Mind-Body Health Benefits of Traditional Chinese Qigong on Women: A Systematic Review of Randomized Controlled Trials

Table 2

Summary of randomized controlled trials included in the systematic review (n = 18).

	Study participants			Intervention	Control	Attrition rate	Outcome measures	Key findings^Ϯ
	Health condition	Age (years)
Author and place		Range	Mean/median
General women
Wu et al. (1996), China [49]^¶	Menopausal	40–60	50	Unspecified QG (n = 32); 1 month	Treated with vitamins E, B6, and/or oryzanol (n = 18)	QG: 6%; Control: 17%	a) Climacteric syndrome (KI); b) Autonomic balance (Wengerǁ); c) Serum FSH (RIA); d) serum LH (RIA); e) serum 2 (RIA); f) serum P (RIA); g) serum T (RIA)	Within-group improvement: (a); b), d), e); c), f), g) No significant changes; QG/control: a); b)
Chen et al. (2006), Taiwan [57]	Middle-aged	35–60	QG: 45.7 ± 6.1; Control: 44.6 ± 5.5	Baduanjin QG (n = 45): 3 times/week; 12 weeks	No treatment (n = 45)	QG: 2%; Control: 4%	a) Serum IL-6 (ELISA); b) BMD (densitometry)	Within-group improvement: a); b) No significant changes; QG/control: a); b)
González López-Arza et al. (2013), Spain [56]	Young	18–25	22.4 ± 2.5	Wang Ziping QG (n = 15); 60 min/session; twice a week; 4 weeks	No treatment (n = 15)	QG: 13%; Control: 7%	a) Balance (UBT)	Within-group improvement: a); QG/control: a) No significant differences
Abused women
Cheung et al. (2019), China [24]	Survivors of intimate partner violence	≥18	QG: 42.0 ± 8.7; Control: 41.5 ± 9.3	Baduanjin QG (n = 136); Week 1–6 (training): 120 min/session; twice a week; 6 weeks; Week 7–22: 60 min/session; once a week; 16 weeks; Home practice: 30 min/day; once daily, 22 weeks	Wait-list with health education (n = 135)	QG: 12%; Control: 6%	a) PBMC telomerase activity (ELISA); b) Plasma TNF (ELISA); c) Plasma IL-6 (ELISA); d) Depression (BDI); e) Stress (PSS); f) Coping (PCS)	Within-group improvement: a); d), e); QG/control: d), e) 6-week: , respectively; 22-week: No significant differences; a), b), c), f) No significant differences
Women with chronic conditions
Chen et al. (2013), China [47]^⸸	Breast cancer patients receiving radiotherapy	25–64	QG: 45.3 ± 6.3; Control: 44.7 ± 9.7	Guolin QG (n = 49); 40 min/session; once a week; 5 weeks	Wait-list with usual care (n = 47)	QG: 2%; Control: 8%	a) QOL (FACT-G); b) Depression (CES-D); c) Fatigue (BFI); d) Sleep quality (PSQI); e) Stress/cortisol rhythm (TRFIA)	Within-group improvement: b); a), c), d), e) No significant changes; QG/control: b); a), c), d), e) No significant differences; Higher baseline depressive group: a); b); c); d), e) No significant differences
Oh et al. (2014), Australia [30]	Metastatic breast cancer	≥18	QG: 56.9 ± 12.1; Control: 57.8 ± 10.8	Medical QG (n = 14); 60 min/session; once a week; 10 weeks; Home practice: 15–30 min/session; 3–4 times/week; 10 weeks	Meditation (n = 13)	QG: 36%; Control: 38%	a) QOL (FACT-B); b) Fatigue (FACT-F); c) Stress (PSS); d) Neuropathy (FACT-GOG-NTX); e) Sexual function (SFQ)	QG/control: d); a), b), c), e) No significant differences
Liu et al. (2017), China [48]	Breast cancer survivors	21–80	QG: 50.9 ± 7.0; Control: 51.3 ± 7.3	Guolin QG (n = 79); 60 min/session; twice a week; 24 weeks; Home practice: 40 min/session; 5 times/week; 24 weeks	Physical stretching (n = 75)	QG: 41%; Control: 18%	a) QOL (FACT-B); b) Anxiety (HADS); c) Depression (HADS); d) Immunological markers (serum IL-2, IFN-γ, and TNF) (ELISA); e) Breast cancer-specific marker (serum CA 15–3) (RIA)	Within-group improvement: a), c); b); d) All markers: e); QG/control: a); d) IFN-γ and TNF: b), c), e) No significant differences
Loh et al. (2014), Malaysia [55]	Breast cancer survivors	18–65	n/a	Zhi Neng QG (n = 66): 90 min/session; once a week; 8 weeks; Home practice: 30 min/session; twice a week; 8 weeks	(i) Line dancing (n = 65); (ii) Wait-list with usual care (n = 66)	QG: 52%; Line dancing: 52%; Usual care: 52%	a) QOL (FACT-B); b) Fatigue (FACIT-F); c) Depression (DASS-21); d) Anxiety (DASS-21); e) Stress (DASS-21)	QG/Line dancing: a); b), c), d), e) No significant differences; QG/usual care: a); b), c), d), e) No significant differences
Larkey et al. (2015), United states [52]	Breast cancer survivors	40–75	QG: 57.7 ± 8.9; Control: 59.8 ± 8.9	QG/TCE^§ (n = 49); 60 min/session; 1–2 times/week; 12 weeks; Home practice: 30 min/session; 5 times/week; 12 weeks	Sham QG^ǂ (n = 52)	QG: 14%; Control: 13%	a) Fatigue (FSI); b) Depression (BDI); c) Sleep quality (PSQI)	Within-group improvement: b), c) p < 0.05; QG/control: a) p = 0.005 at postintervention; p = 0.024 at 3-month follow-up; b), c) No significant differences
Larkey et al. (2016), United States [51]	Breast cancer survivors	40–75	QG: 57.7 ± 8.9; Control: 59.8 ± 8.9	QG/TCE^§ (n = 49); 60 min/session; 1–2 times/week; 12 weeks; Home practice: 30 min/session; 5 times/week; 12 weeks	Sham QG^ǂ (n = 52)	QG: 14%; Control: 13%	a) Mental and physical QOL (SF-36); b) Cognitive function (FACT-COG (subjective) and WAIS-III (objective)); c) PA levels (BPAQ); d) BMI	Within-group improvement: a); b) FACT-COG: ; WAIS-III: c); d); QG/control: d); a), b), c) No significant differences; 3-month follow-up: all with no significant changes across time or intergroup differences
Myers et al. (2019), United States [53]	Breast cancer survivors	>18	QG: 52.9 ± 12.0; Sham QG: 53.1 ± 10.7; SS: 56.2 ± 11.3	Liuzijue QG (n = 19); 60 min/session; once a week; 8 weeks; Home practice: 15 min/session; twice daily; 8 weeks	(i) Sham QG^ǂ (n = 20); (ii) Survivorship support (SS) (n = 11)	QG: 21%; Sham QG^ǂ: 50%; SS: 0%	a) Cognitive function (FACT- COG (subjective), RAVLT, and TMT (objective)); b) Fatigue (MDASI); c) Sleep disturbance (MDASI); d) Distress (MDASI); e) PA levels (WHI PAQ)	QG/sham: a) TMT: b), c), d), e) No significant differences; QG/SS: a) FACT-COG: d); b), c), e) No significant differences
Ying et al. (2019), China [50]	Breast cancer survivors	36–72	54.1 ± 7.8	Baduanjin QG (n = 50): 60 min/session; 3 times/week; 6 months; Home practice: 20 min/session; 4 times/week; 6 months	No treatment (n = 50)	QG: 8%; Control: 20%	a) BMI; b) Heart rate variability (heart rate monitor); c) Lung capacity (spirometry); d) Arm circumference on the affected side; e) Shoulder ROM on the affected side (goniometry); f) Cardiopulmonary function (3-min step test); g) Anxiety (GAD-7); h) Depression (PHQ-9); i) QOL (FACT-B)	QG/control: b); e), i); h); a), c), d), f), g) No significant differences
Youngwanich setha et al. (2013), Thailand [58]	Diabetic, postpartum	n/a	QG: 35.0 ± 5.6; Control: 36.2 ± 4.5	Lin Housheng QG (n = 34); Week 1 and 2: 50 min/session; 3 times/week; 2 weeks; Week 3–12: Home practice: 5 times/week; 10 weeks	Usual care (n = 35)	QG: 6%; Control: 9%	a) FPG (chemical analyzer); b) HbA1c (chemical analyzer); c) Blood pressure; d) Body weight, BMI	QG/control: a); b); c) Systolic: ; diastolic: d) No significant differences
Liu et al. (2018), China [26]^¶	Diabetic, obese	n/a	57.2 ± 5.4	Baduanjin QG (n = 20): 90 min/session; 6 times/week; 24 weeks (2-week training, followed by 22-week self-practice)	No treatment (n = 20)	QG: 15%; Control: 10%	a) Body weight, BMI; b) WC, WHR; c) FPG (chemical analyzer); d) HbA1c (chemical analyzer); e) TG (chemical analyzer); f) TC (chemical analyzer); g) LDL (chemical analyzer); h) HDL (chemical analyzer); i) serum RBP4 (ELISA)	Within-group improvement: b), c), d), e), h), i); a), f), g) No significant changes; QG/control: b), c), d), e), h), i); a), f), g) No significant differences
Liu et al. (2012), United States [18]	Fibromyalgia	24–70	QG: 55.7; Control: 57.5	Liuzijue QG (n = 8); 45–60 min/session; once a week; 6 weeks; Home practice: 15–20 min/session; twice daily; 6 weeks	Sham QG^ǂ (n = 6)	QG: 25%; Control: 0%	a) Pain (SMPQ); b) Fatigue (MFI-20); c) Sleep quality (PSQI); d) Fibromyalgia impact (FIQ)	QG/control: a), b), c), d)
Sarmento et al. (2020), United States [54]	Fibromyalgia	18–70	QG: 42.6 ± 10.7; Control: 56.1 ± 12.3	Liuzijue QG (n = 14); 45 min/session; once a week; 10 weeks; Home practice: Twice daily; 10 weeks	Sham QG^ǂ (n = 14)	QG: 29%; Control: 29%	a) Pain (SMPQ, VAS, and PPT); b) Sleep quality (PSQI); c) Fatigue (FIQ); d) Anxiety (HADS); e) Depression (HADS); f) Fibromyalgia impact (FIQ); g) QOL (QOLS)	QG/control: a), b), c), d), e), f); g) for control group presenting greater improvement
An et al. (2008), China [23]	Knee osteoarthritis	>55	QG: 65.4 ± 8.2; Control: 64.6 ± 6.7	Baduanjin QG (n = 14): 30 min/session; 5 times/week; 8 weeks	No treatment (n = 14)	QG: 21%; Control: 29%	a) Pain (WOMAC); b) Stiffness (WOMAC); c) Physical function (WOMAC); d) Aerobic capacity (6-MWT); e) Peak torque of the knee extensors (Isokinetic dynamometry); f) General health, social function, and mental health (SF-36)	QG/control: a); b); c); d); e); f) No significant differences
Chan et al. (2017), China [46]	Chronic fatigue syndrome	<50	QG: 39.5; Control: 42.0	Baduanjin QG (n = 46): 90 min/session; 16 sessions; 9 weeks	Wait-list with usual care (n = 62)	n/a	a) Plasma adiponectin (ELISA); b) Anxiety (HADS); c) Depression (HADS)	QG/control: a), b); c); 3-month follow-up: all with no significant differences

6-MWT, 6-minute walk test; BDI, Beck Depression Inventory; BMD, bone mineral density; BMI, body mass index; BFI, Brief Fatigue Inventory; BPAQ, Brief Physical Activity Questionnaire; CA 15-3, carcinoma antigen 15-3, CES-D, Center for Epidemiologic Studies Depression Scale; DASS-21, Depression and Anxiety Stress Scale-21; E2, estradiol; ELISA, enzyme-linked immunosorbent assay; FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue; FACT-B, Functional Assessment of Cancer Therapy-Breast; FACT-COG, FACT-Cognitive Function; FACT-F, FACT-fatigue; FACT-G, FACT-General; FACT-GOG-NTX, FACT-Gynecologic Oncology Group-Neurotoxicity; FIQ, Fibromyalgia Impact Questionnaire; FPG, fasting plasma glucose; FSH, follicle-stimulating hormone; FSI, Fatigue Symptom Inventory; GAD-7, generalized anxiety disorder-7; HADS, Hospital Anxiety and Depression Scale; HbA1c, hemoglobin A1c; HDL, high-density lipoprotein; IFN-γ, interferon- γ; IL-2, interleukin-2; IL-6, interleukin-6; KI, Kupperman Index; LDL, low-density lipoprotein; LH, luteinizing hormone; MDASI, MD Anderson Cancer Symptom Inventory; MFI-20, Multidimensional Fatigue Inventory; P, progesterone; PA, physical activity; PBMC, peripheral blood mononuclear cells; PCS, Perceived Coping Scale; PHQ-9, Patient Health Questionnaire; PPT, pressure pain threshold; PSQI, Pittsburgh Sleep Quality Index; PSS, Perceived Stress Scale; QG, Qigong; QOL, quality of life; QOLS, Quality of Life Scale; RAVLT, Rey auditory verbal learning test; SF-36, Short Form-36; SFQ, Sexual Functioning Questionnaire; RBP4, retinol binding protein 4; RIA, ROM, range of motion; radioimmunoassay; SMPQ, short-form McGill Pain Questionnaire; T, testosterone; TC, total cholesterol; TCE, Tai Chi Easy; TG, triglyceride; TMT, trail making test; TNF, tumor necrosis factor; TRFIA, time-resolved fluorescence immunoassay; UBT, unipedal balance test; VAS, visual analog scale; WAIS-III, Wechsler Adult Intelligence Scale-Third Edition; WC, waist circumference; WHI PAQ, women’s health initiative brief physical activity questionnaire; WHR; waist-to-hip ratio; and WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index. ^¶Only Chinese version is available. ^⸸Participants were randomly assigned to either the QG or control groups by adaptive randomization, namely “minimization”, so the groups were balanced evenly according to demographic information and clinical conditions. ^§Tai Chi Easy (QG/TCE) is a simplified form of traditional Tai Chi, which is repeated and also includes QG bodily movements. The adaptations to the pace, the repetition, and the ease of learning make TCE like a typical QG exercise. ^ǂSham QG mimicked the QG movements but without healing sounds or meditation and breath focus. ^ǁAutonomic response patterns in resting conditions (i.e., salivary output, systolic and diastolic blood pressure, heart period, respiration period, and sublingual temperature) were examined in order to reflect participants’ autonomic balance conditions before and after the intervention. ^ϮAll key findings with significant levels demonstrated improvements in the outcome measures, except specifically indicated. “Within-group improvement” represented within-group improvement for specific outcomes for intervention groups from baseline to the completion of the intervention, while “QG/control”, “QG/line dancing”, “QG/usual care”, “QG/sham”, and “QG/SS” represented between-group differences in either percentage or absolute changes from baseline to the completion of the intervention.