The Effect of Qigong on Functional Outcomes, Balance, General Well-Being, and Depression in Patients Diagnosed With Multiple Sclerosis
Phase: NA
Conditions: Multiple Sclerosis
Sponsor: Baskent University

 
 
 
 
 
 
 
 
 
 
 
16.02.2026 
      
 
 
 
 
 
 
 
 
 
 
 
PROJECT TITLE: The Effects of Ch8nese Med8cal Exerc8ses (Q8gong) on Funct8onal Level,  
Qual8ty of L8fe, Depress8on, and Balance 8n Pat8ents w8th Mult8ple Scleros8s (MS)  
 
INTRODUCTION  
 
Ch8nese med8cal exerc8ses (Q8gong) cons8st of exerc8se sequences or8g8nat8ng from  
trad8t8onal Ch8nese med8c8ne and mart8al arts. They have been used 8n Ch8na for thousands  
of years to ma8nta8n phys8cal and psycholog8cal health and treat d8seases, and they have  
8ncreas8ngly attracted attent8on 8n modern med8c8ne. Q8gong 8s a prac-t8ce that comb8nes  
concentrat8on, v8sual8zat8on, breath8ng, posture, and movement techn8ques. Its a8m 8s to  
8ncrease, mob8l8ze, enhance, and balance l8fe energy (q8).  
Mechan8sms of act8on:  
1.Through the effect of “m8ndfulness med8tat8on,” Q8gong 8s bel8eved to enhance emot8onal  
regulat8on, attent8on control, well-be8ng, and body awareness.  
2.A second mechan8sm 8s expla8ned v8a the hypothalam8c-p8tu8tary-adrenal (HPA) ax8s.  
Stressful st8mul8 act8vate the amygdala, wh8ch st8mulates the hypothalamus. Cort8cotrop8n-  
releas8ng hormone (CRH) 8s secreted from the hypothalamus, tr8gger8ng adrenocort8cotrop8c  
hormone (ACTH) release from the an-ter8or p8tu8tary. ACTH st8mulates the adrenal glands to  
produce and release cort8sol. Cort8sol release 8ncreases blood pressure, ra8ses blood  
glucose, converts fatty ac8ds 8nto energy, and suppresses the 8mmune system.  
S8multaneously, the sympathet8c system 8s act8vated, and adrenal8ne (ep8nephr8ne) and  
noradrenal8ne (norep8nephr8ne) are released 8nto the blood. Th8s tr8ggers the “f8ght or fl8ght”  
res-ponse, caus8ng pup8l d8lat8on, 8ncreased heart rate and blood pressure, bronchod8lat8on,  
and decreased bowel mot8l8ty. Q8gong 8s thought to act8vate the parasympathet8c system,  
8nduc8ng a “relaxat8on res-ponse.”  
3.Th8rdly, Q8gong regulates the 8mmune system by 8ncreas8ng ant8-8nflammatory responses. A  
me-ta-analys8s exam8n8ng the 8mmune effects of m8nd-body approaches such as Ta8 Ch8  
Chuan and Q8gong found that these pract8ces reduce 8nflammatory responses and 8nfluence  
v8rus-spec8f8c 8mmun8ty. S8gn8-f8cant reduct8ons 8n CRP and IL-6 levels have been observed.  
Many neurolog8cal d8seases of 8nterest to Phys8cal Med8c8ne and Rehab8l8tat8on phys8c8ans  
reduce pat8ents’ qua-l8ty of l8fe due to chron8c d8sab8l8ty, dependency, and assoc8ated  
psychosoc8al d8sorders such as anx8ety and dep-ress8on. The goal of neurolog8cal  
rehab8l8tat8on—“opt8mal b8opsychosoc8al well-be8ng” al8gns w8th the object8-ves of m8nd 
body med8c8ne. Today, m8nd-body components are 8ncreas8ngly 8ncorporated 8nto neurolog8cal 
rehab8l8tat8on.  
In 2014, a study 8nvest8gated the therapeut8c effects of Ta8 Ch8 on balance, coord8nat8on,  
fat8gue, and depress8on 8n MS pat8ents. Th8rty-two m8ldly d8sabled MS pat8ents part8c8pated 8n  
90-m8nute Ta8 Ch8 sess8ons tw8ce weekly for s8x months, wh8le the control group rece8ved  
standard treatment. The Ta8 Ch8 group showed s8gn8f8cant 8mp-rovements 8n balance,  
coord8nat8on, and depress8on (effect s8ze η2 = 0.16–0.20). L8fe sat8sfact8on 8ncreased, and  
fat8gue rema8ned stable 8n the Ta8 Ch8 group but worsened 8n the control group (η2 = 0.24–  
0.31). The results suggested that Ta8 Ch8 could be a prom8s8ng complementary therapy for  
MS pat8ents.  
A 2024 study exam8ned the effects of one year of Ta8 Ch8 on balance and coord8nat8on 8n MS  
pat8ents us8ng both subject8ve and object8ve measures. F8fteen female MS pat8ents showed  
s8gn8f8cant 8mprovements 8n M8-n8-BESTest, posturography, and 25-Foot Walk Test results  
after 12 months of regular Ta8 Ch8 pract8ce. Stat8st8cally s8gn8f8cant 8mprovements were also  

observed 8n anx8ety and cogn8t8ve performance (PASAT). Although trends toward  
8mprovement were noted 8n depress8on, other cogn8t8ve tests, and qual8ty of l8fe, these d8d not  
reach s8gn8f8cance due to the small sample s8ze. F8nd8ngs suggest long-term Ta8 Ch8 may be  
benef8c8al for MS pat8ents but requ8re val8dat8on w8th larger, controlled stud8es.  
Another study compared the effects of Baduanj8n and yoga on motor funct8on, posture  
control, fat8gue, and  
depress8on 8n MS pat8ents. After 24 weeks, both Baduanj8n and yoga groups showed  
s8gn8f8cant 8mprovements 8n balance (BBS), trunk mob8l8ty (TIS), fat8gue (FSS), and  
depress8on (SDS). However, the Baduanj8n group showed greater 8mprovements 8n balance  
and depress8on compared to the yoga group. No s8gn8f8cant changes were observed 8n the  
control group. The study suggested that Baduanj8n may be a more effect8ve and su8table  
opt8on than yoga for MS pat8ents.  
Desp8te numerous Q8gong stud8es 8n the l8terature, no study has compared pract8cal Q8gong  
exerc8ses w8th con-vent8onal rehab8l8tat8on methods. Th8s study a8ms to 8nvest8gate the effects  
of Q8gong on overall well-be8ng and balance 8n MS pat8ents.  
 
MATERIALS AND METHODS 
Study Type: Random8zed controlled cl8n8cal tr8al  
Study Sample: Pat8ents d8agnosed w8th MS who present to Başkent Un8vers8ty Phys8cal  
Med8c8ne and Rehab8l8-tat8on outpat8ent cl8n8c, enrolled 8n a rehab8l8tat8on program, and  
consent to part8c8pate.  
The m8n8mum sample s8ze requ8red for the study, based on a repeated-measures ANOVA  
w8th effect s8ze f=0.25* and 95% power at 95% conf8dence, 8s n=36 pat8ents.  
 
Inclus8on cr8ter8a:  
•Age 18–65, d8agnosed w8th MS accord8ng to McDonald cr8ter8a  
•Expanded D8sab8l8ty Status Scale (EDSS) ≤5, able to walk 8ndependently or w8th m8n8mal  
ass8stance  
•No relapse or treatment changes 8n the last 30 days  
Exclus8on cr8ter8a:  
•Part8c8pat8on 8n hybr8d exerc8se programs 8nclud8ng trad8t8onal Ch8nese exerc8ses (Ta8 Ch8,  
Q8gong, yoga, etc.) 8n the last 3 months  
•Severe card8opulmonary or musculoskeletal problems contra8nd8cat8ng trad8t8onal Ch8nese  
exerc8ses; commun8cat8on d8ff8cult8es due to cogn8t8ve 8ssues; progress8ve comorb8d  
cond8t8ons  
 
Random8zat8on: Conducted us8ng computer-generated block random8zat8on (random8zer.org) 
8n order of outpa-t8ent presentat8on.  
 
Convent8onal Rehab8l8tat8on Protocol: Pat8ents 8n the convent8onal rehab8l8tat8on group w8ll  
undergo a rehab8l8-tat8on program at the phys8cal therapy un8t for at least 1.5 hours, three  
t8mes a week. The program 8ncludes neurophys8olog8cal exerc8ses, strengthen8ng exerc8ses,  
and balance-coord8nat8on exerc8ses (3 sets of 10 repet8-t8ons). Warm-up and cool-down  
per8ods are 8ncluded.  
 
Ch8nese Med8cal Exerc8se Protocol (Q8gong): Cons8sts of e8ght trad8t8onal movements.  
Wh8le names may vary by reg8on, movement sequences are mostly cons8stent. Exerc8ses 
8nclude: Ra8s8ng Hands to the Sky, Draw8ng the Bow to Shoot the Hawk, Separat8ng Earth  
and Sky, W8se Owl Look8ng Back, Nodd8ng Head and Shak8ng Ta8l, Ben-d8ng to Touch Feet,  
Clench8ng F8sts and Gather8ng Energy w8th a Hard Gaze, and Shak8ng Body by Stomp8ng  

Heels.  
The Q8gong group w8ll perform 45-m8nute face-to-face sess8ons led by a phys8otherap8st 8n  
add8t8on to the 1.5-hour convent8onal rehab8l8tat8on program, three t8mes a week. Sess8ons  
8nclude a 5-m8nute warm-up (f8ve deep breaths), three sets of 10 repet8t8ons w8th 1–2 m8nute  
breaks, and a 5-m8nute cool-down focus8ng on energy flow and m8ndfulness.  
Outcome Measures:  
•Berg Balance Scale  
•Mult8ple Scleros8s Impact Scale-29 (MSIS-29)  
•Barthel Index  
•Beck Depress8on Inventory  
All pat8ents w8ll cont8nue the8r ongo8ng MS treatment prescr8bed by neurology and w8ll be 
fully 8nformed about th8s.  
Assessment Schedule: Pat8ents w8ll be evaluated at the f8rst v8s8t, 1 month, 2 months, and 3  
months for funct8-onal status, qual8ty of l8fe, balance, and depress8ve mood.  
 
EXPECTED SCIENTIFIC CONTRIBUTIONS  
 
Although numerous Q8gong stud8es ex8st, many share common l8m8tat8ons. Th8s study w8ll be  
the f8rst random8-zed controlled tr8al compar8ng Q8gong w8th convent8onal rehab8l8tat8on 8n 
MS pat8ents.  
 
 
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Eth8cal Approval