Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy:a pilot study

Objective:This study aimed to determine the effect of the relaxation breathing exercise(RBE)on fatigue and cortisol levels among Indonesian women with gynecological cancer undergoing chemotherapy.Methods:This pilot study consecutively recruited 44 gynecological cancer patients to receive RBE(22)or usual care(22).Cortisol level was measured before and after completion of the intervention(day 8).Fatigue was measured using the Piper Fatigue Scale(PFS).Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale(HADS)at the baseline days of the study for days 1,4,and 8.The obtained data were analyzed using Fisher’s exact test,the independent t-test,and the Mann-Whitney U test.Results:There were significant increases in cortisol levels within the groups,either the intervention or control groups,respectively(P-value=0.0003 and 0.001).Despite there being no statistical significance between the intervention and control groups,there were noticeable differences in the cortisol levels,indicating the extreme increase in cortisol levels in the control group(Median[IQR1-IQR3]:2.30[0.99-9.09];Min-Max:0.43-23.38)compared with the intervention group(Median[IQR1-IQR3]=2.97[1.26-5.18];Min-Max=0.39-6.91).Conclusions:RBE helps prevent a significant increase in cortisol levels that can alleviate fatigue for women with gynecological cancer.Further research was recommended to compare several intervention modalities for fatigue and cancer-related symptom management based on cortisol level changes.

Analysis of the Effect of Psychological Nursing Combined with Breathing Exercises in Improving Lung Function in Patients with Pneumoconiosis

Objective: To analyze the effect of psychological nursing combined with breathing exercises on lung function of patients with pneumoconiosis, and to analyze the methods. A total of 64 cases of pneumoconiosis admitted from January 2020 to December 2022 were divided into the reference group and the experimental group by random numerical table. On the basis of symptomatic treatment, the control group was combined with conventional nursing measures and breathing exercises, while the experimental group was treated with psychological nursing on the basis of the control group, and the pulmonary function indexes and adverse mood of the two groups before and after nursing were compared. Results: There was no difference in SAS score, SDS score and pulmonary function indexes between the two groups before intervention (P > 0.05), and the SAS score in the experimental group was the SDS score was lower than that of the control group, and FEV1, FEV1% and FEV1/FVC were higher than those of the control group, and the P < 0.05 was lower.

The effect of slow deep breathing relaxation exercise on pain levels during and post chest tube removal after coronary artery bypass graft surgery

Objectives:This study aimed to evaluate the effectiveness of slow deep breathing relaxation exercise(SDBRE)in reducing patients’pain levels during chest tube removal(CTR)post coronary artery bypass grafting(CABG)surgery.Methods:In 2019,fifty post-CABG patients were conveniently selected from a cardiac intensive care unit in Jordan’s major referral heart institute.The patients were randomly assigned to either an intervention group or a control group.A total of 25 patients were assigned into the experimental group who received slow deep breathing relaxation Exercise(SDBRE)alongside the conventional care before CTR.The remaining 25 patients constituted the control group(50%)that had CTR following conventional care.The Visual Analogue Scale(VAS)was used to measure the participants’pain levels during three phases:before CTR(Time 1),5-min post CTR(Time 2),and 15-min post CTR(Time 2)to compare the intervention effect between the two groups.Results:The data analysis findings for the control and intervention group of patients showed that there was a statistically significant decline in their pain level across time for both groups(H¼32.71,P<0.01;H=47.23,P<0.01)respectively.The intervention group had significantly lower pain levels than the control group at Time 2(3.50[1.20,5.30]vs.7.90[7.00,9.00],P<0.01)and Time 3(0.00[0.00,1.30]vs.3.60[2.40,4.10]P<0.01).Conclusions:Using SDBRE during CTR is an effective technique for reducing pain which can minimize the need for analgesics and their associated adverse effects.

Effectiveness of Relaxation Breathing Exercise on fatigue in gynecological cancer patients undergoing chemotherapy

Purpose:This study aimed to determine the effectiveness of Relaxation Breathing Exercise(RBE)on fatigue in patients with gynaecological cancer undergoing chemotherapy.Methods:We used a quasi-experiment with pre-and post-test design.Forty-two patients were consecutively sampled,21 of whom were assigned to the group receiving RBE four times a day and 21 to the group receiving RBE twice a day.Fatigue scores were measured every day for 7 days for both groups using the Piper Fatigue Scale.Data obtained were analysed using repeated-ANOVA and independent ttest with a significant level of a<0.01.Results:We found a significant decrease(P<0.01)in the mean fatigue scores of both groups(four times RBE in a day group=3.29±0.59 and twice RBE in a day group=4.19±0.61)after the completion of the intervention.However,the four times RBE a day group showed larger decrease on fatigue scores than the twice RBE a day group did(Mean Difference=0.91;99%CI=0.41 to 1.41;P=0.001).Conclusion:Conducting RBE four times a day effectively alleviated fatigue better than RBE twice a day on gynaecological cancer patients undergoing chemotherapy.

Efficacy Evaluation of Self-created"Lung Health Breathing Exercise"in Adjuvant Therapy for Patients with Stable Chronic Obstructive Pulmonary Disease

[Objectives]To evaluate the intervention effect and safety of self-created Lung Health Breathing Exercise on TCM syndromes,6-min walk test(6MWT)and quality of life in patients with stable chronic obstructive pulmonary disease(COPD).[Methods]76 cases of outpatient or inpatient patients who were diagnosed with stable COPD in Nanchong Traditional Chinese Medicine Hospital from January 2020 to March 2021 were selected,randomly divided into experimental group and control group,38 cases in each group.Both groups were given conventional western medicine treatment and nursing measures.The experimental group was added with the self-created Lung Health Breathing Exercise.After 12 weeks of treatment,the TCM syndrome score,6MWT distance,quality of life score and the incidence of adverse events were observed in the both groups.[Results]After treatment,the 6MWT distance and quality of life scores in both groups were significantly improved(P<0.01),and the TCM syndrome scores were significantly lower than those before treatment(P<0.01).[Conclusions]Lung Health Breathing Exercise can benefit patients in terms of symptom improvement,quality of life and exercise ability,and is a safe and effective rehabilitation measure for patients with stable COPD.

Study on the Effect of High-quality Nursing Combined with Breathing Exercises on Patients with Chronic Obstructive Pulmonary Disease

Objective:To study the effect of high-quality nursing combined with breathing exercises on patients with COPD.Methods:Using the random number table method of medical experiments,60 patients with COPD received in our hospital from March 2020 to March 2021 were used as research samples.According to the differences in treatment measures,they were equally divided into control group and intervention group.Symptomatic support treatment and nursing routine,high-quality nursing combined with respiratory function exercise treatment and nursing were given respectively,and the application effects of the two groups were compared and analyzed.Results:The controllable rate of disease between the intervention group and the control group was 93.33%(28/30)and 66.67%(20/30)respectively,which was statistically significant(P<0.05).The comparison between the intervention group and the control group on the pulmonary function indexes of VT,TPTEF/Te,VEF/Te/,Ti/Te was statistically significant(P<0.05).The results of the intervention group on exercise pulse and 6-minute walking distance were significantly higher than those of the control group(P<0.05).Conclusions:The combination of high-quality nursing care and breathing exercises has outstanding disease controllable rate in patients with COPD,especially in improving the lung function of the patients and the level of treatment and care.It can be used as a feasible measure in the subsequent clinical treatment and nursing practice of patients.It is worthy of clinical promotion and implementation.

Suggested Exercise Protocol for High Risk Population with COVID-19

Background: People who have underlying medical conditions and those over 60 years old have a higher risk of developing coronavirus disease complications (COVID-19) with more mortality rate. Breathing exercises is good for clearing the mucus from lungs and improves chest expansion while circulatory exercises enhance cardiopulmonary/vascular systems. Aim: This study aims to suggest exercise program for prevention, decrease morbidity and mortality in COVID-19 patients and patients with other respiratory co-morbidities. Conclusion: Regular simple exercises include respiratory and circulatory exercises may have a great effect on improving lung function and immunity in addition to relieving psychological stress thus can help in treatment of high risk people from COVID-19.

Effectiveness of breathing exercises during the second stage of labor on labor pain and duration： a randomized controlled trial

BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor. OBJECTIVE： To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain, duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration （APGAR） scores. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups： intervention group （IG; n = 125） and control group （CG; n = 125）. IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training. MAIN OUTCOME MEASURES： The effects of breathing exercises on maternal pain were determined by Visual Analogue Scale （VAS）, duration of the second stage of labor, and the first-minute APGAR scores. RESULTS： The mean age of the participants was （23.2 _＋ 4.2） （range： 18 to 42） years. Both IG and CG had similar baseline characteristics in terms of age, education level, occupation, and smoking （P 〉 0.05）. The mean VAS scores of IG and CG were （88.2 ＋_ 6.3） and （90.5 ＋_ 7.0）, respectively （P 〈 0.001）. The duration of the second stage of labor was （369.6 ＋ 92.0） s for IG and （440.7 ＋ 142.5） s for CG （P 〈 0.001 ）. The mean first-minute APGAR scores were （8.84 ＋ 0.50） for IG and （8.73 ＋ 0.89） for CG （P 〉 0.05）. CONCLUSION： Based on this study, breathing exercises with deep inhalation and exhalation in pregnant women are effective in reducing the perception of labor pain and shortening the duration of the second stage of delivery. Therefore, we recommend breathing exercises as an effective modality for labor pain management and shortening the duration of labor. TRIAL REGISTRATION： This study is registered on the website of ClinicalTrials.gov （www.clinicaltrials.gov） with the number of NCT03066973.

Effect of breathing and Daoyin exercises on the quality of life in patients with chronic obstructive pulmonary disease

Objective： To observe the effect of breathing and Daoyin exercises on the quality of life in patients with stable chronic obstructive pulmonary disease（COPD） due to deficiency of the lung and kidney（grade II-III）.Methods： A total of 60 eligible cases were randomly allocated into a treatment group（n=30） and a control group（n=30） by random number table. Cases in the control group received routine Western medical treatment, whereas cases in the treatment group conducted breathing and Daoyin exercises in addition to routine Western medical treatment. Patients in both groups were treated for a total of 3 months. Then the observation was made on changes in pulmonary ventilation function, major clinical symptoms, modified Medical Research Council scale（m MRC）, distance in 6-minute walk test（6-MWT）, COPD assessment test（CAT） and efficacy satisfaction questionnaire for COPD（ESQ-COPD） before and after treatment. Results： After treatment, the total effective rate was 80.0% in the treatment group, versus 66.7% in the control group, showing a statistical difference（P〈0.05）. Patients in the treatment group obtained more significant improvement in coughing, sputum production, dyspnea and shortness of breath than those in the control group（P〈0.05）. Patients in the treatment group obtained more significant elevation in the forced expiratory volume in 1 second percentage of predicted value（FEV1%） and peak expiratory flow rate（PEF%） than those in the control group（P〈0.05）. Patients in the treatment group obtained lower m MRC score than those in the control group（P〈0.05）. Patients in the treatment group obtained longer 6-MWT distance than those in the control group（P〈0.05）. Patients in the treatment group obtained lower CAT score（P〈0.01） and higher ESQ-COPD score（P〈0.05） than those in the control group. Conclusion： Breathing and Daoyin exercises combined with routine Western medical treatment are effective for stable COPD（grade II-III） due to deficiency of the lung and kidney and can improve the patients＇ quality of life.

Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy:a systematic review and meta-analysis

Background Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy(CP)populations.Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients.The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function,functional capacity,respiratory muscle strength,gross motor function and quality of life in children and adolescents with CP.Methods We searched for randomized controlled clinical trials in PubMed/Medline,Lilacs,SciELO,EMBASE and Physi-otheraphy Evidence(PEDro)from their inception until July 2022 without language restrictions.Studies that included respiratory exercises(breathing exercise program;feedback respiratory training;incentive spirometer exercise;inspiratory muscle training;and combination of respiratory exercises+incentive spirometer exercise)in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers.The mean difference(MD)and 95%confidence interval(CI)were estimated by random effect models.Results Ten studies met the eligibility criteria,including 324 children aged from 6 to 16 years.The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O(18.63-27.27,n=55)and pulmonary function of 0.60(0.38-0.82,n=98)for forced vital capacity(L);0.22(0.06-0.39,n=98)for forced expiratory volume at 1 second(L);and 0.50(0.05-0.04,n=98)for peak expiratory flow(L/min).Functional skills in daily living activities improved in the intervention group.Caregivers'assistance of daily living activities,functional capacity,gross motor function and expiratory muscle strength showed a nonsignificant improvement.Social well-being and acceptance and functioning domains improved in only one study.Conclusions Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation.There is no consensus on the frequency,type or intensity of respiratory exercises for children with and adolescents with CP.

Respiratory Physiotherapy in a Web Browser,Feasibility Study

In this paper, feasibility of web based breathing exercises for respiratory rehabilitation is examined. A system included visual guidance in a web browser and a microphone equipped headset for biofeedback and interaction. Feasibility was assessed in a controlled environment on 34 subjects with anxiety disorders that were not offered any help from the personnel. Weak points of comprehensibility were identified as applying headset (21%) and adhering to breathing exercises instructions (7%). No adverse events were identified. Design flaws that correlated with poor user’s experience were 1) the unpleasant feelings induced by watching the computer screen (21%) and 2) ease/difficulty of physically applying headset (14%). We conclude that conducting breathing exercises by using an acoustic microphone and a web browser is feasible and should be further researched. Additionally we conclude that audio feedback might be more pleasant to some people.

Immediate and Long-Term Effects of Qigong on Cold Intolerance in Patients with Post-Poliomyelitis Syndrome

Post-poliomyelitis syndrome (PPS) is a disorder in individuals who have had poliomyelitis, characterized by new muscle weakness and often associated with other symptoms, including cold intolerance (CI). Qigong is a Traditional Chinese Medicine technique to adjust energy and blood circulation. Objective: To verify the effects and late repercussions of Qigong on CI complaints in PPS patients. Methods: PPS patients (n = 22, 14 females, 8 males;ages 35 - 60) performed Qigong exercises in 40-minute sessions, three times per week, for three consecutive months. They were evaluated at baseline, the end of treatment and every three months for a year using a visual analogue scale adapted for CI (VAS-cold). Results: The systemic VAS-cold scores exhibited significant differences between the baseline, the end of treatment and throughout 12 months of follow-up. Conclusion: The CI scores were low and bearable at the end of intervention and for the following 12 months without activity.

Yi Jin Jing （Sinew-transforming Qigong Exercises） for primary osteoporosis in the elderly： a clinical trial

Objective：To observe the clinical efficacy of Yi Jin Jing （Sinew-transforming Qigong Exercises） for primary osteoporosis in the elderly.Methods：Eighty old patients with primary osteoporosis were randomized into a Yi Jin Jing group and a medication group,40 cases in each group.The Yi Jin Jing group was intervened by Yi Jin Jing （Sinew-transforming Qigong Exercises） training,while the medication group was intervened by oral administration of alendronate sodium tablet.Prior to and after 6-month intervention,the bone mineral density （BMD） of the proximal femur,visual analog scale （VAS） and activities of daily living （ADL） were estimated.Results：There were no significant differences in the BMD of the proximal femur,and VAS and ADL scores between the two groups before the intervention （P〉0.05）.After 6-month intervention,the above items all improved significantly in both groups （both P〈0.01）;the improvements in VAS and ADL scores in Yi Jin Jing group were more significant than those in the medication group （P〈0.01）,while the between-group difference in the BMD of the proximal femur was statistically insignificant （P〉0.05）.Conclusion：Practice of Yi Jin Jing （Sinew-transforming Qigong Exercises） can effectively ameliorate the BMD in the elderly with primary osteoporosis,and it can reduce the pain and improve ADL,with a better general effect compared to oral administration of alendronate sodium tablet.

Effect of Yi Jin Jing(Sinew-transforming Qigong Exercises) on skeletal muscle strength in the elderly

Objective： To observe the effect of Yi Jin Jing（Sinew-transforming Qigong Exercises） on the muscle strength in senile sarcopenia. Methods： Sixty-five old people with sarcopenia were randomized into Yi Jin Jing group and a blank control group. Thirty-three patients in Yi Jin Jing group practiced Yi Jin Jing（Sinew-transforming Qigong Exercises）, while 32 patients in the blank control group didn＇t receive any interventions. The muscle strength was measured before and after 12-week training. Results： During the study, each group had 1 dropout. The muscle strength was improved after 12-week training in Yi Jin Jing group, and the difference was statistically significant（P〈0.05）; there was no significant difference in the blank control group（P〈0.05）. After the intervention, there was a significant difference between Yi Jin Jing group and the blank control group in comparing the muscle strength（P〈0.05）. Conclusion： Constant Yi Jin Jing（Sinew-transforming Qigong Exercises） training can notably improve skeletal muscle strength in senile sarcopenia.

Clinical observation of acupuncture and traction plus Ba Duan Jin(Eight-brocade Exercise)for improving discogenic low back pain

Objective:To observe the short-term and long-term efficacy of acupuncture and traction plus Ba Duan Jin(Eight-brocade Exercise)in treating discogenic low back pain(DLBP).Methods:Sixty patients were divided into an observation group and a control group using the random number table method,with 30 cases in each group.The control group was intervened by acupuncture and traction,while the observation group was given additional Ba Duan Jin(Eight-brocade Exercise)practice.The intervention lasted for a total of 1 month,with a follow-up study conducted 6 months later.The visual analog scale(VAS)and Oswestry disability index(ODI)scores in the two groups were compared before and after treatment,and the efficacy was compared at the end of the treatment between the two groups;the relapse rate was compared at the 6-month follow-up between the two groups.Results:The pain VAS and ODI scores decreased after treatment in both groups,and the intra-group differences were statistically significant(all P<0.05);the pain VAS and ODI scores in the observation group were lower than those in the control group after treatment with statistical significance(both P<0.05).At the 6-month follow-up,the relapse rate was 10.3%in the observation group versus 48.0%in the control group,and the between-group difference was statistically significant(P<0.05).Conclusion:The combination of acupuncture,traction and Ba Duan Jin(Eight-brocade Exercise)is an effective method for DLBP and patients who received this method are less likely to relapse.

Effect of Shaolin internal qigong exercise on the surface electromyography signals of shoulder muscle groups in patients with capsulitis of the shoulder

Objective:To unveil the efficacy of Shaolin internal qigong exercise in treating capsulitis of the shoulder(CS)and explore objective outcome measures by observing the changes in the surface electromyography(sEMG)signals of shoulder muscle groups after regular practice of Shaolin internal qigong exercise in CS patients.Methods:Sixty CS patients were randomized into two groups by the random number table method,with 30 cases in each group.Patients in the qigong group practiced Shaolin internal qigong exercise on a regular basis,while patients in the electroacupuncture(EA)group received EA treatment.Before and after treatment,the sEMG signals of six muscles,i.e.biceps brachii,triceps brachii,deltoid,pectoralis major,latissimus dorsi and trapezius muscles,of the affected side were recorded at 45°abduction of the shoulder,60°forward flexion and 90°internal rotation with the elbow flexed during maximal isometric contraction,and the integrated electromyography(iEMG)of each muscle was calculated.Results:The total effective rate was 93.3%in the qigong group,higher than 83.3%in the EA group(P<0.05).Intra-group comparison showed that the iEMG of biceps brachii,triceps brachii,pectoralis major and deltoid muscles in the qigong group increased significantly after intervention at 45°abduction of the shoulder,60°forward flexion and 90°internal rotation with the elbow flexed(all P<0.05),and the iEMG of trapezius and latissimus dorsi muscles decreased(both P<0.05);in the EA group,the iEMG of biceps brachii,pectoralis major and deltoid muscles increased significantly during contraction(all P<0.05),while the iEMG of triceps brachii,trapezius and latissimus dorsi muscles had no significant changes(all P>0.05).After intervention,there were significant differences in the iEMG of most of muscles between the two groups(all P<0.05),except for the iEMG of deltoid muscle at 45°of abduction of the shoulder joint during isometric contraction(P>0.05).Conclusion:Shaolin internal qigong exercise can effectively increase the motion intensity of the biceps brachii,triceps brachii,pectoralis major and deltoid muscles and reduce the compensation of the latissimus dorsi and trapezius muscles in CS patients;compared with EA,it produces a better result in improving the coordination and stability in shoulder joint movements.

Abdomen-rubbing qigong exercise and health preservation concept of Fang Kai,a Xin'an medical physician

The abdomen-rubbing qigong exercise was first developed by Fang Kai, a Xin＇an medical practitioner. It＇s an essential part of Xin＇an health preservation works. This health preservation method integrates massage with Daoyin and integrates meridian theory with Zangxiang theory. It＇s safe, simple and has no side effects. Practice of this qigong exercise can protect the spleen and stomach, tonify qi and essence, harmonize Ying-Nutrients and Wei-Defense, unblock meridians and circulate qi. This paper aims to summarize and promote this exercise.

Effect of tuina exercise on simple obesity in college students

Objective:To observe the effect of tuina exercise on simple obesity in college students.Methods:Fifty-seven college students with simple obesity were divided into two groups according to the stratified randomization method.Twenty-eight in the tuina exercise group were trained in tuina exercise;while 29 in the auricular acupoint sticking group were treated with acuricular acupoint sticking.The tuina exercise group was trained once every other day,and 10 times made one course.The auricular acupoint sticking was replaced once every 4 d,and 5 times made one course.After 2-course treatment,the total therapeutic effect,weight,body mass index (BMI),waist and hip circumferences,serum total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed.Results:The total therapeutic effect was 86.2% in the auricular acupoint sticking group and 85.7% in the tuina exercise group.There was no significant difference between the two groups (P>0.05).After treatment,the weight,BMI,waist and hip circumferences were decreased and the differences were statistically significant (all P<0.05).The waist and hip circumferences in the tuina exercise group were lower than those in the auricular acupoint sticking group,showing statistically significant differences (all P<0.05).After treatment,there were no significant intra-group differences in TC,TG,HDL-C and LDL-C in the two groups (all P>0.05),and the between-group differences were not significant (all P>0.05).Conclusion:Tuina exercise has reliable effect in treating obesity.It can produce more significant improvements in waist and hip circumferences than auricular acupoint sticking.But no obvious effect is shown in blood lipid indicators.

Clinical observation on Yi Jin Jing(Sinew-transforming Qigong Exercises)plus tuina on the neck for stiff neck

Objective:To observe the effect of Yi Jin Jing(Sinew-transforming Qigong Exercises)plus tuina on the neck for stiff neck.Methods:A total of 60 patients with stiff neck who met the screening criteria were selected and randomly divided into two groups,with 30 cases in each group.Patients in the control group received tuina on the neck,30 min every time,once a day,while patients in the observation group practiced Yi Jin Jing(Sinew-transforming Qigong Exercises)plus the same tuina therapy as the control group,and Yi Jin Jing(Sinew-transforming Qigong Exercises)was conducted for more than 30 min every time,once a day.Visual analog scale(VAS)scores were observed before treatment,and after 1 time,3 times and 5 times of treatment to evaluate the degree of neck pain.Results:During the treatment,each group had 2 dropouts.After treatment,the total effective rate was 92.9%in the observation group versus 82.1%in the control group,showing a statistical significance(P<0.05).The VAS scores in the observation group at the three time points were significantly lower than those in the control group(all P<0.05).Conclusion:Yi Jin Jing(Sinew-transforming Qigong Exercises)plus tuina on the neck can effectively relieve neck pain and improve cervical range of motion in patients with stiff neck,and can achieve a better effect than tuina alone.

Protocol-optimizing study of combining Tuina and horse-riding squat exercise for knee osteoarthritis

Objective To evaluate the efficacy of Tuina(Chinese therapeutic massage)manipulation plus horse-riding squat exercise in treating knee osteoarthritis(KOA)and optimize the combining protocol.Methods Based on a 2×2 factorial design,120 eligible KOA patients were randomized into a manipulation group(group A1B2),a manipulation plus horse-riding squat group(group A1B1),a sitting knee-adjustment group(group A2B2 group),and a sitting knee-adjustment plus horse-riding squat group(group A2B1),with 30 cases in each group.The intervention was conducted three times a week,lasting for four weeks.The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was taken as the major measure for efficacy evaluation(including three component scores,pain,stiffness,and daily function,and total score).Results The three component scores(pain,stiffness,and daily function)and the total score of WOMAC showed significant differences after the intervention in the four groups(P<0.05).There were significant inter-group differences in the WOMAC stiffness score amongst the four groups after the intervention(P<0.05).In group A1B1,the step length,stride,walking speed,and knee joint flexion angle changed significantly after treatment(P<0.05).After the intervention,the step length changed significantly in group A1B2(P<0.05),and the walking speed changed significantly in group A2B1(P<0.05).There were no significant differences in the step length,stride,walking speed,or knee joint flexion angle among the four groups(P>0.05).The extensor peak torque at 180°/s changed significantly in group A1B2 after treatment(P<0.05).Neither the intra-group nor the inter-group comparisons of the four groups revealed significant differences in the other isokinetic muscle strength parameters(P>0.05).The main effect of manipulation showed significant in affecting the WOMAC pain and total scores(P<0.05).The main effect of horse-riding squat exercise showed significant in affecting the WOMAC pain and stiffness scores(P<0.05).Conclusion The four treatment protocols all can improve the symptoms of KOA,for instance,relieving pain and stiffness,and enhancing daily function.Group A2B1 produces the most eminent effect in relieving joint stiffness.The main effects of both manipulation and horse-riding squat exercise are significant in reducing pain.Besides,the main effect of horse-riding squat exercise is significant in relieving joint stiffness.