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Review
. 2024 Oct 11;12(20):2020.
doi: 10.3390/healthcare12202020.

Exploring the Effects of Qigong, Tai Chi, and Yoga on Fatigue, Mental Health, and Sleep Quality in Chronic Fatigue and Post-COVID Syndromes: A Systematic Review with Meta-Analysis

Hermann Fricke-Comellas  1   2 , Alberto Marcos Heredia-Rizo  2   3 , María Jesús Casuso-Holgado  2   3 , Jesús Salas-González  1   2 , Lourdes María Fernández-Seguín  2   3
Affiliations
Review

Exploring the Effects of Qigong, Tai Chi, and Yoga on Fatigue, Mental Health, and Sleep Quality in Chronic Fatigue and Post-COVID Syndromes: A Systematic Review with Meta-Analysis

Hermann Fricke-Comellas et al. Healthcare (Basel). .

Abstract

Background/Objectives: Chronic fatigue syndrome (CFS) and post-COVID syndrome (PCS) pose a substantial socioeconomic burden. The aim of this systematic review was to assess current evidence regarding the effect of the most popular forms of movement-based mindful exercises, i.e., qigong, tai chi, and yoga, on fatigue and associated symptoms in CFS and PCS. Methods: CINAHL, Embase, PsycINFO, PubMed, Scopus, and the Cochrane Library were searched from inception to October 2023. Randomized controlled trials (RCTs) where qigong, tai chi, or yoga were compared with waitlist, no intervention, or active controls were included. Independent reviewers participated in data extraction, and evaluated risk of bias, spin of information, completeness of intervention description, and certainty of the evidence (GRADE). Meta-analyses were conducted. The primary outcome was the level of fatigue. Secondary measures were the severity of anxiety and depressive symptoms and sleep quality. Results were expressed as mean difference (MD) or standardized mean difference (SMD) with a 95% confidence interval (CI). Results: Thirteen RCTs with 661 participants were included, with most studies presenting a moderate or high risk of bias. Mindful exercises were more effective than control interventions to alleviate fatigue: SMD (95%CI) = -0.44 (-0.63 to -0.25), I2 = 48%, p < 0.0001. Positive effects were also observed for secondary outcomes. The certainty of the evidence was low or very low. Conclusions: Qigong, tai chi, and yoga may be effective to reduce fatigue and improve anxiety, depression, and sleep quality in adults with CFS or PCS. However, serious methodological concerns limit the clinical applicability of these findings.

Keywords: chronic; exercise movement techniques; fatigue syndrome; mind–body therapies; post-acute COVID-19 syndrome; qigong; tai ji; yoga.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart diagram of studies through the review process.
Figure 2
Figure 2
Risk of bias summary. Green circles indicate a low risk of bias; yellow circles with a question mark indicate an unclear risk of bias; red circles indicate a high risk of bias [34,35,36,37,39,40,41,42,43,44,45,46,47].
Figure 3
Figure 3
Risk of bias graph.
Figure 4
Figure 4
Forest plot of treatment effect for physical fatigue [34,36,39,43,45].
Figure 5
Figure 5
Forest plot of treatment effect for mental fatigue [34,36,39,43,45].
Figure 6
Figure 6
Forest plot of treatment effect for overall fatigue [34,36,39,43,45,46].
See this image and copyright information in PMC

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