Integrative Medicine Research 9 (2020) 100416 Contents lists available at ScienceDirect Integrative Medicine Research j o ur na l homepage: www.imr-journal.com Original Article The therapeutic efficacy of Qigong exercise on the main symptoms of fibromyalgia: A pilot randomized clinical trial Caio V.M. Sarmento a,b,∗ , Sanghee Moon b , Taylor Pfeifer b , Irina V. Smirnova b , Yvonne Colgrove b , Sue Min Lai c , Wen Liu b a Department of Physical Therapy, California State University, Fresno, CA, United States b Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States c Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States a r t i c l e i n f o Article history: Received 2 March 2020 Received in revised form 13 April 2020 Accepted 14 April 2020 Available online 25 April 2020 Keywords: Fibromyalgia Widespread pain Mind–body therapies Qigong a b s t r a c t Background: Some of the most debilitating symptoms of fibromyalgia (FM) include widespread chronic pain, sleep disturbances, chronic fatigue, anxiety, and depression. Yet, there is a lack of effective self- management exercise interventions capable of alleviating FM symptoms. The objective of this study is to examine the efficacy of a 10-week daily Qigong, a mind–body intervention program, on FM symptoms. Methods: 20 participants with FM were randomly assigned to Qigong (experimental) or sham-Qigong (control) groups, with participants blinded to the intervention allocation. The Qigong group practiced mild body movements synchronized with deep diaphragmatic breathing and meditation. The sham- Qigong group practiced only mild body movements. Both groups practiced the interventions two times per day at home, plus one weekly group practice session with a Qigong instructor. Primary outcomes were: pain changes measured by the Short-Form McGill Pain Questionnaire, a visual analog scale for pain, pressure pain threshold measured by a dolorimeter. Secondary outcomes were: the Revised Fibromyalgia Impact Questionnaire the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale and the Quality of Life Scale. Results: The experimental group experienced greater clinical improvements when compared to the con- trol group on the mean score differences of pain, sleep quality, chronic fatigue, anxiety, depression, and fibromyalgia impact, all being statistically significant at p < 0.05. Conclusion: Daily practice of Qigong appears to have a positive impact on the main fibromyalgia symptoms that is beyond group interaction. Trial registration: ClinicalTrials.gov NCT03441997. © 2020 Korea Institute of Oriental Medicine. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 1. Introduction Fibromyalgia (FM) is a chronic syndrome that was recognized as a clinical entity in 1990. The most prevalent and debilitating symptoms of FM are widespread chronic pain, chronic fatigue, and sleep disturbances. 1–3 To date, the cause of FM is unknown. Recent guidelines for the treatment of FM developed by the European League Against Rheumatism (EULAR) 4 focus on the management of FM symptoms. Suggested interventions for the management of FM include pharmacological therapies such as nonsteroidal anti-inflammatory drugs, antidepressants, neuropathic pain ∗ Corresponding author at: California State University, Fresno, 5315 N. Campus Dr. M/S PT29, Fresno, CA 93740, United States. E-mail address: caio@csufresno.edu (C.V.M. Sarmento). modulators, cognitive behavior therapy, and physical exercise such as moderate to high-intensity aerobic exercise. The guide- lines published by the EULAR 4 and the guidelines developed by the Canadian Pain Society and the Canadian Rheumatology 5 rec- ommend that available interventions should be tailored according to symptom intensity and patient preferences. With mind–body interventions gaining popularity in a variety of diseases and conditions, in the past ten years, the effectiveness of Qigong for the management of FM symptoms have been under investigation. 6 Qigong is a type of mind–body self-management approach rooted in traditional Chinese medicine. To date, there are six randomized controlled trials reporting the effects of Qigong in indi- viduals with FM 7–12 and several other reports such as open-label studies, case reports and retrospective studies. 6 In general, past clinical trials report positive results. However, the trials are noted with significant inconsistency in the design of the trials, different https://doi.org/10.1016/j.imr.2020.100416 2213-4220/© 2020 Korea Institute of Oriental Medicine. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).