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Table of Contents
CASE REPORT
Year : 2018  |  Volume : 1  |  Issue : 3  |  Page : 150-154

The influence of health qigong on the subjectively expressed psychophysical state of patients with rheumatoid arthritis, rheum, osteoporosis, osteopenia


Teacher of the Health Qigong by the Program of the Chinese Association of Health Qigong; Bowen Therapist, Serbia

Date of Web Publication8-Jan-2019

Correspondence Address:
Prof. Ilinka Acimovic
Pedje Milosavljevica 12/14 11 000 Belgrade
Serbia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CMAC.CMAC_33_18

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  Abstract 


This study assesses the impact of exercise on the health of the Qigong (Jibengong, Health Qigong Ba Duan Jin and Health Qigong Yi Jin Jing) in patients with rheumatoid arthritis, rheumatism, osteoporosis, osteopenia. Through the given questionnaire we have come up with data showing how and how much health qigong affects the patients with rheumatoid arthritis, rheumatism, osteoporosis, osteopenia according to the subjective assessment.

Keywords: Ba Duan Jin, depression, health qigong, Jibengong, osteopathy, osteopenia, osteoporosis, physical activity, rheumatoid arthritis, therapy, Yi Jin Jing


How to cite this article:
Acimovic I. The influence of health qigong on the subjectively expressed psychophysical state of patients with rheumatoid arthritis, rheum, osteoporosis, osteopenia. Chin Med Cult 2018;1:150-4

How to cite this URL:
Acimovic I. The influence of health qigong on the subjectively expressed psychophysical state of patients with rheumatoid arthritis, rheum, osteoporosis, osteopenia. Chin Med Cult [serial online] 2018 [cited 2019 Mar 23];1:150-4. Available from: http://www.cmaconweb.org/text.asp?2018/1/3/150/249578






  Introduction Top


Goals

This study assesses the impact of exercise on the health of the Qigong (Jibengong, Health Qigong Ba Duan Jin and Health Qigong Yi Jin Jing) in patients with rheumatoid arthritis, rheumatism, osteoporosis, and osteopenia. Patients with this diagnosis have common symptoms, such as stiffness, fatigue, poor mobility, joint and muscles pain, anxiety and depression, and lack of fitness. Through the given questionnaire we have come up with data showing how and how much health qigong affects the patients with rheumatoid arthritis, rheumatism, osteoporosis, osteopenia according to the subjective assessment.

Measured effects are:

  • Pain reduction
  • Increased joint range of movement
  • Muscle strengthening
  • Improving general fitness
  • Impact on the psychological/mental state.



  Methods Top


A study was conducted on the basis of a questionnaire of 22 questions, with 22 patients, practicing the health qigong from April 1, 2012 to May 1, 2018.

They attended a training session of the health qigong twice per week for 1h per session. All patients are a female population aged 60 to 84, with rheumatoid arthritis, rheumatism, osteoporosis, osteopenia.

Class concept

Each class consists of:

  • Jibengong exercises represent simple qigong exercises that use the practitioner to adopt the principles of qigong – the proper posture, body, breath, and mind conditioning and prepare the body for the proper performance of the health qigong
  • Isometric or static exercises (muscle tightening without making movements in the wrist, joint) serve to achieve muscle strengthening without a joint load
  • Low-intensity fitness exercises Variety of exercises with a full range of movements that engage all the main groups of muscles and all the joints


    • Health Qigong Ba Duan Jin
    • Health Qigong Yi Jin Jing.



  Description of Disease Top


The word “rheumatism” comes from Greek, meaning “flowing” – Characteristic: joint pain and limited ability to move are common symptoms of all rheumatic diseases.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory rheumatic disease that primarily involves the joints but also intestinal and internal organs, the nervous system and the skin. It belongs to the group so-called systemic connective tissue diseases. The joints most commonly affected by this disease are: hands, wrists, shoulders, knees, feet and ankles. The cause of the disease is unknown, but there are doubts that the disease may have a genetic predisposition or may be caused by some infections in the body. In severe cases, this disease can lead to patient disability. The illness may have chronic or subacute currents with excavations or remissions. The disease gradually leads to destruction, deformation of the joints.

It is thought that about 1% of adults are affected by rheumatoid arthritis [Figure 1].
Figure 1: Normal hand and hand with rheumatoid arthritis

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“Rheumatoid arthritis is a widespread disease, and is present in almost every one hundred inhabitants of the Globe. It more often occurs in women, especially in the period between the fourth and sixth decades of life. Women get sick three times more often than men. In Serbia, there are about 1 million people, or every fourth person suffering from some form of chronic rheumatism. Of the total number of severe inflammatory forms of rheumatism, there are 60,000, and every other person with disability” (Dr. Mirjana Lapšević http://www.novosti.rs/vesti/zivot_+.304.html: 424859-Reumatoidni-artritis-skracuje-zivotni-vek).

Osteoporosis

Osteoporosis is a health problem in which the normal bone hardness is lost, which makes them fragile. Bones lose their hardness due to the lack of material matter and become spongy.

Osteopenia

This term refers to bone density that is less than normal, but not as low as to be considered osteoporosis.


  Class Description Top


The concept of one class with a patient with rheumatoid arthritis, rheumatism, osteoporosis, osteopenia.

Jibengong exercises – basic workout the first 30 min of training.

In practice, it is advised that all the exercises they do have to work with 70% of their strength and capabilities. This is done so that excessive exercise would not lead to fatigue, inflammation of the joints.

Exercises are performed lightly while the concentration is on the body movements and breathing. The advice is to breathe normally during exercise in order not to keep the heartbeat normal.

Short description of some of the Jibengong exercises.

  1. Basic posture: Shoulder width between the feet, feet are parallel. Slowly relaxing from head to foot from Bai Hui (GV 20) to Yongquan (KD1). This posture alignment or basic Zhan Zhuang posture is done for 5 up to 15 min[1]
  2. Mobilization of the hand and shoulder joints:First interlock fingers and move wrist in circles, then change sides (carpal tunnel exercises). The second exercise is to extend hands and move them in circular motion from the shoulder from down to up and in opposite direction (shoulder exercise)
  3. Exercises for the neck: Elbows connected, head rests in the hands; slowly pushing the head up and tensing the neck. Second exercise fingers interlocked, palms placed behind the neck supporting the whole length of the neck; pushing the head forward and downwards, extending the neck. Next exercise is to move the neck with semicircular movements to the left, i.e., the right side[2]
  4. Exercises for the elbows and shoulders: (1)First just turning and moving the arm from the elbows to one side and the other. (2) The shoulder exercises-move first one and the other hand in circular movements forward and backward, then together both hands and then the arms in different directions[3]
  5. Exercise for massage of internal organs: Chin is set on the chest bone and body slowly descends to the middle of the stomach, then lift the first chin and extend out the entire front Ren mai channel, and then repeat the movement with extension of Du mai channel
  6. Stretching exercise: Shifting weight to left leg and body goes stretching to the right and vice versa
  7. Hips exercises: Circular hip movement on both sides while both feet must be on the ground and head set in the middle[3]
  8. Knee exercise: Lifting and rotating the knees, fingers grab the “eyes of the knees”
  9. Exercises for the feet: Foot rotation in the ankles
  10. Foot exercises: Heel fingers (tightened both legs a little forward but taut and the one that moves forward-fingers heel, fingers heel), etc.[4]


After around 30 min of warming up, joints and muscle stretching and loosening, patients start to practice Ba Duan Jin.

Eight pieces of brocade (Ba Duan Jin) is one of the most famous health qigong practice systems in the world. It consists of 8 or 12 exercises (number depends on counting and repetition) in standing and sitting position.[5] According to the legend, the origin of these exercises is led by General Yue Fei, who devised exercises to make his soldiers healthy, strong and ready for battle. Some sources claim that General Yue Fei was one of the bearers of the knowledge of Yi Jin Jing and that he adapted the exercises to conditions at the battlefield.

According to historical data, the exercises originate from Song Dynasty 960-1279. AD. Simple movements and great effects of health improvement make this exercise a real jewel of a rich Chinese health and physical culture. The purpose of the exercise is to increase the circulation of internal energy through physical exercises, breath control and focusing on the mind and intent in order to improve and preserve health and psychophysical strengthening.

It can also be used as an extraordinary morning exercise. The most important effects of this training system are improvement of the cardiovascular system, assistance in the treatment of coronary arteriosclerosis and osteoporosis, immune suppression, slowing down of aging and improving mental health.

The last 15 min of the training with the patients is reserved for practice of Yi Jin Jing (Classic of tendon-muscle change). It is a traditional health and fitness training system derived from ancient China. Health qigong Yi Jin Jing is part of a series of new health-care qigong exercises compiled, standardized and marketed by the Chinese Association of Health Care Products.

As a safe aerobic exercise, it contains movements that are in line with theories of kinetics and physiology. Traditional movements have added the opening and closing positions, which make the exercises more complete, standardized and more rational.

Based on the traditional 12 exercises, Yi Jin Jing, the health qigong Yi Jin Jing has the same names, function and key points of original exercises, while the theoretical basis, the way of knowledge transfer and learning is adapted to modern times, with the latest knowledge in Chinese medicine, sports and other related fields.

Reasons why choose these health qigong systems:

  1. It has been proved that practice of Ba Duan Jin improves the respiratory, limb strength, and flexibility of the joints, and fortifies the nerves, as well as enchances the general balance. Ba Duan Jin – Compiled by the Chinese Health Qigong Association, Third Printing 2009[6]
  2. Yi Jin Jing movements have been proved to be able to improve health and fitness, prevents diseases, lengthen life and improve the intellect. In particular practice of the Yi Jin Jing exercises has very impressive effects on the respirator system, flexibility, balance and muscular strength. Yi Jin Jing – Compiled by the Chinese Health Qigong Association, Fourth Printing 2012.[7]


Note: During the training, there was no aerobic exercise (in which practitioner is easily sweating and loosing breath) that is advised for general fitness, muscle strength, and better general condition of the patient. Aerobic exercises were avoided because, in the course of their performance, there is an accelerated work of heart and fatigue, and as far as the 60+ age population is concerned, these types of exercises should be avoided.


  Results Top


Statistical data

Overall, 100% of the survey participants are women where the youngest person is 60 years old and the oldest is 84 years old.

Of the 22 interviewed patients, 68% of the patients are undergoing medical care for more than 4 years, 32% of the participants are practicing health qigong for minimum 2 years.

It should be noted that 68% of patients reported physical activity only 2 h/week, and they just practicing health qigong.

Results that show how the patients felt before practicing a health qigong:

  • The general condition before the beginning of the exercise of the health qigong: 41% felt fatigue that did not disturb them, and 36% felt a severe fatigue and had to make longer breaks
  • Prior to the beginning of the health qigong practice, the patients evaluated the subjectivity of their condition – first the mobility where 32% of the patients said they were poorly mobile, and 36% said that some joints could not be moved in any way, while in 32% of the patients the mobility of the joints was excellent
  • The pain in the joints before the beginning of the practice of a health qigong-36% of the patients had occasional pain most commonly in the morning while 46% had constant pain all day but tolerable, and 18% had no pain
  • The pain in the muscles before the beginning of the practice of a health qigong-26% of the patients said that they had no muscle pain, 22% had occasional pain, and most often in the morning, 39% of the patients had constant pain but were tolerable and the pain was present throughout the day while 13% of patients experienced occasional pain in the evening
  • Assessment of the psycho-physical condition prior to coming to the practice of the health qigong: 68% of the patients predominated with negative emotions (fear, anger, sadness, depression), while 28% did not pay attention to the psychophysical condition, while 4% were positive.


During the training, 64% of the patients did not feel fatigue, and 36% feel fatigue but it did not disturb them.

The condition of the patients after more than 2 years of practicing the health qigong:

  • Since they started to practice health qigong, 32% of the patients say that their therapy has been reduced (prescribed drug therapy), while 68% say that their treatment is the same
  • Mobility during stagnation since exercising a health qigong 91% said they are very mobile, and 9% expressed low-mobility
  • 50% of the patients said that there is no joint pain since they started to practice health qigong, 45% occasionally get aches and 5% say they are the same as before the training
  • Assessment of the mobility of the joints since patients started to practice health qigong: 95% of patients said that the joints are very mobile since they practice a health qigong 5% that the joints are still weak [Pie Chart 1]
  • 73% of patients said that there was no muscle pain since they started to practice health qigong, 18% said that pain occasionally occurred in the morning, and 9% said it still felt constant pain all day, but it was tolerable [Pie Chart 2]
  • According to the subject's assessment, the feeling after the training-32% of the patients said that they feel increased energy, and 45% of the students have a feeling of satisfaction, and 23% of the patients feel calm [Pie Chart 3]
  • When asked “How often they had a cold or flu since they started to practice health qigong”, 55% of patients said that it was less common to catch cold and flu, and 45% did not have a cold or flu since they were started to practice health qigong
  • When asked how often negative emotions are expressed since they started to practice health qigong: 59% of patients say that negative emotions are much less pronounced, and 41% say that there are no negative emotions since they started to practice health qigong.
  • Since the beginning of the practice of a health qigong, 73% of patients did not feel fatigue during the day, and 27% of patients said that they feel fatigue but are not disturbed [Pie Chart 4].




  Conclusion Top


None of the patients had a worsening of the condition, as many as 32% of the patients said that their drug therapy treatment was reduced only from the health qigong which they practiced 2 times a week per hour.

  • Reduction of pain: 50% of patients said there was no joint pain and increase in the volume of movement in the wrist-95% of the patients said that the joints were very mobile since they started to practice health qigong, and 5% still with poor joint mobility
  • Muscle strength: 73% of the patients do not have muscle pains since they started to practice health qigong
  • Improvement of general fitness: 73% of the patients do not feel fatigue, while 27% feel fatigue that does not disturb them, and 0%, i.e., no patients complain about the fact that there is no strength or that they are in poor condition
  • Impact on the psychological-mental state: 59% of the patients say that negative emotions are much less represented and 41% said that there are no negative emotions since they started to practice health qigong


    • By practicing the health qigong, an increase in the volume of movement in the joint, the strengthening of joint muscles and the improvement of general fitness were achieved
    • By practicing health qigong, we observed reducing of pain, increased mobility, reduced fatigue, and it helps patients look and feel better
    • By practicing health qigong, the change in the psychological state of the patients led to a positive way of thinking.



  About Qigong Association of Serbia Top


The Qigong Association of Serbia was established in May 2012 as a sports federation with the Agency for Business Registers and the Ministry of Youth and Sports in accordance with the current Law on Sports of the Republic of Serbia.

The Alliance aims to transfer the learned skills of Qigong to anyone who wants to become familiar with techniques that will enable them to live a healthier life and make it easier to deal with day-to-day challenges.

The Alliance is a co-founder of the International Federation of Health Qigong based in Beijing and has signed a cooperation agreement with the Shanghai University of Traditional Chinese Medicine and the Shanghai Qigong Institute.

The training program for future trainers of health-care products was accredited by the Health Council of Serbia, and it was promoted by the Association of Cardiologists of Serbia and the Association of ORS.

Ilinka Acimovic, a professor of geography who in 2008 meets the world of kung fu wushu practicing Tai Chi Chuan at Peng School, where she also starts practicing health Qigong as a special kind of psychophysical exercise.

In 2009, she goes to Germany for professional development with Sasa Kristofjak. In 2012, with Sasa Balaneskovic, initiating the establishment of the Qigong Association of Serbia with the support of the Chinese Association of Health Qigong, she is acting in the Association as the Secretary General since the establishment.

In 2013, she went to the first professional training with the Shanghai University of Traditional Chinese Medicine (traditional Korean medicine theory, diagnostics, basics of acupuncture and moxibustion, other than manual therapy, herbology, pharmacology, cosmetology, and qigong).

Since then, she has been traveling once a year to China (Shanghai, Beijing, Wuhan, Chengdu) for additional training and learning related to Qigong.

In addition, since 2011, she holds classes at the Qigong Institute at Rheumatology Institute, together with the representatives of the Qigong Association of Serbia (from the position of the Secretary of the Association), and from 2012 to 2017, hosted six delegations of top masters and professors of the Chinese Association of Health Qigong.

Together with Sasa Balaneskovic, she conducts seminars and courses for the professional development of the qigong.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jin P. Efficacy of tai chi, brisk walking, meditation, and reading in reducing mental and emotional stress. J Psychosom Res 1992;36:361-70.  Back to cited text no. 1
    
2.
Lephart SM, Pincivero DM, Giraldo JL, Fu FH. The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med 1997;25:130-7.  Back to cited text no. 2
    
3.
Petrella RJ, Lattanzio PJ, Nelson MG. Effect of age and activity on knee joint proprioception. Am J Phys Med Rehabil 1997;76:235-41.  Back to cited text no. 3
    
4.
Lord SR, Rogers MW, Howland A, Fitzpatrick R. Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc 1999;47:1077-81.  Back to cited text no. 4
    
5.
Yang JM. Eight Simple Qigong Exercises fot Health – The Eight Pieces of Brocade. Jamaica Plain, Mass, USA: YMAA Publication Center; 2003.  Back to cited text no. 5
    
6.
Jin BD. Compiled by the Chinese Health Qigong Association. Third Printing; 2009.  Back to cited text no. 6
    
7.
Jing YJ. Compiled by the Chinese Health Qigong Association. Fourth Printing; 2012.  Back to cited text no. 7
    


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