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10 lipca 2019

NR 107 (Lipiec 2019)

The effect of regular Ba Duan Jin practice on the well-being of Lebanese young adults – a pilot study

288

Szanowni Czytelnicy,

po raz pierwszy na łamach naszego czasopisma zamieszczamy artykuł w języku angielskim. Z jakiego powodu zdecydowaliśmy się na taką innowację? Powodów jest kilka. Wielu z naszych kolegów fizjoterapeutów poszukuje pracy poza granicami Polski, wielu przygotowuje się już do wyjazdu, ucząc się języka, najczęściej właśnie języka angielskiego. Dlaczego więc nie stworzyć im możliwości sprawdzenia znajomości języka właśnie poprzez kontakt z oryginalnymi pracami przygotowanymi w języku obcym, opracowanymi przez lub pod kierunkiem znanych i cenionych w świecie fizjoterapeutów z zaprzyjaźnionych z naszą redakcją ośrodków naukowych oraz praktyk fizjoterapeutycznych? Wiemy również, że w Polsce jest wielu fizjoterapeutów, którzy w swojej pracy w kraju posługują się językiem angielskim. Może więc będzie to okazja do ugruntowania znajomości języka i posługiwania się nim, możliwość poznania nowych zwrotów czy określeń już stricte fizjoterapeutycznych. Za pomocą tego i kolejnych artykułów w języku angielskim chcieliśmy również przedstawić pracę naszych kolegów fizjoterapeutów z innych krajów. Być może tego rodzaju artykuły i zawarte w nich informacje będą inspiracją do działań w naszych placówkach. 
Mamy również nadzieję, że zamieszczanie na naszych łamach artykułów w innym języku przyczyni się do podniesienia atrakcyjności czasopisma i stanie się ono jeszcze bardziej przydatne dla kolejnej grupy naszych czytelników.
W tym numerze zamieszczamy artykuł przygotowany w Bejrucie, w zespole naukowym prof. Georges’a Boueiriego*, sekretarza generalnego Arab Confederation for Physical Therapy, honorowego prezydenta FIOPF, twórcy, fundatora i prezesa organizacji Order of Physiotherapists in Lebanon, aktywnego fizjoterapeuty i wykładowcy na kilku uczelniach. 
Na początek ciekawy temat dotyczący zastosowania ćwiczeń z sytemu Ba Duan Jin, Qi Gong. Tak więc praca o charakterze uniwersalnym, interdyscyplinarnym i międzynarodowym. 
Jesteśmy bardzo ciekawi, czy zaproponowana przez naszą redakcję formuła zostanie przez Państwa przyjęta i zaakceptowana. Prosimy, aby podzielili się Państwo z nami swoimi opiniami.
Artykuł wraz z tłumaczeniem dostępny w wersji online czasopisma.

dr Marek Wiecheć 
redaktor prowadzący

* Georges Boueiri – Doctor of Physical Therapy, Secretary General of the Arab Confederation for Physical Therapy (ACPT), Honorary Vice-President of the International Federation of French speaker Physiotherapists (FIOPF), Founder & Former Chief Executive Officer of the Order of Physiotherapists in Lebanon (OPTL), Former member of the Professional Issues Working Group in the European Region of the World Confederation for Physical Therapy (PIWG-ER-WCPT).
 

Background – Regular physical activity (PA) can insure several positive effects on health and well-being. Thus, college students may have continuous decline in their health status due to lack of this activity while recent studies showed that eight to twelve weeks of exercise may be effective to improve physical fitness and mental health of these students.

Objective – To evaluate the short-term effects of specific type of exercises called “BA DUAN JIN (BDJ)” on well-being of young adult students.

Methods – Twenty college students with were recruited from different colleges in Beirut-Lebanon area. Each participant followed the BDJ exercise routine during 8 weeks. Participants underwent the regular BDJ exercise training at a frequency of 3 days per week with 30-60 minutes per session. Oxford Happiness Questionnaire (OHQ), derived from the Oxford Happiness Inventory, (OHI) was collected before and after the exercise routine.

Results – The main terms of the OHQ showed valid and significant change after the completion of the protocol.

Conclusion – Baduanjin routine may have a direct effect on participants’ subjective well-being.


Benefits of regular exercise and physical activity are hard to ignore. Regular physical activity (PA) can insure several positive effects on health and well-being [1] .

In our society, we can witness a continuous decline in health mental performance of our college students due to several factors and especially, lack of activity. It is well known that all students, either in college or in university, have a transition state of growth and development [2]. Therefore, a special focus must be stressed in order to improve not only their physical health but also their psyche [3].

During this period of growth and development, young adults may experience many rapid changes in their body, mind, and social relationships [4]. This can enable them to make decisions and develop their own behavior patterns in an autonomic way and in particular health behaviors which usually continue throughout their whole [5]. Thus, college students may continue their development in good health and in most cases they do not need more attention [6].

This cycle of growth and development can sometimes be influenced by lifestyles and risk factors adopted by these college adult students. This perturbation may have a substantial negative effect lately in the future [4]. Among these influencing factors is inactivity. Many studies showed these students gradually decreased their level of activity by changing their life habits and behavior accompanied by lower pressure of study and presence of pervasive Internet [7].

Risk factors and problems affecting the psychological state of a young adult students can be multifactorial such as academic challenge, achievements, and peers competition [8]. It has been demonstrated that disorders, resulted from these negative factors, are increasing in term of frequency and severity [9]. Thus, subjective well-being and psychological life status could be influenced and affected [10], leading in most of cases to a devastating state of distress and psychological consequences [11].

While evidence concerning the perturbation of adults’ well-being in young adults is well known, outcome measures has not well identified [12]. Diener suggested that there are three hallmarks to the area of well-being: first, it is subjective – it remains within the experience of the individual. Second, it is not just the absence of negative factors, but also includes positive measures, and third, it includes a global assessment rather than only a narrow assessment of one life domain [13].

In different perspective, research has defined happiness as the extent to which an individual judges the overall quality of his or her life as favorable [14]. The term subjective well-being (SWB) was first introduced by Diener as a way to identify the domain of psychology that attempts to understand the evaluation of the person’s quality of life. This scientific term is used to avoid the ambiguous meaning of the term „happiness”[11].

Psychological well-being is important in the life of a college student, it is beneficial for adults to live a healthy life [15].

SWB, is a broad category of phenomena that includes people’s emotional responses, domain satisfactions, global judgments of life satisfaction [16]. It is the personal perception and experience of positive and negative emotional responses and global and specific cognitive evaluations of satisfaction with life [11].

Psychologists draw a distinction between the SWB from life as a whole and the well-being associated with a single area of life so they used two terms to identify each one: ‘context-free’ and ‘context-specific’ [14]. Past research has linked the mental and social well-being, including reduced risk of depression and suicide, with the physical activity and sports participation [17]. Accordingly, sitting for prolonged periods can affect metabolic health even when adults do physical activity [18].

Factors that affect psychological well-being is also sedentary behaviors. People who are less physically active can be subject to a high risk of health problem [19]. The integration of digital technology within daily life is becoming the cultural norm with the progress of science and technology. More young people spend a majority of their spare time in the digital devices [20]. Many studies aimed to resolve this problem while recent studies showed that 8 to 12 weeks of exercise was effective for improving physical fitness, mental health and body composition in college students [21]. Regular physical activities or exercises have been demonstrated to benefit participants’ physical, mental, and social well-being [20].

From an arrow of different modality of exercises, Baduanjin (BDJ), a traditional Chinese exercise that combines movements with breath and mind, may be one of the selectable effective exercises to improve person’s well-being. However, the effect of BDJ exercise on college students has not been established. In this study, we systematically assessed the effectiveness and safety of BDJ exercise on physical and mental health of college students by a rigorous randomized, parallel-controlled design for the improvement of health and well-being. Traditional Chinese exercise is a form of exercise that is becoming very popular in the world. It includes different types of exercise; the main types are Tai Chi, Qigong, BDJ, and Liuzijue, among others [22]. In this study our interest is the BDJ exercises.

Many Chinese people are still nowadays practicing the BDJ (Chinese Ba Duan Jin qigong) which is a long-time component of Chinese medicine [23]. BDJ is a typical exercise to improve health and has more than one thousand years of history in China [21]. This technique has been translated to the Eight Section Brocades, which refers to eight individual movements for improving general health [22]. BDJ includes breathing exercise, a comprehensive mind-body practice that involves physical postures and movement, and relaxation. It has been recommended for general use in the community by the Chinese Health Qigong Association [24].

BDJ, as a low-intensity medical exercise, is not only easy to practice, but also has little physical and cognitive demand. Over the past decade, it has been practiced by patients with chronic diseases [25]. Recent review has proven the benefits of BDJ exercise on cardiopulmonary function and body morphology [26].

The aim of our study is to examine the effectiveness of BDJ practice on the subjective well-being of young adult students. Our hypothesis is that a repetitive routine of 8 detailed exercises of BDJ practice for 8 consecutive weeks may ameliorate the subjective well-being of Lebanese college students.

Methods
Participants

Twenty college students from Beirut area where recruited and screen for eligibility. Subjects undertook the learning of BDJ exercise two days prior to the intervention. The training was under the guidance of professional coach. The learning status of the subjects was evaluated before the intervention began. The 15 subjects that could practice the whole BDJ exercise were enrolled in the intervention program: the subjects practiced BDJ exercise 3 times or above each week, 30–60 minutes each time for two months. Subjects have been included in the study if: 1) they are healthy, 2) aged between18 to 25 years, 3) can give the informed consent form [20]. Excluded from the study subjects: 1) being or having been engaged in a long-term regular practice of BDJ; 2) being a member of the Martial Arts Association, Dance Association, Aerobics Association, Sanda Association, or Taekwondo Association [20] and 3) with no cardiovascular diseases, diabetes, or abnormal glucose tolerance or other acute or chronic diseases that might affect the sports activity [21].

Written informed consent has been obtained from all participants and local ethical committee has approved this protocol.

Experimental protocol
Outcome Measurement

An improved instrument, the Oxford Happiness Questionnaire (OHQ), has been derived from the Oxford Happiness Inventory, (OHI). The OHI comprises 29 items, each involving the selection of one of four options that are different for each item. The OHQ includes similar items to those of the OHI, each presented as a single statement which can be endorsed on a uniform six-point Likert Scale. Respondents were invited to complete and return a self-report questionnaire constructed from the OHI, the OHQ.(99)

The OHQ in our study is a test-rest questionnaire. The participant should answer all the questions before and after the intervention so we can make the comparison of the test and re-test and see if the BDJ practice ameliorates the well-being.


Procedure
Before collecting data, experimental protocol and purpose of the study has been explained explicitly to participants who were free to ask further information. The Oxford Happiness Questionnaire was administrated two times to each subject, before and after the intervention of the traditional Chinese exercise-BDJ, asking each individual to complete the questionnaire without consulting anyone. Confidentiality of individual responses was assured.

The intervention period in this trial will last 8 weeks. Participants will undergo the regular Baduanjin exercise training at a frequency of 3 days a week with 30–60 minutes per day. The participants will have to draw several drawings only one time – during the first session – in order to create a stable image in the mind. The drawings should be done with maximum details before each exercise.

Descriptions of the Baduanjin Routines
The whole set of BDJ exercise consists of 9 postures: 1) ready position, 2) holding the hands high with palms up to regulate the internal organs, 3) posing like an archer shooting on left and right sides, 4) holding one arm aloft to regulate the functions of the spleen and stomach, 5) turning the head and looking behind the shoulder to prevent sickness and strain, 6) swinging the head and lowering the body to relieve stress, 7) moving the hands down the back and legs and touching the feet to strengthen the kidneys, 8) thrusting the fists and making the eyes glare to enhance strength, 9) raising and lowering the heels to cure diseases [21].

Results

Answers to the Oxford Happiness Questionnaire were performed before and after the application of experimental protocol.

In question 1, participants change their evaluation of how they feel pleased with the way they are. To the question „I don’t feel particularly please with the way I am” they change their rating especially in „moderately disagree” from 60% before to 45% after. Also for slightly disagree from 15% to 50%.

In question 2 „I am intensely interested in other people” they become 65% „moderately agree” after the experimental protocol compared to 20% before and 10% became „Strongly agree”.

In question 3 „I feel that life is very rewarding” 55% became „strongly agree” after doing exercises compared to 15% before, and disagree became less.

In question 4 „I have very warm feelings towards almost everyone, 40% became moderately agree and 15% became strongly agree compared to 30% and 0% respectively before doing exercises.

In question 5 „I rarely wake up feeling rested”, 30% became moderately agreed and 15% strongly agreed compared to 25% and10% respectively before the baduanjin routine.

In question 6 „I am not particularly optimistic about the future” 40% of the participants strongly disagreed after the baduan jin routine in comparison with the pre-score of 0% of strongly disagreeing. In addition to a 5% of slight agreement after the exercise (0% before the routines).

In question 7 „I find most things amusing” patients who disagreed whether moderately 20% or strongly 15% disappeared after the completion of the protocol where we can note an improvement in the percentage of participants who moderately 55% and strongly 10% agreed after being 30 and 0% respectively before the training.

In question 8 „I am always committed and involved”, the percentage of moderate agree improved from 20% to 50% a...

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