A Study of the Improving Effect of Health Qigong • Ba Duan Jin on Vertebrobasilar Ischemia of Old and Middle-aged People

Xia Bin, He Songhua, and Shen Xiaodong; Shanghai Qigong Institute

Ma Xiao Gang, Jin Miao

Cerebrovascular diseases are common and frequently-occurring diseases that threaten people’s lives and health. Their high morbidity, high disability rate, high mortality rate, and high relapse rate have become public health problems of people’s concern. According to the estimate and analysis by World Health Organization (WHO), there are currently 5 million patients of cerebrovascular diseases in Chinese and about 1.6 million of them die of cerebrovascular diseases annually. Vertebrobasilar ischemia is an ischemic cerebrovascular disease frequently encountered in clinical cases. Characterized by repeated attacks and great persistence, it is extremely liable to cause acute cerebrovascular diseases and often seen in old and middle-aged people that are more than 50 years of age [1]. Aerobic exercise is an important aspect of the early intervention against vertebrobasilar ischemia and belongs to Level 1 prevention. Health Qigong•Ba Duan Jin is a medium-low intensity aerobic exercise. Former studies have shown that a certain period (about 3 months) of Health Qigong ● Ba Duan Jin exercise can improve the cardiovascular functions, increase the oxygen content of blood, and enhance the compliance of blood vessels [2-3]. Therefore we designed an experiment to observe the possible effects and influences of 3-month Health Qigong•Ba Duan Jin exercise on vertebrobasilar ischemia of old and middle-aged people.

1. General conditions

1.1 Inclusion and exclusion criteria

Old and middle-aged male and female patients aged between 45 and 78 (inclusive) with paroxysmal positional vertigo; patients having vertebrobasilar ischemia (slow blood circulation) by TCD detection, one secondary symptom of headache, and history of cerebral arteriosclerosis; hemorrhage of brain stem, epencephalon, and occipital lobe and secondary vertigo like infarctus were excluded.

1.2 Test objects and intervening measures

A total of 61 test objects were included and then randomly grouped by their serial numbers given at the time of enrollment. The control group had 32 cases (12 males and 19 females aged 59.0±7.8 on an average). The experimental group had 29 cases (10 males and 19 females aged 65.0±7.6 on an average). All test objects came from clinic or hospital patients of Shanghai Longhua Hospital and received normal therapies of traditional Chinese medicine and western medicine. The experimental group attended a Health Qigong ● Ba Duan Jin training class which administered one teaching and reviewing activity per week. On other days of the week, they practiced twice a day for 3 consecutive months.

1.3 Methodology and indexes

A Vertigo Symptom Rating Sheet [4] and a customized Vertebrobasilar Ischemia Symptom Self-Rating Sheet were used; German EV-4.0TCD diagnostic unit was used; 2MHz Doppler probes were placed on the pulvinar window to detect the peak systolic velocity (Vp) of the basal arteries (BA), left and right vertebral arteries (LVA, RVA), diastolic velocity (Vd), mean velocity (Vm), pulsatility index (PI), and resistance index (RI). The detection was undertaken by a professional doctor. Brief Health Rating Scale SF-36 was used to evaluate the life quality of the test objects, including physical function (PF), role physical (RP), bodily pain (BP), general health (GH), social function (SF), role emotional, and mental health (MH) dimensions [5]. All indexes were measured respectively before and after the experiment.

1.4 Statistics and analysis

SPSS12.0 was used for statistical analysis. Pair T-test was used for before-after comparison of the experimental group. T-test of independent samples was used for inter-group comparison.

2. Results

2.1 Evaluation of vertigo ratings

No significant difference was found between vertigo ratings of both groups before the intervention. By comparison between the ratings of the experimental group before and after the intervention, the degree, frequency, duration, and overall rating of vertigo were all significantly increased (P<0.01). After 3 months of intervention, the degree, frequency, duration, and overall rating of vertigo of the experimental were all significantly higher than the control group (P<0.05). (See Table 1)

2.2 Self-rating of related symptoms

By observing the changes in the percentage morbidities of all symptoms, we can see that all symptoms, especially headache, carebaria, vomiting, and nausea, of the experimental group were improved after intervention. Compared with those of the control group, some minor symptoms such as headache and carebaria were also significantly improved. (See Table 2)

2.3 Blood supply of vertebral-basal arteries (detected with TCD)

After intervention, the Vp, Vm, and Vd of LVA and RVA of the experimental group were significantly increased (P

Table 1. Comparison between Vertigo Ratings of Both Groups before and after Intervention (mean ±SD)

GroupnVertigo degreeVertigo frequencyVertigo durationOverall vertigo rating

Before interventionAfter interventionBefore interventionAfter interventionBefore interventionAfter interventionBeforeinterventionAfter intervention

Experimental group295.52±1.156.83±1.00△△1.34±1.042.45±1.38△△2.34±1.043.14±0.79△△9.21±2.6512.41±2.85△△

Control group325.63±0.796.00±0.00▲▲1.47±0.982.28±0.922.22±0.9752.69±0.78▲9.31±2.0610.97±1.51▲

Notes: △P▲P▲▲P

Table 2. Variation of Percentage Self-Ratings of Related Symptoms before and after Intervention (%)

SymptomHeadacheCarebariaNausea & vomittingVision disorder

AmbiopaHearing loss

TinnitusUnstable gait

AtaxiaHusky voice, choking on drinking water, dysphagia

GroupExperimental groupControl groupExperimental groupControl groupExperimental groupControl groupExperimentalgroupControl groupExperimental groupControl groupExperimental groupControl groupExperimental groupControl group

n2932293229322932293229322932

Before24.131.124.153.124.121.975.978.141.481.344.862.534.50.0

After6.921.90.031.30.00.062.181.331.059.424.128.127.60.0

Table 3. TCD Values of Vertebral-Basal Arteries of Experimental Group before and after Intervention (Mean ±SD)

GroupnVpVmVd

LVARVABALVARVABALVARVABA

Before intervention2933.4±6.3336.8±7.5244.5±9.6521.8±4.5625.4±5.3531.2±7.8013.2±3.5916.6±3.8821.5±6.08

After intervention2941.1±6.20△44.0±8.36△50.1±9.90△△27.1±4.45△29.5±6.41△35.5±8.20△16.5±5.09△△18.5±6.03△24.6±7.18△

Notes: △P<0.05，△△P

Table 4. Changes in TCD Values of Vertebral-Basal Arteries of Both Group before and after Intervention (Mean ±SD)

GroupnVpVmVd

LVARVABALVARVABALVARVABA

Experimental group297.68±6.457,15±4.745.65±8.885.24±4.714.04±4.174.33±7.063.34±4.862.02±5.293.09±6.56

Control group322.17±11.1▲0.21±4.03▲1.25±6.27▲-0.80±4.59▲▲-1.36±5.48▲▲-2.90±4.19▲▲1.13±4.23▲0.43±4.020.97±4.83

Notes: ▲P<0.05，▲▲P

2.4 SF-36 self-rating

After intervention, RP, GH, and RE levels of the experimental group were significantly increased (PGH, and RE were improved (P

Table 5. SF-36 Ratings of Experimental Group before and after Intervention (Mean ±SD)

nPFRPBPGHVTSFREMH

Before intervention2980.2±12.946.6±42.673.8±14.3341.7±11.467.8±1.8291.8±20.149.4±49.373.2±12.5

After intervention2978.1±16.780.2±34.3△△76.9±1.2550.1±14.9△72.4±12.393.5±18.575.9±37.7△70.5±13.2

Notes: △P<0.05，△△P

Table 6. Changes in SF-36 Ratings of Both Groups before and after Intervention (Mean ±SD)

nPFRPBPGHVTSFREMH

Experimental group29-2.0±16.734.0±34.23.1±14,58.3±14.14.7±9.251.7±15.226.0±45.8-3.0±11.9

Control group321.3±19.013.0±60.9-5.0±13.9▲-5.0±18.0▲-1.0±17.60.0±24.6-25.0±58.0▲-3.0±13.7

Notes: ▲P<0.05，▲▲P

3. Discussion

The vertebral-basal artery system is an important blood supply system of the human brain. It mainly meets the blood demand of the occipital lobe, epencephalon, brain stem, thalamus, and inner ear, which takes up 1/5 of the blood flow volume of the entire brain. When all kinds of pathogens reduce the blood flow volume of the system to a certain extent, cerebral ischemia of corresponding parts will be caused, leading to symptoms like vertigo, vision disorder, headache, dyskinesia, sensory disturbance, and viscerogenic disorder. The acute onset period is usually not longer than 24 hours but repeated outbreaks may follow, causing trauma, dizziness, nausea, vomiting, anxiety, and sleep disorder among the old and middle-aged people and seriously abasing the quality of life. 1/3 of the patients will eventually develop cerebral apoplexy (stroke) and cerebromalacia which deprive them of the abilities to take care of themselves. Health Qigong ● Ba Duan Jin is an exercise for the entire body and mind. It counteracts multiple pathogens from various perspectives. Studies have shown that: Health Qigong ● Ba Duan Jin is helpful for reducing the blood fat, controlling the body weight, and improving the oxidation resistance of old and middle-aged people [6]. And Health Qigong ● Ba Duan Jin lays great emphasis on the exercise of the neck and shoulders and almost every movement is favorable for improving the anatomic structure and blood supply of the neck and thus favorable for assuaging the compression and spasm of the vertebral arteries [7]. Health Qigong ● Ba Duan Jin advocates abdominal respiration, promotes the cardiac and pulmonary functions, and improves the blood and oxygen supply of the brain.

Judged from the data of this study, the 3-month exercise of Health Qigong ● Ba Duan Jin helped improve the blood and oxygen deficiency symptoms of the brain, such as dizziness, headache, and carebaria among old and middle-aged people and elevated the self-ratings of physical, mental, and overall health. Objective TCD test data also shows that Ba Duan Jin exercise improved the blood flow and blood supply of patients having slow vertebral-basal diseases and helped improve the elasticity of blood vessels. All this has shown that Health Qigong•Ba Duan Jin can improve the vertebrobasilar ischemia of old and middle-aged people to a certain extent. In addition, significant reduction of blood glucose and blood fat was found in some individuals during the experiment. This indicates that the improvement of cerebral blood supply engendered by BaDuan Jin should be of a systemic nature. Since this study only involved observation of the efficacy of the exercise with a small sample size and a short time period, the effect of Ba Duan Jin on the control and prevention of vertebrobasilar ischemia and cerebral ischemia still needs to be verified with further long-period experiments with greater sample sizes.

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