Effect of Baduanjin Qigong and transcranial direct current stimulation on quality of sleep and disease impact in elderly patients with fibromyalgia: a randomised, sham-controlled study.

Objectives: The aim of this randomised double-blinded controlled trial was to investigate the effect of Baduanjin Qigong (BQG) and transcranial direct current stimulation (tDCS) on quality of sleep and disease impact in elderly patients with fibromyalgia (FM).

Methods: A randomised, double-blind, clinical trial conducted, involving 68 elderly female and male patients with FM were selected through convenience sampling, and randomly assigned into one of four intervention groups: (1) BQG combined with the tDCS group (BQGT) (n=17); (2) BQG combined with the sham tDCS group (BQGS) (n=17); (3) walking combined with tDCS (WAT) (n=17); and (4) walking combined with sham tDCS (WAS) (n=17). All participants were assessed at baseline and 12 weeks post-test for disease impact and sleep quality using the Revised FM Impact Questionnaire (FIQR) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Data were analysed using Multivariate Analysis of Variance (MANOVA).

Results: Sleep quality was significantly associated with individual interventions (F(21, 167) =2.88, p<0.05, Wilk's Λ=0.411, partial η²=0.257). FIQ scores also showed significant associations (F(3, 64) =4.47, p< 0.05, Wilk's Λ=0.210, partial η²=0.173). Treatments significantly affected FIQR (F(3) =3.901, p<0.05, partial η²=0.155), FIQR symptoms (F(3) =4.458, p<0.05, partial η² =0.173), PSQI total (F(3) =6.044, p<0.05, partial η² =0.221), sleep disturbances (F(3) =10.314, p<0.05, partial η²=0.326), and sleep dysfunction (F(3) =11.487, p<0.05, partial η²=0.350). Significant differences were found between WAT and WAS for FIQR (p=0.016), and between BQGT and WAS (p=0.049), and WAT and WAS (p=0.009) for FIQR symptoms. PSQI total showed significant differences between BQGT and BQGS (p=0.030), BQGT and WAT (p=0.039), and BQGT and WAS (p=0.000). Significant differences in sleep disturbances were observed between BQGT and BQGS (p=0.000), BQGT and WAT (p=0.001), and BQGT and WAS (p=0.000). Further differences were found between BQGT and WAS (p=0.000), BQGS and WAS (p=0.004), and WAT and WAS (p=0.000).

Conclusions: This study shows that physical activity interventions, and especially BQG, significantly improve sleep quality and disease symptoms, with notable effects on PSQI scores and FIQR, especially when combined with tDCS across different groups. These findings highlight the importance of combining interventions into holistic brain-body treatments for managing FM effectively.