Key points.
Home‐based exercise programs are widely accepted to improve immunity and prevent infection at home.
In the COVID‐19 epidemic particular situation, home‐based exercise programs play a key part in immunity enhancement as well as infection prevention.
Wu Qin Xi (WQX) can improve the cognitive function, anxiety, depression, sleeping, and balance ability in elderly people.
An important component facilitating the optimal effectiveness of exercise programs is a high level of exercise adherence.
This conclusion is that WQX exercise program was found to be an home‐exercise program that achieves high adherence in elderly adults who lived in these communities during outbreak of the COVID‐19 epidemic in Shanghai.
Dear Editor
Since the outbreak of the COVID‐19 epidemic, comprehensive prevention and control measures are well accepted as the most effective way to prevent the virus from further spreading and ultimately contain the outbreak. Many residents are in home isolation to avoid coronavirus exposure. In this particular situation, home‐based exercise programs play a key part in immunity enhancement as well as infection prevention. Furthermore, home‐based exercise program will greatly alleviate the shortage of community medical service, especially be of help for those aging people with chronic diseases. Physical activity is an effective intervention strategy that can help to improve immunity, prevent infection, and reduce depression and anxiety 1 . Recognizing the role of home‐based exercise programs in supporting the senior citizens, accrediting agencies have increased their responsibility for the senior citizens. They selected the Wu Qin Xi (WQX) exercises program because of its effectiveness of keeping fit for the aging groups 2 , 3 , 4 , 5 , 6 , 7 , 8 . The WQX exercise, with moderate intensity, is a safe and ideal life‐time exercise for the elderly people without too much exertion on the body 2 .
1. METHODS
The senior citizens (aged ≥60 years) participated in the study were recruited through an advertisement in the Internet from Shanghai, China. None of the subjects had previous WQX practice experience. Communities use Enterprise WeChat group to manage Health Qigong WQX home‐exercise program for older citizens (aged ≥60 years) in Shanghai. There were 50 older citizens per Enterprise WeChat group. WQX exercise with a frequency of five sessions per week for approximately 60 minutes (warm‐up: 10 minutes, WQX: 45 minutes, cool‐down: 5 minutes). During each exercise session, senior citizens were instructed and managed by a trained exercise specialist. Participants receive video‐based instructions of each WQX exercise from their trained exercise specialist in every WeChat group. “Attendance” was the median attendance rate for every participant signed in in the WeChat group at the every session. During each exercise session, their trained exercise specialist instructed them and managed their WQX exercises, answered questions, and guided the discussion using prompts; they reported the total duration of the WQX exercises in minutes, as well as the duration of the WQX exercises intervals via WeChat online meeting. The compliance with the WQX exercises prescribed intensity and duration of the individual training sessions.
The compliance of WQX exercises with the following elements were determined for every senior citizen in percentages: (number of sessions complied with)/(number of sessions attended). Every session was considered completed when each participant performed three repetitions with a 2‐minute rest period between sets.
2. RESULTS
We investigated the exercise adherence with a sample of 1500 (67.2 ± 9.3 years) WQX sport participants. Participants' attendance of the 60 supervised sessions in the WQX exercise intervention was registered in by the trained exercise specialists. The median attendance rate for participants was 97.9% (interquartile range [IQR]: 81.7%‐100%): 0% attended fewer than 31 of the supervised exercise sessions, 8% attended 32 to 45 sessions, and 92% attended 46 to 60 sessions. The median compliance rate (number of sessions complied with)/(number of sessions attended) for participants was 89.1% (IQR: 76.5%‐96.8%); 84.9% (IRQ: 70.1‐90.2%) completed 32 to 45 sessions, and 96.1% (IQR 79.4%‐99.0%) completed 46 to 60 sessions (Table 1).
TABLE 1.
Compliance rates of the Wu Qin Xi exercise intervention
| Total group (n = 1500) | 0‐31 exercise sessions attended (n = 0) | 32‐45 exercise sessions attended (n = 120) | 46‐60 exercise sessions attended (n = 1380) | |||||
|---|---|---|---|---|---|---|---|---|
| Median | IQR | Median | IQR | Median | IQR | Median | IQR | |
| Compliance | 89.1% | 76.5%‐96.8% | 0 | 0 | 84.9% | 70.1%‐90.2% | 96.1% | 79.4%‐99.0% |
Note: Compliance was defined as following the prescribed exercise protocol: Compliance: numbers were computed as the (number of sessions complied with)/(number of sessions attended).
Abbreviation: IQR, interquartile range.
3. DISSCUSSION
An important component facilitating the optimal effectiveness of exercise programs is a high level of exercise adherence. Our data showed high adherence rates to an 12‐week WQX exercises program in older citizens (aged ≥60 years) in Shanghai, both in terms of attendance rates 97.9% (IQR: 81.7%‐100%) and compliance rates 89.1% (IQR: 76.5%‐96.8%). High exercise adherence was reported in the WQX exercise, probably due to enjoyable exercise mode, duration, and intensity, and it produced significant health benefits.
WQX is an ancient Chinese traditional health qigong designed by Hua Tuo, a leading physician of the Eastern Han Dynasty (25‐220 ad). 3 The practice of WQX is the imitation of the postures and movements of wild creatures. WQX exercise mode is elegant, comparatively simple, and easy to remember so as to stimulate enthusiasm for learning and practicing the exercises 2 , 3 , 4 . WQX exercise duration was approximately 60 minutes (warm‐up: 10 minutes, WQX: 45 minutes, cool‐down: 5 minutes) per session. The WQX exercise duration is more suitable for the elderly 4 . The WQX exercise intensity was of low to moderate intensity, and also very safe, as the physical exertion required will not tax even old people 2 . In addition, the WQX participants demonstrated high adherence. According to Fuhong et al 5 and Bogao et al 6 , the study data analysis indicated that WQX exercises can improve static and dynamic balance ability, body mineral density, and cardiovascular function in older people. WQX practicing might effectively improve the cognitive function, anxiety, depression, stress, sleep quality, and immunity of old people 6 , 7 , 8 , 9 , 10 . Because of the rising epidemic of the novel coronavirus, it is increasingly important for high‐adherence home‐based WQX exercise program to help improve immunity, prevent infection, and reduce depression and anxiety in the older people.
In conclusion, the WQX exercise program was found to be a home‐exercise program that achieves high adherence in older adults who lived in these communities during outbreak of the COVID‐19 epidemic in Shanghai.
ETHICAL STANDARDS
All authors certify that we comply with the ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2015.” Reference: von Haehling S, Morley JE, Coats AJS, Anker SD. Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2015. J Cachexia Sarcopenia Muscle 2015;6:315‐316.
CONFLICT OF INTEREST
The authors have declared no conflict of interest for this article.
ACKNOWLEDGEMENTS
This work is supported in part by Beijing Municipal Education Commission of Science and Technology plans to the general project (KM201910015001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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