Author: Yuen, Shuk Man
Title: Effect of Qigong on balance, fall efficacy, physical functions and psychological wellbeing of people with stroke
Degree: DHSc
Year: 2018
Subject: Hong Kong Polytechnic University -- Dissertations
Cerebrovascular disease -- Patients -- Rehabilitation
Qi gong -- Therapeutic use
Department: Faculty of Health and Social Sciences
Pages: xvi, 124 pages : color illustrations
Language: English
Abstract: Background: Stroke is one of the leading causes of death and the most common cause of disability worldwide. The burden of stroke is high due to the management cost of acute care, long-term rehabilitation, and life-time care and also the loss of economic productivity of the stroke survivors and their caregivers. Hence, a safe, economical and sustainable method to improve physical and psychological function in stroke patients is essential to relieve this burden. Qigong has been used as a body-mind exercise that can be practiced at home to improve both physical and psychological functions for other patient populations, and may have useful application in individuals with stroke. Methods: An assessor-blinded randomized controlled design was undertaken. Stroke patients of Kowloon Hospital who fulfilled all eligibility criteria were recruited and randomly assigned to the experimental (qigong) or control (fitness) groups. Participants allocated to the experimental group received qigong training (8 weeks of qigong class and 8 weeks of home-based qigong practice), while the qigong training was replaced by a home fitness program in the control group. The experimental and control groups were required to engage in a total of 50 min of their respective exercise training, three times per week for 16 weeks. The balance ability, physical and psychological well-being, fall efficacy, activities of daily living, and quality of life were assessed at baseline, week 8, and week 16. Moreover, a custom-made questionnaire was used to collect the feedback of the stroke patients concerning their view of the qigong training and their perception of changes after the training.
Results: From July of 2016 to February of 2018, a total of 58 stroke subjects were recruited and 50 subjects (27 experimental and 23 control) completed all three assessments. The mean age of the participants was 63.0±10.6 (M±SD) years in the experimental group and 62.0±13.1 (M±SD) years in the control group. The mean time since stroke onset was 23.1±21.5 (M±SD) and 25.3±21.6 (M±SD) months in the experimental and control groups, respectively. Analysis of variance with repeated measures revealed a significant time × group interaction effect on the mini balance evaluation systems test (Mini-BESTest), composite equilibrium score, five-times-sit-to-stand test, and timed-up-and-go test. Post-hoc analysis indicated that the significant improvement in the experimental group could be detected as early as week 8. Further improvement in these outcomes was also observed from week 8 to week 16, but only reached statistically significant level for the Mini-BESTest. The effects of the qigong on the limits of stability test, fall efficacy scale-international, geriatric depression scale, modified Barthel index, and stroke-specific quality of life scale of the experimental group were similar to the control training. A custom-made patient questionnaire revealed that significantly higher scores were obtained in the experimental group than in the control group, suggesting that more qigong group participants agreed that this complementary type of exercise is safe and easy to practice for improving their physical and psychological conditions. Conclusion: This study demonstrated that qigong training was effective in improving the balance, leg muscle strength, and mobility of stroke survivors relative to traditional fitness training. It is safe, economical, and well-accepted by patients, and may be a viable treatment option for long-term stroke rehabilitation.

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