Geriatric Care 2018; volume 4:7449

The traditional Chinese dynapenia, which refer to age-associated Baduanjin exercise for the loss of muscle mass11 and muscle Correspondence: Fung Kei Cheng, strength12,13 respectively. More harmfully, Hong Kong enhancements in health of older adults always suffer from emotional E-mail: [email protected] older adults: a narrative review disorders,14 especially with depression.15 Key words: Anti-ageing; complementary and These ailments intensify disabilities, and alternative therapy; health promotion; geron- thus obstruct normal daily activities,16 Fung Kei Cheng 17 tology; martial art; narrative review; qigong; resulting not only in social isolation and rehabilitation; successful ageing; traditional Hong Kong 18 unfavorable quality of life but also Chinese medicine. expanded private and public medical expenses.19 Conflict of interest: the author declares no Physical activity20 is a critical strategy21 conflict of interest. Abstract benefiting physical function, as well as cog- Received for publication: 28 March 2018. nitive and mental health for seniors. It Revision received: 11 July 2018. Health debilitation negatively impacts includes a variety of resistance exercise Accepted for publication: 20 August 2018. the physical and psychiatric states of ageing training22,23 and aerobic exercises,24 such as persons, consequently increasing individ- rowing,25 swimming,26 walking,27 dancing,28 This work is licensed under a Creative ual, familial, and social burdens. Physical pilates,29 yoga,30 and conventional fitness Commons Attribution-NonCommercial 4.0 exercise is an effective measure to cope exercises. International License (CC BY-NC 4.0). with this problem, and Baduanjin, a tradi- Traditional Chinese exercise is one of the tional Chinese exercise, is one of the choic- effective approaches,31 and includes Qigong ©Copyright F.K. Cheng, 2018 Licensee PAGEPress, Italy es. This narrative review analyses 58 clini- and Taiji (Tai Chi Quan), which benefit phys- Geriatric Care 2018; 4:7449 cal studies, which indicate the efficacy of ical and psychological health for the doi:10.4081/gc.2018.7449 Baduanjin for the health of old adults, aged.32,33 Ameliorated conditions encompass including in physiological refinement, bone such items as reductions in knee osteoarthri- 34 only diseases, cardiovascular and cardio-pul- tis incurred pain and stiffness, and enhance- monary illnesses, metabolic disorders, ment in motor function induced by inclines towards self-massaging for facial digestive sicknesses, cognitive impairment, Parkinson’s disease.35 Qigong is an umbrella organs (eyes, ears, mouth, and nose), limbs, and mental disorders. The results not only term, covering a spectrum of exercises such and the trunk. These forms are adaptable for reveal the rehabilitative and preventive as Baduanjin, Tuna (a kind of breathinguse practitioners with different movement capa- functions of Baduanjin, but also suggest method), and Xianggong. Based on tradition- bilities and disparate ages,40 being both health promotion through this physical al Chinese medicinal theory36 and the I- flexible and safe.41 Therefore, they are suit- activity for the ageing population. It also Ching principle37 (related to the yin-yang able for not only healthy older adults but proposes improvements in methodological principle), Baduanjin, also known as the also older people with Parkinson’s dis- design and practical implications for the eight-brocade exercise, eight-section bro- ease,42 cardiovascular autonomic balance,43 well being of seniors and successful ageing. cades or eight-treasured exercise, was used cognitive impairment44 or blood lipid for health training in the form of a martial art, levels.45 Baduanjin is beneficial to gait and and has recently been adopted for communi- balance for stroke rehabilitation,46 fall pre- ty-based health promotion by the General vention, and emotional health.47 Introduction Administration of Sport of China.38 A set of This narrative review investigates the eight sequential movements is stipulated39 effectiveness of Baduanjin, a body-mind Population ageing has become a global involving body-trunk, limb and eye move- intervention,48 on the biological and psy- issue. Demographic studies predict that the ments that are matched with breathing: hold- chological health of old adults. Its analysis number of individuals aged over 60 will ing the hands high with palms up to regulate offers an overview of the research results exceed the number of adolescents by about the internal organs (雙手托天理三焦), pos- and highlights encouraging indicators that 2047,1 challenging social economics,Non-commercial2 ing as an archer shooting both left-and- are favorable for health promotion among organizational productivity,3 and individ- right-handed (左右開弓似射鵰), holding seniors, from which medical professionals ual health.4 one arm aloft to regulate the functions of the can integrate this low-intensity exercise into Physiological changes are inevitable spleen and stomach (調理脾胃須單舉), available treatments for geriatric care. during the ageing process, which diminish- looking backwards to prevent sickness and es the functional status of older adults. strain (五勞七傷向後瞧), swinging the About 81% of people who are 65 years old head lowering the body to relieve stress (搖 or older complain of having at least one 頭擺尾去心火), moving the hands down the Research Method chronic illness.5 Age-related impairments back and legs and touching the feet to are prevalent, particularly hearing6 and strengthen the kidneys (兩手攀足固腎腰), This narrative review utilized ProQuest visual7 deficits that will cause them to mis- thrusting the fists and making the eyes glare to search potential studies, in which there perceive the world around them and mis- to enhance strength (攢拳怒目增氣力), and are 27 prominent electronic databases, communicate with others.8 An increase in raising and lowering the heels to cure dis- including British Nursing Index, Medical neuro-degenerative diseases,9 such as ease (背後七顛百病消). Database, MEDLINE, ProQuest Medical Alzheimer’s disease, increases their vulner- In additional to the principal standing Library, PsycARTICLES, and PsycINFO. ability. Non-communicable illnesses10 dev- form, Baduanjin also has sitting and lying Inputting the keywords Baduanjin and aged astate mobility of the ageing population; for modes. The sitting form focuses on medita- OR elderly OR elders OR old OR senior example, hypertension, and diabetes. Risks tion, oral and auricular proliferation, and resulted in 45 references. Additionally, the of falling increase due to sarcopenia and upper limb training, while the lying method China National Knowledge Infrastructure

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(CNKI) and Taiwan Electronic Periodical self-care, and social relationships, resulting ence, hip circumference, and thickness of Services (TEPS) were searched using the in self-efficacy84 even among older adults abdominal skinfold, the upper arm and the keywords 八段錦 and 老年人, retrieving 85 with chronic illnesses. scapular. Overall improvements were Chinese works. Sixty-two elderly males (aged 60-69) attained in body shape, body composition, A two-tiered selection process was per- who practiced Baduanjin regularly over three physical fitness, nervous response, immune formed under the following eligibility crite- years enhanced their body quality, balance function, sex hormone level, and free radical ria: they were required to be empirical stud- ability and cardiovascular capability.49 scavenging ability,81,98 as supported by perti- ies (quantitative, qualitative or mixed Managing obesity with better body weight, nent research.72,79 inquiries) published in peer-reviewed, body fat mass, waist-hip ratio, body total scholarly journals prior to October 2017. moisture, and protein quality, they improved Bone disease and arthritis Non-resultant trials, duplicates, literature their balance, showing amelioration of issues Osteoporosis is a common disease reviews, book reviews, dissertations, edito- with muscle strength, seat body flexion, hand among older adults, causing fractures, dis- rials, letters to the editor, and commentaries grip, and standing on one leg while closing ability, and pain.107 Pain alleviation was were excluded. First, 75 (n=30 in English, their eyes. Their vital capacity, systolic blood reported by 60 patients with primary osteo- n=45 in Chinese) out of 130 potential arti- pressure, diastolic blood pressure, and rest- porosis51 who also experienced better men- cles were selected (Figure 1) according to ing pulse became more acceptable. tal states after undertaking eight weeks of the exclusion criteria; second, 58 (n=10 in According to evidence from another 139 Baduanjin training, such as vitality, emo- 67 English, n=48 in Chinese) studies were cho- women, Baduanjin produced refinements tional role functioning and social role sen for further analysis in light of the inclu- in the respiratory system and body anteflex- functioning. Consistent outcomes were sion criteria. ion in the sitting position, increased lower delivered by Peng and team in their limb strength, decreased waist circumfer- research.77

Findings and Discussion only The reviewed 58 projects (Table 1)49-106 involved 5084 participants, most of whom were aged 60-84. This narrative review ana- lyzed how Baduanjin can benefit older adults, initially detailing its contribution to use physiological refinement, and subsequently enumerating its efficacy on ageing prob- lems, including bone diseases, cardiovascu- lar and cardio-pulmonary illnesses, meta- bolic disorders, digestive sicknesses, cogni- tive impairment, and mental health.

Physiological refinement Baduanjin positively influences antiox- idant capacity and immune cells, achieving anti-ageing.85 It indicates a range of health enhancements, with the aid of measure- ments, for instance, Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36), Chinese Version of the Personal and Social PerformanceNon-commercial 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 consump- tion, and regulates the endocrine system, hemodynamics, hemorheology, cardiac functions, and nervous system.106 It is con- ducive to the reduction of bodily pain, and the increase of vitality, general health per- ception, health transition, physical function- ing, physical-role functioning, emotional- role functioning, social functioning and mental health.105 Also, this exercise allevi- ates retirement syndrome58 and therefore strengthens self-awareness, attention, emo- Figure 1. Selection Process. tion coping, sense of well being linked to

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Although osteoarthritis may be avoid- plays a positive role.118 This exercise is suit- three months99 shows promise for dealing able within the ageing population, degener- able for stroke rehabilitation,100 and is related with diabetes. Such a reduction in glycosy- ative joint condition is attributable to this to physical and psychological health. In addi- lated hemoglobin (HbA1c) together with disease,108 particularly with knee tion to 30 minutes of daily practice, 83.3% of this exercise is linked to better psychologi- osteoarthritis,109 for which various treat- 60 older patients who underwent acupoint (a cal health,87 including a decrease in depres- ments are provided.110 An and colleagues88 specific point for acupuncture) massage 2-3 sive symptoms.96 In research carried out by offered a one-year program to 22 patients times every day saw relief from constipation Xiao and colleagues,60 Baduanjin was who suffered from knee osteoarthritis. The during the post-stroke period.91 shown to be beneficial to balance, body participants saw significant easing of pain, An estimated 14% of individuals aged flexibility and glucose metabolism among stiffness, and disability, probably caused by 65 or over suffer from chronic obstructive elderly people with diabetes who received a decrease in body-mass index when prac- pulmonary disease due to ageing respiratory 96 45-minute sessions; following which ticing 30 minutes of Baduanjin daily, five systems.119 Baduanjin may represent an they exhibited stronger physical function, times a week, which enhanced knee exten- optional intervention.120 With the aid of an limb strength and flexibility of the joints, sors, flexor strength, and aerobic ability. XXG-D cardiovascular function tester and a fortified nerves, and improved glucose and Their earlier research also reported pneumometer, 48 elderly patients with car- lipid parameters. enhanced quadriceps strength.103 The effec- dio-pulmonary problems who practiced 30 tiveness of Baduanjin on this illness has minutes of Baduanjin daily for one year Digestive ailments been ostensive.65 Similarly, patients with increased the compensatory force of the Age-related changes in intestinal micro- chronic neck pain benefited from 30-minute heart pump, cardiac contractility, cardiac biota increase the risks of illness, including daily sessions for six months.86 output stroke volume, as well as pulmonary inflammatory bowel disease, colon rectal Falling and fear of falling disturbs this function, together with enhancements in cancer, and immune system deficiencies.123 frail population, especially for those with myocardial oxygen supply, their bodies’ Indicators presented advantageous effects osteoporosis111 or osteoarthritis,112 giving scavenging ability of oxygen free radicals, of Baduanjin in positive changes in intestin- rise to threats such as hip and vertebral and respiratory endurance.104 Feng and al flora,97 decreasing the quantity of enter- fractures,113 and limb function limita- team102 added that the efficacy of this exer- obacter and fusobacterium, while increas- 114 only tions. Recent studies illustrated that cise could increase the forced expiratory ing the quantity of bifidobacterium, lacto- Baduanjin practitioners are capable of pre- volume in one second (FEV1), and forced bacillus and the ratio of bifidobacterium venting falls,55,63 as a result of boosting vital capacity (FVC). A positive correlation and enteric bacilli. balance50,64 and coping with the fear of between the strength of lung function and Approximately 10-20% of elderly peo- falling.76 A reduction in fall risk not only emotional stability connects this exerciseuse to ple experience irritable bowel syndrome,124 satisfactorily adjusts functional behavior,62 such issues as depression and anxiety,61 and with pain, cramping, and other negative but also more importantly provided a bet- to quality of life.69 signs. Looking into the efficacy of ter quality of life.59 Baduanjin on irritable bowel syndrome,101 Metabolic syndrome 60 patients saw improvements in abdominal Cardiovascular and Metabolic abnormality is fatal in the pain, abdominal distension, constipation, cardio-pulmonary diseases ageing population.121 Baduanjin is a possi- and abnormal defecation. Cardiovascular and cardio-pulmonary ble vehicle for combating this. diseases weaken heart function and the res- Comparing pre- and post-test outputs, a Cognitive impairment piratory system of seniors115 who suffer study of a 10-week Baduanjin training pro- Age-directed cognitive decline deterio- from hypertension, coronary artery disease, gram74 discerned increases in levels of nitric rates individual health, social connections, or obstructive pulmonary disease. oxide (with a lower level in patients with and social economy,125 for which both phar- The effects of Baduanjin on hyperten- diabetes) and superoxide dismutase (which maceutical and non-medication measures sion82,93 include improvements in heart is a key component in anti-oxidative and are given to combat this decline. Lin53 rate68 and blood pressure: showing a anti-inflammatory activities), particularly in recruited 47 participants who suffered from decrease in systolic blood pressure but an elderly males, and a decrease in malondi- mild cognitive impairment and who increase in diastolic blood pressure,Non-commercial73 along aldehyde (a hazardous compound inducing received Baduanjin with standard treatment with a reduction in serum endothelia oxidative stress), particularly in elderly (including diet control, psychoeducation, levels,54 improved sleep quality, sleep dura- females. and counseling) for six months. The data tion and sleep efficiency.71 Consequently, Serum lipid levels correlate to illnesses marked significant improvements in memo- this exercise diminishes the risk of heart such as cardiovascular diseases and dia- ry, attention, association, and language. failure, stroke, and arteriosclerosis.75 betes.122 An investigation into the effective- Another set of data56 inferred these benefits Supported by 50 patients with coronary ness of Baduanjin on blood lipid and from a decrease in rsFC between the artery disease, a randomized controlled trial antioxidant levels70,80 indicated decreases in DLPFC and the left putamen and insula, showed reductions in angina attacks and triglyceride, total cholesterol, malonyl- whereas mental control enhancement is their duration after three months of dialdehyde, low-density lipoprotein, whole negatively associated with rsFC and Baduanjin exercise.65 Furthermore, blood viscosity, low shear blood viscosity DLPFC-putamen changes. Tao and team57 improved rehabilitation was observed from and plasma viscosity, in contrast to increas- identified an evident increase in grey matter another 60 patients with coronary artery es in high-density lipoprotein, superoxide volume in the insula, medial temporal lobe, bypass grafting who completed 23 weeks of dismutase and glutathione peroxidase. and putamen among their informants who training in which they performed 30-minute Thus, these are able to ameliorate problems participated in 60 30-minute Baduanjin ses- daily practice sessions.95 in the respiratory system.89 sions. As a result, practicing this exercise Interaction between hypertension, heart A decrease in blood glucose among eld- positively correlates to mental control, sickness, and stroke has been unveiled,116,117 erly individuals who carried out a 30- recognition, touch, cognition and compre- for the management of which Baduanjin minute Baduanjin session twice a day for hensive memory.

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Mental health future research on the efficacy of Baduanjin sage.91 An integrative model is therefore The detrimental effects of psychotic in senior health with a larger number of suggested, for instance, simultaneously disorders consist of personal ill-being and informants, which would enable such stud- using with music therapy,133 which may fur- social deprivation126 among older people, ies to be more powerful. ther enhance the physical and emotional for which the scope of traditional and inno- The reviewed studies are cross-section- health of the aged. vative approaches pinpoint Baduanjin127 as al inquiries: 16 (27%) were six-month pro- Although positive signals are exhibited, an effective countermeasure.128 One study, grams, two (3%) were one-year projects, the findings do not suffice to confirm the which interviewed 20 informants who prac- and the remainder was less than these or curative effects of Baduanjin, owing to the ticed Baduanjin 40 minutes daily for 12 unspecified. This research strategy restricts methodological weaknesses explained pre- weeks, reiterated that they felt relaxed phys- the findings to within a specific time span, viously. However, it is apparent that older ically and psychologically due to self-tran- which offers insufficient cause-and-effect patients with different illnesses show signif- quility, pleasure, and relief from emotional results, and is inappropriate for age-associ- icant enhancements in health when practic- 78 131 symptoms. Another 180 participants saw ated research. Instead, longitudinal stud- ing this exercise, demonstrating rehabilita- improvements in somatization, obsession ies would feasibly rectify these weaknesses tive and preventive capabilities. Baduanjin 132 and interpersonal sensitivity, and lessened and measure intra-individual changes: likely contributes to health promotion depression, anxiety, hostility, phobia, para- which is why they are usually utilized for through disease prevention, such as through noia and psychotic symptoms after 20 age-oriented research. the prevention of ischemic stroke,134 and weeks, during which they received six one- All the reviewed projects involve only a relapse prevention. hour Baduanjin training sessions each Chinese population, which may engender A healthy state and long-term engage- week.90 In particular, these sessions favor sampling bias. Such a constraint leads to 52 ment in physical activity are positively cor- housebound elderly people who are after- homogeneity and limits representativeness related.135 It is highly recommended that wards able to reconnect with society. and generalization. It is therefore necessary 92 Baduanjin be practiced 30 minutes regular- Practitioner calmness also helps to extend the research to non-Chinese elder- ly either in an individual or group setting: abate sleep difficulties, accomplishing ly people in order to bolster the evaluation. 94 the latter also promotes psychological overall sleep quality, including subjective The reviewed studies are dominated by healthonly136 and social relationships.137 sleep quality, sleep latency, sleep duration, self-administered psychometric surveys and Despite the fact that Baduanjin is safe sleep efficiency, and controlled daytime basic physiological measurements (for and learner-friendly, this review suggests dysfunction. example, blood pressure, and forced vital to recruit a qualified instructor in order to capacity). However, they tend to refrain maximize the benefits of this exercise, from elaborating on the mechanismsuse of especially for the elderly. The General physiological changes that occur when Administration of Sport of China provides Methodological limitations and practicing Baduanjin, such as on cardiac a set of training programs for various lev- function and antioxidant capacity. It is future research directions els of instructors, associated with develop- advisable to adopt the medical tools neces- ment, theories and techniques of sary to measure the biomarkers that under- This narrative review addresses Baduanjin. methodological limitations among the pin clinical data for scientific research. A sound lifestyle substantially deter- reviewed articles, which arise from con- Furthermore, this review proposes the use mines life expectancy. Baduanjin cannot be ducting randomized controlled research of evaluation tools, such as Performance the sole agent of older adults’ health and with small sample sizes and a cross-section- Oriented Mobility Assessment (POMA), in well-being. This study encourages active al design, particularly focusing on Chinese future research to measure practical advan- ageing138 or successful ageing139 that con- population and using mainly psychometric tages of this exercise. nects to holistic involvement, including surveys. It also gives suggestions for future Despite positivist quantitative research healthy habits,140 nutrition,141 relaxation,142 studies. acquiring a larger pool of data in a shorter 143 144 time, there is a lack of qualitative inquiries religious participation, lifetime learning, Despite there being 36 (62%) random- 145 (only one within the reviewed references) volunteering, and leisure/recreation activi- ized controlled trials among the reviewed 146 147 148 research, incomplete fulfillmentsNon-commercial are and therefore it is unable to represent the ties such as handicrafts, and travel. notable. While this method values evi- social reality experienced by the partici- dence-based assessment,129 it requires pants. This study recommends that qualita- strong reliability and validity, especially tive or mixed research be conducted that through randomization. However, most ran- allows informants (perhaps with case exam- Conclusions domized controlled projects in this review ples) to disclose their experience in practic- failed to demonstrate random allocation, ing Baduanjin. Baduanjin, a traditional Chinese exer- blinding, prevention of selection bias, and cise, is a body-mind, learning-friendly, details of p-value. This study suggests the safe, self-paced, cost-effective, conven- need for well-designed scientific research, ient, non-intrusive, low-intensity exercise. such as through a proper randomization Practical implications Its anti-ageing capabilities rejuvenate the process, not only for convincing results but physical and psychological health of the also for research replication. Owing to the presence of more promis- older individuals. This narrative review Nineteen (32%) of the reviewed articles ing results, combined therapy is not rare reveals that this physical activity is con- were carried out with less than 61 partici- within the reviewed research: 14 (24%) ducive to health promotion due to its reha- pants. A small sample size can potentially projects demonstrate this; Baduanjin with bilitative and preventive effectiveness, undermine data performance, cross-valida- varied instruments, such as cognitive resulting in quality of life and well-being tion, and statistical power.130 In order to behavioral therapy,52 medication,54 medita- and a large population of people who age attain data confidence, this study proposes tion,58 dance,68 diet management,72 or mas- successfully.

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Non-commercial To look into the effect of regular Baduanjin 62 men, aged 60-69, who practiced Assigned to the Baduanjin (n=32), and control Improvements in body weight, body fat mass, waist-hip mass, fat body weight, body in Improvements control and (n=32), Baduanjin the to Assigned practiced who 60-69, aged men, 62 Baduanjin regular of effect the into look To with Baduanjin in pain of alleviation significant Much assorted with Baduanjin the to assigned Randomly osteoporosis primary with patients 60 pain on Baduanjin of effect the into look To 51 49 To investigate the effect of Baduanjin and 80 participants (n=34 males, n=46 females), Randomly allocated to the Baduanjing (n=20; Significant improvements in balance ability in ability balance in improvements Significant (n=20; Baduanjing the to allocated females), n=46 Randomly males, (n=34 participants 80 and Baduanjin of effect the investigate To To compare the effect of Baduanjin and 118 participants (n=40 males, n=78 females), Randomly assigned to the Baduanjin (n=39; n=11 Significant reduction in housebound in combined therapy, combined in housebound in reduction Significant n=11 (n=39; Baduanjin the to assigned Randomly females), n=78 males, (n=40 and participants Baduanjin of 118 effect the compare To 50 52 To examine the effect of Baduanjin 94 patients with mild cognitive impairment Randomly distributed to the Baduanjin plus Significant improvements in memory, attention, memory, in improvements Significant plus Baduanjin the to distributed impairmentRandomly cognitive mild with patients 94 Baduanjinof effect the examine To 53 management and overall health among (n=15 males, n=45 females), aged 55-71. treatment (n=30; n=8 males, n=22 females), and ssorted treatment group than that in assorted treatment assorted in that and than group females), n=22 treatment males, n=8 ssorted (n=30; treatment 55-71. aged females), n=45 males, among(n=15 health overall and management a group. n=23 males, n=7 (n=30; treatment assorted osteoporosis. primary with patients balance pad on balance of older adults and aged 60-70. n=8 males, n=12 females), balance pad (n=20; exercise groups, whereas best in combined exercise combined in best whereas groups, exercise (n=20; pad balance females), n=12 pad. males, n=8 balance in then and Baduanjin, in second group, (n=20; combined and adults females), n=13 older of males, 60-70. n=7 balance on aged pad balance prevention. fall therapy behavioural cognitive then and Baduanjing, then cognitive 62-97), aged females; n=28 males, 60-97. aged the on therapy behavioural cognitive n=28 males, groups. n=12 (n=40; therapy behavioural elderly. housebound on mild cognitive impairment. (n=58 males, n=36 females), aged 61-79. standard treatment (n=47; n=28 males, n=19 association, language, depressive symptoms, and quality of quality and symptoms, depressive language, association, n=19 males, n=28 (n=47; treatment standard 61-79. aged females), n=36 males, (n=58 impairment. cognitive mild on on health of older adults. Baduanjin 30 minutes daily, >3 times (n=30) groups. ratio, muscle content, body total moisture, protein quality, protein moisture, total body content, muscle ratio, groups. (n=30) times>3 daily, minutes 30 Baduanjin adults. older of health on pulse, vital capacity, seat body flexion, grip, closed eyes closed grip, flexion, body seat capacity, vital pulse, standing with one leg, choice reaction, and balance ability. balance and reaction, choice leg, one with standing 20-minute session, 5 times a week, 8 weeks. a week, 5 times session, 20-minute a week, >3 years. systolic blood pressure, diastolic blood pressure, rested pressure, blood diastolic pressure, blood systolic years. >3 a week, Low-frequency impulse magnetic stimulation: stimulation: magnetic impulse Low-frequency tablets, twice a day, 8 weeks. emotional role functioning, and social role functioning. role social and functioning, role emotional 8 weeks. a day, twice tablets, Medication: calcium carbonate and vitamin D3 health, physical functioning, physical role functioning, role physical functioning, physical D3health, vitamin and carbonate calcium Medication: 8 weeks. group, including vitality, general health perception, mental perception, health general vitality, including group, 8 weeks. aged 63-78) groups. 63-78) aged Baduanjin: 40-60 minutes a session, twice a day, assorted treatment group than that in assorted treatment assorted in that than group treatment a day,assorted twice a session, minutes 40-60 Baduanjin: counseling) (n=47; n=30 males, n=17 females; n=17 males, n=30 (n=47; counseling) females) groups. Better improvements in mental state in Baduanjin with Baduanjin in state mental in improvements Better groups. females) (including diet control, psychoeducation, while enhancements began after 3 months. after began enhancements while psychoeducation, control, diet (including n=11 males, n=9 females), and non-treatment and females), n=9 males, n=11 groups. females) n=12 males, n=8 (n=20; a week, 6 times session, 20-minute Baduanjin: weeks. 12 a week, 6 times session, 20-minute pad: Balance weeks. 12 Baduanjin for minutes 10 each exercise: Combined weeks. 12 a week, 6 times pad, balance and combined in scores highest Scale: Living Daily of therapyActivity combined and 60-95), aged females; then and therapy, behavioural cognitive then therapy, 60-87) aged females; n=22 males, n=17 (n=39; groups. Baduanjin groups. a week, 5 times daily, minutes 30 Baduanjin: 6 months. a hours 1-1.5 therapy: behavioural Cognitive 6 months. a week, once session, 6 months. a week, 6 times females; aged 61-79), and standard treatment life in Baduanjin plus standard treatment after 6 months, 6 months, after treatment standard plus Baduanjin in life treatment standard and 61-79), aged females; Lin Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Shi and Cao Pei Chen, Xing Jin, Chen, Xiong Chen, Table 1. Analysis of the Table reviewed 58 clinical projects.

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Non-commercial To examine the effect of Baduanjin and 116 patients with hypertension (n=62 males, Randomly assigned to the Baduanjin and Better improvements in systolic blood pressure, diastolic pressure, blood systolic in improvements Better and Baduanjin the to males, (n=62 assigned Randomly hypertension with patients 116 and Baduanjin of effect the examine To To look into the effect of Baduanjin and 89 patients with retirement syndrome Randomly assigned to the Baduanjin and meditation More significant improvements in Baduanjin and and Baduanjin in improvements significant meditationMore and Baduanjin the to assigned Randomly syndrome retirement with patients 89 and Baduanjin of effect the into look To 54 To compare the effect of Taiji and Baduanjin 61 participants (n=20 males, 41 females), Assigned to the Baduanjin (n=15; n=6 males, n=9 Both Taiji Chuan and Baduanjin groups demonstrated groups Baduanjin and Chuan Taiji n=9Both males, n=6 (n=15; Baduanjin the to Assigned females), 41 males, (n=20 participants 61 Baduanjin and Taiji of effect the compare To 58 56 To evaluate the effect of Baduanjin on fall 120 participants (n=36 males, n=84 females), Randomly distributed to the Baduanjin (n=60; Significant improvements in fall prevention, mental health, mental prevention, fall in improvements Significant (n=60; Baduanjin the to distributed females), n=84 Randomly males, (n=36 participants 120 fall on Baduanjin of effect the evaluate To To compare the effect of Taiji and Baduanjin 61 participants (n=20 males, n=41 females), Assigned to Baduanjin (n=16; n=6 males, n=10 Both groups significantly increased grey matter volume matter grey increased significantly groups n=10Both males, n=6 (n=16; Baduanjin to females), n=41 Assigned males, (n=20 participants 61 Baduanjin and Taiji of effect the compare To 59 57 To compare the effect of Baduanjin and 104 participants (n=53 males, n=51 females), Randomly distributed to the Baduanjin (n=52; Better improvements in balance ability, fall prevention, and prevention, fall ability, balance in improvements Better (n=52; Baduanjin the to distributed Randomly females), n=51 males, (n=53 and participants Baduanjin of 104 effect the compare To 55 Amlodipine Besylate on hypertension n=54 females), average aged at 58. Amlodipine Besylate (drug) (n=58), and blood pressure and heart rate, and a decrease in serum in a decrease and rate, heart and pressure blood and (n=58), (drug) Besylate Amlodipine 58. at aged average females), n=54 group. hypertension on therapy Besylate combined the in Amlodipine endothelin groups. (n=58) Besylate Amlodipine adults. older among function. control mental in improvements significant females), n=13 males, n=8 (n=21; Taiji females), 62. at aged average network. control cognitive on including group, Baduanjin in these than group meditation 49-68), aged females; n=16 males, n=29 (n=45; 49-68. aged females), n=33 males, (n=56 syndrome. retirement on meditation prevention. aged 65-80. n=18 males, n=42 females, aged 65-80), and and quality of life in Baduanjin group. Baduanjin in life of and quality and 65-80), aged females, n=42 males, n=18 65-80. aged prevention. on grey matter volume. average aged at 62. females), Taiji (Yang style 24-form) (n=21; (GMV) in the insula, medial temporal lobe, and putamen. and lobe, temporal medial insula, the in (GMV) (n=21; 24-form) style (Yang Taiji females), 62. at aged average volume. matter grey on walking on fall prevention. aged 55-75. n=25 males, n=27 females; aged 55-74), and quality of life. of and quality 55-74), aged females; n=27 males, n=25 55-75. aged prevention. fall on walking Improvements in cognition and memory. and cognition in Improvements hippocampus. both associated with GMV increases in the putamen and putamen the in increases GMV with associated both Memory quotient and visual reproduction subscores were subscores reproduction visual and quotient Memory compared to the control group. control the to compared and comprehension memory subscores of the WMS-CR the of subscores memory comprehension and Baduanjin also improved mental control, recognition, touch, recognition, control, mental improved also Baduanjin reproduction subscores on the WMS-CR. the on subscores reproduction The Baduanjin group showed a significant decrease in rsFC in decrease significant a showed group Baduanjin The insula. and putamen left the and DLPFC the between with associated negatively was improvement control Mental subjects. all across changes DLPFC-putamen rsFC 30-minute session, 5 times a week, 12 weeks. Taiji Chuan and Baduanjin significantly improved visual improved significantly Baduanjin and Chuan Taiji weeks. 12 a week, 5 times session, 30-minute non-treatment (n=60; n=18 males, n=42 females, n=42 males, n=18 (n=60; non-treatment groups. 65-80) aged (n=24; n=6 males, n=18 females) groups. 2 2 groups. groups. females) n=18 males, n=6 (n=24; Baduanjin: 30-40 minutes daily, 5 times a week, 5 times daily, minutes 30-40 Baduanjin: 6 months. daily. 5mg Besylate: Amlodipine in decrease a significant showed group Chuan Chi Tai The n=19 males, n=6 (n=25; gyrus non-treatment and frontal superior left the and DLPFC the between rsFC groups. females) cortex. cingulate anterior and weeks. 12 (SFG) week, a times 5 session, 60-minute coping, emotion attention, activities, social self-awareness, females; n=17 males, n=27 (n=44; Baduanjin and and self-care, relationships, social well-being, of sense groups. 51-67) aged behavior. disturbing 3 months. daily, 1 hour Baduanjin: 3 months. daily, 1 hour Meditation: days. 30 a day, 2 times n=8 males, n=13 females), and non-treatment No significant differences were observed in GMV between GMV in observed were differences significant No non-treatment and females), n=13 males, n=8 walking (n=52; n=28 males, n=24 females; n=24 males, n=28 (n=52; walking aged 56-75). aged Baduanjin: 30-40 minutes per session, 12 weeks. 12 session, per minutes 30-40 Baduanjin: Walking: 40-60 minutes a day, 12 weeks. 12 a day, minutes 40-60 Walking: Tao, Liu Tao, Wu, Xue Wu, Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Yan and Lin Chen Tao, Hao Wang, Shi Table 1. Continued from previous page. Table

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Non-commercial To compare the effect of Baduanjin and 60 patients with knee osteoarthritis (n=27 Randomly distributed to the Baduanjin (n=30; Better improvements in Baduanjin group. Baduanjin in improvements Better (n=30; Baduanjin the to (n=27distributed Randomly osteoarthritis and knee with Baduanjin of patients 60 effect the compare To 66 To assess the effects of Baduajin on balance 94 patients with type 2 diabetes mellitus Randomly allocated to the Baduanjin, and no Improvements in arm curls right, 30-second chair stand, stand, chair 30-second right, curls arm in Improvements no and Baduanjin, the to allocated mellitusRandomly 2 diabetes type with balance on patients 94 Baduajin of effects the assess To To compare the effect of Baduanjin and 50 patients with coronary artery disease Randomly assigned to the Baduanjin with standard Significant and more decreases in angina attacks and its and attacks angina in decreases more and Significant standard with Baduanjin the to assigned Randomly disease artery andcoronary with Baduanjin of patients 50 effect the compare To 60 65 To assess the effect of Baduanjin on fall 47 participants, aged over 60. 30-40 minutes daily, 12 weeks. Increases in balance ability, and fall prevention. fall and ability, balance in Increases weeks. 12 daily, minutes 30-40 60. over aged fallon Baduanjin of participants, 47 effect the assess To To compare the effect of Baduanjin and 102 patients with chronic obstructive Randomly allocated to the Baduanjin (n=52; Better improvements in lung function, depressive and depressive function, lung in improvements Better (n=52; Baduanjin the to allocated Randomly obstructive chronic and with Baduanjin of patients 102 effect the compare To To examine the effect of Baduanjin on fall 100 participants (n=51 males, n=49 females) Allocated to the Baduanjin (n=50; n=24 males, Reduced fall risk, and improved mental health and quality of quality and health mental improved and risk, fall Reduced males, n=24 (n=50; Baduanjin the to females) n=49 Allocated males, (n=51 fallon participants 100 Baduanjin of effect the examine To 64 To investigate the effect of Baduanjin on 95 participants (n=20 males, n=75 females), Distributed to the Baduanjin (n=47; n=9 males, Better improvements in balance ability, and fall prevention fall and ability, balance in improvements Better males, n=9 (n=47; Baduanjin the to females), n=75 Distributed males, (n=20 participants 95 on Baduanjin of effect the investigate To pressure, blood system, respiratory in Improvements 45-55) (aged aged middle the to Distributed 45-65. aged women, 139 on Baduanjin of effect the compare To 61 62 63 67 To assess the effect of Baduanjin and dance 115 patients with hypertension (n=62 males, Randomly assigned to the Baduanjin and dance Improvements in emotion, blood pressure and heart rate. heart and pressure blood emotion, in danceand Improvements Baduanjin the to males, (n=62 assigned Randomly hypertension with danceand patients 115 Baduanjin of effect the assess To 68 women in different ages. (n=60), and senior (aged 56-65) (n=79) groups. grip, pulmonary capacity, body anteflexion in sitting in anteflexion body capacity, groups. (n=79) pulmonary grip, 56-65) (aged senior and (n=60), ages. different in women medication on coronary artery disease. (n=31 males, n=19 females), aged 60-70. care (n=25; n=15 males, n=10 females), and duration, anxiety and depression, and improvement in improvement and depression, and anxiety duration, and females), n=10 males, n=15 (n=25; care 60-70. aged females), n=19 males, disease. (n=31 artery coronary on medication and fitness ability in older adults with type 2 (n=40 males, n=54 females), aged 60-70. treatment groups. back scratch-right, right chair sit-and-reach, left chair left sit-and-reach, chair right scratch-right, back groups. treatment 60-70. aged Up-and-Go, females), 2 Timed n=54 and type with males, test, walk (n=40 adults older in 6-minute ability fitness and sit-and-reach, weeks. 24 a week, 4 times session, 45-minute mellitus. diabetes group. Baduanjin in life males, n=27 (n=50; walking and females), n=26 67. at aged average adults. older among health mental and risk ratio. sex Unspecified prevention. medication and females), n=16 males, n=14 60. over aged females), n=33 males, osteoarthritis. knee on medication and females), n=28 males, n=30 (n=58; 65. at aged average females), n=53 adults. older of hypertension on walking on lung function, depression, and pulmonary disease (n=62 males, n=40 n=31 males, n=21 females), and walking (n=50; anxiety symptoms in Baduanjin group. Baduanjin in symptoms anxiety (n=50; walking and females), n=21 males, n=31 n=40 males, (n=62 disease andpulmonary depression, function, lung on walking balance ability of old people. averaged aged at 67. n=38 females), and walking (n=48; n=11 males, in Baduanjin group. Baduanjin in males, n=11 (n=48; walking and females), n=38 67. at aged averaged people. old of ability balance anxiety among old adults with chronic females), average aged at 70. n=31 males, n=19 females) groups. females) n=19 males, n=31 70. at aged average females), chronic with adults old among anxiety obstructive pulmonary disease. pulmonary obstructive 50-60 minutes per session, 4 times a week, 12 weeks. 12 week, a times 4 session, per minutes 50-60 No significant differences between the 2 groups. the between differences significant No scapular in both groups. both in scapular and thickness of abdominal skinfold, upper arm and arm upper skinfold, abdominal of thickness and circumference, hip circumference, waist-hip ratio, waist-hip circumference, hip circumference, and a decrease in glycosylated haemoglobin (HbA1c ) in (HbA1c haemoglobin glycosylated in a decrease and group. Baduanjin 3 3 months. 1 hour daily, 7 days a week, 90 days. position, lower limb strength, body weight, waist weight, body strength, limb lower position, days. 90 a week, 7 days daily, 1 hour groups. 40-minute session, 12 weeks. 12 session, 40-minute standard care (n=25; n=16 males, n=9 females) quality of life in combined therapy group. therapy combined in females) n=9 life of males, quality n=16 (n=25; care standard n=23 females) groups. More significant improvements in function, functional function, in improvements significant More groups. females) n=23 group. Baduanjin in loss sensory environment, behavior, a week, 5 times daily, minutes 30 Baduanjin: weeks. 24 weeks. 24 daily, minutes 30-60 Walking: groups. females) n=17 males, n=13 (n=30; 3 months. a week, 5 times session, 30-minute daily, twice 7.5mg, Meloxicam, Medication: 3 months. females) n=25 males, n=32 (n=57; non-treatment groups. n=37 females) groups. females) n=37 Wu, Fan Wu, Wang, Guan Wang, Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Zhuang Xiao, Xu Chen, Yi and Liu Meng and Wang Li Xu, Cao, Guo Cao, Liu, Gao Liu, Table 1. Continued from previous page. Table

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Non-commercial To evaluate the effect of Baduanjin 60 patients with hypertension (n=34 males, Allocated to the Baduanjin (lying form) and No cases of heart failure and stroke, and 1 case of 1 case and stroke, and failure heart of cases No and form) (lying Baduanjin the to males, (n=34 Allocated hypertension with patients 60 Baduanjinof effect the evaluate To To investigate the effect of Baduanjin on 50 participants (n=22 males, n=28 females), Randomly allocated to the Baduanjin (n=25), and Decreases in triglyceride, total cholesterol, total triglyceride, in and Decreases (n=25), Baduanjin the to allocated females), n=28 Randomly males, (n=22 participants 50 on Baduanjin of effect the investigate To To examine the effect of Baduanjin and 60 patients with hypertension (n=31 males, Distributed to the Baduanjin with psychoeducation Better improvements in blood pressure, quality of sleep, of quality pressure, blood in improvements Better psychoeducation with Baduanjin the males,to (n=31 Distributed hypertension with patients 60 and Baduanjin of effect the examine To 75 70 To assess the effect of Baduanjin on fall 95 participants (n=20 males, n=75 females), Assigned to the Baduanjin (n=47; n=9 males, More significant increase in fall prevention and decrease in decrease and prevention fall in increase significant More males, n=9 (n=47; Baduanjin the to females), n=75 Assigned males, (n=20 fallon Baduanjin of participants 95 effect the assess To 71 To examine the effect of Baduanjin and diet 72 participants, average aged at 65. Randomly allocated to the Baduanjin with diet Better improvements in overall health state in Baduanjin in state health overall in dietimprovements with Better Baduanjin the to allocated Randomly 65. at aged average participants, 72 diet and Baduanjin of effect the examine To 76 metabolism of nitric oxide, malondialdehyde, aged 45-65. n=12 females; aged 45-55), and older adults dismutase, particularly in the male elderly. male the in particularly dismutase, adults older and 45-55), aged females; n=12 45-65. aged malondialdehyde, oxide, nitric of metabolism 72 74 To evaluate the effect of Baduanjin on 80 patients with chronic obstructive Randomly allocated to the Baduanjin with standard Better improvements in vitality, bodily pain, general health general pain, bodily vitality, in standard with improvements Better Baduanjin the to allocated Randomly obstructive chronic onwith patients Baduanjin 80 of effect the evaluate To increase and pressure blood systolic in decrease Greater (sitting Baduanjin the to males, distributed (n=45 Randomly hypertension with patients 84 Baduanjin of effect the investigate To 73 69 (lying form) and standard care on m=26 females), aged 65-82. standard care (n=30; n=18 males, n=12 females; arteriosclerosis in Baduanjin and standard care group, group, care standard and Baduanjin in arteriosclerosis females; n=12 males, n=18 (n=30; care standard group. care standard than 65-82. aged better females), m=26 significantly on care showed standard and which form) (lying n=16 (n=30; care standard and 65-80), aged hypertension. blood lipid level and antioxidant level. aged 55-65. non-treatment (n=25) groups. malonyldialdehyde, low-density lipoprotein, whole blood whole lipoprotein, low-density malonyldialdehyde, groups. (n=25) non-treatment 55-65. aged level. antioxidant and level lipid blood group. control diet with groups. (n=36) control diet and (n=36), control ratio. sex Unspecified adults. older among sub-health on control female the in particularly malondialdehyde, in A decrease 56-65) aged females; n=11 males, n=11 (n=22; elderly. the on dismutase superoxide and groups. adults. older and middle-aged fall. of fear males, n=11 (n=48; walking and females), n=38 67. at aged average prevention. (sitting form) and standard care on n=39 females), average aged at 69. form) and standard care (n=42; n=22 males, n=20 in diastolic blood pressure in Baduanjin group than in than group Baduanjin in n=20 pressure males, blood n=22 (n=42; care diastolic in standard and form) 69. at aged average females), n=39 on care standard and form) (sitting group. care males, n=23 standard (n=42; care standard and females), adults. older among hypertension quality of life among patients with chronic pulmonary disease (n=51 males, n=29 treatment (n=40; n=25 males, n=15 females), perception, mental health, physical functioning, physical functioning, physical health, mental females),perception, n=15 males, n=25 (n=40; treatment n=29 males, (n=51 disease pulmonary chronic with patients among life of quality psychoeducation on quality of sleep among n=29 females), aged 60-75. (n=30; n=14 males, n=16 females; aged 60-75), sleep duration, and sleep efficiency in combined therapy. combined in efficiency sleep and duration, sleep 60-75), aged females; n=16 males, n=14 (n=30; 60-75. aged amongfemales), n=29 sleep of quality on psychoeducation older adults with hypertension. and psychoeducation (n=30; n=17 males, n=13 males, n=17 (n=30; psychoeducation and hypertension. with adults older obstructive pulmonary disease. females), average aged at 65. and standard treatment (n=40; n=26 males, role functioning, emotional role functioning, and social role social and functioning, role emotional functioning, role males, n=26 (n=40; treatment standard and 65. at aged average females), disease. pulmonary obstructive increases in high-density lipoprotein, superoxide lipoprotein, high-density in increases group. Baduanjin in peroxidise glutathione and dismutase males, n=14 females; aged 65-82) groups. 65-82) aged females; n=14 males, daily. minutes 30 40 minutes daily, 3 times a week, 6 months. viscosity, low shear blood viscosity and plasma viscosity, and viscosity, plasma and viscosity blood shear viscosity, low 6 months. a week, 3 times daily, minutes 40 6 months. daily, minutes 30 weeks. 10 a week, 7 times daily, minutes 50 groups. females) n=37 a day, twice a session, minutes 30-40 Baduanjin: weeks. 12 weeks. 12 a day, minutes 40-60 Walking: n=19 females) groups. females) n=19 weeks. 12 a week, 5 days daily, minutes 30 females; aged 62-73) groups. 62-73) aged females; a week, times 3-4 a day, twice session, 1-hour weeks. 12 n=14 females) groups. functioning in Baduanjin group. Baduanjin in functioning groups. females) n=14 Baduanjin: 40-minute session, twice a day, 5 times a day, twice session, 40-minute Baduanjin: a week, 4 weeks. a week, Standard treatment: oxygenotherapy, abdominal oxygenotherapy, treatment: Standard breathing, half-closed lip respiratory training, respiratory lip half-closed breathing, diet control, drug. control, diet He Lin and Lin Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Ye Ma Zhang, Shi He, superoxide and oxide nitric of levels in Increases males, n=10 (n=22; middle-aged the to females), n=23 Assigned males, the(n=21 on Baduanjin of participants 44 effects the compare To and Huang Chang Gao Liu, Chen, Liu Chen, Table 1. Continued from previous page. Table

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Non-commercial To examine the effect of Baduanjin on 20 participants (n=11 males, n=9 females), 40 minutes daily, 5 times a week, 12 weeks. Improvements in digestive function, circulatory system circulatory function, digestive in Improvements weeks. 12 a week, 5 times daily, females),n=9 minutes 40 males, (n=11 participants 20 on Baduanjin of effect the examine To To compare the effect of Baduanjin and 55 patients with hypertension (n=26 males, Randomly allocated to the Baduanjin (n=27; Effect rate: 85% in Baduanjin group, 89% in medication medication in 89% group, Baduanjin in 85% rate: Effect (n=27; Baduanjin the to males, allocated (n=26 Randomly and hypertension with Baduanjin of patients 55 effect the compare To 78 To investigate the effect of Baduanjin and 93 participants (n=45 males, n=48 females), Randomly assigned to the middle aged (n=43; Decreases in total cholesterol, and low-density lipoprotein, low-density and cholesterol, total in Decreases (n=43; aged middle the to assigned females), n=48 Randomly males, (n=45 participants 93 and Baduanjin of effect the investigate To general vitality, pain, bodily in n=25 (n=55; improvements Baduanjin the to Significant distributed females), n=44 Randomly males, (n=55 participants 109 health on Baduanjin of effect the assess To 82 To assess the effect of Baduanjin with 119 patients (n=69 males, n=50 females), Distributed to the Baduanjin with standard care Significant improvement in self-efficacy in combined combined in self-efficacy in improvement Significant care standard with Baduanjin the to Distributed females), n=50 males, (n=69 patients 119 with Baduanjin of effect the assess To 80 81 To compare the effect of Baduanjin and 100 women, average aged at 61. Distributed to the Baduanjin (n=50), and More improvements in abdominal fat mass, and body weight body and mass, fat abdominal in improvements More and (n=50), Baduanjin the to Distributed 61. at aged and average Baduanjin of women, 100 effect the compare To To assess the effect of Baduanjin (sitting 91 patients with osteoporosis (n=43 males, Randomly distributed to the Baduanjin (sitting Much higher score in Baduanjin and Chinese medicine medicine Chinese and Baduanjin in score higher Much (sitting Baduanjin the to males, distributed (n=43 Randomly osteoporosis with (sitting patients 91 Baduanjin of effect the assess To in than group Baduanjin in improvements significant More (n=47), Baduanjin the to distributed Randomly quality on participants.95 Baduanjin of effect the assess To 84 79 83 77 of life among older adults. Unspecified sex ratio, and age range. and walking (n=48) groups. walking group, including bodily pain, general health, vitality, health, general pain, bodily including group, walking groups. (n=48) walking and range. age and ratio, sex Unspecified adults. older among life of physical and psychological benefits. aged 50-69. function, immunity and sleep quality, relaxed body and body relaxed quality, sleep and immunity function, 50-69. aged benefits. psychological and physical groups. both in lipoprotein high-density in and increase and 46-60), aged females; n=23 males, n=20 45-70. aged adults. older among lipid blood on Taiji group. medication and females), n=13 males, n=14 62. at aged average females), n=29 hypertension. one stage on medication group. therapy groups. (n=60) care standard and (n=59), older 77. at among aged average self-efficacy on care weeks. 24 standard daily, minutes 30 diseases. chronic with adults of older adults. aged 53-70. males, n=20 females), and non-treatment (n=54; health perception, physical functioning, physical role physical functioning, physical perception, health (n=54; non-treatment and females), n=20 males, 53-70. aged adults. older of physical exercise on health among older physical activity (n=50) groups. in Baduanjin group. Baduanjin in groups. (n=50) activity physical older among health on exercise physical form) and Chinese medicine on n=48 females), average aged at 69. form) and Chinese medicine (n=47; n=21 males, group than in Chinese medicine group. medicine Chinese in males, than n=21 group (n=47; medicine Chinese and form) 69. at aged average females), n=48 on medicine Chinese and form) females. Baduanjin: 90-minute session, 12 weeks. 12 session, 90-minute Baduanjin: females. osteoporosis. n=26 females), and Chinese medicine (n=44; n=22 (n=44; medicine Chinese and females), n=26 osteoporosis. ability, and mental health level in Baduanjin group. Baduanjin in level health mental and ability, blood lipids, sex hormone level, free radical scavenging scavenging radical free level, hormone sex lipids, blood physical fitness, cardiovascular function, immune function, function, immune function, cardiovascular fitness, physical Improvements in the body shape, body composition, body shape, body the in Improvements leg balance ability in Baduanjin group. Baduanjin in ability balance leg pressure, but increases in vital capacity, grip strength, grip capacity, vital in increases but pressure, Decreases in systolic blood pressure and diastolic blood diastolic and pressure blood systolic in Decreases moods, and enhanced self-tranquillity, pleasure, and pleasure, self-tranquillity, enhanced and moods, relief. symptom Walking: 40-60 minutes daily, 12 weeks. health. weeks. 12 daily, minutes 40-60 Walking: Baduanjin: 30-40 minutes daily, 12 weeks. social functioning, role-emotional functioning, and mental and functioning, role-emotional functioning, social weeks. 12 daily, minutes 30-40 Baduanjin: 30-60 minutes daily, 4-7 times a week, 6 months. Baduanjin group. Baduanjin 6 months. a week, times 4-7 daily, minutes 30-60 n=30 males, n=24 females) groups. functioning, social role functioning, and mental health in health mental and functioning, role social functioning, groups. females) n=24 males, n=30 elderly (n=50; n=25 males, n=25 females; n=25 males, n=25 (n=50; elderly groups. 60-70) aged 6 months. a week, times 6-7 daily, 1 hour Baduanjin: 6 months. a daily, twice session, 30-minute Taiji: n=16 males, n=12 (n=28; Besylate) (Amlodipine group. females) a day, twice session, per minutes 30 Baduanjin: weeks. 12 weeks. 12 daily, 5mg Besylate Amlodipine Medication: Physical activity: 90 minutes daily. minutes 90 activity: Physical males, n=22 females) groups. females) n=22 males, Hu and Gu and Hu Gao Liu, Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Li Peng, Fang Zheng, Hu and Gu He and Lin Peng Liu, Bai, Tien Bai, Table 1. Continued from previous page. Table

[Geriatric Care 2018; 4:7449] [page 49] Review To be continued on next To page

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Non-commercial To compare the effect of Baduanjin (sitting 120 patients with hypertension (n=52 males, Randomly distributed to the Baduanjin (sitting Effect rate: 83% in Baduanjin group, 52% in drug group. drug in 52% group, Baduanjin in 83% rate: Effect (sitting Baduanjin the to males, (n=52 distributed Randomly hypertension with patients 120 (sitting Baduanjin of effect the compare To To compare the effect of Baduanjin, walking, 60 patients with type II diabetes (n=38 males, Randomly assigned to the Baduanjin (n=20), Better improvements in diabetes symptoms and mental and symptoms diabetes in improvements Better (n=20), Baduanjin the to assigned males,Randomly (n=38 walking, diabetes II type with Baduanjin, of effect patients 60 the compare To 93 To evaluate the long-term effect of 69 patients with chronic neck pain (n=18 Assigned to Baduanjin (n=34; n=7 males, n=27 Baduanjin groups achieved significantly greater greater significantly achieved groups n=27Baduanjin males, n=7 (n=34; Baduanjin to (n=18 pain Assigned neck chronic with patients 69 of effect long-term the evaluate To To look into the effect of Baduanjin on vital 105 participants, aged 55-65. 30 minutes daily, twice a day, 3 months. Improvements in the respiratory system. respiratory the in Improvements 3 months. a day, twice daily, minutes 30 55-65. aged vital on participants, 105 Baduanjin of effect the into look To anger. controlled (n=33), Baduanjin Taiji (n=67), Taiji the to Distributed 61. at aged average participants, 362 Baduanjin, Taiji, of effect the compare To 87 To investigate the effect of Baduanjin 55 participants (n=19 males, n=36 females), Randomly assigned to the Baduanjin (n=27; n=10 Enhancements in overall sleep quality, subjective sleep subjective quality, sleep overall in Enhancements n=10 (n=27; Baduanjin the to assigned females), n=36 Randomly males, (n=19 participants 55 Baduanjin of effect the investigate To To evaluate the effect of regular Baduanjin 22 patients (n=3 males, n=19 females), 30-minute session, 5 times a week, 1 year. Reductions in pain, stiffness, disability, and improvement in improvement and disability, stiffness, pain, in Reductions 1 year. a week, 5 times session, 30-minute females), n=19 males, (n=3 patients 22 Baduanjin regular of effect the evaluate To 86 89 To examine the effect of Baduanjin on 146 participants, average aged at 62. Randomly distributed to Baduanjin (n=72), and Significant improvements in antioxidant capacity and and capacity antioxidant in improvements Significant and (n=72), Baduanjin to distributed Randomly 62. at aged average participants, 146 on Baduanjin of effect the examine To 92 94 To examine the effect of Baduanjin with 60 patients (n=31 males, n=29 females), Randomly assigned to the Baduanjin with acupoint Effect rate: 83.3% in Baduanjin with acupoint massage and massage acupoint with Baduanjin in 83.3% rate: acupoint with Effect Baduanjin the to assigned Randomly females), n=29 males, (n=31 patients 60 with Baduanjin of effect the examine To 88 85 91 To investigate the effect of Baduanjin on 180 participants (n=79 males, n=89 females), Randomly allocated to the Baduanjin (n=80; n=38 Significant improvements in mental health, including health, mental in improvements n=38 (n=80; Significant Baduanjin the to allocated females), n=89 Randomly males, (n=79 participants 180 on Baduanjin of effect the investigate To 90 Baduanjin on chronic neck pain. males, n=51 females), average aged at 58. females), and control (n=35; n=11 males, n=24 improvement than the controls in visual analogue scale, scale, analogue visual in controls the than improvement n=24 males, n=11 (n=35; 58.at control and aged average females), females), n=51 males, pain. neck chronic on Baduanjin health. emotional 55-82. aged osteoarthritis. knee on sensitivity, interpersonal obsession, somatisation, and 60-82), aged females; n=42 males, 60-84. aged adults. older of health mental calm. (n=81), improved walking (n=27), Baduanjin Yijinjing (n=19), Wuqinxi level. attention focus the increased Wuqinxi ratio. sex Unspecified mental on walking groups. and (n=135) Yijinjing, exercise no and Wuqinxi, function. immune and health and efficiency, sleep duration, sleep latency, sleep quality, (n=28; non-treatment and females), n=17 males, 71. at aged average quality. sleep on form) and drug on hypertension among n=68 females), average aged at 75. form) (n=60; n=28 males, n=32 females), and females), n=32 males, n=28 (n=60; form) 75. at aged average females), n=68 among hypertension on drug and form) groups. females) n=36 males, n=24 (n=60; drug adults. older capacity. Unspecified sex ratio. sex Unspecified capacity. acupoint massage and standard care on average aged at 64. massage and standard care (n=30; n=15 males, standard care group, 6.7% in standard care group. care standard in 6.7% group, care males,standard n=15 (n=30; care standard and massage on64. at care aged average standard and massage acupoint n=16 (n=30; care standard and females), n=15 stroke. after adults older among constipation anti-ageing. Unspecified sex ratio. diet control (n=74) groups. immune cells. immune groups. (n=74) control diet ratio. sex Unspecified anti-ageing. and drug on type II diabetes. n=22 females), aged 54-73. walking (n=20), and drug (n=20) groups. health in Baduanjin group than in other groups. other in than group Baduanjin in health groups. (n=20) drug and (n=20), walking 54-73. aged females), n=22 diabetes. II type on drug and There were no significant differences between the 2 groups groups 2 the between differences significant no were There flexors and extensors knee enhanced BMI in A decrease ability. aerobic patients and strength effect. adverse No well-being. improved Yijinjing depression. reduced Walking 12-week the throughout maintained was which weeks, four period. exercise females) groups. Northwick Park Neck Pain Questionnaire, and SF-36 health SF-36 and Questionnaire, Pain Neck Park Northwick groups. females) group. control in these than scores transition 6 months. daily, minutes 30 and paranoid, phobia, hostility, anxiety, depression, females; n=47 males, n=41 (n=88; non-treatment psychotism. groups. 60-84) aged weeks. 20 a week, 6 times session, 1-hour group. Baduanjin in dysfunction daytime groups. females) n=19 males, n=9 after group Baduanjin in quality sleep better Significantly weeks. 12 a week, 3 times session, 30-minute males, n=14 females) groups. females) n=14 males, daily. minutes 30 Baduanjin: daily. times 2-3 massage: Acupoint 90-minute session, twice a day, 5 times a week, 5 times a day, twice session, 90-minute Baduanjin: 3 times a day, 5 times a week, 3 months. a week, 5 times a day, 3 times Baduanjin: 24 weeks. 24 Walking; 30 minutes daily, 5 times a week, 3 months. a week, 5 times daily, minutes 30 Walking; in SF-36 physical or mental component summaries. component mental or physical SF-36 in Bao, Wang Bao, Ai and Zhang Men, Li Men, Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Pan Qiu, Guo Wang, Wang An, Chen Jing Shen, Liu Chen, Wei and Wu and Wei Table 1. Continued from previous page. Table

[page 50] [Geriatric Care 2018; 4:7449] Review To be continued on next To page

only use

Non-commercial To look into the effect of Baduanjin on 60 patients with irritable bowel syndrome Randomly allocated to the Baduanjin with Effect rate: 90% in Baduanjin with medication group; 83% in 83% group; medication with Baduanjin in 90% rate: Effect with Baduanjin the to allocated Randomly syndrome bowel irritable with patients 60 on Baduanjin of effect the into look To To investigate the effect of Baduanjin on 60 patients with chronic obstructive Randomly distributed to the Baduanjin (n=30; Improvements in forced expiratory volume in one in volume expiratory forced in Improvements (n=30; Baduanjin the to distributed Randomly obstructive chronic with patients 60 on Baduanjin of effect the investigate To To compare the effect of Baduanjin 60 patients with coronary artery bypass Randomly allocated to the Baduanjin (lying form) Great improvements in rehabilitation and exercise skills in skills exercise and rehabilitation in improvements Great form) (lying Baduanjin the to allocated Randomly bypass artery coronary with patients 60 Baduanjin of effect the compare To 101 To compare the effect of Baduanjin and 69 patients with type II diabetes (n=28 males, Randomly assigned to the Baduanjin (n=33; n=14 Much significant improvements in depressive symptoms symptoms depressive in improvements significant Much n=14 (n=33; Baduanjin the to assigned males,Randomly (n=28 diabetes II andtype with Baduanjin of patients 69 effect the compare To an but group, Baduanjin in glucose blood in A decrease walking and (n=47), Baduanjin the to Assigned 55-65. aged and Baduanjin of participants, 95 effect the compare To 102 95 To investigate the effect of Baduanjin on 80 women in army, aged 61-65. Randomly allocated to the Baduanjin (n=40), More increases in superoxide dismutase and close eyes close and dismutase superoxide in increases More (n=40), Baduanjin the to allocated Randomly 61-65. aged army, in women 80 on Baduanjin of effect the investigate To Baduanjin in disability and stiffness, pain, in Decreases and (n=11), Baduanjin the to assigned Randomly 65. at aged average women, 21 on Baduanjin of effect the examine To 96 99 98 103 To assess the effect of Baduanjin on 45 participants (n=22 males, n=23 females), 40-50 minutes daily, 6 times a week, 6 months. Significantly decreased the quantity of enterobacter and enterobacter of quantity the decreased 6 months.Significantly a week, 6 times daily, females), minutes n=23 40-50 males, (n=22 on participants 45 Baduanjin of effect the assess To health, physical in improvements form) (sitting significant More Baduanjing the to assigned n=17 males, Randomly (n=43 stroke with patients 60 Baduanjin of effect the compare To 97 100 women with knee osteoarthritis. non-treatment (n=10) groups. group. groups. (n=10) non-treatment osteoarthritis. knee with women irritable bowel syndrome. (n=36 males, n=24 females), average aged medication (n=30; n=17 males, n=13 females), medication group. females), medication n=13 males, n=17 aged (n=30; average medication females), n=24 males, (n=36 syndrome. bowel irritable walking on blood glucose among older adults. Unspecified sex ratio. (n=48) groups. increase in walking group. walking in increase groups. (n=48) adults. ratio. sex older Unspecified among glucose blood on walking community care on depression and quality n=41 females), average aged at 64. males, n=19 females), and community care (n=36; and mental health in Baduanjin group. Baduanjin in (n=36;health care mental and community and females), n=19 males, 64. at aged average qualityfemales), and n=41 depression on care community in (HbA1c) hemoglobin glycosylated in reduction Greater groups. females) n=22 males, n=14 diabetes. II type with patients among life of sexual of level the in improvements and balance, one-foot groups. (n=40) non-treatment and army. in women older of health environment, relationships, social health, psychological education and females), n=10 males, n=20 (n=30; 61. at aged average females), in stroke on perception education quality and form) living and (sitting perception, health groups. females) n=7 males, n=23 (n=30; rehabilitation. walk 6-minute (FVC), capacity vital forced (FEV1), second (n=30; control and females), n=12 males, n=18 n=21 males, (n=39 disease pulmonary disease pulmonary obstructive chronic distance. groups. females) n=9 males, n=21 63. at aged average females), adults. older among (lying form) and walking on rehabilitation grafting (n=46 males, n=14 females), (n=30; n=24 males, n=6 females), and walking Baduanjin group. Baduanjin walking and females), n=6 males, n=24 (n=30; females), n=14 males, (n=46 grafting rehabilitation on walking and form) (lying changes of intestinal flora. average aged at 63. fusobacterium, but increased the quantity of quantity the increased but fusobacterium, 63. at aged average flora. intestinal of changes after coronary artery bypass grafting. average aged at 65. (n=30; n=22 males, n=8 females) groups. females) n=8 males, n=22 (n=30; 65. at aged average grafting. bypass artery coronary after Baduanjin group than these in non-treatment group. non-treatment in these than group Baduanjin group. Baduanjin in injury radical free Delayed group. Baduanjin bifidobacterium, lactobacillus and the ratio of ratio the and lactobacillus bifidobacterium, bifidobacterium and enteric bacilli. enteric and bifidobacterium at 66. and medication (n=30; n=19 males, n=11 females) Improvements in abdominal pain, abdominal distension, abdominal pain, females) abdominal n=11 in males, n=19 Improvements (n=30; medication and 66.at Medication: Tegasero, 6mg. Tegasero, Medication: 45-minute session, twice a day, 12 weeks. weeks.12 a day, twice session, 45-minute Walking: 30-minute session, twice a day, 3 months. a day, twice session, 30-minute Walking: 30-minute session, 5 sessions a week, 8 weeks. Improvements in quadriceps strength and aerobic ability in ability aerobic and strength quadriceps in Improvements 8 weeks. a week, 5 sessions session, 30-minute groups. constipation, and abnormal defecation. abnormal and constipation, groups. Baduanjin: 30-minute session, twice a day, 3 months. a day, twice session, 30-minute Baduanjin: 40 minutes daily, 3-5 times a week, 12 weeks. Baduanjin group than in community care group. care community in than group Baduanjin weeks. 12 a week, times 3-5 daily, minutes 40 in ability balance and response nervous hormone, weeks.20 daily, minutes 45 group. education in than group 3 months.Baduanjin a week, times 4-5 daily, minutes 30 a week, 5 days a day, twice sessions, 45-minute weeks. 24 Baduanjin: 30 minutes daily, 4-5 times a week, times 4-5 daily, minutes 30 Baduanjin: 23 weeks. 23 Walking: 30-100 minutes a session, 3 times a day, 3 times a session, minutes 30-100 Walking: 23 weeks. 23 Feng, Bian Feng, Liu, Guo Liu, An, Dai An, Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Chen Lin, Huo Liu, Yao He, Cai Pan Feng, Sun Table 1. Continued from previous page. Table

[Geriatric Care 2018; 4:7449] [page 51] Review

in elderly people: The European References MentDis_ICF65+ study. Br J Psychiatr 2017;210:125-31. 1. Miranda LCV, Soares SM, Silva 15. Esmayel EM, Eldarawy MM, PAB. Quality of life and associat- Hassan MM, et al. Mental health ed factors in elderly people at a problems and sociodemographic Reference Centre. Ciência Saúde correlates in elderly medical inpa- Coletiva 2016;21:3533-44. tients in a university hospital in 2. Bloom DE, Chatterji S, Kowal P, Egypt. Curr Gerontol Geriatr Res et al. Macroeconomic implications 2013;2013:1-4. of population ageing and selected 16. Andrews MA, Shaji KS, Asokan policy responses. Lancet 2015; Kuttichira P. Health problems of 385:649-57. the elderly: Cross-sectional study 3. Aiyar S, Ebeke C, Shao X. The in a rural population in Kerala. impact of workforce ageing on Kerala Med J 2015;8:14-7. European productivity. Washington, 17. Steptoe A, Shankar A, DC, USA: International Monetary Demakakos P, Wardle J. Social Fund; 2016. isolation, loneliness, and all-cause 4. Thakur RP, Banerjee A, Nikumb mortality in older men and VB. Health problems among the women. Proc Natl Acad Sci U S A elderly: A cross-sectional study. 2013;110:5797-801. Ann Med Health Sci Res 18. de Souza Pinho Costa V, Molari 2013;3:19-25. M, dos Santos JPM, de Freitas 5. Tiwari SC, Trichal M, Mehrotra B, ERS, et al. Evaluation factors for Najeeb S. A study of awareness of onlydetermining the quality of life of health problems of the elderly with physically independent elderly. reference to mental health. Delhi Manual Ther Posturo Rehab J Psychiatr J 2009;12:263-8. 2015;13:1-8. 6. Contrera KJ, Wallhagen MI, 19. de Nardi M, French E, Jones JB, Mamo SK, et al. Hearinguse loss McCauley J. Medical spending of health care for older adults. J Am the US elderly. Fiscal Stud J Appl Board Fam Med 2016;29:394-403. Publ Econ 2016;37:717-47. 7. Pan C-W, Qian D-J, Sun H-P, et al. 20. Sun F, Norman IJ, While AE. Visual impairment among older Physical activity in older people: adults in a rural community in A systematic review. BMC Public Eastern China. J Ophthalmol Health 2013; 13:1-17. 2016;2016:Article ID 9620542. 21. Rosenberg DE, Bombardier CH, 8. Rooth MA. The prevalence and Hoffman JM, Belz B. Physical impact of vision and hearing loss activity among persons ageing in the elderly. N C Med J 2017; with mobility disabilities: Shaping 78:118-20. a research agenda. J Ageing Res 9. Batista P, Pereira A. Quality of life 2011;2011:1-16. in patients with neurodegenerative 22. Law TD, Clark LA, Clark BC. diseases. J Neurol Neurosci 2016; Resistance exercise to prevent and 7:1-7. manage sarcopenia and dynapenia. Non-commercial10. Wandera SO, Kwagala B, Ntozi J. Annu Rev Gerontol Geriatr Prevalence and risk factors for 2016;36:205-28. self-reported non-communicable 23. Peterson MD, Rhea MR, Sen A, diseases among older Ugandans: A Gordon PM. Resistance exercise crosssectional study. Global for muscular strength in older Health Action 2015;8:1-11. adults: A meta-analysis. Ageing 11. Roubenoff R, Hughes VA. Res Rev 2010;9:226-37. Sarcopenia: current concepts. J 24. Kwon I-H, Song J-Y, Kim D-Y, et Gerontol Med Sci 2000;55A: al. Comparison of rhythmic and M716-24. non-rhythmic aerobic exercises on 12. Clark BC, Manini TM. What is depression and balance in the eld- dynapenia. Nutrition 2012;28:495- erly. Phys Ther Rehab Sci 503. 2017;6:146-51. 13. Manini TM, Clark BC. Dynapenia 25. Asaka M, Kawano H, Higuchi M. Rowing as an aerobic and resist-

To look into the effect of Baduanjin on 200 participants (n=100 males, n=100 Randomly allocated to the Baduanjin (n=120; n=60 More significant improvements in bodily pain, vitality, pain, bodily in improvements n=60 (n=120; significant More Baduanjin the to allocated Randomly n=100 males, (n=100 participants 200 on Baduanjin of effect the into look To and ageing: An update. J Gerontol

105 Series A Biol Sci Med Sci ance exercise for elderly people. J To test the effect of Baduanjin on health 113 participants (n=42 males, n=71 females), Distributed to the Badunajin (n=58; n=22 males, Delayed hypophrenia (intelligence recession), and recession), (intelligence hypophrenia Delayed males, n=22 (n=58; Badunajin the to females), n=71 Distributed males, (n=42 participants 113 healthon Baduanjin of effect the test To

To assess the effect of Baduanjin on 48 patients with cardio-pulmonary problems 30 minutes daily, 1 year. Increases in compensatory force of heart pump, cardiac pump, heart of force compensatory in Increases 1 year. daily, problems minutes 30 cardio-pulmonary with on patients 48 Baduanjin of effect the assess To Phys Fitness Sports Med 2012;1:

106 2012;67A:28-40. 104 14. Andreas S, Schulz H, Volkert J, et 227-34. cardio-pulmonary function. (n=22 males, n=26 females). contractility, cardiac output stroke volume, and pulmonary and volume, stroke output cardiac contractility, females). n=26 males, (n=22 function. cardio-pulmonary consumption. oxygen metabolic n=20 (n=55; decreased non-treatment and females), n=36 56-65. aged adults. older among intelligence and health among older adults. females), average aged at 60. males, n=60 females), and non-treatment (n=80; general health perception, health transition, physical transition, health perception, health general (n=80; non-treatment and females), n=60 males, 60. at aged average females), adults. older among health Improvements in myocardial oxygen supply, scavenging scavenging supply, oxygen myocardial in Improvements endurance. respiratory and radicals, free oxygen of ability and functions, cardiac haemorheology, haemodynamics, system nervous of regulation Unspecified age range. function. range. age Unspecified group. males, n=35 females) groups. Increased mental activities and self confidence. self and activities mental Increased groups. females) n=35 males, system, endocrine system, immune Enhanced 6 months. a week, times 5-7 daily, 1 hour n=40 males, n=40 females) groups. functioning, physical-role functioning, emotional-role functioning, physical-role functioning, groups. females) n=40 males, n=40 1 hour daily, 7 times a week, 6 months. functioning, social functioning, mental health in Baduanjin in health mental functioning, social functioning, 6 months. a week, 7 times daily, 1 hour Source Research objective Sample size Intervention Results Intervention size Sample objective Research Source Pan Wang Wang, Zhu Wang, Table 1. Continued from previous page. Table al. Prevalence of mental disorders 26. Merom D, Stanaway FF,

[page 52] [Geriatric Care 2018; 4:7449] Review

Handelsman DJ, et al. Swimming and http://jsqg.sport.org.cn/en/illustra- bound elderly housebound. Chinese J other sporting activities and the rate of tion/2008-12-03/226049.html Gerontol 2017;37:698-70. falls in older men: longitudinal find- 40. Zou L, Wang C. Traditional Chinese 53. Lin Q. Effect of Baduanjin on patients ings from the concord health and age- baduanjin qigong for older adults. with mild cognitive impairment and ing in men project. Am J Epidemiol Open Access J Gerontol Geriatr Med improvements in cognitive function. 2014;180:830-7. 2017;1:1-2. Chinese J Gerontol 2017;37:3358-60. 27. Lee J-Y, Lee D-C. Cardiac and pul- 41. Li R, Jin L, Hong P, et al. The effect of 54. Lin Q, Yan XH. Effect of Baduanjin on monary benefits of forest walking ver- baduanjin on promoting the physical fit- hypertension among the elderly. sus city walking in elderly women: A ness and health of adults. Evid Based Chinese J Gerontol 2017;37:3324-6. randomised, controlled, open-label Complement Alternat Med. 2014;2014: 55. Shi XY. Effect of Baduanjin on fall trial. Eur J Integrat Med 2014;6:5-11. 1-8. prevention among old people. Modern 28. Guzman-Garcıa A, Johannsen L, Wing 42. Xiao C, Zhuang Y, Kang Y. Effect of Diagn Treat 2017;28:222-3. AM. Dance exercise for older adults: A health qigong baduanjin on fall pre- 56. Tao J, Chen X, Egorova N, et al. Tai pilot study investigating standing bal- vention in individuals with Chi Chuan and Baduanjin practice ance following a single lesson of dan- Parkinson’s disease. J Am Geriatr Soc modulates functional connectivity of zon. Am J Dance Ther 2011;33:148-56. 2016;64:e227-e8. the cognitive control network in older 29. Boguszewski D, Slodkowska (Cieślik) 43. Wang S, Zhou X, Wang A. Effect of adults. Sci Rep 2017;7:1-9. M, Adamczyk J, Ochal A. The role of Ba-Duan-Jin on cardiovascular auto- 57. Tao J, Liu J, Liu W, et al. Tai Chi pilates and aquafitness exercises in nomic balance in aged women. Res Q Chuan and Baduanjin increase grey sustaining the Health and fitness of Exerc Sport 2014;5:A89-90. matter volume in older adults: A brain elderly women. Sport Sci Rev 44. Zheng G, Huang M, Li S, et al. Effect imaging study. J Alzheim Dis 2012;21:127-38. of Baduanjin exercise on cognitive 2017;60:389-400. 30. Farinatti P, Rubini E, Silva E, function in older adults with mild cog- 58. Wang X-J, Hao Z-W, Li J-N, et al. Vanfraechem J. Flexibility of the elder- nitive impairment: Study protocol for a Effect of mindfulness meditation train- ly after one-year practice of yoga and randomised controlled trial. BMJ Open onlying combined with Ba Duan Jin exer- calisthenics. Int J Yoga Ther 2016;2016:1-10. cise on retirement syndrome. Shanghai 2014;24:71-7. 45. Wen J, Lin T, Jiang C, et al. Effect of Nurs 2017;17:22-6. 31. Chen S, Zhang Y, Wang YT, Liu XL. Baduanjin exercises on elevated blood 59. Wu X, Xue W, Fang J, et al. Baduanjin Traditional Chinese mind and body lipid levels of middle-aged and elderly of movements on the risk of falls in exercises for promoting balance ability individuals: protocol for a systematicuse community elderly people for 60 cases. of old adults: A systematic review and review and meta-analysis of ran- Chinese Med Modern Distance Educ meta-analysis. Evid Based Complement domised controlled trials. BMJ Open China 2017;15:106-9. Alternat Med 2016;2016:1-9. 2017;2017:1-6. 60. Xiao CM, Zhuang YC, Kang Y. Effects 32. Guo Y, Shi H, Yu D, Qiu P. Health ben- 46. Chen B-L, Guo J-B, Liu M-S, et al. of Ba Duan Jin Qigong on balance and efits of traditional Chinese sports and Effect of traditional Chinese exercise fitness ability in older adults with type physical activity for older adults: A on gait and balance for stroke: A sys- 2 diabetes mellitus. J Tradit Med Clin systematic review of evidence. J Sport tematic review and meta-analysis. Naturopathy 2017;6:1-3. Health Sci 2016;5:270-80. PLoS One 2015;10:1-15. 61. Cao C, Guo X, Chen N, et al. Research 33. Dong XQ, Bergren S. Qigong among 47. Wang X, Pi Y, Chen B, et al. Effect of of effects of eight-section brocade of older adults: A global review. Clin Res traditional Chinese exercise on the qual- TCM on treating anxiety and depres- Trials 2016;2:120-44. ity of life and depression for chronic sion in the elderly patients with lung- 34. Zhang Y, Huang L, Su Y, et al. The diseases: A meta-analysis of randomised spleen qi deficiency in stable period of effects of traditional Chinese exercise trials. Sci Rep 2015;5:1-16. COPD. J Liaoning Univ Tradit Chinese in treating knee osteoarthritis: A sys- 48. Chen T, Yue GH, Tian Y, Jiang C. Med 2016;18:120-3. tematic review and meta-analysis. Baduanjin mind-body intervention 62. Chen C, Xu H, Gu Q, Wu J. Study on PLoS One 2017;12:1-18. Non-commercialimproves the executive control func- the effect of group baduanjin exercises 35. Yang Y, Qiu WQ, Hao YL, et al. The tion. Front Psychol 2017;7:1-5. on fall risk and quality of life of elderly efficacy of traditional Chinese medical 49. Cao B, Shi F. An analysis of regular patients. Chinese Commun Doct exercise for Parkinson’s disease: A sys- practising Baduanjin on health and 2016;32:170-2. tematic review and meta-analysis. body composition among the male eld- 63. Liu X-Y, Gao J, Yin B-X, et al. PLoS One 2015;10:1-18. erly. Sport 2017;153:155-6. Efficacy of Ba Duan Jin in improving 36. Su X, Ru K. On Eight Segments of 50. Chen GP, Pei F, Wang Y. Balance of the balance: A study in Chinese communi- Brocade (Baduanjin) and its creation elderly and fall prevention by ty-dwelling older adults. J Gerontol and compilation theory. J Capital Baduanjin with balance pad. Chinese J Nurs 2016;42:38-46. College Phys Educ 2002;14:85-7. Rehab 2017;32:141-2. 64. Liu X, Yi B. Application and effect of 37. Koh TC. Baduanjin: An ancient 51. Chen Y, Xiong XJ, Liu H, et al. Effect of eight-section brocade exercise therapy in Chinese exercise. Am J Chin Med. Baduanjin on pain management and prevention of fall in community elderly. 1982;10:14-21. quality of life among patients with pri- Chinese Nursing Res 2016;20:423-5. 38. General Administration of Sport of mary osteoporosis. China’s Naturopathy 65. Wang R, Guan F, Yan X. Qigong China. Baduanjin; 2013. Available 2017;25:18-9. Baduanjin rehabilitation of elderly from: http://www.sport.gov.cn/n16/n 52. Jin AP, Xing FM, Jing LW, Wang FL. patients with coronary artery disease. J 1107/n1638/3886341.html Effect of Baduanjin with cognitive Changchun Univ Chinese Med 39. Chinese Health Qigong Association. behavioural therapy on Activity of 2016;32:752-4. Baduanjin; 2014. Available from: Daily Living Scale among the house- 66. Wang CM, Meng LG. A clinical study

[Geriatric Care 2018; 4:7449] [page 53] Review

of Baduanjin in treating knee 80. Gu KP, Hu GX. Effect of Baduanjin exercise) on sleep quality of older osteoarthritis. Cardiovasc Dis J and Qigong on blood lipid among the adults: A randomised controlled trial. Integrat Trad Chinese Western Med elderly. Chinese Rural Health Serv Int J Nurs Stud 2012;49:265-73. 2016;4:158. Admin 2014;34:1027-8. 95. Lin X-L, Chen J-W, Zhang G-Q, et al. 67. Wu S, Fan Y, Huang L. Study of influ- 81. Hu G, Gu K. Effects of Qigong eight Effects of eight sections brocade (Ba ence of Baduanjin exercise on middle section brocade exercise on quality of Duan Jin) on quality of life for patients and old-aged women. Bull Sport Sci life of the elderly in a district, Jilin. after coronary artery bypass grafting. J Tecnol 2016;24:41-3. Med Soc 2014;27:74-6. Nursing (China) 2012;19:63-5. 68. Xu W, Li M, Yao J. Intervention of col- 82. Lin F, He QX. Effect of Baduanjin on 96. Liu Y, Huo R, Lai Y, et al. Community- lective exercise on the mental health of stage one hypertension among the eld- based study on effects of Chinese elderly hypertensive patients. Iran J erly. Chinese J Geriatric Care 2014;12: Qigong-Baduanjin on depression Public Health 2016;45:314-21. 25-6. symptoms and life quality of patients 69. Ye XP. Effect of Baduanjin on quality 83. Liu X, Gao J, Bai D, et al. Influence of with type 2 diabetes mellitus. Chinese of life among the elderly with chronic Ba Duan Jin exercise on quality of life J Sports Med 2012;31:212-7. obstructive pulmonary disease. Today of elderly in community. Chinese 97. Sun H. Beneficial influence on the Nurse 2016;2016:80-2. Gener Pract Nursing 2014;12:577-9. breeding and growth of intestinal flora 70. Zhang J, Ma X, Sun X-Q, Wang J. 84. Liu Q, Peng DZ, Wang H, Li FY. Effect through gymnastic Qigong-Baduanjin Effects of health-care qigong of Baduanjin on self-efficacy among exercise in the aged. Chinese J Sports Baduanjin on the blood lipid level and the elderly with chronic diseases. Med 2012;31:973-7. antioxidant level of the middle-aged Chinese J Convalescent Med 98. He J-H, Yao L, Chang Z, Liu G-N. The and aged people. Shandong Sports Sci 2014;23:414-6. influence of new Ba Duan Jin on the Technol 2016;38:65-8. 85. Qiu WM, Pan HS, Wen X, et al. Effect physiological function in aged women 71. Chen YQ, Liu RZ, He R. Effect of of Baduanjin on anti-ageing. J N of army. Acta Acad Med CPAF Baduanjin on quality of sleep among Chinese Med 2014;46:82-4. 2011;20:10-2. the elderly with hypertension. Hunan J 86. Wang J-Y, Guo H, Tang L, et al. Case- 99.only Liu JR, Guo YS, Zhang RF, et al. Effect Tradit Chinese Med 2015;31:52-3, 82. control study on regular Ba Duan Jin of Baduanjin on glycemia among the 72. He Y, Shi HL, Zhao MJ, et al. 36 cases practice for patients with chronic neck middle-aged and older adults. Chinese J of using Baduanjin in sub-health pain. Int J Nursing Sci 2014;1:360-6. Gerontol 2011;31:3196-7. among the elderly. J Extern Ther Tradit 87. Wei Q, Wu Y. Clinical study of 100. Cai W. Influence of sitting Baduanjin Chinese Med 2015;24:9-11. Baduanjin on health status inpatientsuse on quality of life of cerebral apoplexy 73. He X. Rehabilitation therapeutic effect with type 2 diabetes. J Liaoning Univ patients with sequela in community. of baduanjin training in aged patients Traditional Chinese Med. 2014;16: Chinese Nursing Res 2010;24:2667-8. with hypertension. Chinese J 103-5. 101. Feng Y-C, Bian B-G, Pan H-S, et al. Cardiovasc Rehab Med 2015;24:252-4. 88. An B-C, Wang Y, Jiang X, et al. Effects Observation of the efficacy of 74. Huang T, Chang JD. Influence of body of Baduanjin exercise on knee Baduanjin exercise on the constipa- building Qigong and eight-section bro- osteoarthritis: A one-year study. Chin J tion-predominant irritable bowel syn- cade on the metabolisms of nitric Integr Med 2013;19:143-8. drome of the elderly. Sport Sci Res oxide, malondialdehyde and superox- 89. Bao LY, Wang Y, Liu JR. Effect of 2010;31:89-91. ide dismutase in middle-aged and eld- Baduanjin on different levels of blood 102. Feng YC, Pan HS, Wen X, et al. Effect erly people of different gender. lipid and vital capacity among the elder- of Baduanjin on the stabilised period of Chinese J Clin Rehab. 2015;9:162-4. ly. Chinese J Gerontol 2013;33:1140-1. elderly patients with chronic obstruc- 75. Lin XM, Lin WZ. 60 cases of using 90. Chen W. Effects of Baduanjin on men- tive pulmonary disease. J N Chinese Baduanjin (lying form) in hypertension tal health of urban-dwelling elders. Med 2009;41:36-7. among the elderly. Fujian J Tradit Chinese J Gerontol 2013;33:3472-3. 103. An B, Dai K, Shu Z, et al. Baduanjin Chinese Med 2015;46:75-6. 91. Men HY, Li SX, Chen CX. Effect of alleviates the symptoms of knee 76. Liu X, Gao J, Bai D, et al. StudyNon-commercial on Baduanjin with acupoint massage on osteoarthritis. J Alternat Complement influence of eight-sectioned exercise constipation among patients with Med 2008;14:167-74. on falls efficacy in community elderly. stroke. J Hebei United Univ Health Sci 104. Pan HS. Effect of Baduanjin on cardio- Chinese Nursing Res 2015;29:90-3. 2013;15:330-2. pulmonary function among the elderly. 77. Peng X, Li Q, Li X. The efficacy of sit- 92. Shen H-J, Jing T, Wang Z-L. J N Chinese Med 2008;40:55-7. ting Baduanjin exercise on lumbago and Comparative study on five kinds of tra- 105. Wang S-T, Zhu H-X, Zhang Y, et al. back pain of elderly patients with osteo- ditional health exercises for multidi- The effects of new Baduanjin on mid- porosis. J Nursing Sci 2015;30:4-6. mensional psychological and immune dle/old aged people’s life quality. J 78. Zheng G, Fang Q, Chen B, et al. function of elder adults. Chinese J Inf Beijing Sport Univ 2007;30:203-5. Qualitative evaluation of Baduanjin Tradit Chinese Med 2013;20:17-20. 106. Wang S-T. Effect of Baduanjin on (traditional Chinese qigong) on health 93. Zhang JF, Ai J. Effects of stress reduc- physiological age of intelligence for Promotion among an elderly communi- tion based Baduanjin with anti-hyper- old people. J Clin Rehab Tissue Engine ty population at risk for ischemic tensive drugs on quality of life of the Res 2007;11:7910-3. stroke. Evid Based Complement elderly with high blood pressure. 107. Li G, Thabane L, Papaioannou A, et al. Alternat Med 2015;2015:1-10. Chinese J Truma Disab Med An overview of osteoporosis and 79. Bai SG, Tien Y, Qiu Y. Effect of 2013;21:179-80. frailty in the elderly. BMC Baduanjin on body composition among 94. Chen M-C, Liu H-E, Huang H-Y, Musculoskelet Disord 2017;18:1-5. the female elderly. Chinese Rural Chiou A-F. The effect of a simple tradi- 108. Anderson AS, Loeser RF. Why is Health Serv Admin 2014;34:1164-5. tional exercise programme (Baduanjin osteoarthritis an age-related disease.

[page 54] [Geriatric Care 2018; 4:7449] Review

Best Pract Res Clin Rheumatol 123. Magrone T, Jirillo E. The interaction Eur J Person Centred Healthc 2010;24:15-26. between gut microbiota and age-related 2015;3:369-76. 109. Blagojevicy M, Jinksy C, Jefferyz A, changes in immune function and 136. Mortazavi SS, Shati M, Aredbili HE, et Jordan KP. Risk factors for onset of inflammation. Immunity Ageing 2013; al. Comparing the effects of group and osteoarthritis of the knee in older 10:1-6. home-based physical activity on men- adults: A systematic review and meta- 124. Kurniawan I, Kolopaking MS. tal health in the elderly. Int J Prev Med analysis. Osteoarthr Cartilage Management of irritable bowel syn- 2013;4:1282-9. 2010;18:24-33. drome in the elderly. Indones J Intern 137. Chang P-J, Wray L, Lin Y. Social rela- 110. Zhang W, Ouyang H, Dass CR, Xu J. Med 2014;46:138-47. Current research on pharmacologic and 125. Deary IJ, Corley J, Gow AJ, et al. Age- tionships, leisure activity, and health in regenerative therapies for osteoarthri- associated cognitive decline. Br Med older adults. Health Psychol 2014;33: tis. Bone Res 2016;4:1-14. Bull 2009;92:135-52. 516-23. 111. Hsu W-L, Chen C-Y, Tsauo J-Y, Yang 126. Skoog I. Psychiatric disorders in the 138. Fernández-Ballesteros R, Robine JM, R-S. Balance control in elderly people elderly. Canad J Psychiatr 2011;56:387- Walker A, Kalache A. Active ageing: A with osteoporosis. J Formos Med 97. global goal. Curr Gerontol Geriatr Res Assoc 2014;113:334-9. 127. Cheng FK. Effects of Baduanjin on 2013;2013:1-4. 112. Ng CT, Tan MP. Osteoarthritis and falls mental health: A comprehensive review. 139. Yap P. What constitutes successful age- in the older person. Age Ageing J Bodyw Mov Ther 2015;19:138-49. ing. Eur Health Psychol 2015;17:62-3. 2013;42:561-6. 128. Thirthalli J, Zhou L, Kumar K, et al. 140. Flores TR, Nunes BP, Assunção MCF, 113. Cauley JA. Public health impact of Traditional, complementary, and alter- Bertold AD. Healthy habits: What kind osteoporosis. J Gerontol A Biol Sci native medicine approaches to mental Med Sci 2013;68:1243-51. health care and psychological wellbe- of guidance the elderly population is 114. McDonough CM, Jette AM. The con- ing in India and China. Lancet receiving from health professionals. tribution of osteoarthritis to functional Psychiatr 2016;3:660-72. Rev Brasil Epidemiol 2016;19:167-80. limitations and disability. Clin Geriatr 129. Mahboobi H, Khorgoei T, Bansal N. 141.only Rivlin RS. Keeping the young-elderly Med 2010;26:387-99. Designing, conducting and reporting healthy: Is it too late to improve our 115. Waheed S, Chaves PHM, Gardin JM, randomised controlled trials: A few key health through nutrition. Am J Clin Cao JJ. Cardiovascular and mortality points. In: Sitaras N, editor. Evidence Nutr 2007;86:1572S-6S. outcomes in the elderly with impaired based medicine: Closer to patientsuse or 142.Reig-Ferrer A, Ferrer-Cascales R, cardiac and pulmonary function: The scientists. Rijeka, Croatia: InTech Santos-Ruiz A, et al. A relaxation tech- Cardiovascular Health Study (CHS). J Europe; 2012. p. 1-10. nique enhances psychological well- Am Heart Assoc 2015;4:1-8. 130. Varoquaux G. Cross-validation failure: being and immune parameters in elderly 116. Gunnoo T, Hasan N, Khan MS, et al. Small sample sizes lead to large error people from a nursing home: A ran- Quantifying the risk of heart disease bars. Neuroimage 2017 [Epub ahead of following acute ischaemic stroke: A print]. domised controlled study. BMC meta-analysis of over 50000 partici- 131. Hofer SM, Sliwinski MJ, Flaherty BP. Complement Altern Med 2014;14:1-14. pants. BMJ Open 2016;6:1-8. Understanding ageing: Further com- 143. Roh HW, Hong CH, Lee Y, et al. 117. Turin TC, Okamura T, Afzal AR, et al. mentary on the limitations of cross- Participation in physical, social, and Hypertension and lifetime risk of sectional designs for ageing research. religious activity and risk of depression stroke. J Hypertens 2016;34:116-22. Gerontology 2002;48:22-9. in the elderly: A community-based 118. Zou L, Sasaki JE, Wang H, et al. A sys- 132. Schaie KW. What can we learn from the three-year longitudinal study in Korea. tematic review and meta-analysis longtitudinal study of adult psychologi- PLoS One 2015;10:1-13. Baduanjin Qigong for health benefits: cal development. In: Schaie KW, editor. 144. Findsen B, Formosa M. Lifelong learn- Randomised controlled trials. Evid Longtitudinal studies of adult psycho- ing in later life: A handbook on older Based Complement Alternat Med logical development. New York: The dult learning. Rotterdam, The 2017;2017:1-7. Non-commercialGuilford Press; 1983. p. 1-19. 119. El-Moselhy EA, Hay AHIA. Chronic 133. Bruer RA, Spitznagel E, Cloninger Netherlands: Sense Publishers; 2011. obstructive pulmonary disease in the CR. The temporal limits of cognitive 145. Ho H-C. Elderly volunteering and psy- elderly. J Gerontol Geriatr Res change from music therapy in elderly chological well-being. Int Soc Work 2016;5:e140. persons with dementia or dementia- 2017;60:1028-38. 120. Liu X-D, Jin H-Z, Ng BH-P, et al. like cognitive impairment: A ran- 146. Rizzuto D, Orsini N, Qiu C, et al. Therapeutic effects of Qigong in domised controlled trial. J Music Ther Lifestyle, social factors, and survival patients with COPD: A randomised 2007;44:308-28. after age 75: Population based study. controlled trial. Hong Kong J Occupat 134. Zheng G, Chen B, Fang Q, et al. Br Med J 2012;345:1-10. Ther 2012;22:38-46. Primary prevention for risk factors of 147. Kim DJ. The effects of a combined 121. Saad MAN, Cardoso GP, de Andrade ischemic stroke with Baduanjin exer- physical activity, recreation, and art Martins W, et al. Prevalence of meta- cise intervention in the community and craft program on ADL, cognition, bolic syndrome in elderly and agree- elder population: Study protocol for a and depression in the elderly. J Phys ment among four diagnostic criteria. randomised controlled trial. Trials Arq Bras Cardiol 2014;102:263-9. 2014;15:1-10. Ther Sci. 2017;29:744-7. 122. Davidson MH, Kurlandsky SB, 135. Queen M, Crone D, Parker A. Long- 148. Liu W, Lu H, Sun Z, Liu J. Elderly’s Kleinpell RM, Maki KC. Lipid man- term engagement with a practiced- travel patterns and trends: The empiri- agement and the elderly. Prev Cardiol based exercise referral scheme: cal analysis of Beijing. Sustainability 2003;6:128-35. Patients’ perceptions of effectiveness. 2017;9:1-11.

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