Review Article

Beneficial Effects of Qigong Wuqinxi in the Improvement of Health Condition, Prevention, and Treatment of Chronic Diseases: Evidence from a Systematic Review

Table 1

Studies regarding effects of Wuqinxi exercise in healthy populations included in the analysis.

Authors/ Year/ CountryStudy design/ BlindingSample sizeMean age (year)/ Sex (m/f)Wuqinxi practicing phasesWuqinxi Learning phaseControl intervention designRelevant OutcomesResultsFollow-up/ Adverse eventsConclusion
WuqinxiControl

Li-Ping Liang/
2018/
China
[37]
Historical cohort study/ Non-blinding31 middle-aged and elderly people30
Middle-aged and elderly people
Wuqinxi:
58.38±7.14 (16/15)
Control:
57.65±8.27
(16/14)
Entire exercise:
30 mins/
session, 4 sessions/
week,
at least 2 years
Not mentionedunaltered lifestyle1. Simplified version of graphic reasoning (Raven) test.
2. Cancellation test.
3. Self-report
symptom inventory
(SCL-90).
4. BFS mood scale.
5. Immunological index: CD3+, CD4+,
CD8+, natural killer (NK) cells, immunoglobulins (IgG, IgA, IgM).
1. The scores of simplified version of graphic reasoning (Raven) test and cancellation test in Wuqinxi group were significantly higher than those in the control group (all P < 0.05).
2. The scores of somatic symptoms, depression, hostility, terror, paranoia and psychotic symptoms of SCL-90 in Wuqinxi group were significantly lower than those in the control group
(all P < 0.05).
3. The scores of active, joyful and calm mood of BFS mood scale in Wuqinxi group were significantly higher than those in the control group (all P < 0.05), while the scores of thought, anger, excitement, depression and inactive in Wuqinxi group were significantly lower than those in the control group (all P < 0.05).
4. Immunological index of CD3+, CD4+, CD8+, natural killer (NK) cells in Wuqinxi group were significantly higher than those in the control group (all P < 0.05).
Not mentioned/ Not reportedWuqinxi had effect on regulating and improving body immunity, cognitive function and psychological emotion in middle-aged and elderly people.

Feng Zhang et al. /2014/
China [10]
RCT/ Non-blinding15 male volunteers15 male volunteersAge
41.3±3.5
(30/0)
Entire exercise: 5 times/week,
1 year
Not mentionedAerobic exercise (walking): 30 mins/ time, 5 times /week, 1 yearThe average surface electromyography (ASEMG) in the process of flexion and extension was recorded and analyzed using DASYLab10.0 software, and the
flexion extension ratio (FER) was calculated
The ASEMG in the process of
flexion was lower than the ASEMG in the process of extension both before and after the 1 year exercise intervention on both groups of all volunteers. There was no significant difference in FER between the Wuqinxi group and control group before the 1 year Intervention. However, the FER of Wuqinxi group was lower than that of the control group after the 1 year intervention.
Not mentioned/ Not reportedWuqinxi had effect on improving the function of the lumbosacral multifidus, and it thought to be an alternative method of reducing low back pain.

De-Sheng Chang et al. /2013/
China [38]
RCT/ Non-blinding30 middle-aged and elderly peopleQiong Yijinjing group,
Qigong Liuzijue group,
Qigong Baduanjin group: 30 middle-aged and elderly people in each group
50≤age≤70
(16/104)
Entire exercise: 60 mins/session,
at morning, 5 sessions/week,
12 weeks
Not mentionedQiong Yijinjing group,
Qigong Liuzijue group,
Qigong Baduanjin group: 60 mins/session,
at morning, 5 sessions/ week12 weeks
Geriatric depression scale (GDS), self- rating anxiety scale (SAS), self-rated health measurement scale version (SRHMS)The four kinds of Qigong exercises had positive effects on psychological emotion of middle-aged and elderly people, but their emphasis was different. In terms of improving depression: Qiong Yijinjing group > Qigong Liuzijue group > Qigong Baduanjin group > Qigong Wuqinxi group.
In terms of improving anxiety: Qiong Liuzijue group > Qigong Wuqinxi group > Qigong Yijinjing group > Qigong Baduanjin group.
In terms of improving self-test health: Qiong Baduanjin group > Qigong Wuqinxi group > Qigong Liuzijue group > Qigong Yijinjing group.
Not mentioned/ Not reportedThe four kinds of Qigong exercises showed good health preservation value, and had a positive impact on regulating and improving middle-aged and elderly people's mental state. Because of the emphasis of Qigong exercise, middle-aged and elderly people who are interested in Qigong exercises can choose a Qigong exercise suitable for themselves according to their specific circumstances and hobbies.

Gang Qin/2012/ China [39]RCT/ Non-blinding10 healthy college students10 healthy college students21≤age≤22
(unspecified gender ratio)
Entire exercise: 60 mins/session, 5 sessions/week,
20 weeks
Not mentionedunaltered lifestyleCardiac function index and vascular function index: pulse rate (HR), stroke volume (SV), cardiac index (CI), left ventricular pump power effective (VPE), mean systolic pressure (MSP), mean diastolic pressure (MDP), mean arterial pressure (MAP), vascular compliance (AC), total peripheral resistance (TR), stroke index (SI), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), vascular elastic dilatation coefficient (ETK).The cardiac vascular main index of the control group had no significant changes. SV, CI, VPE, the HDL increased significantly, HR, MSP, MDP, MAP, the TR dropped obviously in Wuqinxi group.
Not mentioned/ Not reportedWuqinxi was thought to have a positive impact on cardiovascular function of healthy college students.

Lei Yu et al./ 2012/
China [40]
RCT/ Non-blinding60
Middle-aged and elderly people
60
Middle-aged and elderly people
Age:
68.29±2.17
(unspecified gender ratio)
Entire exercise:
3 times/week,
1 year
Not mentionedconventional exercise1. Physiological function index: systolic pressure (SP),
diastolic pressure (DP), heart rate (HR), vital capacity (VC).
2. Physical quality index: back strength, grip strength, trunk bending forward, sit-up, push-up, vertical jump, agility test.
3. Biochemical index: hemoglobin, albumin, glucose, triglyceride, cholesterol.
Before exercise, there was no significant difference in physiological function index and physical quality index, biochemical index between Wuqinxi group and control group. After the 1-year intervention period, all physiological function index and physical quality index, biochemical index in Wuqinxi group were significantly improved. Whereas these positive changes were not observed in the control group.Not mentioned/ Not reportedWuqinxi was thought to have better effect on improving physiological function and physical quality of middle-aged and elderly people.

Li-Mei Duan/ 2012/China
[41]
PPS/ Non-blinding60
elderly people
---Age:
64.0±3.4
(28/32)
Entire exercise:
45 mins/session, at morning, 6 sessions/week,
16 weeks
Not mentioned---1. Serum antioxidant index: malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), glutathione peroxidase (GSH- Px), glutathione reductase (GR).
2. Intestine lactobacillus.
Compared with pre-exercise, the concentration of MDA decreased significantly, the concentration of GSH, the activity of SOD, CAT, GSH-Px and GR and the quantity of intestine lactobacillus increased significantly after 8 weeks and 16 weeks.Not mentioned/ Not reportedWuqinxi exercise showed effects of producing SOD, GSH and reducing substance to enhance antioxidant capacity and increase quantity of intestine lactobacillus.

Yu-Hua
Bai et al. /2012/
China [42]
Historical cohort study/ Non-blinding15 healthy middle-aged and elderly people15 healthy middle-aged and elderly peopleWuqinxi:
62.63±3.07 (7/8)
Control:
62.71±2.93
(8/7)
Entire exercise:
5 times/week,
at least 1 year
Not mentionedAerobic exercise (walking): at least 30 mins/time, 5 times/ week, 1 yearThe average surface electromyography (ASEMG) in the process of flexion and extension was recorded and analyzed using Biovision surface electromyography test system software, and the
flexion extension ratio (FER) was calculated.
The ASEMG of the process of flexion was less than that of process of extension in two group. In addition, the FER of the Wuqinxi group was significantly lower than that of the control group.
Not mentioned/ Not reportedWuqinxi was thought to have positive improvement on the function of the lumbosacral multifidus in the middle-aged and elderly people so as to reduce low back pain.

Quan-Xi Sang/ 2011/China
[43]
PPS/ Non-blinding55 obese older people---Male:
55≤age≤61
Female:
50≤age≤60
(33/22)
Entire exercise:
120 mins/session / day, 48 weeks
Not mentioned---1. Serum antioxidant index: malondialdehyde (MDA),
superoxide dismutase (SOD), catalase (CAT), peroxidase
(GSH- Px).
2. Lipid peroxidation index: total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C).
3. Intestine lactobacillus: bacillus acidophilus, lactobacillus casei and bacillus bifidus.
48 weeks of Wuqinxi could markedly enhanced blood antioxidant enzymes activities, lipid peroxidation and intestine probiotics count in obese older people.Not mentioned/ Not reportedWuqinxi was thought to be beneficial for obese older people.

Yan-Yang Chen/ 2011/China
[44]
PPS/ Non-blinding64 healthy older people---Age:
60.3±5.61
(23/41)
Entire exercise:
60 mins/session/
day, at morning,
30 days
Not mentioned---Malondialdehyde (MDA), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C),
superoxide dismutase (SOD), catalase (CAT)
30 days of Wuqinxi could significantly reduce the serum levels of TC, TG and LDL-C, while increased the serum level of HDL-C and activities of SOD and CAT.Not mentioned/ Not reported30 days of Wuqinxi exercise can decreased blood lipids levels and oxidative injury in older people. Wuqinxi was thought to be useful for older peoples’ health.

Ding-Hai
Yu et al. /2008/
China [45]
RCT/ Non-blinding50
middle-aged and elderly people
50
middle-aged and elderly people
Male:
61.6±3.8
Female:
58.5±4.1
(30/70)
Wuqinxi:
(12/34)
Control:
(15/35)
Entire exercise:
26-39
mins/session, at least 4 sessions/ week,
24 weeks
Not mentionedunaltered lifestylePlasma NK cell activityAfter 24-week of Wuqinxi, the plasma NK cell activity of middle-aged and elderly people in the Wuqinxi group was obviously higher than that before exercise, while no obvious change had appeared in the control group.Not mentioned/ Not reportedWuqinxi was a middle or low intensity aerobic exercise, it was thought to have an effect on improving state of mind, increasing the activity of NK cells and effectively adjusting the balance of immune ability in middle-aged and elderly people.

Ding-Hai
Yu /2008/
China [46]
RCT/ Non-blinding50
middle-aged and elderly people
50
middle-aged and elderly people
Male:
61.6±3.8
Female:
58.5±4.1
(30/70)
Wuqinxi:
(15/35)
Control:
(15/35)
Entire exercise:
45 mins/session,
at least 4 sessions/ week, 24 weeks
Not mentionedunaltered lifestyleCholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C)After 12-week of Wuqinxi, the TG of Wuqinxi group was significantly lower than that before Wuqinxi exercise (P<0.01), the TC, HDL-C, LDL-C of female in Wuqinxi group was significantly higher than that before Wuqinxi exercise (all P<0.05). After 24-week of Wuqinxi exercise, remarkable decreased for TG and significant increased for LDL-C were observed in the Wuqinxi group (all P<0.05).Not mentioned/ Not reported24-week of Wuqinxi showed a certain effect on improving lipid metabolism in the middle-aged and elderly people.

Han-Xiao
Zhu/2008/China [47]
RCT/ Non-blinding45
female elderly people
30
female elderly people
Wuqinxi:
62.8±1.4 (0/45)
Control:
63.4±1.8
(0/30)
Entire exercise:
45 mins/session/ day, 16 weeks
Not mentionedunaltered lifestyleMalondialdehyde (MDA), superoxide dismutase (SOD), estradiol (E2), cardiac functional capacity (FC) test, blood pressure
(BP), heart rate (HR), vital capacity (VC), reaction time, exercise time, time for close eyes one-foot balance.
After Wuqinxi exercising, the activity of SOD and the level of estradiol in the Wuqinxi group were significantly higher than those before Wuqinxi exercising (all P<0.05),
the content of MDA in the Wuqinxi group was significantly higher than that before Wuqinxi exercising, but it was remarkably lower than that in the control group. In addition, time for close eyes one-foot balance showed increase in the Wuqinxi group after exercising, which was significantly longer than that in the control group (P <0.05).
At the same time, significant decresed were observed in exercise time of Wuqinxi group after exercising (P <0.05).
Not mentioned/ Not reportedWuqinxi was thought to have an effect on improving the activity of peripheral blood SOD, delaying the damage of free radical, increasing the level of sex hormone, and enhancing the ability of nerve reaction and balance in the female elderly people.

Ding-Hai
Yu /2007/
China [48]
RCT/ Non-blinding50
middle-aged and elderly people
50
middle-aged and elderly people
Male:
61.6±3.8
Female:
58.5±4.1
(30/70)
Wuqinxi:
(12/34)
Control:
(15/35)
Entire exercise:
45 mins/session, at least 4 sessions/ week, 24 weeks
Not mentionedunaltered lifestyleImmunological index (Peripheral blood T-cell subsets): , , and the ratio of / .After 24-week of Wuqinxi, the of male subjects in Wuqinxi group was significantly lower than that before Wuqinxi exercise, and the ratio of / of male subjects in Wuqinxi group was remarkably increased after exercise. Meanwhile, Wuqinxi group showed the increase in female subjects, a decreased in was observed in female subjects of Wuqinxi group after exercise. Thus, the ratio of / of female subjects in Wuqinxi group was also remarkablely increased after exercising.Not mentioned/ Not reported24-week of Wuqinxi showed a positive effect on the peripheral blood T lymphocytes of middle-aged and elderly people, and it may be better regulated the immune balance of middle-aged and elderly people.

Jing-Mei
Wu et al. /2006/
China [49]
PPS/ Non-blinding50
middle-aged and elderly people
---Age:
59.2±3
(15/35)
Entire exercise:
45 mins/session, 4 sessions/week,
12 weeks
Not mentioned---Immunological index (Peripheral bl-ood T-cell subsets):
, , and ratio of / .
Wuqinxi showed a positive effect on improving the immunity of middle-aged and elderly people, and the immunity
ability of female practitioners grew even faster. Furthermore the extents of effect varied according to different age groups and the practitioners between 60 and 69 improved faster in the ability of immunity.
Not mentioned/ Not reportedPracticing Wuqinxi may be affected the distribution of the outer sub-group of T-cell of middle-aged and elderly people.
And it is good for the improvement of the immunity of middle-aged and elderly people.

Xiu-Ying
Chen et al. / 2006/
China [50]
PPS/ Non-blinding100
middle-aged and elderly people
---50≤age≤70
(42/58)
Entire exercise:
45 mins/session, 7 sessions/week,
24 weeks
Not mentioned---Attention concentration testing apparatus (ACTA)After 24-week of Wuqinxi, attention concentration ability was significantly improved in middle-aged and elderly, the improvement degree of female volunteers was higher than that of male volunteers and the improvement degree of attention ability in the 61~70 year old middle-aged and elderly volunteers is better than that in the 50~60 year old middle-aged and elderly volunteers.Not mentioned/ Not reportedExercising Wuqinxi showed an effect on improving the middle-aged and elderly people’s attention concentration ability.

Han-Xiao
Zhu/2006/China [51]
RCT/ Non-blinding45
female elderly people
30
female elderly people
61≤age≤65
(0/75)
Entire exercise:
45 mins/session/
day, at morning, 16 weeks
Not mentionedunaltered lifestyleMalondialdehyde (MDA), superoxide dismutase (SOD), estradiol (E2), cardiac functional capacity (FC) test, blood pressure
(BP), heart rate (HR), vital capacity (VC), reaction time, exercise time, time for close eyes one-foot balance
After 16-week of Wuqinxi exercise, the activity of SOD of Wuqinxi group was increased, meanwhile, although the MDA was also increased, it was obvious lower than that of control group. The E2 of the female in the Wuqinxi group was increased. The FC had no obvious change after 16-week exercise, but it was prone to increase. The reaction time of Wuqinxi group had no significant change after Wuqinxi exercise, the exercise time of Wuqinxi group was obviously shorted, the time for close eyes one-foot balance of Wuqinxi group was markedly prolonged, which was obviously higher than that of control group.Not mentioned/ Not reportedWuqinxi was thought to be effectively slowed the process of ageing by increasing serum SOD activity, delaying the free radical injury increased with ageing, improving the level of sexual hormone, and enhancing feeling and balance ability.

Ding-Hai
Yu et al. /2005/
China [52]
PPS/ Non-blinding53
middle-aged and elderly people
---50≤age≤67
(15/38)
Entire exercise:
26~39 mins/ session,
at least
4 sessions/week,
12 weeks
Not mentioned---Plasma NK cell activityAfter 12-week of Wuqinxi exercise, the plasma NK cell activity of Wuqinxi group showed obviously higher than that before exercise, the increased degree of female middle-aged and elderly people was higher than that of male middle-aged and elderly people.Not mentioned/ Not reportedWuqinxi was a middle or low intensity aerobic exercise, it was thought to have better effect on regulating the immunologic balance of middle-aged and elderly people.

Yong-Sheng
Cui et al. /2004/
China [53]
PPS/ Non-blinding200 female
middle-aged and elderly people
---55≤age≤70
(0/200)
Entire exercise:
60
mins/session,
3 sessions/week,
12 weeks
Not mentioned---1. Physiological index: height, weight, waistline, hipline, thickness of upper arm and subscapular skin fold, pulse, systolic pressure,
diastolic pressure, vital capacity, bone density, grip strength, trunk bending forward, time for close eyes one-foot balance, reaction time, maximal oxygen intake, body fat rate, waist/ hip ratio, body mass index, percentage of forced expiratory volume in first second to forced vital capacity.
2. Psychological index: self-rated health measurement scale version
(SRHMS).
Female middle-aged and elderly people’s blood pressure, pulse, waist/ hip ratio, grip strength and vital capacity have had obvious improvement after the exercise of Wuqinxi 12 weeks later, at the same time, an evident effect on mentality follows.Not mentioned/ Not reportedThe layout of Wuqinxi exercise was thought to be good effect on middle-aged and elderly females' body and mind.

Ding-Hai
Yu et al. /2004/
China [54]
PPS/ Non-blinding71 female
middle-aged and elderly people
---Age:
55.1±5.1
(0/71)
Entire exercise:
60
mins/session,
3 sessions/week,
12 weeks
Not mentioned---Height, weight, waistline, hipline, thickness of upper arm and subscapular skin fold, pulse, systolic pressure,
diastolic pressure, vital capacity, bone density, grip strength, trunk bending forward, time for close eyes one-foot balance, reaction time, maximal oxygen intake, body fat rate, waist/ hip ratio, body mass index, percentage of forced expiratory volume in first second to forced vital capacity.
2. Psychological index: self-rated health measurement scale version
(SRHMS).
Female middle-aged and elderly people’s waistline, waist/ hip ratio, systolic pressure,
diastolic pressure have had obvious decreased after the 12-week of Wuqinxi, at the same time, an evident improvement effect on vital capacity and grip strength after exercise.
Not mentioned/ Not reported12-week of Wuqinxi had positive effects on body shape, physical function and physical quality of female
middle-aged and elderly people.

Ding-Hai
Yu et al. /2003/
China [55]
PPS/ Non-blinding85 healthy middle-aged and elderly
people
---Male:
64.4±4.9
Female:
55.1±5.1
(14/71)
Entire exercise:
7 times/week,
8 weeks
Not mentioned---1. Body shape index: height, weight, waistline, hipline, body fat rate, waist/ hip ratio, body mass index
thickness of upper arm and subscapular skin fold.
2. Physical function index: pulse, systolic pressure,
diastolic pressure,
pulse pressure, vital capacity, bone density, percentage of forced expiratory volume in first second to forced vital capacity.
3. Physical quality index: grip strength, trunk bending forward, time for close eyes one-foot balance, reaction time, maximal oxygen intake.
4. Psychological index: self-rated health measurement scale version
(SRHMS).
Wuqinxi = had a positive effect on the body shape, physical function and physical quality of the volunteers, and also had a better effect on improving and adjusting the mental state of the volunteers.Not mentioned/ Not reportedWuqinxi not only accorded with the principle of "Three regulations
(body, breath, mind)" of traditional Qigong and the law of modern human body kinematics, but also can effectively improve the physical and psychological health of the middle-aged and elderly exercisers.

Jia-Duo
Wu et al. /2003/
China [56]
PPS/ Non-blinding85 healthy middle-aged and elderly
people
---Male:
64.4±4.9
Female:
55.1±5.1
(14/71)
Entire exercise:
7 times/week,
8 weeks
Not mentioned---1. Self-rated health measurement scale version
(SRHMS).
2. Attention concentration testing apparatus (ACTA).
3. Perceived-
exercise-effect rating scale (PEERS).
After 8-week of Wuqinxi exercise, the physical and mental function of the volunteers, especially the mental health sub scale, showed a preliminary change, indicating that the wuqinxi had a certain effect on improving and regulating the mental state of the individual. The improvement of body symptoms, positive emotions and error time indicators of attention concentration testing in female was better than that in male after exercise. Error time indicators of attention concentration testing in 55 years old volunteers were less than that in 56~65 years old volunteers. Wuqinxi exercise was accepted by most volunteers.Not mentioned/ Not reportedWuqinxi was thought to have certain effects on stabilizing mood, regulating physical and psychological state, and improving the quality of life in middle-aged and elderly people.