Faculty/School/CentreEvidence-Based SMILE* Wellness Program
- Qigong and Tai Chi based Contents
Rationale and Introduction of the SMILE Wellness
Program……………………………. p2 Attachment 1 Abstract of Findings published
in the British Journal of Sports Medicine…….. P6 Attachment 2
Abstract of Findings published in the American Journal of
Preventive Medicine…………………………………………………………………………………
P7
Attachment 3 Press release from The University of Queensland,
beyondblue and National Heart Foundation
P8
Attachment 4 Benefits and Comments from Previous Clinical Study
Participants………….. P9 Attachment 5 Benefits and Comments from
Previous 2 Days Course Participants………….. P21 Attachment 6 Benefits
and Comments from Previous 3 Months Course Participants………..
p27
1
Rationale and Introduction of the SMILE Wellness Program
SMILE: An Innovative Clinically Proven Life-Changing Qigong
Program
Physical activity plays an important role in the prevention and
management of chronic diseases. However, many individuals
especially those who are aging, overweight or obese, or have
physical limitations, are unable to or unwilling to do conventional
types of exercises such as gym-based exercises or aerobics, often
because of fear of injury or heart attack. In addition, mental
health is also strongly associated with physical illnesses. We
therefore designed an innovative gentle, low impact mind-body
therapy program (based on TCM therapies), named SMILE Wellness
Program (SMILE: Sustainable Mastery of Innovative Lifelong
Exercise). The findings from the clinical studies have demonstrated
strong evidence of the positive effects of the SMILE Wellness
Program on many health conditions, including: Reduction in stress,
anxiety and depression level (see Figure 1) Weight loss (see Figure
2) Improved diabetes control (see Figure 2) Strength/physical
functioning improvement (see Figure 3) Blood pressure reduction
Improved sleeping patterns Enhanced immunity Pain reduction
Flexibility and endurance improvement Increased vitality/energy
levels Improved breathing Greater confidence, self-esteem and
coping Positive changes in life perspective Better health
related-quality of life,
general health, and more…
The above findings have been published in top international medical
journals.
Previous Participants Say …
• “In 8 years this exercise is the only kind that made a
difference” • “I really appreciate being a part of this program. I
feel so much better in so many ways
physically and mentally” • “I feel more confident, it has changed
my personality and health”.
For more information: Email:
2
Figure 1: Mean changes in depression, anxiety and stress scores at
12 and 24 weeks. The values
shown are unadjusted means; I bars indicate 95% confidence
intervals. P values assess difference in
mean scores at 12 and 24 weeks, after adjusting for baseline. CES-D
= Center for Epidemiologic
Studies Depression Scale 10. DASS = Depression Anxiety Stress Scale
21.
3
Baseline 12 weeks
Fig. 2a, b, c. Absolute changes in the three integral indicators of
developing metabolic syndrome [body mass index (a), waist
circumference (b) and insulin resistance (c)] in the intervention
and control groups after 12 weeks. Outliers excluded. Values are
Mean±SEM (error bar). **Significant between-group difference
(p<0.01).
Intervention (n=21)
Control (n=20)
4
Intervention
Control
6
8
10
12
14
16
18
20
Figure 3: Changes in leg strength after 6 and 12 weeks
intervention. Values are means (standard error). **Significant
improvement in the SMILE intervention group compared to control
group (P < 0.01).
baseline 6 weeks 12 weeks
N o.
5
Attachment 1 Abstract of Findings published in the British Journal
of Sports
Medicine http://bjsm.bmj.com/content/44/10/704.full.html
ABSTRACT
Objectives To evaluate the feasibility, acceptability and effects
of a Tai Chi and Qigong exercise programme in adults with elevated
blood glucose.
Design, Setting, and Participants A single group pre–post
feasibility trial with 11 participants (3 male and 8 female; aged
42–65 years) with elevated blood glucose.
Intervention Participants attended Tai Chi and Qigong exercise
training for 1 to 1.5 h, 3 times per week for 12 weeks, and were
encouraged to practise the exercises at home.
Main Outcome Measures Indicators of metabolic syndrome (body mass
index (BMI), waist circumference, blood pressure, fasting blood
glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c,
fasting insulin and insulin resistance (HOMA)); health-related
quality of life; stress and depressive symptoms.
Results There was good adherence and high acceptability. There were
significant improvements in four of the seven indicators of
metabolic syndrome including BMI (mean difference −1.05,
p<0.001), waist circumference (−2.80 cm, p<0.05), and
systolic (−11.64 mm Hg, p<0.01) and diastolic blood pressure
(−9.73 mm Hg, p<0.001), as well as in HbA1c (−0.32%, p<0.01),
insulin resistance (−0.53, p<0.05), stress (−2.27, p<0.05),
depressive symptoms (−3.60, p<0.05), and the SF-36 mental health
summary score (5.13, p<0.05) and subscales for general health
(19.00, p<0.01), mental health (10.55, p<0.01) and vitality
(23.18, p<0.05).
Conclusions The programme was feasible and acceptable and
participants showed improvements in metabolic and psychological
variables. A larger controlled trial is now needed to confirm these
promising preliminary results.
Attachment 2 Abstract of Findings published in the American Journal
of
Preventive Medicine
http://www.ajpmonline.org/article/S0749-3797(11)00264-9/abstract
ABSTRACT
Background Previous studies have shown that qi-gong, a form of
mind–body movement therapy, may be beneficial for people with type
2 diabetes; however, no controlled studies have been conducted to
examine the predictors and mediators of qi-gong effects on
indicators of diabetes control. This study examined the effects of
qi-gong on diabetes control and identified the predictors and
mediators of these effects. Design Randomized Controlled Trial
Setting/participants The study included forty-one participants (16
men and 25 women; aged 41– 71 years) with elevated blood glucose
levels. Interventions Participants were randomized to qi-gong
intervention or a usual medical care control group. Physical and
hematologic measures were assessed at baseline and after 12 weeks.
Main outcome measures The outcomes were indicators of diabetes
control (HbA1c, insulin resistance, fasting blood glucose and
insulin, and 2-hour blood glucose and insulin) and potential
mediators of these (body weight, waist circumference, and leg
strength). Data were collected in 2006 and analyzed in 2007 to
2009. Results Linear regression analyses showed significant
between-group differences in favor of the intervention group in
weight (p<0.01); waist circumference (p<0.01); leg strength
(p<0.01); HbA1c (p<0.05); insulin resistance (p<0.01); and
fasting blood insulin (p<0.01) at 12 weeks. Logistic regression
analyses showed that the qi-gong intervention was a significant
predictor of reduced weight (odds for decreasing by –2 kg=11.14,
p<0.01); waist circumference (by –5 cm=22.50, p<0.01);
insulin resistance (by –0.2 unit=3.75, p<0.05); and improved leg
strength (odds for increasing by 4 stands in 30 seconds=7.00,
p<0.01). The effect of the qi-gong intervention on improved
insulin resistance was mediated by reduced weight. Conclusions The
qi-gong intervention was associated with improvements in weight,
waist circumference, leg strength, and insulin resistance. The
mediation analyses highlight the importance of weight reduction in
the control of diabetes.
Attachment 3 Press release from University of Queensland,
beyondblue and National Heart Foundation UQ revitalizes ancient art
of Tai Chi to help people SMILE A University of Queensland study
has revitalised an ancient martial art into a world-first Tai Chi-
based exercise program that targets obese people suffering
depression, anxiety and stress. UQ School of Medicine research
scientist and mind-body therapy expert Dr Xin Liu said the program
was the first to establish scientifically-significant benefits for
the three common mental health conditions in people with fat around
the waist. He said the research was funded by beyondblue and the
National Heart Foundation and published in the journal,
Evidence-based Complementary and Alternative Medicine. “Depression,
anxiety and stress often co-exist, all are contributing factors to
cardiovascular diseases and other health issues, including stroke,
diabetes, cancer, arthritis, osteoporosis and obesity,” Dr Liu
said. The study of the Sustainable Mastery of Innovative Lifelong
Exercise (SMILE) program involved more than 200 participants aged
between 19 and 77, suffering depression and obesity, with 65 per
cent having a range of other chronic illnesses. Dr Liu said this
program is effective for this group as it has been tailored as an
enjoyable, therapeutic regime that is easily learned and targets
specific internal organs. “The group’s level of severity of
depression decreased by 32 per cent after three months of the
program, and by nearly 40 per cent after six months,” Dr Liu said.
“The study also showed significant improvements in anxiety (by 23
per cent) and stress levels (by 24 per cent) after a six-month
intervention.” Dr Liu said the results also showed improvement in
the participants’ leg strength, essential to increasing physical
activity, adding to mental and heart health benefits. “The program
could also be easily implemented in the workplace where there is
high pressure causing stress and anxiety, thereby benefiting the
wellness of staff and improving productivity.” beyondblue CEO
Georgie Harman said finding something that reduces the severity of
depression or anxiety through regular physical exercise and
building social connections can be a huge challenge. “The research
demonstrates that this form of exercise program may be an effective
way for some people to manage their anxiety or depression, in
concert with other treatment recommended by their GP,” Ms Harman
said. Media: Dr Xin Liu,
[email protected]; Faculty of
Medicine and Biomedical Sciences Media Manager Bernadette Condren,
+61 7 3346 5309,
[email protected] or Reid Sexton, +61 3 9810
6187 or 0413 777 393 to arrange an interview with Ms Harman.
Clinical Evidence
Perceived benefits of participation in the program
Participants reported benefits of the program in terms of both
physical health and mental health.
The most commonly reported physical benefits were
• Improved energy level and physical well being (“more energy”, “
more energetic”,
“stronger”, “improved fitness”, “faster energy recovery”, “more
active”, “feel healthier”,
“program answer to many health problems like joint pain and
stiffness”, “after the program
I feel normal and not sick and can do more”);
• Improved sleeping patterns and bladder function (“no or less
urination at night”; “better
bladder control”);
• Weight and waist circumference reduction (“lost some of my ‘spare
tyre’”, “lost a lot of
weight”, “clothes sized reduced”“1st time in 8 years that my weight
is below 110 kg”,
“having tried other kinds of exercises this was the only kind of
exercise that made a
difference”);
• Improved muscle (“muscle tone improved”, “no or less cramps”,
“increased muscle”).
• Improved flexibility (“more supple and agile”).
Other reported physical benefits included:
• Improved endurance (“with gym program I got more exhausted as
time went by, with the
program I feel better as time goes by”, “able to exercise in a way
not achieved since trauma
in Jan ’96”, “possible to continue with training in spite of
injury”);
• Reduced need for other therapies (“I don’t need to go to a
physiotherapist to have ankles,
hips and shoulders mobilized”).
• Improved sensations (“skin feels better”, “less numbness of arms
and fingers during the
night”);
• Reduced food cravings (“stop myself from eating more”, “ fewer
sweet cravings”);
• Improved immunity (“less prone to infections”, “faster recovery
to minor infection”);
• Lower blood pressure (“reduced/lower blood pressure”, “lower
BP”);
• Lower blood glucose (“blood sugar is down”, “lower BSL”);
• Improved circulation in legs (“the program has improved
circulation in left leg”, “improved
circulation”);
• Improved breathing capacity (“more breath capacity, walking up
hills etc”, “occurrence
asthma minimal”);
• Improved nail growth (“nails longer and faster grown”);
• Pain reduction (“feel no longer pain”, “shoulder pain reduced to
rarely”).
The most commonly reported mental health benefits were:
• Improved confidence, self-esteem and coping mechanisms (“more
confident”, “feel more
confident, confidence has changed my personality and health”, “more
focused”, “focused
on me”, “feel in charge and connected with my body for the first
time”, “some well being
and balance in my life”, “a lot of stress at work and family I
would not have managed it as
well as if I had not been doing the program”, “cope better with
stress”, “cope better with
problems”);
10
• Emotional improvements (“feel happier”, “less sad”, “emotional
stronger”);
• Less stress (“feel peaceful”, “less stress”, “less irritable”,
“stress levels reduced”, “calmer
and less moody”, “exercises helped me to deal with the stress and
release the stress”).
Other reported mental health benefits included:
• Training motivation (“motivated to do the program”, “easier to
develop training regime”);
• Change in life perspective (“I have a purpose to my physical
training: long, healthier,
happier life”, “feel more positive in my outlook”).
• Improved social support (“it was helpful to have other people in
the group to talk to”);
• Family harmony (“family members have commented on how much calmer
and happier I am
now, I didn’t realize I was so difficult to deal with”).
Participants’ plans for physical activity after the
intervention
All participants planned to continue with the SMILE program.
Thanks and appreciation from the participants
Participants expressed their appreciation for the opportunity to
participate in the program, with
comments including:
• “I would like to tell you: thanks, I feel privileged to have
taken part in what, for me, is
probably a life changing and life saving experience”;
• “I have really benefited from this program, this is something I
can do all the time, no
special equipment required”;
• “This 12 weeks has made me form good habits, I walk and exercise
daily, will not go back
to my old way of life”;
• “I found this an excellent program for me, I enjoyed it and I’m
certain my health is now
improving”;
11
• “I really appreciate being a part of this program. I feel so much
better in so many ways. I
feel as though I have a change to have a new start with my
health”;
• “Thank you for the program!!!, the program was excellent”.
More from the Following Randomized Controlled Clinical Trial:
Perceived benefits of participation in the program
Participants reported benefits of the program in terms of both
physical health and mental health.
The most commonly reported physical benefits during the
‘instructor-led’ group training were:
• Improved energy level and physical well being (“I feel more
energetic and a touch with my
physical body. I have a greater sense of well-being and generally
feel my health is
improved”, “I feel that I want to do the exercise more and more.
After the exercise, I tend to
get more energy”, “Now I am not so tired. I have a happy feeling
doing the program with
the class. Gradually feel happier”, “I have more energy, especially
after doing the
exercise”, “Yes. I feel healthier and doing active things easier
than before”, “the program
helps me to concentrate my chi. It makes me aware of my internal
organ where my chi
flows”, “improved strength”, “I feel so much better when I do the
program. It energizes
me”, “I feel stronger more full of energy. I enjoy the exercise and
feel healthier”, “It is the
type of exercise program I have been looking for a long time, apart
from the health benefits,
the overall fitness is beneficial to keep your body strength”, “I
feel I walk taller. I feel a new
strength in my abdomen, back and legs”);
• Improved sleeping patterns and bladder function (“I have slept
better”, “I no longer need to
make 3 or 4 trips to the bathroom during the night. I do still go
1-2 times”, “I also do not
need to get up and go to the toilet so often during the night! A
big plus”, “slept better while
exercising”, “the quantity of sleep has surprised me. I do not have
to get up through the
night”);
• Weight and waist circumference reduction (“I appear to be losing
weight”, “It has made me
exercise, lose weight”, “The activities have helped me lose
weight”, “I have lost a little
weight and intend to continue so”, “I noticed that certain
measurements of my body have
12
decreased”);
• Improved flexibility (“body a little more supple”, “has made me a
bit more flexible than
previously”, “I bend with more ease”);
• Improved muscle and balance (“Accompanied with the program, it
helps with the general
health i.e. muscles and joints and fatty tissues get the movements
(the exercise) that need it”,
“The stretching of the various muscles assist with prevention of
future ailments i.e. kidney
trouble etc”, “Better balance”).
Other reported physical benefits during the ‘instructor-led’ group
training included:
• Reduced pain (“Sciatic pain has gone”, “I suffer shocking
diverticulitis. Always cramping.
In the third week of the program noted No Pain”);
• Improved health problem (“It has helped my arthritis”, “My
Inflammation in my knee joint
is also better. I can lift my leg and bend back, feel so much
better”);
• Improved endurance (“This is the first exercise program that I
haven not had to give up due
to extreme reaction by previous injuries”);
• Improved diabetic symptom (“Well I would say I like the program.
It has helped with
feeling in feet”, “little irritating things, like itchy feet,
disappears”, “Improved my health
especially my feet”).
The most commonly reported physical benefits during the ‘self-led’
home training were:
• Improved energy level and physical well being (“I continue to
feel good in my body and
mind and maintain a good level of physical Activity and Healthy
Eating”, “I have felt great
improvements in my health and well-being, which I attribute to the
program”, “Improved
my health”, “It left me feeling very good”, “When I do the program
I feel more energized”,
“It has shown me a way to improve my health”, “even with limited
participation. I feel I
have more energy”, “I can do more things”, “I feel the program has
improved by health
and wellbeing, making me aware of the importance of regular
exercise”, “I found it help me
to feel good Plus just over all well being”, “I believe the quality
of life is much better and 13
general well being feels whole lot better and I believe I am more
fitter and stronger as a
result. I do have withdrawn if I miss too many days of the
exercise”, “I have not felt so fit
for years. I am sleeping better and my back is the best it has been
for years”, “I feel
generally I have more energy”, “I was feeling stronger and stronger
and healthier”,
“Having been accepted to the program I feel my general health and
well being has benefited
immensely”, “I feel better in myself doing these exercises. I feel
stronger and healthier”,
“The program has made such a difference to me. I feel so much
better physically and
mentally”);
• Improved muscle and flexibility (“I feel my muscles and bones are
improving - able to kneel
down and bend easier”, “I seem to notice my muscle tone has
improved. I feel this indicates
there have been some health benefits”, “I think my muscle tone has
improved and my range
of movement”, “I enjoyed the classes and felt that I gained some
flexibility”, “It has shown
me a way to improve flexibility”, “I could move more
easily”).
Other reported physical benefits during the ‘self-led’ home
training were:
• Improved sleeping patterns (“sleep better”, “I am sleeping
better”);
• Reduced pain (“I have no pain from diverticulitis and no cramping
pain”, “I can do more
things and some of the pain had gone”);
• Improved health problems (“I have no pain from diverticulitis and
no cramping pain”, “My
inflammation in my knee joint is also better”, “my back is the best
it has been for years”);
• Weight and waist circumference reduction (“Yes very much - has
helped me also lose
weight!!!”).
diabetic feet:
• “When I rubbed my hands, for the last time i.e. the third time,
my hands felt like those of a 8
years old boy whereas previously I felt they were the hands of a 58
year old man”;
• “Before I started this program, I had the feelings of pins and
needles in the sole of my feet 14
for over a year and half. The short time I was able to do this
course there was a change for
the better and I felt a lot happy with this improvement. There was
a change in the next two
weeks after attending the class as this pins and needles started to
get better. In the past six
weeks, it has stayed the same improvement”).
The most commonly reported mental health benefits during the
‘instructor-led’ group training were:
• Improved confidence, self-esteem and coping mechanisms
(“Confident that I can personally
continue to look after my health without looking for the most
appropriate activity”, “feel
that my emotional, physical and intellectual attributes are in
greater harmony”, “I feel
more confident than before”, “feel better about myself”, “exercise
and focus and more
calmness at end”, “Secure”, “Provided new way of thinking about
exercise and diabetes”);
• Emotional improvements (“I am generally feeling a lot more
positive”, “Feel mentally
healthier”, “I feel happier! I feel better about myself”, “I have
been more positive and able
to handle stress problems”, “I feel it has help me to get out and
do things”, “I feel
extremely happy”, “I behave a bit calmer and my mood may possibly
be a little better”, “I
feel happier and more optimistic”);
• Less stress (“Slightly more relaxed”, “the program clears my
mind”, “I also feel calmer”,
“Very good program. Helps with stress”, “relaxation”, “I feel
calmer and more balanced
and temperate in my moods”, “I feel more tolerant and less stressed
about daily grind”, “I
have been more positive and able to handle stress problems”, “Less
tense, more relaxed and
calm”);
• Training motivation (“The program has also motivated me to do
other things to improve my
health, e.g. more exercise etc.”, “I am keener to do exercise”,
“The exercise is addictive
and one can do it anywhere and not dependent on any sport equipment
one gets committed.
And enjoy it immensely”, “I look forward to doing the program –
sometimes twice a day.
The exercise program is more interesting and demanding than other
forms of exercise. I
found I have to concentrate more, synchronize my breathing styles
and get the benefit of an
exercise regime that I can do for the rest of my life”, “It is a
holistic exercise which should
be of great benefit. I would like it to be a part of my
lifestyle”);
15
• Change in life perspective (“More positive attitude”, “I am happy
and peaceful most of the
time, because I know will be able to exercise whenever or wherever
I will be; and thus
regulate my general health and diabetes mellitus”, “It gives
confidence and hope for the
future, it is in fact for me”, “The Gift of Life”, “I have learned
skills that I can do easily
ANYWHERE (without equipment) for the rest of my life. It works and
I intend to keep it up,
perfecting it in the years to come. I liked the fact that I
exercise the whole of my body and
my mind. You can not beat that”, “I feel much better, have a better
outlook (more positive)
and look forward to the future”, “It has shown me a way to improve
my own health and this
has given me new hope for a healthier future”).
Other reported mental health benefits during the ‘instructor-led’
group training included:
• Family harmony (“It has also calmed me down and able to cope with
my home life (invalid
husband)).
The most commonly reported mental health benefits during the
‘self-led’ home training were:
• Improved confidence, self-esteem and coping mechanisms (“I feel
mental and physical
healthier”, “I am more conscious of my weight and general well –
being. I am aware that I
have to do the program to prevent me from early type II Diabetes.
It is a constant reminder
to me that health is so important”, “Improved my feeling about
myself, i.e. more capable”,
“opened up another aspect of my life”, “the program has made me
aware of the different
part of the body where the 'Chi' will flow”, “it does make me feel
healthier physically and
mentally”, “It left me feeling very good”, “I have generally
continued to feel much better
about myself, both physically and emotionally”, “I feel the program
has improved by health
and wellbeing, making me aware of the importance of regular
exercise”, “It is a holistic
exercise which I believe will help me if I can persevere”);
• Training motivation (“I believe that I will continue to do the
program because of the benefit
and well being it promotes in oneself. It feels like a ‘knowledge’
or contentment–Whatever”,
“I think the program has been a great help”, “helps with focus and
exercise”, “I think of
my health more often”, “the program has helped me personally. It
has given me some
regular exercise which I did not have prior to the program”, “Only
that I will not go a day
16
without doing my exercise program”);
• Emotional improvements (“I do feel more positive usually”, “I am
happier”, “I feel very
relaxed and clam”, “My mood has improved”, “It has got me feeling
and thinking better”,
“The program has made such a difference to me. I feel so much
better physically and
mentally”);
• Less stress (“I am a lot calmer within myself”, “I feel calm”,
“has helped me with stress
problems”, “I also handle stress better now”).
17
Participants expressed their appreciation for the opportunity to
participate in the program, with
comments including:
• “At this stage, I feel that I would like to do the program as
part of my lifestyle, so that I can
maintain my weight and health well-being. I would like to continue
to do more the program
if there is any further research. I feel very privileged to be in
the program. Much thanks”;
• “I am so glad I am on this program and will be continuing the
life-style changes I have
made”;
• “I thought the whole program was EXCELLENT. 1. The instructor is
very professional and
a good teacher. One of the best I have seen. I have been a teacher/
educator for over 30
years. 2. I have experienced a good, purposeful, selection of
ancient exercise – tried and
proven - that will help anybody to exercise their whole body and
mind. Very good. 3. I have
noticed some great benefits as a result of this program. i.e. I
sleep better, I sleep less but
awake sharp and refreshed, the exercise regime makes me feel
energetic for a long while, I
concentrate better, I have lost weight and centimeters of my waist,
I feel more positive, I like
the exposure to ancient Chinese medicinal skills”;
• “I liked the fact that the teacher did every exercise EVERY time
we worked together and
that he took the time to carefully explain, explain, explain any
little thing we wanted to know
as many times as we wanted. He was very good, very knowledgeable,
professional and
clearly very highly skilled”;
• “I would like to thank the University of Queensland people of the
SMILE program”;
• “I haven not done the program much over the last 6 weeks and I
have put on weight, sleep is
not as good, do not have the energy I had when I was doing the
program, get tingling in my
feet (which went away when I was doing the program during the 12
weeks of class) and
generally do not feel as good as I did when I was at the program. I
now realize how useful
the program is to me and I am going to pick it up again. I feel
better, eat better, sleep better
and little irritating things, like itchy feet, disappear. I believe
the program is very subtle, but
18
effective and can be deceptive in that you do not think it is
making much of a difference –
until you stop – then you suddenly see what it was doing. It is a
MUST program and a wise
investment in oneself. Program participants would benefit from a
follow on maintenance
program”;
• “I think the program has greatly added to my quality of life and
I intend to continue with the
exercises. But I would greatly appreciate being able to attend more
sessions. I think there
should be a follow up weekly sessions to enable the students in the
program to build on our
healthy success. It was a pleasure to participate in this
study”;
• “I am grateful for the opportunity of participating in this
program. I know that had I been
part of a group after the medical procedure, I would have found it
easier to overcome the set
back. Six week program is too short”;
• “I feel very lucky having met our teacher and being introduced to
the program. I feel it is
very beautiful for my health and wellbeing. I hope to be able to
increase the number of
sessions I do at home, and hopefully join a program if there are
any organized at the
university”;
• “Health wise I have gained benefits due to this program. My body
has loosened up which
gives me more energy”;
• “My feeling about myself has improved. My feet are back to
normal. I miss the classes - our
teacher gave of himself totally and helped us in any we asked when
doing the classes as well
as making himself available for queries before and after the class.
I feel privileged to have
been part of the study”;
• “Only having 6 weeks I feel our teacher is wonderful and very
understand but feel short
changed expecting 12 weeks. After 6 weeks, I can bend, lift my leg,
and no pain from my
diverticulitis - What would have 12 weeks done. I will keep it up
at home and I am so
grateful. Thank you”;
• “My doctor was so pleased he did a lot of tests all were better
than before the diabetes
program”;
19
• “I have appreciated the opportunity to participate in this
program. Our teacher was a very
good teacher who related very well to students. He made the
sessions relaxed and enjoyable
and was able to generate a good feeling in the group”;
• “the program has broadened my knowledge of health and the
importance of the program. I
am very impressed with the expertise from our instructor. I am very
fortunate to be able to
join this research program”.
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Attachment 5: Benefits and Comments from Previous 2 Days Weekend
Course
Participants:
My feedback:
• Cost, Venue, Meals, Facilities on site and nearby parking –
EXCELLENT
• "SMILE PROGRAM" on arrival made to feel very welcomed -
EXCELLENT
• Introduction & background to SMILE program informative, this
clearly spelt out for me
that SMILE was clearly focussed on my Type II Diabetes issues –
EXCELLENT
• Presentation and use of Aids to deliver knowledge and
skills/technique very easy to follow,
very good use of time during course presentation and timing of
breaks, 2 day duration for
course was appropriate – EXCELLENT
• Design of SMILE content very user friendly, it's low impact on
the body, it's centralised to
one spot (either standing or sitting) and personal health gains
will increase through
proficiency - EXCELLENT, Personal responsibility = Personal health
gains.
Participant 2:
• Thank you so much for the Smile Program at weekend.
• I admire your high standard of Chinese Wushu, knowledge in
medicine, your teaching
method, your interacting way with people and your beautiful
personality.
• It was a wonderful workshop and I enjoyed very much.
• I felt that this program is going to be very effective.
• Because of the nature of my health and depression I have tried
everything I could to improve
my condition but sometimes not very successful because my body
often reacted very
intensely. I have been learning community Tai Chi but I felt your
program is much more
effective. I attended Qigong exercise in park too, but it was too
intense for me; I was too
tired and felt too bloated with Qi afterwards. Your exercise was
very gentle, easy and
enjoyable. After the workshop yesterday, I felt as if I had hot
spring bath; I felt warm and
comfortable. I slept soundly without taking a sleeping pill, I did
not feel bloated although I
21
could feel Qi which stayed quietly and comfortably at Dantian. I
haven't felt so comfortable
for long time since I became depressed. Other people may not be
able to feel the effect so
quickly, but after continuing for a few months I am sure everyone
will feel the benefit.
• I definitely would love to continue with this program and to
learn more.
Participant 3:
• After the Saturday class, I went home pleasantly tired but
feeling very uplifted in spirits and
not as stressed.
• I slept well that night, without the extreme discomfort I had
been experiencing in my feet
lately and having only one trip to the toilet at about 3.40am.
(Believe me this was an
absolute blessing.)
• Sunday morning I woke up feeling lighter in spirit and with more
bounce in my step and
eagerly looking forward to the next class.
• I also found I could remember quite a few of the moves from the
day before and that my
concentration wasn't quite as lacking as it usually is.
• I also noticed a decline in the number of times I went to the
toilet on Sunday in comparison
to Saturday.
• I could really feel the effects of improved circulation in my
body. Found the exercises easy
to do without aching all over.
• Slept well Sunday night, again, without any discomfort with my
feet and only one trip to the
toilet.
• Extremely grateful that I was given this opportunity to
participate in these classes and the
fact that I was aware of and could feel improvements in my health,
especially just after the
first day.
• The course was well run, easy to follow and good fun. I look
forward to the next stage.
Participant 4:
• I found the weekend very good and will be joining you for the 3
times a week course if you
can keep me informed
22
• I thoroughly enjoyed the program. I think however that it could
be condensed into 1.5 days-
just shorten the breaks for M & A/Tea and lunch.
• I find the DVD ok, but would prefer weekly classes-the energy is
better. I look forward to
classes starting soon.
Participant 6:
• Personally, I thoroughly enjoyed last weekend attending the Smile
Program and came away
feeling empowered that I now have the knowledge to really make a
difference in controlling
my Type 2 Diabetes.
• Dr LIU Xin's ability to impart his knowledge in such a succinct
and relaxed manner soon
had everyone participating in such a friendly way. I am sure that
once we experience
improvements in our own health, word will automatically spread
throughout the community
regarding the health benefits of the Smile program.
Participant 7:
• Thank you and Dr Liu for such a fantastic weekend. I would highly
recommend this to
anyone not just those with medical problems.
• I did not attend with a view to fixing any of the mentioned
medical issues as I do not have
any of them. However, I have been attending Dr Liu’s classes here
at UQ St Lucia and
found that they gave me a mental focus (and relief) that benefited
me immensely at a time
when stress levels at work were extremely high. I wished to explore
this further.
• As a result of the often very hard physical work I have done over
the years and still do, and
as I get older, I find I do not recover as well as I used to and
often can be relatively stiff and
inflexible due to overworked muscles and old injuries combined with
my 8hrs of mainly
sitting for work.
• After Dr Liu’s weekend I felt renewed. My body ‘flowed’ once
again instead of feeling like
all the joints and muscles needed lubricating before they could
work properly. Everything
had loosened. I felt like I had done a great workout – tired, but
everything was back in sync.
I am finding it hard to put in words, but both my mind and body can
remember the feeling of
being extremely fit and pushing to the limit – it was like Dr Liu’s
program brought this
connection back to life. When I walk I can feel my body working
again – I can feel my
muscles working together, feel the seamless connections instead of
hesitations because of
23
twinges, etc. I can stretch my entire body first thing in the
morning without cramping in a
number of places. The word I have finally thought of is that my
body and brain felt satiated.
Participant 8:
• I thoroughly enjoyed the weekend SMILE program and definitely
wish to do the 3 month
follow-up program (Mon, Wed & Fri nights) throughout
August-October and then to
complete the train-the-trainer program, as I would really love to
be involved in making this
great program available to as many people as possible as soon as
possible.
• In terms of other feedback, I loved the great sandwiches and
fruit provided, but was
disappointed by the morning and afternoon tea offerings of muffins,
biscuits and high-sugar
muesli bars. In fact I was quite shocked that these were the only
options provided and no
healthy options were available, in light of the aims of the SMILE
program!
• Please put my name on the list for the Aug-Oct SMILE program, as
I can't wait to practise
what I learned with the benefit of group energy and to learn more
so I can teach it to others
for their better health too.
Participant 9:
• I am one of the Mungindi Three and thoroughly enjoyed the
weekend. I think that it was
well-structured and inspiring enough for me to continue doing the
program. Indeed, I think it
has had a big impact on my mental well-being.
Participant 10:
• I really enjoyed the workshop with Dr Liu and am interested in
participating his next
sessions (trial program).
Participant 11:
• I did enjoy the workshop very much and got a lot out of it,
thanks to Dr Liu.
Participant 12:
• I really enjoyed participating in the smile program at the
weekend and got a great deal out of
it. The Dr was a great teacher and conveyed the course with a
degree of professionalism and
friendliness.
24
Participant 13:
• The Smile Program weekend course at the PA Hospital on 30 June/1
July conducted by Dr
Liu Xin was very enjoyable and informative, and offers me definite
health benefits.
• I would be keen to participate in the proposed 3 sessions per
week for 3 months as
mentioned by Dr Liu Xin for future follow up.
Participant 14:
• Thank you very much for your help. I really enjoyed the weekend,
and we played the DVD
through last night. Dr. Liu Xin is an excellent teacher and has
produced a DVD that is so
easy to follow.
Participant 15:
• I would like to thank you for the special training weekend and I
will now try to explain the
very positive effects my body experienced as a consequence of the
course. I had a lot more
energy on the following Monday and to my surprise I noticed my
right knee wasn't stiff and
painful while putting my flipper on in the water. This usually
stiff knee has been good all
week.
• My back and shoulders feel loose and free and much easier to
move. On Tuesday and
Wednesday I felt a little good sore in my back and thighs. This was
a big change from
feeling stiff and sore all over as I used to feel before the
weekend.
• I was amazed learning part one warm up 1 -7 in a weekend. All the
extra tips made such a
difference, e.g. strengthening the bladder during trembling.
• The weekend was a wonderful taste of the program's benefits but I
really need a lot of group
training to master part 3 patting and the cooling down massage. I
look forward to hearing
from you regarding the new 3 month program on Monday, Wednesday and
Friday.
Participant 16:
• I'd like to say what a thoroughly enjoyable week-end it proved to
be and ask if you could
please email me copies of the papers that were available for
reading at the course?
Participant 17:
25
• I firstly want to say big thanks (with a smile) for a wonderful
weekend. I am still feeling the
free flowing chi, and my liver is calmly humming. Also I am quite
profoundly aware of the
depth and integrity of the system and its capacity to heal on many
levels.
• As you know I am very very interested in the Instructor Training
course, and await the
details of the weekly classes starting in July.
Participant 18:
• Dr Liu is an amazing individual with a wonderful program to share
and I enjoyed learning
the program.
Participant 19:
• We enjoyed a very stimulating and enjoyable week-end with Dr Liu
Xin and a nice group of
other people, so please convey my thanks for that.
Many more…
Attachment 6: Benefits and Comments from Previous 3 Months
Course
Participants:
SMILE 3 Months Course
• I have been able to have my main medication for blood glucose
control reduced by 75%
and have been able to completely cease another medication
prescribed for Gastro-
Oesophageal Reflux Disease
• My energy level has been greatly increased
• My weight has been reduced considerably and I have been able to
keep it at a stable level
• Digestion is so improved that I am now completely free of any
symptoms of GORD
• I am much more motivated to accomplish more, such as tasks, “to
do lists” and better
lifestyle management etc.
• My muscles, Lower Leg especially, have improved in strength and
tone.
• Balance and co-ordination also improved
• I very much enjoy my weekly classes with the other participants
and greatly appreciate the
professional tuition of Dr. Liu Xin.
• The three month program has been more beneficial than I ever
could have expected. I
experienced major improvement in how I feel ever day including more
sleep and the loss of
8 kg.
• I found that I was able to do the exercises and slowly but
progressively felt stronger from
head to toe. I feel I’m standing taller, straighter and
stronger.
• As I progressed through the program I slowly experienced the
following:
o Increased energy which enabled increase in exercises such as
swimming
o Flexibility
o Slow but gradual weight loss
o A reduction in the amount of fluid in my feet
o I am now walking further and longer than what I was previously
able to do
o A lot less sleeping during the day
o I developed a tolerance to minor sore muscles following
classes
o I now can tolerate sweating a lot from the exercises
27
• The different parts of my body were impacted as follows:
o SLEEPING – Before I started the program I always felt too tired
to care passed what I
had to do and what I had to do was a real effort. Because I am
sleeping so much better
and only going to the toilet once a night instead of 3 – 4 times a
night I am not so tired.
Now I feel like doing extra things that interest me. I just feel
happier all the time.
o BREATHING – I have found that I have stopped holding my breath, a
bad habit I didn’t
realize I was doing a lot of the time. My breathing has become a
lot deeper and stronger
rather than being shallow most of the time.
o LEGS – I feel lighter and I stand stronger instead of wanting to
sit down all the time.
o FEET – I can now do the whole program in no shoes. This is a huge
improvement for me
because my feet normally cause me pain and discomfort and I have to
wear runner with
arch support everywhere. I can now bend over to do up shoe laces
now. Before the
program I had to put my foot up on a chair etc to reach the
laces.
o NECK – My neck now moves freely and I can not remember my neck
ever being so
flexible. My neck used to always be stiff and I was continually
frightened to move
fearing it would seize up. I always suffered lots of head arches
and now I hardly get any.
o BODY - I can roll over in bed and not feel stiff and so sore all
the time. Little jobs like
bending into low cupboards are a lot easier.
o BACK – I can move again and turn easily to check traffic while
driving. Before the
program I felt my back could easily seize up.
o ARMS – My arms feel lighter and so much stronger especially
holding up for a long time
during the carry water exercise.
o APPETITE and CRAVINGS – I now don’t want for as much food and
drink.
o BODY SHAPE – I now feel a slight change by being able to feel
muscles in my upper
arms and bottom and my legs pass each other easier.
o WAIST – I can feel the muscles working when I move.
o BLOOD PRESSURE – My blood pressure has been very high for a long
time it came
down after the first and subsequent SMILE courses but my doctor was
concerned at how
high the diastolic pressure was so he put me on a higher grade
blood pressure pill
coincidentally at the start of the last course. My blood pressure
readings at the start of the
last course averaged 137 / 99 and my pulse was 70. The new blood
pressure pills had an
immediate impact however my blood pressure has continued to
decrease and I am sure
28
this is due to doing the SMILE Program. My average readings are now
115 / 78 and my
pulse is 73.
• The people on the Smile Program are all very friendly / happy
lot. Everyone feels part of the
group and they are happy to share their positive stories with each
other e.g. weight loss,
body shape changes, taking less prescription pills and feeling so
much better for it. I can feel
huge class energy when Dr Liu Xin is watching everyone. I still
have a long way to go with
weight loss but I never expected to feel this good ever again
especially with my current
weight. Thank you DR Liu Xin for sharing your years of experience
by helping all the class
with their individual needs. I look forward to pushing myself for
the next 3 month program.
Once again thank you so much for what you have done for me.
• Since my participation in the SMILE Program, I’ve noticed some
positive changes in my
health, Diabetes and my general well-being:
o Firstly, my Diabetes management outcomes are more positive and
easier to manage with
my doctor being very happy with my results in HbA1c and other areas
of my condition
o Secondly, I’ve lost about 3-4kgs and my waist size has reduced
around 5cm
o Thirdly, my leg and arm strength has improved considerably
o Fourthly, my general health and outlook on my diabetes is
improved
• Week 1-4
I realized that I hadn't been involved in any routine exercise
program for years, due to being time
poor & running my own business and that the Smile program was
the perfect way to get my body
back into shape as it is a gentle routine & the music is
relaxing. The first few weeks I felt quite tired
throughout the day & was yawning several times throughout the
routine. I also moved house in the
first week, when I became stressed I was able to focus on relaxing
through breathing slowly &
focusing my thoughts, which I had learnt on the weekend
course.
My appetite started to decrease around the 2nd week I also started
to concentrate on keeping my PH
levels balanced and increased my water intake, and dropped back on
coffee and alcohol intake.
My knee had been swollen for a few months prior, I had receiving
Acupuncture but had no relief,
by the fourth week of class the swelling had gone down & the
ache was subsiding
Week 4-8
29
By the 4th week I had lost 3kg, mainly around the waist &
bottom half as I went down a size in
pants. As I became familiar with the routine I focused on
lengthening & pulling up throughout the
lesson & now can feel my muscles tightening & building in
my arms, legs & stomach...feels great.
It's amazing that the exercise feels simple and yet the physical
rewards are so beneficial. My energy
level has increased; my headspace is light and content.
Week 8-12
My knee has stopped aching so I walk up and down the stairs to each
lesson, I have discovered I
have biceps developing (could be the chairs we move!). I am
sleeping through the night, have more
energy, I enjoy parking in the furthest spot at shops and walking.
My acupuncturist is impressed
with the improvement of my energy levels. Overall I'm feeling
great.
The class energy is a bonus as everyone enjoys turning up and
working hard, and we all leave
happy to have come to class and exercised, at the end of the week
you realise how important it is to
dedicate a minimum of 4.5hrs a week to focus on yourself and only
you.
I think if there are to be trainers that it would be good to work
in some form of unity with a clear
vision of the SMILE Program in place, I feel there is a great
benefit in running it as a 3 month
program rather than a fitness class that you attend on odd
occasions, as throughout this time people
can become aware of the physical / emotional changes that occur and
there is also the gentle
reminders and positive input that change can occur with
persistence. Re-education takes time.
In the 3 months I have noticed friendships have started to develop
which can then form a network of
ongoing support.
The 3 months program has proven results in place, with growth of
this format of class throughout
Brisbane / Aus... It would produce further positive results. This
could grow into stronger
community support which may produce greater recognition with
medical practitioners, Diabetes
Australia & hopefully federal government for funding
opportunities.
• It has been a positive change for me just to commit to an
exercise program for three sessions
a week and to attend them. I feel that I do have more energy and
feel motivated to walk
more but I also know that I still have a long way to go. The
program still challenges me in
many ways. I still need to modify some of the arm movements but
there is progress. The 30
rehabilitation has been slow following the surgery but I have
noticed the right arm gradually
getting stronger with program.
• My leg muscles and joints have strengthened from movements such
as ‘trembling’ and
‘walking on the mountain’, and the massage techniques.
• My overall balance has improved for the whole body.
• My lower stomach muscles definitely feel stronger and more
toned.
• Consciously, being more aware of breathing ‘in and out’ during
exercise is helping
relaxation and lowering stress levels.
• Consciously, being more aware of breathing ‘in and out’ during
exercise is helping
relaxation and lowering stress levels.
• I find the visualization of moving and strengthening internal
organs in the program is a
positive incentive in improving health, and targeting specific
areas.
• Greater flexibility – much easier to perform simple task like
tying shoelaces
• Greater stability / balance – much easier to perform tasks at
ground level that require
bending or reaching down
• Have lost 4 kilos – 2 notches on the belt – much thinner in the
face
• Feel great – not as stressed – handling conflict situations
easier - more relaxed about a lot of
things
• Sleeping better
• Seems easier to maintain diet
• I feel I am slightly more toned, I don’t have as much ‘back to
grasp’ as I used to. My blood
sugar levels haven’t changed significantly but they are more
stable.
• Most noticeable for me is the fact that I don’t need to go to bed
at 8:30pm because of
fatigue. So I guess my energy levels have improved.
• The SMILE program relieves my stress and tight knots especially
sitting at my desk for the
whole day in the university. I feel very relax and happy after each
lesson. After 12 weeks
of SMILE program, I lost about 3kg without any major changes in my
diet. I do realize my
appetite becomes smaller and lesser tendency to overeat nowadays.
As I have been
sedentary for more than a year, the gentle movements are great to
get me back to exercise. I
can feel my leg muscles are toning up after 8 weeks into the
program.
31
• As I used to train competitively in tai chi during my younger
days, the techniques taught
by Dr Liu in SMILE program makes what I have learnt in the past
more wholesome. The
knowledge imparted by Dr Liu makes me understand better how our
body works and
how certain movements can be beneficial to our body. Dr Liu
conducts the class in a
friendly and relax manner which promotes good learning. He revives
my good old days and
makes me want to pick up where I have stopped. I really enjoyed the
class and wish to
continue to learn from Dr Liu if there is an opportunity.
• I continue to thoroughly enjoy your teaching and have felt a
significant positive change in
feeling more focused and grounded. My massage clients and Yoga Chi
Gung
participants are all enjoying (and noticing) the benefits.
• Although diagnosed with osteoarthritis (have had a full hip
replacement) and borderline
osteoporosis I have no symptoms of these conditions. I have
excellent blood pressure,
cholesterol levels and I am very energetic for my age. In addition
I am fortunate enough to
have a great sense of wellbeing. I attribute this to participating
in Dr. Liu’s program. The
program has obviously improved my muscular strength, flexibility
and aerobic fitness which
have allowed me to maintain good health. It has also enhanced my
mental and physical
relaxation which has led to my sense of wellbeing.
• I have enjoyed the exercise and have noticed and increased
fitness and I feel stronger
physically.
• It has been enjoyable to participate in a supportive group and to
learn some theory behind
the practice of the program.
• I feel more relaxed and able to cope better with stress
situations at work.
• I look forward to the Train the Trainer course and ultimately
being able to help others
experience the benefits of the program.
• I am more relaxed and enjoying more feeling of sex.
Many more…
32
ABSTRACT
ABSTRACT
Background Previous studies have shown that qi-gong, a form of
mind–body movement therapy, may be beneficial for people with type
2 diabetes; however, no controlled studies have been conducted to
examine the predictors and mediators of qi-gong effect...
Design Randomized Controlled Trial
Setting/participants The study included forty-one participants (16
men and 25 women; aged 41–71 years) with elevated blood glucose
levels.
Interventions Participants were randomized to qi-gong intervention
or a usual medical care control group. Physical and hematologic
measures were assessed at baseline and after 12 weeks.
Main outcome measures The outcomes were indicators of diabetes
control (HbA1c, insulin resistance, fasting blood glucose and
insulin, and 2-hour blood glucose and insulin) and potential
mediators of these (body weight, waist circumference, and leg
st...
Results Linear regression analyses showed significant between-group
differences in favor of the intervention group in weight
(p<0.01); waist circumference (p<0.01); leg strength
(p<0.01); HbA1c (p<0.05); insulin resistance (p<0.01); and
fasting blood...