Efficacy of Virtually-Delivered Qigong/Tai Chi for Depression in Middle- and Older-Age Adults with Bipolar Disorder (QT-BD): A Pilot Randomized Controlled Trial during the COVID-19 Pandemic

Background : Depressive symptoms in middle-aged and older age bipolar disorder (BD) are associated with decreased quality of life and premature mortality. Yet, currently available pharmacological treatments are limited in efficacy. Mind-body interventions have been shown to improve mood, quality of life, and cognition in other adult populations, and may thus provide a promising therapeutic alternative. Here we conduct the first randomized controlled trial (RCT) examining the efficacy of a group Qigong/Tai Chi intervention (QT-BD) for reducing depressive symptoms in middle-aged and older adults with BD. As a further innovation during the COVID pandemic, we used Zoom to deliver the group intervention and active control. Methods : We conducted a virtually-delivered 12-week pilot RCT with 23 patients with BD aged >= 40 comparing a QT-BD intervention versus an active control (light exercise). We assessed depressive symptoms (primary outcome), verbal fluency (secondary outcome), and functioning/quality of life (exploratory outcomes) at baseline and 12-weeks. Results : No statistically significant differences were observed between groups for all outcomes (all p's>0.05). However, non-significant decreases in depressive symptoms were found in the subgroup of participants with baseline MADRS scores ≥10 in the QT-BD intervention only (p=0.07). Limitations : Our sample size was limited and the virtually-delivered format may have limited the positive benefits of face-to-face interventions. Conclusions : This novel pilot study suggests that QT-BD may be a feasible and efficacious intervention for reducing depressive symptoms in middle- and older-aged BD, particularly when baseline MADRS is ≥10, warranting further investigation in larger-scale trials.

A tai chi/qigong intervention for older adults living with HIV: a study protocol of an exploratory clinical trial.

BACKGROUND: Almost half of people living with HIV (PLWH) in the USA are over 50 years of age; this is expected to increase to 70% by 2020. Yet, few interventions exist for older PLWH that address psychological and physical symptoms combined, both prevalent in this population. There is a need to find innovative and accessible interventions that can help older PLWH to manage their symptoms. Mind-body interventions, like tai chi/qigong (TCQ), improve both physical and psychological health. TCQ is a series of slow, low-impact meditative movements that integrates breathwork, meditation, and stances. METHODS: The present study is an exploratory clinical trial that will evaluate the acceptability and feasibility of a 12-week, small group TCQ intervention (n = 24), a sham qigong control condition (n = 24), and a standard of care control condition (n = 24) for older people living with HIV/AIDS. It will also explore any preliminary associations between the TCQ intervention and symptom alleviation. Participants will be recruited from community-based health and social services organizations in Miami, FL, and randomized to one of the 3 conditions. DISCUSSION: We will assess feasibility and acceptability through questionnaires and adherence to TCQ. We will assess preliminary associations with symptoms such as depression, anxiety, social support, chronic HIV-related fatigue, and clinical outcomes. These will be described through proportions, means, and changes over time through graphing techniques. Outcomes will be assessed at baseline, at post-intervention, and at 3 months follow-up. These preliminary analyses also will provide information necessary to estimate effect size and power needed for a larger clinical trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT03840525 . Registered on 16 July 2018.

Efficacy of traditional Chinese exercise for obesity: A systematic review and meta-analysis.

Background: Obesity is considered one of the biggest public health problems, especially in the background of the coronavirus disease 2019 (COVID-19) lockdown. It is urgent to find interventions to control and improve it. We performed this systematic review and meta-analysis to summarize the effect of traditional Chinese exercise on obesity. Methods: We searched PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database (VIP), the Chinese Biomedical Literature Database (CBM), and WanFang database for updated articles published from the inception of each database to June 2022. Randomized controlled trials (RCTs) on traditional Chinese exercise in weight reduction were included, and related data were extracted. The random-effects model was used to adjust for the heterogeneity of the included studies, and funnel plots were used to examine publication bias. Results: A total of 701 participants were included in the 10 studies. Compared with the control group, the outcome of body weight [mean difference (MD) = -6.10; 95% CI = -8.79, -3.42], body mass index (MD = -2.03; 95% CI = -2.66, -1.41), body fat mass (MD = -3.12; 95% CI = -4.49, -1.75), waist circumference (MD = -3.46; 95% CI = -4.67, -2.24), hip circumference (MD = -2.94; 95% CI = -4.75, -1.30), and waist-to-hip ratio (MD = -0.04; 95% CI = -0.06, -0.03) in the intervention group had significant differences. Egger's test and funnel plots showed that the potential publication bias of the included studies was slight (p = 0.249). Conclusion: Traditional Chinese exercise is an effective treatment for obesity; people under the COVID-19 lockdown could do these exercises to control weight. However, a precise and comprehensive conclusion calls for RCTs on a larger scale with more rigorous designs considering the inferior methodological quality and limited retrieved articles. Systematic review registration: www.crd.york.ac.uk/PROSPERO/, identifier CRD42021270015.

Feasibility, Usability, and Acceptability of Online Mind-Body Exercise Programs for Older Adults: A Scoping Review.

Objectives: Engaging in mind-body exercises (MBEs: e.g., Tai Chi and yoga) can have physical and mental health benefits particularly for older adults. Many MBEs require precise timing and coordination of complex body postures posing challenges for online instruction. Such challenges include difficulty viewing instructors as they demonstrate different movements and lack of feedback to participants. With the shift of exercise programs to online platforms during the COVID-19 pandemic, we conducted a scoping review to examine the feasibility, usability, and acceptability of online MBE classes for older adults. Materials and Methods: We followed the scoping review methodology and adhered to the PRISMA reporting checklist. We searched five databases: Medline, Embase, CINHAL, Web of Science, and ACM digital library. Screening of articles and data extraction was conducted independently by two reviewers. Settings/Location: Online/virtual. Subjects: Older adults ≥55 years of age. Outcome Measures: Feasibility measures. Results: Of 6711 studies retrieved, 18 studies were included (715 participants, mean age 66.9 years). Studies reported moderate to high retention and adherence rates (mean >75%). Older adults reported online MBE classes were easy to use and reported high satisfaction with the online format. We also identified barriers (e.g., lack of space and privacy and unstable internet connection) and facilitators (e.g., convenience and technical support) to the online format. Opinions related to social connectedness were mixed. Conclusion: Online MBE programs for older adults appear to be a feasible and acceptable alternative to in-person programs. It is important to consider the type of exercise (e.g., MBE), diverse teaching styles, and learner needs when designing online exercise classes.

Can Qigong Be a Tool to Assist Students in Handling COVID-19's Resulting Academic Stress?

The recent COVID-19 pandemic has increased students' stress as they may feel under increased pressure to have a good performance and compensate for the disruption to their education. Improving attention levels and learning capacity may assist in ameliorating academic performance. Qigong is a traditional Chinese medicine technique that appears to have positive effects on the management of mental health and may provide tools for coping with stressful situations. This paper explores data obtained while conducting a previous study and includes an excess of data from a total of 44 participants who were previously divided into an experimental Qigong group and a sham Qigong control group. The improvements in specific auditory processing and reaction times may indicate benefits in attention and learning capacity. These improvements were more pronounced in the experimental Qigong group compared to the sham Qigong group. Qigong may be able to assist in improving students' academic performance and can be easily integrated into physical education classes. It could also assist students to cope with the increased academic pressure resulting from the COVID-19 pandemic context.

Evaluation of the effect of drug on physiotherapy methods on cytokines and chemokines of Covid-19 patients

Previous investigations have demonstrated that interleukin-6 (IL-6), C reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), in Coronavirus disease 2019 (COVID-19) patients are considerably increased, and their progressive elevation are clinical threat indicators of disease severity. The purpose of this systematic review is to evaluate the efficacy of physiotherapy, specifically chest physiotherapy, on different cytokines in Covid-19 and non-covid-19 patients. The main complications and symptoms of this virus are as follows;a dry cough, fever, and progressive dyspnea. Quickly, the coronavirus, which is named SARS-CoV-21, has spread worldwide, causing severe lung inflammation, respiratory distress syndrome, cardiac and renal injury, especially in comorbidities patients. Approximately 96% of the cases experience mild respiratory symptoms;some progress to pneumonia, respiratory insufficiency, acute respiratory distress syndrome, and multiorgan failure. The overall mortality rate per number of diagnosed cases is 4.6%;it can range from 0.2% to 15% according to age and health problems. Combination MeSH and text terms were used to perform the search strategy. Interventions in RCTs and clinical trials with or without comparison were assessed. Six studies met the inclusion criteria. Studies demonstrated that physiotherapy could have an effect on TNF-alpha, IL-6, IL-10, IL-1 beta and CRP.

Kangyi Qiangshen Gong exercise prescription for pulmonary function and quality of life in patients recovered from COVID-19: a study protocol for a randomized controlled trial.

BACKGROUND: Since early 2022, patients with 2019 novel coronavirus (COVID-19) infection have increased rapidly in Shanghai, China. Nevertheless, there is no widely used unified rehabilitation treatment available for discharged patients with post-infection sequelae such as dyspnea, depression, and fatigue. To promote the rehabilitation of discharged patients, our team formulated Kangyi Qiangshen Gong exercise prescription on the basis of traditional Chinese medicine rehabilitation exercises (TCMRE). We designed a randomized controlled trial to evaluate the efficacy of rehabilitation and advantages of KQG for discharged patients with post-COVID-19 syndrome. METHODS/DESIGN: This is a parallel-design, two-arm, analyst assessor-blinded, randomized controlled trial. In total, 60 discharged patients with COVID-19 sequelae, aged from 20 to 80 years will be recruited and randomly assigned to the World Health Organization instructed breathing techniques (BT) group and the Kangyi Qiangshen Gong exercise prescription (KQG) group at a ratio of 1:1. The patients in the BT group will perform breathing techniques exercise, and the patients in the KQG group will perform KQG exercise. Both groups will perform exercises twice a day for 3 months. The primary outcome will be measured with the Modified Medical Research Council Dyspnea Scale, and the secondary outcomes will include the Modified Borg Scale, Fatigue Scale-14, Patient Health Questionnaire-9 Scale, Pittsburgh Sleep Quality Index, and the Respiratory Symptoms Scale. Clinical scales will be assessed at three points (pre-exercise, 3 months post-exercise, and 3 months follow-up). Adverse events will be recorded for safety assessment. DISCUSSION: This trial will serve high-quality evidence of the value of KQG for treating discharged patients with COVID-19 in rehabilitation period. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200059504. Registered on 03 May 2022. DISSEMINATION: The results will be published in peer-reviewed journals and disseminated through the study's website, and conferences.

Can Yoga, Qigong, and Tai Chi Breathing Work Support the Psycho-Immune Homeostasis during and after the COVID-19 Pandemic? A Narrative Review.

Breathing is crucial in life; nevertheless, the healthcare community often overlooks the health potential of breathing techniques. Conscious manipulation of breathing to achieve specific health goals is found in yoga, Qigong and Tai Chi. This paper reviews the value of breathing exercises as a foremost mechanism for promoting, recuperating and maintaining health. Practices involving breathing techniques are described, and their prophylactic or therapeutic characteristics are explored. The main goals of this review are: (i) to summarize the evidence supporting the hypothesis that breathing practices have a significant beneficial impact on human health; (ii) to provide a deeper understanding of traditional biofeedback practices, particularly yoga, Qigong and Tai Chi, and outline their focus on breathing techniques; (iii) to outline specific immune-related responses, relevant for COVID-19 disorders; and (iv) to call for committed attention and action from the scientific community and health agencies in promoting the implementation of a practical and costless health program based on breathing techniques. This review shows the health potentials of breathing practices and exercises, which, by having a high benefit-cost ratio, could be selected and implemented as a primary standard routine in public health programs.

Mental Health Benefits of a Traditional Vegetative Biofeedback Therapy Online Program during the COVID-19 Lockdown: A Controlled Trial.

Mandatory lockdown resulting from a pandemic may be effective against the physical impact of the virus; however, the resulting mental strains can lead to the development of several mental disturbances. Taijiquan and Qigong are considered traditional vegetative biofeedback therapies that allow the practitioner to control the functions and processes of the body through specific movements or stances, breathing techniques, and meditative exercises. This study aims to understand if these techniques can be applied as an online distance therapeutic option to reduce the psychological impact of home confinement and social distancing. Sixty-four participants were recruited and allocated to three groups. The experienced and novice Taijiquan and Qigong participants' groups received the intervention for 8 weeks while the control group did not receive any intervention. The outcomes were psychological well-being and psychological distress levels and were assessed by the Mental Health Inventory and a written interview. The experienced Taijiquan and Qigong participants achieved significant improvements in psychological well-being and psychological distress. Novice Taijiquan and Qigong participants achieved a significant improvement in anxiety levels. Additionally, the control group showed a significant decrease in psychological well-being. This study suggests that this distance online program of Taijiquan and Qigong is feasible and may benefit the mental health of participants during a lockdown.

COMPLEMENTARY THERAPY IN A HOSPICE SETTING- SO MUCH MORE THAN THE POWER OF TOUCH

Background In March 2020, staff began dealing with the effects of COVID-19. When the complementary therapy team returned from furlough, they created a new programme of support for patients, carers and staff, working remotely and social distanced as hands-on treatments were put on hold. Aims To use the hospice complementary therapists' skills and experience to support staff and strengthen the resilience of healthcare workers. To provide much needed support to patients and carers to improve their mental health and wellbeing through this challenging time. Methods Access to one-to-one consultations with an Ayrshire Hospice complementary therapist, remotely via video call or telephone and face-to-face where safe to do so.•Bespoke aromatherapy products to support wellbeing delivered inhouse and to homes.•Relaxation and self-management advice for staff, patients and carers.•A comfortable space in which to relax and recharge and provide socially distanced treatments - such as Reiki, yoga, qi gong, mindfulness.•Wellbeing group sessions for staff x weekly online: Massage self-treatment, qi gong, relaxation, mindfulness, breathwork, yoga.•Regular relaxation sessions for patients and carers on new virtual day services.•Staff access to recorded wellbeing sessions on the intranet.•Evaluation developed - Identification of key issues experienced by staff Outcomes•Support service to staff evaluated extremely well - evidence of feeling supported and understood, improved sleep, stress reduction.•Self-help tools given to empower people to manage their own wellbeing moving forward.•Staff have continued access to weekly wellbeing sessions on the intranet.•Future plans to share the library of our recorded wellbeing sessions with outside agencies such as local council and prison, for a small cost and use for fundraising.•Ability to reach patients and carers to support them without the need to travel to the hospice.•Blended approach to delivering complementary therapy service to reach more people.

Medical Acupuncture and Global Wellness

Physical and mental health challenges seem to be part of our daily living. To understand the latest consensus, I attended a symposium, June 30, 2021, advocating global health by using acupuncture and integrative medicine at the Lansdowne Resort for a Global Wellness Event, in Leesburg, Virginia. Group sound bathing and meditation were offered to the participants in a therapeutic session. This was to prepare our minds and bodies for the experience of this symposium. Do we wish to lead a revolution in the science of health—especially now—to maintain and thrive in the era of COVID-19? This was the main theme of this event. To understand COVID-19 better, experts were present who explained its biology and perhaps what might be expected in the future as this virus winds down or rebounds as variants.

Feasibility and safety of Qigong training delivered from two different digital platforms in physically inactive adults: A pilot randomized controlled study

Introduction Qigong training has positive effects on various health outcomes. Asynchronous or video-conference-based digital platforms may be options to maintain physical activity at home. Methods The aim of the study was to assess feasibility and safety of asynchronous and video-conference-based Qigong training. Thirty-four physically inactive adults were assigned to video-conference or asynchronous group. While subjects in the video-conference group followed the program through Zoom®, exercise videos were delivered to the participants in the asynchronous group via YouTube®. Both groups performed Qigong training with the same characteristics for 6 weeks, 3 days/week. The feasibility was assessed by retention rate and attendance rate. The program considered to be feasible if the retention rate was <80% and mean attendance rate was at least 15 out of 18 sessions. Safety was determined as any adverse events reported by the participants during the intervention period. Satisfaction from the interventions assessed using 5-points Likert Scale. The International Physical Activity Questionnaire-Short Form (IPAQ-SF), 1-minute sit-to-stand test (STS), Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and Coronavirus Anxiety Scale were also assessed. Results No adverse events were observed in either group. Attendance rate was ≥15 sessions in both groups (asynchronous group= 18, video-conference group= 15.35±5.98). The retention rate was 100% in asynchronous and 88.2% in video-conference group. The satisfaction level obtained with the Qigong training in both groups was similar (p = 0.533, r=-0.106). Conclusions Qigong training performed with the video-conference method or asynchronous videos appear to be safe, well tolerated, and feasible in physically inactive adults.

The effect of the Baduanjin exercise on COVID-19-related anxiety, psychological well-being and lower back pain of college students during the pandemic.

BACKGROUND: This study aimed to examine the effect of Baduanjin exercise on COVID-19-related anxiety, psychological well-being, and the lower back pain of college students during the coronavirus pandemic in China. SETTING: The study was carried out in a temporary experimental center of four universities in Wenzhou city in Zhejiang Province, China. POPULATION: 387 participants who were college students were allocated to two groups: the Baduanjin exercise group(BEG, n = 195); and the Control group(CG,n = 192). METHODS: In this randomized controlled trial,387 participants who were college students were randomly allocated in a 1:1 ratio to 12-week Baduanjin exercise group (BEG, n = 195)and 12-week Control group(CG,n = 192).CAS(Coronavirus Anxiety Scale), PWBS(Psychological Well-being Scale),NMQ( Nordic Musculoskeletal Questionnaire), was used to assess COVID-19-related anxiety, psychological well-being, and lower back pain at second times ( before and after the intervention). The paired t-test and an independent t-test (with a 95% confidence interval) was used to compare the outcome variables of the two groups. RESULTS: Within-group comparison, there was no significant difference in the control group before and after the intervention. In contrast, the Baduanjin group had a significant improvement before and after the intervention. Between-group comparison, the Baduanjin group had a significant difference from the control group. The intervention effect on the Baduanjin exercise group was remarkably better than that of the control group (p < 0.05). Participants in the Baduanjin group significantly improved the corvid-19-related anxiety score decreased from ( 5.22 ± 0.45 to 5.07 ± 0.27, p < 0.05). The total psychological well-being score increased from (70.11 ± 8.65 to 84.12 ± 7.38,p < 0.05) and the prevalence of low back pain decreased from (22.45 ± 1.67 to 18.35 ± 1.05, p < 0.05) among college students. CONCLUSION: During the pandemic, the Baduanjin exercise contributes to the reduction of the perceived anxiety related to COVID-19, decreases the prevalence of the lower back pain, and improves the psychological well-being of college students. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04432038. Registered on June 16, 2020.

Veterans Health Administration's National Delivery of CIH Therapies, Whole Health Services and Chiropractic Care in 2020 and the Pivot to Telehealth

Methods: Databases were searched using CPT codes (acupuncture, chiropractic, and massage therapy), clinic stop codes (chiropractic care), clinic location names, internal accounting codes, clinic note titles, and structured coding templates (Health Factors) unique to VHA's electronic medical record. Results: A total of 441,891 Veterans used 2,930,700 of these services in FY20, representing a slight decrease from FY19 (3,083,806 total visits). Prior to the COVID19 pandemic, VHA was on track for expanded utilization in FY20. Of these visits, 422,313 (14%) were delivered through telehealth. Over 8.1% of all Veterans receiving VHA care in FY20 received at least oneCIH therapy, Whole Health service, or chiropractic care service. Use was highest among women (14.3%), patients with chronic pain (18.1%), opioid use disorder (15.6%), rheumatoid arthritis (13.3%), obesity (12.9%), or a mental health condition (12.8%). VHA medical centers worked quickly during the pandemic to expand telehealth offerings;comparing against FY19, nearly onethird of the monthly in-person visit volume was provided through telehealth by the end of 2020 for therapies including Core Whole Health services, yoga, Tai Chi/Qigong, meditation, biofeedback, guided imagery, and hypnosis. Background: Given that VHA is the largest healthcare system provider of CIH therapies in the U.S., we examined the VHA's national provision of nine CIH therapies (acupuncture, battlefield acupuncture, biofeedback, clinical hypnosis, guided imagery, massage therapy, meditation, Tai Chi/Qigong, and yoga), chiropractic care, and Whole Health services for fiscal years (FYs) 2017 to 2020 using data from electronic medical records and community-based claims, and assessed utilization as VHA expanded CIH offerings and pivoted to tele-CIH and tele-Whole Health in response to the COVID19 pandemic. Conclusion: Despite the impact of COVID19 on reduced FY20 in-person visits, including group CIH therapies, VHA continued to provide nearly the same number of visits as the prior year, in part due to expansion of telehealth services.

Complementary and Integrative Health in the Community: Expanding Access for Veterans Seeking Care through the Veterans Health Administration

Methods: Data were pulled from an internal administrative dashboard. Referrals include services for Veterans who live a prescribed driving distance from a VAMC, wait times over threshold, services unavailable, or for reasons of the best medical interest. Data was pulled for fiscal years 2020 through 2021 and included: chiropractic care, acupuncture, biofeedback, neuron feedback, clinical hypnosis, massage therapy, meditation (specifically MBSR), Tai Chi/qigong, and yoga. Standardized tracking of referrals began with the implementation of Standard Episodes of Care (SEOC) which define care requested and include number of visits permitted and timeframe. Results: Referrals increased for all approaches from FY20-21 shown as (FY20;FY21): chiropractic (104,197;197,357), acupuncture (59,787;100,908), massage therapy (5,021;17,646), biofeedback (31;69), neuron feedback (27;74), clinical hypnosis (10;40), MBSR (2;8), Tai Chi (2;8) and Yoga (1;2). Background: The Veterans Health Administration (VHA) Directive 1137: Provision of Complementary and Integrative Health (CIH) identifies the inclusion of evidence-based CIH approaches in the VHA's Medical Benefits Package (acupuncture, biofeedback, clinical hypnosis, guided imagery, massage therapy, meditation, Tai Chi/qigong, and yoga). The purpose of this administrative data review is to identify which approaches are being referred to Community Care from VHA medical centers (VAMC), and to identify if COVID-19 has had an impact on referrals to the community. Conclusion: CIH is expanding across the VHA and could be useful in supporting a cultural transformation that includes integrative health approaches within conventional medical systems. While all VAMCs provide some CIH in-house, a substantial amount is provided through Community Care. As the largest integrated healthcare system in the United States, this could impact growth of CIH and the need for more providers in the community. By hiring CIH professionals onstation and expanding the network to the community, VHA could be one of the largest providers and users of CIH.

Feasibility of a Pilot Randomized Trial of Virtual and In-Person Qigong for Cancer Caregivers

Methods: A three-arm, pilot, randomized controlled, mixed-methods clinical trial design was used to randomize cancer caregivers to: 1) virtual Qigong classes;2) in-person Qigong classes;or 3) a self-care control. Feasibility goals included recruiting 54 caregivers over 12 months, ≥ 50% of screened individuals study eligible, ≥ 50% of eligible individuals enrolled, and < 20% lost to follow-up at 12 weeks. Participants were considered adherent to the intervention if they attended ≥ 70% of all Qigong classes. Results: A total of 47 caregivers were recruited (in-person group: n=15;virtual group: n=16;control group: n=16), thus falling short of the recruitment goal by 13%. All other feasibility metrics were met: 1) out of total individuals screened, 72% were eligible;2) 64% of those eligible enrolled in the study;3) 13% were lost to follow-up;and 4) 63% and 73% of participants in the virtual group and in person group attended ≥ 70% of all Qigong classes, respectively. Background: Caregiving for someone with cancer can cause significant psychological and physical distress, leading to lower overall quality of life. Although mind-body interventions offer a solution for caregiver distress and to improve quality of life, current research has not evaluated the virtual delivery of mind-body programs for caregivers in the home. The purpose of this study was to examine and compare the feasibility of providing a virtual Qigong program, an in-person Qigong program, and a self-care control for cancer caregivers. Conclusion: Findings indicate that a virtual Qigong intervention for cancer caregivers is feasible. Not meeting the recruitment goal was partially explained by the COVID-19 pandemic occurring during the study time period. Ongoing analyses of qualitative and quantitative data will inform facilitators and barriers related to meeting the feasibility metrics, as well as providing initial data regarding the effectiveness of Qigong programs for subsequent clinical trials.

Veteran Engagement in Well-being Programming in the VA Whole Health System of Care Prior to and During COVID-19 Operations

Methods: The population included Veterans enrolled in the WHS nationally. Students t-test was used to assess the difference in unique Veterans engaged in WBP the six quarters prior to COVID (pre-COV) and the six quarters during COVID response (resp-COV). The differences in delivery of virtual WBP was assessed, including: (RFLX) Intro to WH Group, (HTAC) Take Charge of My Life & Health Group, (SCHC) EVP WH, (SNVC) EVP Mindful Movement, (HTFC) WH Partner Indiv., (WCHC) WH Coaching Indiv., (WCDC) WH Coaching Group, (CGQC) Qigong, (TAIC) TAI CHI, (YOGA) YOGA, (GIMA) Guided Imagery, (RLXT) Relaxation Techniques, (MANT) Mantram Repetition, (MDTN) Meditation, (MMMT) Mindfulness (non-MBSR), (REIK) REIKI, and (TPHT) Therapeutic/ Healing Touch. Results: Pre-COV, a total of 58,165 unique Veterans were engaged in 14,163 tele-health WBP encounters, compared to 63,648 unique Veterans engaged in 334,472 tele-health WBP encounters resp-COV. A significant increase in average number of tele-health WBP encounters per quarter was observed: 2,593 (95%CI 1537, 3649) telehealth pre-COV compared to 52,548 (95%CI 34169, 70926) during resp-COV, p=0.0008. There were significant increases in the delivery of all virtual WBP offerings (all P <0.05), except for SCHC and TPHT. Background: Well-being programming (WBP) is a core part of delivery of Whole Health (WH). During the COVID response, there was a pronounced decrease in delivery of WBP care, with a shift of delivery from face-to-face to virtual. This study describes the impact of COVID on delivery of WBP within the VA WH System (WHS). Conclusion: These data suggest that the response to COVID had little impact on the number of unique Veterans engaged in WBP overall, but the number of virtual WBP encounters increased significantly, comparing the same time periods. This analysis shows that the VA COVID response to increase delivery of virtual WBP as part of the national offering of the WHS was effective.

Decreasing Loneliness and Social Isolation during the COVID Pandemic using Cancer Support Services: Case Study of a Geriatric Patient with Diffuse Large B-cell Lymphoma

Background/Purpose: We present a case study demonstrating how cancer support services assisted a patient diagnosed with diffuse large B-cell lymphoma (DLBCL) to cope throughout the COVID-19 pandemic. Perceived social isolation and loneliness were exacerbated for this patient due to the interaction of 1) cancer diagnosis, 2) COVID- 19 social distancing, 3) inability of vaccination to produce immunity to COVID-19, and 4) diminution of her social network due to aging. Methods: We summarize clinical encounters and chart review for an 88-year-old female patient (divorced, living with son) with DLBCL evaluated at a large urban university hospital to illustrate the impact of cancer support service interventions on social isolation and loneliness. Results: Systematic review revealed that interventions such as exercise, mindfulness-based practice, Tai Chi Qigong meditation, and art therapies decrease loneliness and increase perceived social support. The patient consistently observed COVID-19 social distancing precautions throughout the pandemic, receiving Pfizer vaccine immediately once available, and Moderna vaccine thereafter. However, she did not develop antibodies, reinforcing her need to strictly isolate. The patient has participated in a regimen of online cancer support activities: twice-weekly group exercise physiology sessions and gentle chair yoga sessions, twice-monthly individual exercise physiology, weekly music therapy, weekly chaplain meetings, and daily treadmill walking. She recognizes distress and anxiety as temporary feelings and understands how these support activities enhance her repertoire of coping strategies. Despite being restricted to home;she states that regular interaction with her support services team-and attentive care from her son-have decreased feelings of loneliness. Conclusions and Implications: Our patient has demonstrated resilience, overcoming the combined challenges that amplify loneliness and social isolation: DLBCL diagnosis, lack of COVID-19 antibody response, and aging. Although she is unable to socialize in person, her interactions with cancer support services staff and engagement in a suite of activities have mitigated loneliness and isolation.

A pilot randomized controlled trial using Baduanjin qigong to reverse frailty status among post-treatment older cancer survivors.

OBJECTIVES: To evaluate the feasibility and potential effects of qigong Baduanjin for reversing frailty status among older cancer survivors. MATERIALS AND METHODS: Twenty-eight older cancer survivors screened as pre-frail or frail were recruited. They were randomly assigned (1:1) to receive a sixteen-week Baduanjin intervention or an active control condition (light flexibility exercise). Frailty status (primary outcome) and secondary outcomes (physical performance, activities of daily living performance, psychological well-being, and health-related quality of life) were measured by physical performance tests and questionnaires. Qualitative interviews were conducted to explore participants' perspectives on the intervention. RESULTS: Twenty-one participants (75%) completed the study, with reasons of withdrawal mainly relating to the COVID-19 pandemic. Attendance at Baduanjin sessions and adherence to self-practice were satisfactory, with all retained participants attending all sessions and 81.8% practicing Baduanjin for more than 90 min per week. Qualitative findings demonstrated that participants accepted Baduanjin. The proportion of improvement in frailty status at post-intervention appeared to be higher in the intervention group (26.7%; 95% confidence interval [CI], 10.1% to 54.0%) than the control group (15.4%; 95% CI, 3.7% to 46.0%); yet the difference was not statistically significant (p = 0.461). CONCLUSIONS: Baduanjin qigong appears to be feasible and acceptable among older cancer survivors. To confirm the intervention effect, an adequately powered trial is warranted. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04694066. Retrospectively registered 5 January 2021, https://clinicaltrials.gov/ct2/show/NCT04694066.

Effectiveness of Qigong exercises and resilience training on the perceived stress of male students due to COVID-19

Background According to experts, stress cuase a weak immune system and make people vulnerable to corona virus. Accordingly, the aim of this study was to compare the effectiveness of Qigong exercises and resilience training on the perceived stress of male students due to COVID-19. Methods A semi-experimental design was conducted (pre-test and post-test) with two experimental and one control groups. 45 male students of Tabriz university who had higher scores on the Cohen Perceived Stress Scale (PSS-14) were selected by convenience sampling and randomly divided into two experimental groups (15 participants in each group) and one control group (15 participants). For the first group, resilience training (10 sessions;a week 2 sessions, one and a half hours) and for the second group, Qigong exercises (10 sessions;a week 2 sessions, 30 minutes) was applied and the control group did not receive any training. Prior and after the training, the subjects completed Cohen et al. (1983) Perceived Stress Scale (PSS-14). Univariate analysis of covariance (ANCOVA) was used to analyze the data. Results The results showed that the mean scores of Perceived Stress due to COVID-19 reduced significantly in the resilience training group comparison to Qigong exercises group and in the Qigong exercises group comparison to the control group in the post-test (p < 0.05). Conclusions The results showed that resilience training is more effective in reducing perceived stress among male students due to Covid-19 disease than Qigong exercises.