functioning, and mental health.
Liu, Peng84 To assess the effect of Baduanjin with standard care on self-efficacy among older adults with chronic diseases. 119 patients (n=69 males, n=50 females), average aged at 77. Distributed to the Baduanjin with standard care (n=59), and standard care (n=60) groups. 30 minutes daily, 24 weeks. Significant improvement in self-efficacy in combined therapy group.
Qiu, Pan85 To examine the effect of Baduanjin on anti-ageing. 146 participants, average aged at 62. Unspecified sex ratio. Randomly distributed to Baduanjin (n=72), and diet control (n=74) groups. 90-minute session, twice a day, 5 times a week, 24 weeks. Significant improvements in antioxidant capacity and immune cells.
Wang, Guo86 To evaluate the long-term effect of Baduanjin on chronic neck pain. 69 patients with chronic neck pain (n=18 males, n=51 females), average aged at 58. Assigned to Baduanjin (n=34; n=7 males, n=27 females), and control (n=35; n=11 males, n=24 females) groups. 30 minutes daily, 6 months. Baduanjin groups achieved significantly greater improvement than the controls in visual analogue scale, Northwick Park Neck Pain Questionnaire, and SF-36 health transition scores than these in control group. There were no significant differences between the 2 groups in SF-36 physical or mental component summaries.
Wei and Wu87 To compare the effect of Baduanjin, walking, and drug on type II diabetes. 60 patients with type II diabetes (n=38 males, n=22 females), aged 54-73. Randomly assigned to the Baduanjin (n=20), walking (n=20), and drug (n=20) groups. Baduanjin: 3 times a day, 5 times a week, 3 months. Walking; 30 minutes daily, 5 times a week, 3 months. Better improvements in diabetes symptoms and mental health in Baduanjin group than in other groups.
An, Wang88 To evaluate the effect of regular Baduanjin on knee osteoarthritis. 22 patients (n=3 males, n=19 females), aged 55-82. 30-minute session, 5 times a week, 1 year. Reductions in pain, stiffness, disability, and improvement in emotional health. A decrease in BMI enhanced knee extensors and flexors strength and patients aerobic ability. No adverse effect.
Bao, Wang89 To look into the effect of Baduanjin on vital capacity. 105 participants, aged 55-65. Unspecified sex ratio. 30 minutes daily, twice a day, 3 months. Improvements in the respiratory system.
Chen90 To investigate the effect of Baduanjin on mental health of older adults. 180 participants (n=79 males, n=89 females), aged 60-84. Randomly allocated to the Baduanjin (n=80; n=38 males, n=42 females; aged 60-82), and non-treatment (n=88; n=41 males, n=47 females; aged 60-84) groups. 1-hour session, 6 times a week, 20 weeks. Significant improvements in mental health, including somatisation, obsession, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid, and psychotism.
Men, Li91 To examine the effect of Baduanjin with acupoint massage and standard care on constipation among older adults after stroke. 60 patients (n=31 males, n=29 females), average aged at 64. Randomly assigned to the Baduanjin with acupoint massage and standard care (n=30; n=15 males, n=15 females), and standard care (n=30; n=16 males, n=14 females) groups. Baduanjin: 30 minutes daily. Acupoint massage: 2-3 times daily. Effect rate: 83.3% in Baduanjin with acupoint massage and standard care group, 6.7% in standard care group.
Shen, Jing92 To compare the effect of Taiji, Baduanjin, Wuqinxi, Yijinjing, and walking on mental health and immune function. 362 participants, average aged at 61. Unspecified sex ratio. Distributed to the Taiji (n=67), Baduanjin (n=33), Wuqinxi (n=19), Yijinjing (n=27), walking (n=81), and no exercise (n=135) groups. Taiji controlled anger. Baduanjin improved calm. Wuqinxi increased the focus attention level. Yijinjing improved well-being. Walking reduced depression.
Zhang and Ai93 To compare the effect of Baduanjin (sitting form) and drug on hypertension among older adults. 120 patients with hypertension (n=52 males, n=68 females), average aged at 75. Randomly distributed to the Baduanjin (sitting form) (n=60; n=28 males, n=32 females), and drug (n=60; n=24 males, n=36 females) groups. Effect rate: 83% in Baduanjin group, 52% in drug group.
Chen, Liu94 To investigate the effect of Baduanjin on sleep quality. 55 participants (n=19 males, n=36 females), average aged at 71. Randomly assigned to the Baduanjin (n=27; n=10 males, n=17 females), and non-treatment (n=28; n=9 males, n=19 females) groups. 30-minute session, 3 times a week, 12 weeks. Enhancements in overall sleep quality, subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction in Baduanjin group. Significantly better sleep quality in Baduanjin group after four weeks, which was maintained throughout the 12-week exercise period.
Lin, Chen95 To compare the effect of Baduanjin (lying form) and walking on rehabilitation after coronary artery bypass grafting. 60 patients with coronary artery bypass grafting (n=46 males, n=14 females), average aged at 65. Randomly allocated to the Baduanjin (lying form) (n=30; n=24 males, n=6 females), and walking (n=30; n=22 males, n=8 females) groups. Baduanjin: 30 minutes daily, 4-5 times a week, 23 weeks. Walking: 30-100 minutes a session, 3 times a day, 23 weeks. Great improvements in rehabilitation and exercise skills in Baduanjin group.
Liu, Huo96 To compare the effect of Baduanjin and community care on depression and quality of life among patients with type II diabetes. 69 patients with type II diabetes (n=28 males, n=41 females), average aged at 64. Randomly assigned to the Baduanjin (n=33; n=14 males, n=19 females), and community care (n=36; n=14 males, n=22 females) groups. 40 minutes daily, 3-5 times a week, 12 weeks. Much significant improvements in depressive symptoms and mental health in Baduanjin group. Greater reduction in glycosylated hemoglobin (HbA1c) in Baduanjin group than in community care group.
Sun97 To assess the effect of Baduanjin on changes of intestinal flora. 45 participants (n=22 males, n=23 females), average aged at 63. 40-50 minutes daily, 6 times a week, 6 months. Significantly decreased the quantity of enterobacter and fusobacterium, but increased the quantity of bifidobacterium, lactobacillus and the ratio of bifidobacterium and enteric bacilli.
He, Yao98 To investigate the effect of Baduanjin on health of older women in army. 80 women in army, aged 61-65. Randomly allocated to the Baduanjin (n=40), and non-treatment (n=40) groups. 45 minutes daily, 20 weeks. More increases in superoxide dismutase and close eyes one-foot balance, and improvements in the level of sexual hormone, nervous response and balance ability in Baduanjin group than these in non-treatment group. Delayed free radical injury in Baduanjin group.
Liu, Guo99 To compare the effect of Baduanjin and walking on blood glucose among older adults. 95 participants, aged 55-65. Unspecified sex ratio. Assigned to the Baduanjin (n=47), and walking (n=48) groups. Baduanjin: 30-minute session, twice a day, 3 months. Walking: 30-minute session, twice a day, 3 months. A decrease in blood glucose in Baduanjin group, but an increase in walking group.
Cai100 To compare the effect of Baduanjin (sitting form) and education on stroke rehabilitation. 60 patients with stroke (n=43 males, n=17 females), average aged at 61. Randomly assigned to the Baduanjing (sitting form) (n=30; n=20 males, n=10 females), and education (n=30; n=23 males, n=7 females) groups. 30 minutes daily, 4-5 times a week, 3 months. More significant improvements in physical health, psychological health, social relationships, environment, health perception, and living quality perception in Baduanjin group than in education group.
Feng, Bian101 To look into the effect of Baduanjin on irritable bowel syndrome. 60 patients with irritable bowel syndrome (n=36 males, n=24 females), average aged at 66. Randomly allocated to the Baduanjin with medication (n=30; n=17 males, n=13 females), and medication (n=30; n=19 males, n=11 females) groups. 45-minute session, twice a day, 12 weeks. Medication: Tegasero, 6mg. Effect rate: 90% in Baduanjin with medication group; 83% in medication group. Improvements in abdominal pain, abdominal distension, constipation, and abnormal defecation.
Feng, Pan102 To investigate the effect of Baduanjin on chronic obstructive pulmonary disease among older adults. 60 patients with chronic obstructive pulmonary disease (n=39 males, n=21 females), average aged at 63. Randomly distributed to the Baduanjin (n=30; n=18 males, n=12 females), and control (n=30; n=21 males, n=9 females) groups. 45-minute sessions, twice a day, 5 days a week, 24 weeks. Improvements in forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 6-minute walk distance.
An, Dai103 To examine the effect of Baduanjin on women with knee osteoarthritis. 21 women, average aged at 65. Randomly assigned to the Baduanjin (n=11), and non-treatment (n=10) groups. 30-minute session, 5 sessions a week, 8 weeks. Decreases in pain, stiffness, and disability in Baduanjin group. Improvements in quadriceps strength and aerobic ability in Baduanjin group.
Pan104 To assess the effect of Baduanjin on cardio-pulmonary function. 48 patients with cardio-pulmonary problems (n=22 males, n=26 females). Unspecified age range. 30 minutes daily, 1 year. Increases in compensatory force of heart pump, cardiac contractility, cardiac output stroke volume, and pulmonary function. Improvements in myocardial oxygen supply, scavenging ability of oxygen free radicals, and respiratory endurance.
Wang, Zhu105 To look into the effect of Baduanjin on health among older adults. 200 participants (n=100 males, n=100 females), average aged at 60. Randomly allocated to the Baduanjin (n=120; n=60 males, n=60 females), and non-treatment (n=80; n=40 males, n=40 females) groups. 1 hour daily, 7 times a week, 6 months. More significant improvements in bodily pain, vitality, general health perception, health transition, physical functioning, physical-role functioning, emotional-role functioning, social functioning, mental health in Baduanjin group.
Wang106 To test the effect of Baduanjin on health and intelligence among older adults. 113 participants (n=42 males, n=71 females), aged 56-65. Distributed to the Badunajin (n=58; n=22 males, n=36 females), and non-treatment (n=55; n=20 males, n=35 females) groups. 1 hour daily, 5-7 times a week, 6 months. Delayed hypophrenia (intelligence recession), and decreased metabolic oxygen consumption. Increased mental activities and self confidence. Enhanced immune system, endocrine system, haemodynamics, haemorheology, cardiac functions, and regulation of nervous system
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