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 of at least 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 Outcome(s) and Measure(s): 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 neuropathic pain of 7.94+/-2.33 on the NPRS, which was reduced to 4.17+/-3.07 after 12 weeks of Qigong practice (Cohen d=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, d=0.98) and severity (0.72+/-1.02, d=0.71), and reduced interference of neuropathic pain on mood (3.44+/-2.53, d=1.36), sleep (3.39+/-2.40, d=1.41), and daily activities (3.17+/-2.77, d=1.14). They had a greater ability to perform functional activities (Patient Specific Functional Scale, 6.68+/-3.07, d=2.18) and had improved mood (Patient Health Questionnaire-9, 2.33+/-3.31, d=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.

The authors have declared no competing interest.

NCT04917107

https://www.medrxiv.org/content/10.1101/2022.03.09.22271844v1.full

This study was funded by the Division of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota. The research was supported by the National Institutes of Health National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health National Center for Advancing Translational Sciences. The funders have no role in study design, data collection, analysis, the decision to publish, or the preparation of the manuscript.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Institutional Review Board (IRB) of the University of Minnesota approved the study (IRB# STUDY00011997).

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All data produced in the present study are available upon reasonable request to the authors.