Effects of Ba-Duan-Jin Based Deep Breathing on Multimorbidity: A Case Study

Abstract

Introduction: Interventions for older adults with multiple medical diagnoses may need to have a more general focus that can be applied across a broad range of medical conditions. Ba-Duan-Jin (BDJ), a non-disease specific Tai Chi-QI Gong based mind-body training coordinated with deep breathing, may be a good choice. Case Description: A 79-year-old white female patient, with diagnoses of cardiopulmonary, gastrointestinal, and perceived sleep dysfunctions, was referred for consultation of geriatric rehabilitation for poor endurance and balance in a senior living retirement complex where rehabilitation services were provided. A BDJ-based deep diaphragmatic breathing (DDB) progressive training was provided 45-50 minutes each time and 3 times a week for 6 months. At the baseline, the end of 3rd and 5th month of this study, this patient was assessed with the Barthel index for activity of daily living, 1-minute heart rate recovery, Pittsburg sleep quality index, head elevation during sleeping, 4-stage balance, and 2-minute walk test. At the end of 3rd and 6th month, the patient was able to have improved strength, endurance, balance, cardiorespiratory function, gastral regurgitation, and activities of daily living. The mechanism of the beneficial effects of BDJ-based deep breathing in this case was discussed with body mechanical and anatomical consideration. KEY WORDS: Older adults, Ba-Duan-Jin, Tai Chi, Multimorbidity, Diaphragmatic anatomy.

Deep Diaphragmatic Breathing—Anatomical and Biomechanical Consideration

“…The diaphragmatic strength might get increased via these exercise practices, particularly when resistance like extra cuff weight, waist weight, and ankle weight are applied to the DDB practice (Bao et al, 2020;Hao et al, 2012). In a recently published case report (Liu, Miller, et al, 2022), an elderly patient was able to improve strength, endurance, balance, cardiorespiratory function, gastral regurgitation, sleep, and activities of daily living after performing a 6-month DDB-based Tai-Chi Qigong exercise, indicating a favorite function of the DDB-based exercise for patients with multimorbidity.…”

“…As a part of the management for multimorbidity from a holistic healthcare perspective, the deep breathing technique alone or as an essential part of the mind-body interventions such as Tai Chi, Yoga, and Ayurveda has often been used by practicing holistic healthcare professionals including holistic nurses (AHNCC, 2017; Liu, Miller, et al, 2022; Thornton, 2019). These mind-body interventions emphasize static and dynamic postural control, as well as an integration of body movement with deep breathing (Bao et al, 2020).…”

Understanding Yin-Yang Philosophic Concept Behind Tai Chi Practice

“…Also, this coordinated TC breathing can work on internal organs by stretching chest cavity and lung capacity, improving abdominal organs' mobility, and being conducive to transporting blood, since there are hiatuses and many suspensory ligaments attached to the diaphragm. 8,9,19…”

“…1,17 As a health promotion exercise, TC is safe and effective to reduce cardiopulmonary dysfunctions, 22,23 neural degeneration, 21,24,25 musculoskeletal pain, 26,27 sleep apnea, 19,28 and even can possibly improve the gut microbiome for patients with digestive problems. 19,29 Pathophysiologically TC may take effect by improving inflammatory biomarkers and decreasing oxidative stressors in the body. 21 However, in the view of Chinese medicine, any medical problems could be caused by yin-yang disharmonized due to poor flow of qi and/or blood circulation.…”

“…In this way, the opening and closing, deep exhaling (yin) and inhaling (Yang), can exercise the muscles, particularly the diaphragmatic muscle, joints, and ligaments of the chest and back. Also, this coordinated TC breathing can work on internal organs by stretching chest cavity and lung capacity, improving abdominal organs' mobility, and being conducive to transporting blood, since there are hiatuses and many suspensory ligaments attached to the diaphragm 8,9,19…”