The effects on pain, physical function, and quality of life of quadriceps strengthening exercises combined with Baduanjin qigong in older adults with knee osteoarthritis: a quasi-experimental study

Abstract

Background Exercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA). However, the best choice for an optimal exercise program able to promote long-term compliance in KOA patients is not clear. This study aims to compare the effect of combined exercise (CE: quadriceps strengthening exercises (QSE) and Baduanjin qigong training (BDJ)) versus QSE alone and BDJ alone on older adults with KOA. Methods A three-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from three community centers were assigned respectively to QSE group, BDJ group and CE group. We assessed pain intensity, physical function, self-efficacy, and health-related quality-of-life (HRQoL) using standardized instruments at baseline, 3 months and 6 months follow-up. Results One hundred and twenty-eight participants with KOA aged over 60 completed the study. Over the 6 months, there were significant group interaction effects on pain intensity (F = 28.888, P < 0.001), physical function (F = 26.646, P < 0.001), and self-efficacy (F = 22.359, P < 0.001), and, based on a short form-12 item health survey questionnaire (SF-12), physical component summary (F = 7.470, P < 0.001), and mental component summary (F = 10.207, P < 0.001). Overall, the CE group exhibited significantly greater improvement in all outcomes when compared to the QSE group and the BDJ group. Conclusions CE treatment is more effective than QSE and BDJ in pain relief, increasing physical function, improving self-efficacy, and raising quality-of-life in community-dwelling KOA older adults. Moreover, it promotes long-term compliance in KOA community patients. Trial registration Chinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020.

Are Mind-Body Exercise Beneficial for Treating Pain, Function, and Quality of Life in Middle-Aged and Old People With Chronic Pain? A Systematic Review and Meta-Analysis

“…Almost all studies included both women and men, except (Cheung et al, 2017 ) which did not report sex ratios and (Qiu, 2018 ) which included only women. A total of 11 studies (64.7%) (Raub, 2002 ; Cheung et al, 2014 , 2017 ; Wang et al, 2016 , 2021 ; Hu, 2017 ; Song et al, 2017 ; Cao, 2018 ; Qiu, 2018 ; Ye et al, 2019 ; Xiao et al, 2020 ) included patients who suffer chronic pain from KOA. Three studies (Teut et al, 2016 ; Cao, 2018 ; Liu et al, 2019 ) included patients with CLBP and three studies (Yang et al, 2005 ; von Trott et al, 2009 ; You et al, 2018 ) included other chronic pain patients.…”

“…The researchers implemented various mindful exercise interventions, which included yoga [two Hatha yoga (Cheung et al, 2014 , 2017 ) and one Viniyoga (Teut et al, 2016 )], TC [two Yang-style TC (Wang et al, 2016 ; Song et al, 2017 ); one Chen-style TC (Liu et al, 2019 ); one Sun-style TC (Raub, 2002 ); and three just demonstrated TC (Hu, 2017 ; Cao, 2018 ; You et al, 2018 )], and qigong [five Baduanjin qigong (Ding, 2014 ; Hu, 2017 ; Qiu, 2018 ; Ye et al, 2019 ; Wang et al, 2021 ); one Wu Qin Xi Qigong (Xiao et al, 2020 ); one Korean qigong (Yang et al, 2005 ); and two just mentioned qigong (von Trott et al, 2009 ; Teut et al, 2016 )]. There were five control comparators included nonphysical therapy [usual care (Cheung et al, 2014 ; Ding, 2014 ; Teut et al, 2016 ; Qiu, 2018 ; Ye et al, 2019 ); wait list (Raub, 2002 ; Yang et al, 2005 ; von Trott et al, 2009 ); education (Cheung et al, 2017 ; Hu, 2017 ); attention control group (Song et al, 2017 )], physical therapy (Wang et al, 2016 ; You et al, 2018 ; Xiao et al, 2020 ), quadriceps strengthening exercises (QSEs) (Wang et al, 2021 ), core stabilization (Liu et al, 2019 ), and stretching (Cao, 2018 ). The intervention duration of all mindful exercises was between 4 and 24 weeks, and sessions ranged from 8 to 96 weeks.…”

“…Pain intensity as the main outcome can be obtained from 17 studies. The evaluation scales were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-pain (Raub, 2002 ; Cheung et al, 2014 ; Wang et al, 2016 , 2021 ; Hu, 2017 ; Ye et al, 2019 ; Xiao et al, 2020 ) and Visual Analog Scale (VAS) (Yang et al, 2005 ; von Trott et al, 2009 ; Teut et al, 2016 ; Cheung et al, 2017 ; Song et al, 2017 ; Cao, 2018 ; Qiu, 2018 ; You et al, 2018 ; Liu et al, 2019 ). Twelve studies reported functional improvement outcomes using WOMAC-function (Cheung et al, 2014 , 2017 ; Ding, 2014 ; Wang et al, 2016 , 2021 ; Hu, 2017 ; Song et al, 2017 ; Qiu, 2018 ; Ye et al, 2019 ; Xiao et al, 2020 ), FFbHR (Teut et al, 2016 ), and Neck Pain and Disability (NPAD) (von Trott et al, 2009 ).…”

“…The evaluation scales were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-pain (Raub, 2002 ; Cheung et al, 2014 ; Wang et al, 2016 , 2021 ; Hu, 2017 ; Ye et al, 2019 ; Xiao et al, 2020 ) and Visual Analog Scale (VAS) (Yang et al, 2005 ; von Trott et al, 2009 ; Teut et al, 2016 ; Cheung et al, 2017 ; Song et al, 2017 ; Cao, 2018 ; Qiu, 2018 ; You et al, 2018 ; Liu et al, 2019 ). Twelve studies reported functional improvement outcomes using WOMAC-function (Cheung et al, 2014 , 2017 ; Ding, 2014 ; Wang et al, 2016 , 2021 ; Hu, 2017 ; Song et al, 2017 ; Qiu, 2018 ; Ye et al, 2019 ; Xiao et al, 2020 ), FFbHR (Teut et al, 2016 ), and Neck Pain and Disability (NPAD) (von Trott et al, 2009 ). QOL indicators were obtained from eight studies using the Health-related Short Form 12 (SF-12) (Raub, 2002 ; Cheung et al, 2014 , 2017 ; Wang et al, 2021 ) and Health-related Short Form 36 (SF-36) scales (von Trott et al, 2009 ; Teut et al, 2016 ; Wang et al, 2016 ).…”

“…Twelve studies reported functional improvement outcomes using WOMAC-function (Cheung et al, 2014 , 2017 ; Ding, 2014 ; Wang et al, 2016 , 2021 ; Hu, 2017 ; Song et al, 2017 ; Qiu, 2018 ; Ye et al, 2019 ; Xiao et al, 2020 ), FFbHR (Teut et al, 2016 ), and Neck Pain and Disability (NPAD) (von Trott et al, 2009 ). QOL indicators were obtained from eight studies using the Health-related Short Form 12 (SF-12) (Raub, 2002 ; Cheung et al, 2014 , 2017 ; Wang et al, 2021 ) and Health-related Short Form 36 (SF-36) scales (von Trott et al, 2009 ; Teut et al, 2016 ; Wang et al, 2016 ).…”