Integrative Lifestyle Medicine: Mind-Body Movements for Patient Care
Mind-body movements such as yoga, Pilates, Tai chi, qigong, Feldenkrais Method, and the Alexander Technique are excellent movement strategies that may be incorporated into conventional rehabilitation programs. For example, mind-body exercises may be beneficial for patients with chronic lower back pain, knee osteoarthritis, chronic obstructive pulmonary disease (COPD), cancer survivors, Parkinson’s disease, schizophrenia, and mental health (such as stress, anxiety, depression) and cognitive aging concerns.1-9
Let’s explore simple self-care techniques clinicians can leverage to help patients use integrative healing and recovery movements.
What Are Mind-Body Movements and Exercises?
The Lifestyle Medicine textbook by James Rippe, MD, defines mind-body medicine as “interactions among the brain, mind, body, and behavior, and on the powerful ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health.”10
To provide more clarity to the various bodywork and mind-body systems, let’s look at some basic definitions:
- Yoga – “In the Western world, the term [yoga] has been associated primarily with physical postures (asanas) and coordinated, diaphragmatic breathing.” 11 In the traditional practice in India, yoga is also used for spiritual enlightenment and self-knowledge.
- Pilates – “German-born Joseph H. Pilates (1883-1967) is the creator of the Pilates system, a form of bodywork that uses controlled movements to improve strength, flexibility, balance and mental concentration.” 12 Pilates developed many original exercise machines (such as the Reformer, Cadillac, Wunda Chair, and Ladder Barrel) and created a mat exercise series.
- Tai Chi – “A traditional Chinese martial art in which a series of slow, controlled movements are made through various postures designed to develop flexibility, balance, strength, relaxation, and mental concentration.” 11
- Qigong – “An ancient Chinese practice that combines internal energy, movement, breathing exercises, meditation, and relaxation.” 11
- Feldenkrais Method – “A form of therapy devoted to improving limitations of range of motion, improving poor posture, and relieving stress,” 11 developed by Ukrainian physicist Dr. Moshe Feldenkrais (1904-1984).
- Alexander Technique – “A form of bodily training that promotes postural health, especially of the spine, head, and neck,” 11 developed by Australian actor Frederick Matthias Alexander (1869-1955).
Figure 1. Components of mind-body movements and exercises
Mind-body Movement Highlight: The Practical Use of Qigong
Each of the six common mind-body movements have their own unique uses and benefits for patient care—let’s take a closer look at qigong.
There are many forms of qigong, such as the Eight Section Brocade qigong (also known as Baduanjin), Five Animals Play Qigong (Wuqinxi), Muscle Tendon/Changing Qigong (Yijinjing), Six Healing Sounds Qigong (Liuzijue), Standing Qigong (Zhan Zhuang), and Relaxation Qigong (Fangsonggong).13
To understand the practical use of qigong, we can examine the benefits of Baduanjin. Studies have shown that Baduanjin may be used for patients with COPD, mild cognitive impairment, heart failure, type 2 diabetes mellitus, knee osteoarthritis, depression and anxiety, and sleep disturbances.14-20
Baduanjin uses eight gentle, dynamic upper and lower body stretching and strengthening movements that integrate various postures, diaphragmatic breathing, body awareness, focused attention, and imagery.21
Let’s take a look at Figure 2 for an adapted basic 8-step Baduanjin routine that may be used for patient care:
Figure 2. Eight-step adapted Baduanjin routine. Photos © 2021 by Z Altug.
Interested in exploring the six mind-body movements and exercises further? You can learn more about including integrative movements into your practice with these resources:
- Alexander Technique International
- International Association of Yoga Therapists
- International Feldenkrais Federation
- International Medical Tai Chi and Qigong Association
- National Center for Complementary and Integrative Health
- Pilates Method Alliance
To learn more about the various opportunities for incorporating lifestyle medicine into your clinical practice, MedBridge instructor Lynn Steffes offers a series of courses that explore the role of prescribed diet and exercise, as well as comprehensive instructions, tools, and resources to strengthen your lifestyle medicine skills.
- Zou, L., Zhang, Y., Yang, L., Loprinzi, P. D., Yeung, A. S., Kong, J., Chen, K. W., Song, W., Xiao, T., & Li, H. (2019). Are mindful exercises safe and beneficial for treating chronic lower back pain? a systematic review and meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 8(5), 628.
- Brosseau, L., Taki, J., Desjardins, B., Thevenot, O., Fransen, M., Wells, G. A., Imoto, A. M., Toupin-April, K., Westby, M., Gallardo, I., Gifford, W., Laferrière, L., Rahman, P., Loew, L., Angelis, G., Cavallo, S., Shallwani, S. M., Aburub, A., Bennell, K. L., Van der Esch, M., … McLean, L. (2017). The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. Clinical Rehabilitation, 31(5), 582–595.
- Li, Z., Liu, S., Wang, L., & Smith, L. (2019). Mind-body exercise for anxiety and depression in COPD patients: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 17(1), 22.
- Kreutz, C., Schmidt, M. E., & Steindorf, K. (2019). Effects of physical and mind-body exercise on sleep problems during and after breast cancer treatment: a systematic review and meta-analysis. Breast Cancer Research and Treatment, 176(1), 1–15.
- Duan, L., Xu, Y., & Li, M. (2020). Effects of mind-body exercise in cancer survivors: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine: eCAM, 2020, 7607161.
- Jin, X., Wang, L., Liu, S., Zhu, L., Loprinzi, P. D., & Fan, X. (2019). The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson's Disease: A Systematic Review and Meta-analysis. International Journal of Environmental Research and Public Health, 17(1), 31.
- Wei, G. X., Yang, L., Imm, K., Loprinzi, P. D., Smith, L., Zhang, X., & Yu, Q. (2020). Effects of mind-body exercises on schizophrenia: a systematic review with meta-analysis. Frontiers in Psychiatry, 11, 819.
- Zou, L., Sasaki, J. E., Wei, G. X., Huang, T., Yeung, A. S., Neto, O. B., Chen, K. W., & Hui, S. S. (2018). Effects of mind⁻body exercises (tai chi/yoga) on heart rate variability parameters and perceived stress: a systematic review with meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 7(11), 404.
- Zhang, Y., Li, C., Zou, L., Liu, X., & Song, W. (2018). The effects of mind-body exercise on cognitive performance in elderly: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 15(12), 2791.
- Rippe, J.M. (2019). Lifestyle Medicine, 3rd edition. Boca Raton, FL: CRC Press.
- Venes, D. (2017). Taber's Cyclopedic Medical Dictionary, 23rd edition. Philadelphia, PA: F.A. Davis Company.
- Altug, Z. (2018). Integrative Healing: Developing Wellness in the Mind and Body. Springville, UT: Plain Sight Publishing.
- Guo, Y., Xu, M. M., Huang, Y., Ji, M., Wei, Z., Zhang, J., Hu, Q., Yan, J., Chen, Y., Lyu, J., Shao, X., Wang, Y., Guo, J., & Wei, Y. (2018). Safety of Qigong: Protocol for an overview of systematic reviews. Medicine, 97(44), e13042.
- Liu, S. J., Ren, Z., Wang, L., Wei, G. X., & Zou, L. (2018). Mind-body (Baduanjin) exercise prescription for chronic obstructive pulmonary disease: a systematic review with meta-analysis. International Journal of Environmental Research and Public Health, 15(9), 1830.
- ao, J., Liu, J., Chen, X., Xia, R., Li, M., Huang, M., Li, S., Park, J., Wilson, G., Lang, C., Xie, G., Zhang, B., Zheng, G., Chen, L., & Kong, J. (2019). Mind-body exercise improves cognitive function and modulates the function and structure of the hippocampus and anterior cingulate cortex in patients with mild cognitive impairment. NeuroImage. Clinical, 23, 101834.
- Chen, D. M., Yu, W. C., Hung, H. F., Tsai, J. C., Wu, H. Y., & Chiou, A. F. (2018). The effects of Baduanjin exercise on fatigue and quality of life in patients with heart failure: A randomized controlled trial. European Journal of Cardiovascular Nursing, 17(5), 456–466.
- Wen, J., Lin, T., Cai, Y., Chen, Q., Chen, Y., Ren, Y., Weng, S., Wang, B., Ji, S., & Wu, W. (2017). Baduanjin Exercise for type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Evidence Based Complementary and Alternative Medicine: eCAM, 2017, 8378219.
- Ye, J., Simpson, M. W., Liu, Y., Lin, W., Zhong, W., Cai, S., & Zou, L. (2020). The effects of Baduanjin qigong on postural stability, proprioception, and symptoms of patients with knee osteoarthritis: a randomized controlled trial. Frontiers in Medicine, 6, 307.
- Zou, L., Yeung, A., Quan, X., Hui, S. S., Hu, X., Chan, J., Wang, C., Boyden, S. D., Sun, L., & Wang, H. (2018). Mindfulness-based Baduanjin exercise for depression and anxiety in people with physical or mental illnesses: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 15(2), 321.
- Fan, B., Song, W., Zhang, J., Er, Y., Xie, B., Zhang, H., Liao, Y., Wang, C., Hu, X., Mcintyre, R., & Lee, Y. (2020). The efficacy of mind-body (Baduanjin) exercise on self-reported sleep quality and quality of life in elderly subjects with sleep disturbances: a randomized controlled trial. Sleep & Breathing, 24(2), 695–701.
- Osypiuk, K., Ligibel, J., Giobbie-Hurder, A., Vergara-Diaz, G., Bonato, P., Quinn, R., Ng, W., & Wayne, P. M. (2020). Qigong mind-body exercise as a biopsychosocial therapy for persistent post-surgical pain in breast cancer: a pilot study. Integrative Cancer Therapies, 19, 1534735419893766.