Is additional Qigong effective in reducing anxiety, depression and improving psychological well-being amongst patients with type II diabetes as compared to routine treatment only?
Date of publication of the systematic review: January 2013
Design
Systematic review of 3 randomized controlled trials (RCTs).
Participants
217 adults with type II diabetes (mean age range: 57.8 to 58.8 years, male % range: 25.9% to 42.6%)
Intervention
Qigong exercises, including eight-section Brocade, Liuzijue, relaxation and static Qigong styles, with duration of 4 months.
Comparator
Comparison: Qigong on top of routine type II diabetic treatment versus routine treatment only.
Major Outcomes
Outcome 1: Depression score measured by Symptom Checklist 90 at the end of treatment;
Outcome 2: Anxiety score measured by Symptom Checklist 90 at the end of treatment;
Outcome 3: Psychological well-being score measured by Diabetes Specific Quality of Life Scale at the end of treatment.
For all 3 outcomes, lower score indicates improvement.
Settings
The reviewers did not state whether the studies were conducted in inpatient or outpatient settings.
Comparison    Qigong plus routine treatment versus routine treatment
Main Results
Compared to routine treatment only, add on Qigong showed a marginally significant reduction in depression score (pooled standardized mean difference (pooled SMD): -0.29, 95% CI: -0.58 to -0.00), anxiety score (pooled SMD: -0.37, 95% CI: -0.66 to -0.08) and psychological score (pooled SMD: -0.58, 95% CI: -0.91 to -0.25) among subjects with type II diabetes.
Comparison: Qigong plus routine treatment versus routine treatment only in subjects with type II diabetes
Outcomes No. of studies (Total number of participants) Standardized mean/ No. of participants Heterogeneity test (I2) Pooled SMD (95% CI) Overall quality of evidence*
Intervention Comparator
1 3 (217) 3.04/ 145 3.33/ 72 0.0% -0.29 (-0.58 to -0.00) Moderate
2 3 (217) 2.17/ 145 2.55/ 72 0.0% -0.37 (-0.66 to -0.08) Moderate
3 2 (172) 1.61/ 120 2.19/ 52 0.0% -0.37 (-0.66 to -0.08) Moderate
Keys: SMD = standardized mean difference; CI = confidence interval.
Comparison    Qigong plus routine treatment versus routine treatment
Main Results
Compared to routine treatment only, add on Qigong showed a marginally significant reduction in depression score (pooled standardized mean difference (pooled SMD): -0.29, 95% CI: -0.58 to -0.00), anxiety score (pooled SMD: -0.37, 95% CI: -0.66 to -0.08) and psychological score (pooled SMD: -0.58, 95% CI: -0.91 to -0.25) among subjects with type II diabetes.
Comparison: Qigong plus routine treatment versus routine treatment only in subjects with type II diabetes
Outcomes 1 2 3
No. of studies (Total number of participants) 3 (217) 3 (217) 2 (172)
Standardized mean/ No. of participants Intervention 3.04/ 145 2.17/ 145 1.61/ 120
Comparator 3.33/ 72 2.55/ 72 2.19/ 52
Pooled SMD (95% CI) -0.29 (-0.58 to -0.00) -0.37 (-0.66 to -0.08) -0.37 (-0.66 to -0.08)
Overall quality of evidence* Moderate Moderate Moderate
Keys: SMD = standardized mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to routine treatment only, add on Qigong was effective in reducing depression and anxiety, and improving psychological well-being amongst subjects with type II diabetes. For all outcomes, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
Number of adverse events was not reported in this review. The reviewers stated that Qigong practices were generally considered as safe and few adverse events had been published. The prevalence of Qigong induced psychosis was considered as very low. However, the reviewers also mentioned that there was no systematic review of harms of Qigong.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557628/
The synopsis is based on the following article:
Wang F, Man JKM, Lee E-KO, Wu T, Benson H, Fricchione GL, et al. The effects of qigong on anxiety, depression, and psychological well-being: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine. 2013;2013:16.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.