Using remotely delivered Spring Forest Qigong™ to reduce neuropathic pain in adults with spinal cord injury: A non-randomized controlled trial.

IMPORTANCE

The manuscript proposes the feasibility and potential of a remote Qigong intervention to reduce neuropathic pain in adults with spinal cord injury (SCI)-related neuropathic pain.

OBJECTIVE

We determined the feasibility and estimates of efficacy of a remotely delivered Qigong intervention in adults with SCI-related neuropathic pain.

DESIGN

This is a non-randomized controlled trial with outcomes assessed at baseline-, 6- and 12-weeks of Qigong practice, and at 6-weeks and 1-year follow-up.

SETTING

Completely remote clinical trial.

PARTICIPANTS

Adults with SCI-related neuropathic pain, with SCI ≥3 months, with complete or incomplete SCI, and highest neuropathic pain level of >3 on the Numeric Pain Rating Scale (NPRS). We used nationwide volunteer sampling.We recruited 23 adults with chronic SCI (7/2021-2/2022). Eighteen participants started the study and completed all study components, including the 6-week follow-up. Twelve participants completed the 1-year follow-up assessment.

INTERVENTION

Participants practiced the Spring Forest Qigong™ "Five Element Healing Movements" with an online video by combining movement with kinesthetic imagery, at least 3x/week for 12 weeks.

MAIN OUTCOMES AND MEASURES

To address the feasibility outcome and track adherence, the website automatically monitored the days and duration that the Qigong video was played. Self-report neuropathic pain intensity and SCI-related symptoms such as spasms, functional performance, mood, and body appreciation were also collected.

RESULTS

Eighteen participants, 60±12 years of age, 15±11 years post-SCI had a highest baseline of 7.94±2.33 on the NPRS, which was reduced to 4.17±3.07 after 12 weeks of Qigong practice (Cohen's =1.75). This pain relief remained at 6-week and 1-year follow-ups. Participants reported reduced spasm frequency (change score 1.17±1.20, =0.98) and severity (0.72±1.02, =0.71), and reduced interference of neuropathic pain on mood (3.44±2.53, =1.36), sleep (3.39±2.40, =1.41), and daily activities (3.17±2.77, =1.14). They had a greater ability to perform functional activities (Patient Specific Functional Scale, 6.68±3.07, =2.18) and had improved mood (Patient Health Questionnaire-9, 2.33±3.31, =0.70).

CONCLUSIONS AND RELEVANCE

Our preliminary data demonstrate the feasibility of Qigong practice in adults with SCI-related neuropathic pain and promising results of neuropathic pain relief and improvement in SCI-related symptoms after Qigong practice.

TRIAL REGISTRATION THIS MANUSCRIPT REFERS TO THE QUASI-EXPERIMENTAL SUBSTUDY: CREATION: A Clinical Trial of Qigong for Neuropathic Pain Relief in Adults with Spinal Cord Injury, NCT04917107 , https://www.clinicaltrials.gov/ct2/show/NCT04917107 .