{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T23:55:42Z","timestamp":1771026942039,"version":"3.50.1"},"reference-count":60,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Mandatory lockdown resulting from a pandemic may be effective against the physical impact of the virus; however, the resulting mental strains can lead to the development of several mental disturbances. Taijiquan and Qigong are considered traditional vegetative biofeedback therapies that allow the practitioner to control the functions and processes of the body through specific movements or stances, breathing techniques, and meditative exercises. This study aims to understand if these techniques can be applied as an online distance therapeutic option to reduce the psychological impact of home confinement and social distancing. Sixty-four participants were recruited and allocated to three groups. The experienced and novice Taijiquan and Qigong participants\u2019 groups received the intervention for 8 weeks while the control group did not receive any intervention. The outcomes were psychological well-being and psychological distress levels and were assessed by the Mental Health Inventory and a written interview. The experienced Taijiquan and Qigong participants achieved significant improvements in psychological well-being and psychological distress. Novice Taijiquan and Qigong participants achieved a significant improvement in anxiety levels. Additionally, the control group showed a significant decrease in psychological well-being. This study suggests that this distance online program of Taijiquan and Qigong is feasible and may benefit the mental health of participants during a lockdown.<\/jats:p>","DOI":"10.3390\/healthcare10101843","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T23:13:27Z","timestamp":1664147607000},"page":"1843","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Mental Health Benefits of a Traditional Vegetative Biofeedback Therapy Online Program during the COVID-19 Lockdown: A Controlled Trial"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5892-1855","authenticated-orcid":false,"given":"Jorge Magalh\u00e3es","family":"Rodrigues","sequence":"first","affiliation":[{"name":"ICBAS, School of Medicine Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal"},{"name":"IPTC\u2014Research Department in Complementary Medicine, Portuguese Institute of Taiji and Qigong, 4470-765 Maia, Portugal"},{"name":"CBSin\u2014Center of BioSciences in Integrative Health, 4200-135 Porto, Portugal"},{"name":"Health Level, ABS\u2014Atl\u00e2ntico Business School, 4405-604 Vila Nova de Gaia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9594-7982","authenticated-orcid":false,"given":"Catarina","family":"Santos","sequence":"additional","affiliation":[{"name":"IPTC\u2014Research Department in Complementary Medicine, Portuguese Institute of Taiji and Qigong, 4470-765 Maia, Portugal"},{"name":"Health Level, ABS\u2014Atl\u00e2ntico Business School, 4405-604 Vila Nova de Gaia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6478-4735","authenticated-orcid":false,"given":"Cristina","family":"Ventura","sequence":"additional","affiliation":[{"name":"IPTC\u2014Research Department in Complementary Medicine, Portuguese Institute of Taiji and Qigong, 4470-765 Maia, Portugal"},{"name":"Health Level, ABS\u2014Atl\u00e2ntico Business School, 4405-604 Vila Nova de Gaia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4570-5445","authenticated-orcid":false,"given":"Jorge","family":"Machado","sequence":"additional","affiliation":[{"name":"ICBAS, School of Medicine Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal"},{"name":"CBSin\u2014Center of BioSciences in Integrative Health, 4200-135 Porto, Portugal"},{"name":"Health Level, ABS\u2014Atl\u00e2ntico Business School, 4405-604 Vila Nova de Gaia, Portugal"},{"name":"LABIOMEP\u2014Porto Biomechanics Laboratory, University of Porto, 4200-450 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"key":"ref_1","unstructured":"ProMED (2021, December 30). Undiagnosed Pneumonia\u2014China (Hubei): Request for Information. Available online: https:\/\/scholar.harvard.edu\/files\/kleelerner\/files\/20191230_promed_-_undiagnosed_pneumonia_-_china_hu-_rfi_archive_number-_20191230.6864153.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jhep.2020.09.031","article-title":"COVID-19: Discovery, diagnostics and drug development","volume":"74","author":"Asselah","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_3","unstructured":"World Health Organization (2022). Weekly Epidemiological Update on COVID-19\u20144 May 2022, WHO."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/S0140-6736(21)02796-3","article-title":"Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 2020\u20132021","volume":"399","author":"Wang","year":"2022","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/S0140-6736(20)30185-9","article-title":"A novel coronavirus outbreak of global health concern","volume":"395","author":"Wang","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1007\/s12098-020-03308-w","article-title":"Effect of the pandemic and lockdown on mental health of children","volume":"87","author":"Thakur","year":"2020","journal-title":"Indian J. Pediatr."},{"key":"ref_7","first-page":"139","article-title":"The impact of the coronavirus lockdown on mental health: Evidence from the US","volume":"37","author":"Boneva","year":"2020","journal-title":"Econ. Policy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e044617","DOI":"10.1136\/bmjopen-2020-044617","article-title":"Gender-based approach on the social impact and mental health in Spain during COVID-19 lockdown: A cross-sectional study","volume":"10","author":"Berenguera","year":"2020","journal-title":"BMJ Open"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Dawes, J., May, T., McKinlay, A., Fancourt, D., and Burton, A. (2021). Impact of the COVID-19 pandemic on the mental health and wellbeing of parents with young children: A qualitative interview study. BMC Psychol., 9.","DOI":"10.1186\/s40359-021-00701-8"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"m313","DOI":"10.1136\/bmj.m313","article-title":"The psychological effects of quarantining a city","volume":"368","author":"Rubin","year":"2020","journal-title":"BMJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/alcalc\/agn073","article-title":"Alcohol Abuse\/Dependence Symptoms Among Hospital Employees Exposed to a SARS Outbreak","volume":"43","author":"Wu","year":"2008","journal-title":"Alcohol Alcohol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Xia, Y., Ding, G., and Wu, G.-C. (2013). Chinese Medicine as a Model of System Biology: Diagnosis as the Foundation of Acupoint Selection. Current Research in Acupuncture, Springer.","DOI":"10.1007\/978-1-4614-3357-6"},{"key":"ref_14","unstructured":"Greten, H.J. (2014). Qi Gong: Scientific Chinese Medicine\u2014The Heidelberg Model, Heildeberg School."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"531789","DOI":"10.1155\/2015\/531789","article-title":"Qigong as a Traditional Vegetative Biofeedback Therapy: Long-Term Conditioning of Physiological Mind-Body Effects","volume":"2015","author":"Matos","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Wu, H., Wang, W., and Wang, B. (2010, January 16\u201318). A smartphone based respiratory biofeedback system. Proceedings of the 2010 3rd International Conference on Biomedical Engineering and Informatics, Yantai, China.","DOI":"10.1109\/BMEI.2010.5640072"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/1743-0003-10-60","article-title":"Biofeedback in rehabilitation","volume":"10","author":"Giggins","year":"2013","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_18","first-page":"10","article-title":"Assessment of Qigong Effects on Anxiety of High-school Students: A Randomized Controlled Trial","volume":"35","author":"Rodrigues","year":"2021","journal-title":"Adv. Mind. Body Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.4278\/ajhp.081013-LIT-248","article-title":"A comprehensive review of health benefits of qigong and tai chi","volume":"24","author":"Jahnke","year":"2010","journal-title":"Am. J. Health Promot."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"102743","DOI":"10.1016\/j.ctim.2021.102743","article-title":"Qigong for women with breast cancer: An updated systematic review and meta-analysis","volume":"60","author":"Meng","year":"2021","journal-title":"Complement. Ther. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5585239","DOI":"10.1155\/2021\/5585239","article-title":"TaiChi and Qigong for Depressive Symptoms in Patients with Chronic Heart Failure: A Systematic Review with Meta-Analysis","volume":"2021","author":"Jiang","year":"2021","journal-title":"Evid. Based Complement. Alternat. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.joim.2019.04.003","article-title":"Qigong in the treatment of children with autism spectrum disorder: A systematic review","volume":"17","author":"Rodrigues","year":"2019","journal-title":"J. Integr. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jbmt.2018.01.019","article-title":"Effects of taijiquan and qigong practice over behavioural disorders in school-age children: A pilot study","volume":"23","author":"Rodrigues","year":"2019","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.jbmt.2020.12.024","article-title":"Taijiquan and qigong as a mindfulness cognitive-behavioural based therapy on the treatment of cothymia in school-age children\u2014A preliminary study","volume":"26","author":"Rodrigues","year":"2021","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"614770","DOI":"10.3389\/fpsyg.2020.614770","article-title":"The Psychological Impacts of COVID-19 Home Confinement and Physical Activity: A Structural Equation Model Analysis","volume":"11","author":"Sang","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ijsu.2011.09.004","article-title":"CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials","volume":"9","author":"Schulz","year":"2011","journal-title":"Int. J. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1007\/s00106-011-2409-6","article-title":"Chinese medicine as vegetative systems biology. Part I: Therapeutic methods","volume":"59","author":"Greten","year":"2011","journal-title":"HNO"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Matos, L.C., Machado, J.P., Monteiro, F.J., and Greten, H.J. (2021). Understanding Traditional Chinese Medicine Therapeutics: An Overview of the Basics and Clinical Applications. Healthcare, 9.","DOI":"10.3390\/healthcare9030257"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1037\/0022-006X.51.5.730","article-title":"The structure of psychological distress and well-being in general populations","volume":"51","author":"Veit","year":"1983","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_30","first-page":"77","article-title":"Mental Health Inventory: Um estudo de adapta\u00e7\u00e3o \u00e0 popula\u00e7\u00e3o portuguesa","volume":"2","author":"Ribeiro","year":"2001","journal-title":"Psicol. Sa\u00fade E Doen\u00e7as"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/17439760.2016.1262613","article-title":"Thematic analysis","volume":"12","author":"Clarke","year":"2017","journal-title":"J. Posit. Psychol."},{"key":"ref_32","first-page":"51","article-title":"Pesquisa com an\u00e1lise qualitativa de dados: Conhecendo a An\u00e1lise Tem\u00e1tica","volume":"71","author":"Souza","year":"2019","journal-title":"Arq. Bras. Psicol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.psc.2013.01.011","article-title":"Tai Chi and Qigong for the Treatment and Prevention of Mental Disorders","volume":"36","author":"Abbott","year":"2013","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1142\/S0192415X19500149","article-title":"Physical and Psychological Health Outcomes of Qigong Exercise in Older Adults: A Systematic Review and Meta-Analysis","volume":"47","author":"Chang","year":"2019","journal-title":"Am. J. Chin. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100449","DOI":"10.1016\/j.mhpa.2022.100449","article-title":"Tai Chi and Qigong for trauma exposed populations: A systematic review","volume":"22","author":"Niles","year":"2022","journal-title":"Ment. Health Phys. Act."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1177\/1474515119860232","article-title":"Mind\u2013body interactive qigong improves physical and mental aspects of quality of life in inpatients with stroke: A randomized control study","volume":"18","author":"Chen","year":"2019","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Tong, H., Liu, Y., Zhu, Y., Zhang, B., and Hu, J. (2019). The therapeutic effects of qigong in patients with chronic obstructive pulmonary disease in the stable stage: A meta-analysis. BMC Complement. Altern. Med., 19.","DOI":"10.1186\/s12906-019-2639-9"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s11655-009-9002-2","article-title":"Yoga and qigong in the psychological prevention of mental health disorders: A conceptual synthesis","volume":"16","author":"Posadzki","year":"2010","journal-title":"Chin. J. Integr. Med."},{"key":"ref_39","unstructured":"Robles, D., Yang, Y., Wager, M., Kang, P., Sokan, A., Yuan, N., and Chen, Z. (2021, January 6\u20137). Benefits of virtual Tai Chi and Qigong intervention on sleep quality and wellbeing among university older employees. Proceedings of the 2nd International Conference on Chinese Health Practices-Tai Chi, Beijing, China\/Tucson, AZ, USA."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1142\/S0192415X08005898","article-title":"Acute Psychological Responses to Qigong Exercise of Varying Durations","volume":"36","author":"Johansson","year":"2008","journal-title":"Am. J. Chin. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1037\/0033-295X.106.3.529","article-title":"A neuropsychological theory of positive affect and its influence on cognition","volume":"106","author":"Ashby","year":"1999","journal-title":"Psychol. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/s10862-017-9593-y","article-title":"Responses to Positive Affect in Daily Life: Positive Rumination and Dampening Moderate the Association Between Daily Events and Depressive Symptoms","volume":"39","author":"Li","year":"2017","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1080\/13607863.2015.1043619","article-title":"Positive affect predicts everyday problem-solving ability in older adults","volume":"20","author":"Paterson","year":"2016","journal-title":"Aging Ment. Health"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Li, F., Harmer, P., Fitzgerald, K., and Winters-Stone, K. (2022). A cognitively enhanced online Tai Ji Quan training intervention for community-dwelling older adults with mild cognitive impairment: A feasibility trial. BMC Geriatr., 22.","DOI":"10.1186\/s12877-021-02747-0"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Romero, E., L\u00f3pez-Romero, L., Dom\u00ednguez-\u00c1lvarez, B., Villar, P., and G\u00f3mez-Fraguela, J.A. (2020). Testing the Effects of COVID-19 Confinement in Spanish Children: The Role of Parents\u2019 Distress, Emotional Problems and Specific Parenting. Int. J. Environ. Res. Public Health, 17.","DOI":"10.31234\/osf.io\/spxtw"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"152191","DOI":"10.1016\/j.comppsych.2020.152191","article-title":"Stress and anxiety among university students in France during Covid-19 mandatory confinement","volume":"102","author":"Husky","year":"2020","journal-title":"Compr. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1055\/s-0040-1718644","article-title":"Psychological Distress among Adults in Home Confinement in the Midst of COVID-19 Outbreak","volume":"14","author":"Lal","year":"2020","journal-title":"Eur. J. Dent."},{"key":"ref_48","first-page":"825","article-title":"Psychological symptoms of the outbreak of the COVID-19 confinement in Spain","volume":"27","author":"Irurtia","year":"2020","journal-title":"J. Health Psychol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1177\/1559827620983762","article-title":"An Innovative Tai Chi and Qigong Telehealth Service in Supportive Cancer Care During the COVID-19 Pandemic and Beyond","volume":"15","author":"Oh","year":"2020","journal-title":"Am. J. Lifestyle Med."},{"key":"ref_50","first-page":"1001","article-title":"Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Tai Chi Chih","volume":"31","author":"Irwin","year":"2008","journal-title":"Sleep"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1093\/gerona\/61.11.1177","article-title":"Tai Chi Chih acutely decreases sympathetic nervous system activity in older adults","volume":"61","author":"Motivala","year":"2006","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_52","unstructured":"Rodrigues, J.M., Lopes, L., Goncalves, M., and Machado, J.P. (2021, January 15\u201317). Health Benefits of Taijiquan and Qigong: Participants\u2019 Perception. Proceedings of the International Cappadocia Scientific Research Congress, Cappadocia, Turkey."},{"key":"ref_53","unstructured":"Rodrigues, J.M., Lopes, L., Goncalves, M., and Machado, J.P. (Altern. Ther. Health Med., 2022). Perceived health benefits of taijiquan and qigong, Altern. Ther. Health Med., in press."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1142\/S0192415X96000256","article-title":"Acute effect of qigong training on stress hormonal levels in man","volume":"24","author":"Ryu","year":"1996","journal-title":"Am. J. Chin. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1097\/JGP.0b013e31820ee9ef","article-title":"Complementary use of tai chi chih augments escitalopram treatment of geriatric depression: A randomized controlled trial","volume":"19","author":"Lavretsky","year":"2011","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/smi.1023","article-title":"Effects of Qi-training on anxiety and plasma concentrations of cortisol, ACTH, and aldosterone: A randomized placebo-controlled pilot study","volume":"20","author":"Lee","year":"2004","journal-title":"Stress Health"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1080\/00207450390245306","article-title":"Qigong reduced blood pressure and catecholamine levels of patients with essential hypertension","volume":"113","author":"Lee","year":"2003","journal-title":"Int. J. Neurosci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/nuf.12690","article-title":"Rapid conversion of Tai Chi classes from face-to-face to virtual during the COVID-19 pandemic: A quality improvement project","volume":"57","author":"Sawyer","year":"2022","journal-title":"Nurs. Forum"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e10130","DOI":"10.2196\/10130","article-title":"Using Mobile Apps to Assess and Treat Depression in Hispanic and Latino Populations: Fully Remote Randomized Clinical Trial","volume":"20","author":"Pratap","year":"2018","journal-title":"J. Med. Internet Res."},{"key":"ref_60","unstructured":"Ant\u00f3nio, M., and Ricardo, Q. (2022). Mobile Mental Health for Depression Assistance. Digital Therapies in Psychosocial Rehabilitation and Mental Health, IGI Global. Advances in Psychology, Mental Health, and Behavioral Studies."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/10\/1843\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:37:55Z","timestamp":1760143075000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/10\/1843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,23]]},"references-count":60,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["healthcare10101843"],"URL":"https:\/\/doi.org\/10.3390\/healthcare10101843","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,23]]}}}