Qigong as a Novel Intervention for Service Members With Mild Traumatic Brain Injury

Abstract

Purpose:To describe the experience of internal qigong practice in service members diagnosed with mild traumatic brain injury (mTBI). Theoretical Framework:The study used qualitative descriptive phenomenological methods originally described by Husserl and later refined by Giorgi. Methodology:Participants were interviewed about their experiences while learning qigong to determine their level of interest, benefits, and/or adverse effects; ease of learning/performing the routine; and any barriers to practice.Sample: Six service members with mTBI receiving outpatient neurorehabilitation at the Defense and Veterans Brain Injury Center-Charlottesville Rehabilitation Center.Intervention: Participants learned Reflective Exercise Qigong, a form of qigong developed specifically to require less complex movement and balance than most forms of qigong, making it ideal for those with potential coordination and balance issues.Data Collection: Semistructured interviews took place after four weeks of formal qigong instruction, then again after the subjects completed eight weeks. Interview data were analyzed with phenomenological methods described by Giorgi.Results: Four themes emerged from the interview data: "the physical experience of qigong," "regaining control," "no pain, a lot of gain," and "barriers to qigong practice." Participants offered examples of how qigong enabled them to control refractory symptoms after mTBI while decreasing reliance on pharmacotherapy. All agreed that qigong was uniquely conducive to the disciplined mindset of military service members and that the simplicity of Reflective Exercise qigong, compared with similar modalities such as tai chi and yoga, was well suited to individuals with decreased balance, cognition, and memory related to mTBI. Key words:Mild traumatic brain injury, mTBI, qigong, reflective exercise, phenomenology, military (Explore 2013; 9:142-149. Published by Elsevier Inc.) INTRODUCTION Traumatic brain injury (TBI) is a topic for which its relevance cannot be overstated. Journals, newspapers, magazines, and Web sites reveal new insights and information on the significance of TBI and concussions on a near-daily basis as it pertains to the populations of youth and professional athletes as well as military service members. Studies report that the prevalence of TBI in service members returning from deployment in either Iraq or Afghanistan is as great as 22.8% 1 -a rate for TBI that has caused a call to arms in the military community.It is estimated that 70% of all recent combat-related injuries are the result of a blast 2 and that approximately 60% of these blast exposures may result in a brain injury. 3 The vast majority of battle-related TBIs are mild in nature and may result in symptoms such as headache, depression, memory loss, sleep disturbances, personality changes, anger, communication disorders, cognitive deficits, vestibular disorders, and tinnitus.

Qigong in Injured Military Service Members

“…Some participants reported improvements in sleep quality and somatic symptoms. These findings are consistent with research supporting improvement in mood and reductions in stress, anxiety, depression, and anger with Qigong practice (Jahnke et al, 2010;Johansson et al, 2008;Tsang, Fung, Chan, Lee, & Chan, 2006) and improvements in self-esteem as well as decreased anger and anxiety in patients with TBI (Blake & Batson, 2009;Yost & Taylor, 2013). Reports of decreased anger in this study are promising since anger is a common problem in WII and in those with PTSD.…”

“…An increased sense of empowerment in WII in this study is supported by a recent qualitative study of six military service members attending a rehabilitation program for mild TBI. These researchers identified the theme "regaining control," citing examples of how participants used Qigong to manage anxiety, anger, flashbacks, and chronic headaches (Yost & Taylor, 2013).…”

Biopsychosocial benefits of movement-based complementary and integrative health therapies for patients with chronic conditions

“…[6][7][8][9][10] Moreover, patients in our study developed skills to better cope with physical and emotional distress and health comorbidities, reflecting findings from other qualitative studies. 13,14 Providers who encounter patients with complex physical, psychological, and social comorbidities, as many Veterans have, may consider discussing MBT modalities with patients as alternative or adjunctive strategies to traditional medical treatments. These discussions may hold particular salience for patients seeking alternatives to medication, or as part of an opiate reduction plan.…”

“…13 In a separate study, military service members described increased control over their health and traumatic brain injury symptoms following participation in qigong. 14 Engel's 15 biopsychosocial model ( Figure 1) offers a comprehensive framework in which health and illness encompass the biological, psychological, and social dimensions of patients' lives. We therefore sought to understand perspectives of benefits derived from MBT among patients with chronic illness, and how these addressed biopsychosocial aspects of individual chronic illness experience.…”

The Lived Experience of Individuals with Chronic Traumatic Brain Injury: An Adapted Group Yoga Intervention

“…Attaining this level of care means focusing on an individual's self-perceived experience when designing and implementing interventions in order to enhance outcomes [23]. One way to progress toward this goal is through the expansion of phenomenological inquiry into efficacy and feasibility studies in order to understand the individual's lived experience of the intervention [5,7,24]. The current study used a phenomenological approach to obtain rich narrative data to inform the understanding of how individuals with TBI experience an adapted yoga intervention.…”