Does Liuzijue Qigong affect anxiety in patients with chronic obstructive pulmonary disease,even during the COVID-19 outbreak?a randomized,controlled trial

Background:Anxiety is a common comorbidity associated with chronic obstructive pulmonary disease(COPD),but no well-recognized method can provide effective relief.Liuzijue Qigong(LQG)is a traditional Chinese fitness method,based on breath pronunciation.This study aimed to examine the efficacy of LQG to relieve anxiety in COPD patients and to explore the factors that influence anxiety,including whether LQG is effective during the coronavirus disease 2019(COVID-19)outbreak.Methods:We conducted an open-label,randomized,controlled,clinical trial.A total of 60 patients with stable COPD were randomly assigned to two groups.Both groups were given routine medical treatment,and the patients in the pulmonary rehabilitation(PR)group were given an extra intervention in the form of LQG,performed for 30 minutes each day for 12 weeks.Data collection was performed at baseline and 12 weeks(during the COVID-19 epidemic).The primary outcomes were the self-rating anxiety scale(SAS)scores,and the secondary outcomes were relevant information during the epidemic and analyses of the related factors that influenced SAS scores during the COVID-19 outbreak.Results:Compared with baseline,patients in both groups demonstrated varying degrees of improvements in their SAS scores(all P<0.01).An analysis of covariance,adjusted for baseline scores,indicated that the SAS scores improved more dramatically in the PR group than in the control group(F=9.539,P=0.004).During the outbreak,the SAS scores for sleep disorder were higher than all other factors,reaching 1.38±0.67,and the scores for“I can breathe in and out easily”for the PR group were lower than the scores for the control group(Z=−2.108,P=0.035).Significant differences were identified between the two groups for the categories“How much has the outbreak affected your life”,“Do you practice LQG during the epidemic”and“Do you practice other exercises during the epidemic”(all P<0.05).Compared with current reports,LQG had a relatively high adherence rate(80.95%).A multiple linear regression analysis revealed multiple predictors for SAS scores during the outbreak:group(b=−3.907,t=−3.824,P<0.001),COPD assessment test score(b=0.309,t=2.876,P=0.006),SAS score at baseline(b=0.189,t=3.074,P=0.004),and living in a village(b=4.886,t=2.085,P=0.043).Conclusion:LQG could effectively reduce the risks of anxiety among COPD patients,even during the COVID-19 outbreak.For those COPD patients with high COPD assessment test and high baseline SAS scores or who live in villages,we should reinforce the management and intervention of psychological factors during the epidemic.

Efficacy of Liuzijue respiratory exercise in patients with chronic obstructive pulmonary disease:a meta-analysis

Objective:To evaluate the effects of Liuzijue respiratory exercise in patients with chronic obstructive pulmonary disease(COPD).Method:Randomly controlled trials of Liuzijue respiratory exercise in the treatment of COPD were searched in the database,including PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang,CBM,and VIP.Study screening,data extraction,and quality assessment were conducted by two researchers independently.Data were analyzed using RevMan 5.3 software.Results:11 studies with 915 COPD patients were included.Results of meta-analysis showed that compared with conventional care,Liuzijue respiratory exercise had shown better effects on FEV1(Forced expiratory volume in 1 second)[MD=0.18,95%CI(0.06,0.30),P=0.004],FEV1%pred[MD=10.21,95%CI(7.25,13.18),P<0.001],FEV1/FVC%(Forced vital capacity)[MD=8.32,95%CI(3.23,13.40),P<0.001],6-minute walk distance[MD=10.97,95%CI(5.81,16.12),P<0.001]and life quality[MD=-10.07,95%CI(-12.84,-7.30),P<0.001].However,no difference was observed in the effective rate between these two groups.Compared with whole body respiratory exercise,except for the better effects on 6-minute walk distance[MD=37.82,95%CI(6.51,69.13),P=0.02],no difference in FEV1,FEV1%pred,FEV1/FVC%and life quality were observed between these two groups.Conclusion:Liuzijue respiratory exercise can better improve lung function,functional capacity,and life quality of COPD patients compared with conventional care.Compared with the whole body respiratory exercise,Liuzijue could improve the functional capacity of COPD patients significantly and showed similar effcets on lung function and life quality.

Comparison of Effects of Liuzijue Exercise and Conventional Respiratory Training on Patients after Cardiac Surgery:A Randomized Controlled Trial

Objective To evaluate the feasibility and safety of Liuzijue exercise(LE)for the clinical effect in patients after cardiac surgery.Methods Totally 120 patients who underwent cardiac surgery and were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum Tower Hospital between July and Oclober,2022 were allocated to the LE group,the conventional respiratory training(CRT)group,and the control group by a random number table at a ratio of 1:1:1;40 patients in each group.All patients received routine treatment and cardiac rehabilitation.LE group and CRT group respectively performed LE and CRT once a day for 30 min for 7 days.Control group did not receive specialized respiratory training.The forced vital capacity,forced expiratory volume in 1 s,peak inspiratory flow rate,peak expiratory flow rate,maximum inspiratory pressure,maximum expiratory pressure,modified Barthel index(MBI),and Hamilton Rating Scale for Anxiety(HAM-A)were evaluated before,after 3 and 7 days of intervention.In addition,the postoperative length of hospital stay(LOS)and the adverse events that occurred during the intervention period were compared.Results A total of 107 patients completed the study,120 patients were included in the analysis.After 3 days of intervention,the pulmonary function,respiratory muscle strength,MBI and HAM-A of all 3 groups improved compared with that before the intervention(P<0.05 or P<0.01).Compared with the control group,pulmonary function and respiratory muscle strength were significantly improved in the CRT and LE groups(P<0.05 or P<0.01).MBI and HAM-A were significantly improved in the LE group compared with the control and CRT groups(P<0.05 or P<0.01).On the 7th day after intervention,the difference was still statistically significant(P<0.01),and was significantly different from that on the 3rd day(P<0.05 or P<0.01).In addition,on the 7th day of intervention,the pulmonary function and respiratory muscle strength in the LE group were significantly improved compared with those in the CRT group(P<0.01).MBI and HAM-A were significantly improved in the CRT group compared with the control group(P<0.01).There were no significant differences in postoperative LOS among the 3 groups(P>0.05).No training-related adverse events occurred during the intervention period.Conclusions LE is safe and feasible for improving pulmonary function,respiratory muscle strength,the ability to complete activities of daily living and for relieving anxiety of patients after cardiac surgery(Registration No.ChiCTR2200062964).