EFFECTIVENESS OF INTERNAL QIGONG ON QUALITY OF LIFE, DEPRESSIVE SYMPTOMS AND SELF-EFFICACY AMONGST COMMUNITY-DWELLING OLDER ADULTS WITH CHRONIC DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: With increasingly aged populations worldwide, the quality of life (QoL) and psychosocial wellbeing of older adults, especially those with chronic disease, become of increasing importance. There are multiple studies on the use of internal Qigong, a popular mind-body exercise commonly practiced by older adults. However, the effectiveness of internal Qigong on QoL, depressive symptoms, and self-efficacy on older adults remains unclear. Objectives: To review updated evidence to determine the effectiveness of internal Qigong intervention on QoL, depressive symptoms, and self-efficacy amongst community-dwelling older adults with chronic disease. Method: Six databases (PubMed, CENTRAL, CINAHL, Embase, Scopus, CNKI) were systematically searched for studies from January 2008 to October 2018 in English and Chinese. Relevant trials were screened and assessed for risk of bias by two independent reviewers. A meta-analysis on study outcomes (QoL, depressive symptoms and self-efficacy) were synthesized using the RevMan 5.3 software. Overall effect sizes were evaluated using Cohen’s d. The quality of evidence was assessed using GRADE. Results: The search retrieved 3439 records. After screening, 13 RCTs were eligible for inclusion. Meta-analysis revealed significantly large effect size favouring Qigong on the QoL domains of general (d=3.72), physical (d=2.52), and mental (d=1.54) compared to controls. No significant effects were found for the social domain of QoL, depressive symptoms and self-efficacy. High heterogeneity was found in majority of the meta-analyses hence, extreme caution should be exercised in interpreting findings of this review. Overall quality of evidence using GRADE was very low. Conclusion and Implications: Qigong appears to have potential benefits on QoL in older adults. The findings of this study suggest potential use of Qigong as an adjunct activity for chronic disease management. Future research may enhance the rigour of trials and explore theoretical underpinnings behind Qigong.