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Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (8): 858-865.doi: 10.3736/jcim20120805

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Effects of qigong on performance-related anxiety and physiological stress functions in transverse flute music schoolchildren: A feasibility study

Claudia Maria Sousa1, Mario Gonçalves1,2,3, Jorge Machado1, Thomas Efferth4, Tobias Greten2,3, Petra Froeschen2,3, Henry J. Greten1,2,3()   

  • Received:2012-01-18 Accepted:2012-05-29 Online:2012-08-20 Published:2018-08-15
  • Contact: J. Greten Henry

Objective: Based on individual cases of treatment, we were interested in whether the effects of a special kind of qigong, the “White Ball” exercises, can be objectified by physically measurable parameters and psychological scores.

Methods: We performed a preliminary prospective controlled interventional study with the waiting list design. In the qigong group eight children were included. They received specific qigong lessons of the “White Ball” qigong over seven weeks, twice a week, for 30 min with a waiting list design and instructions to perform the same exercises at home daily. In the control group eight children were included in a waiting list design with no qigong instruction. Subjective perception of anxiety was measured by the Portuguese version of the Depression, Anxiety and Stress Scale adapted for children.In addition, salivary cortisol, heart rate variability, blood pressure, surface electromyography of the trapezius muscle and reaction time were measured at the beginning and the end of the study prior to the regular public auditions.

Results: In comparison to the changes in the control group, the qigong group scored significantly lower in heart rate. Otherwise the groups did not differ significantly; however, the effect size was large for salivary cortisol, surface electromyography of the trapezius muscle and blood pressure. There were relevant reductions of subjective perception of anxiety, salivary cortisol levels and heart rate.

Conclusion: The heart rate of performing schoolchildren can be potentially reduced by “White Ball” exercises. Based on a sample of 8/8, positive tendencies were also observed for anxiety and blood pressure. The next steps of objectifying possible qigong effects are to increase the sample size, to study young people in other situations arousing anxiety, to develop an appropriate control intervention, to solve the problem of blinding and double blinding, to find additional parameters that may be influenced by the “White Ball” qigong, and to compare the qigong effects with other methods reducing anxiety such as more traditional biofeedback or systematic desensitization.

Key words: Qigong, TCM theories, anxiety, stress, music, feasibility study


Group n EADS-C
Heart rate
Blood pressure
max (mmHg)
Blood pressure
min (mmHg)
Blood pressure
mean (mmHg)
Intervention 8 11.6±8.0 107.0±21.8 116.0±12.9 80.0±7.0 92.0±8.7
Control 8 16.6±12.9 81.0±9.5 110.0±10.1 73.0±3.7 85.0±4.4
P value 0.562 0.007 0.399 0.020 0.103
Group n EMGT
time 1 (s)
time 2 (s)
time 3 (s)
Salivary cortisol
Intervention 8 0.007 07±0.003 10 0.286±0.023 0.284±0.028 0.241±0.020 5.46±1.51
Control 8 0.005 73±0.001 49 0.280±0.055 0.292±0.086 0.229±0.056 4.56±5.00
P value 0.462 0.674 0.753 0.600 0.197


Group n EADS-C
Heart rate
Blood pressure
max (mmHg)
Blood pressure
min (mmHg)
Blood pressure
mean (mmHg)
Intervention 8 7.8±6.2 96.0±18.9 109.0±11.9 74.0±4.9 86.0±6.4
Control 8 14.0±14.2 86.0±7.2 105.0±4.5 67.0±8.1 79.0±6.2
P value 0.291 0.155 0.344 0.051 0.093
Group n EMGT
time 1 (s)
time 2 (s)
time 3 (s)
Salivary cortisol
Intervention 8 0.009 86±0.001 87 0.271±0.034 0.272±0.033 0.250±0.026 2.82±1.58
Control 8 0.007 73±0.001 39 0.277±0.026 0.261±0.027 0.215±0.032 3.21±3.91
P value 0.036 0.833 0.600 0.046 0.606


Index Intervention t1 Intervention t2 Control t1 Control t2
Min Max Min Max Min Max Min Max
EADS-C 1.00 26.00 1.00 18.00 5.00 32.00 4.00 45.00
Heart rate 85.00 148.00 68.00 124.00 69.00 100.00 72.00 94.00
Blood pressure max 99.00 135.00 92.00 124.00 96.00 123.00 97.00 110.00
Blood pressure min 72.00 91.00 69.00 82.00 68.00 79.00 49.00 75.00
Blood pressure mean 81.00 105.67 77.33 96.00 77.67 91.67 66.33 85.00
EMGT 0.004 30 0.014 01 0.007 03 0.013 33 0.004 08 0.008 62 0.005 48 0.009 06
Reaction time 1 0.245 0.312 0.216 0.319 0.209 0.371 0.232 0.300
Reaction time 2 0.234 0.316 0.225 0.320 0.196 0.371 0.226 0.301
Reaction time 3 0.210 0.274 0.213 0.306 0.143 0.313 0.171 0.269
Salivary cortisol 0.437 0.836 0.050 0.432 0.066 1.530 0.041 1.220

Figure 1

Mean change of subjective perception of anxiety measured by EADS-C EADS-C: Escala de Ansiedade, Depressão e Stresse para Crianças."

Figure 2

Mean change of heart rate (1/s)"

Figure 3

Mean change in salivary sortisol (μg/L)"


Index α2 Optimal n
EADS-C 4.03 6
Heart rate 1.26 11
Blood pressure max 0.01 104
Blood pressure min 0.08 43
Blood pressure mean 0.05 56
EMGT 9.76 4
Reaction time 1 0.14 33
Reaction time 2 0.73 14
Reaction time 3 1.30 11
Salivary cortisol 2.43 8
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