Faculty/School/CentreEvidence-Based SMILE* Wellness Program
- Qigong and Tai Chi based Contents
Rationale and Introduction of the SMILE Wellness Program……………………………. p2 Attachment 1 Abstract of Findings published in the British Journal of Sports Medicine…….. P6 Attachment 2 Abstract of Findings published in the American Journal of Preventive Medicine…………………………………………………………………………………
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Attachment 3 Press release from The University of Queensland, beyondblue and National Heart Foundation
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Attachment 4 Benefits and Comments from Previous Clinical Study Participants………….. P9 Attachment 5 Benefits and Comments from Previous 2 Days Course Participants………….. P21 Attachment 6 Benefits and Comments from Previous 3 Months Course Participants……….. p27
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Rationale and Introduction of the SMILE Wellness Program
SMILE: An Innovative Clinically Proven Life-Changing Qigong Program
Physical activity plays an important role in the prevention and management of chronic diseases. However, many individuals especially those who are aging, overweight or obese, or have physical limitations, are unable to or unwilling to do conventional types of exercises such as gym-based exercises or aerobics, often because of fear of injury or heart attack. In addition, mental health is also strongly associated with physical illnesses. We therefore designed an innovative gentle, low impact mind-body therapy program (based on TCM therapies), named SMILE Wellness Program (SMILE: Sustainable Mastery of Innovative Lifelong Exercise). The findings from the clinical studies have demonstrated strong evidence of the positive effects of the SMILE Wellness Program on many health conditions, including: Reduction in stress, anxiety and depression level (see Figure 1) Weight loss (see Figure 2) Improved diabetes control (see Figure 2) Strength/physical functioning improvement (see Figure 3) Blood pressure reduction Improved sleeping patterns Enhanced immunity Pain reduction Flexibility and endurance improvement Increased vitality/energy levels Improved breathing Greater confidence, self-esteem and
coping Positive changes in life perspective Better health related-quality of life,
general health, and more…
The above findings have been published in top international medical journals.
Previous Participants Say …
• “In 8 years this exercise is the only kind that made a difference” • “I really appreciate being a part of this program. I feel so much better in so many ways
physically and mentally” • “I feel more confident, it has changed my personality and health”.
For more information: Email:
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Figure 1: Mean changes in depression, anxiety and stress scores at 12 and 24 weeks. The values
shown are unadjusted means; I bars indicate 95% confidence intervals. P values assess difference in
mean scores at 12 and 24 weeks, after adjusting for baseline. CES-D = Center for Epidemiologic
Studies Depression Scale 10. DASS = Depression Anxiety Stress Scale 21.
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Baseline 12 weeks
Fig. 2a, b, c. Absolute changes in the three integral indicators of developing metabolic syndrome [body mass index (a), waist circumference (b) and insulin resistance (c)] in the intervention and control groups after 12 weeks. Outliers excluded. Values are Mean±SEM (error bar). **Significant between-group difference (p<0.01).
Intervention (n=21)
Control (n=20)
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Intervention
Control
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Figure 3: Changes in leg strength after 6 and 12 weeks intervention. Values are means (standard error). **Significant improvement in the SMILE intervention group compared to control group (P < 0.01).
baseline 6 weeks 12 weeks
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Attachment 1 Abstract of Findings published in the British Journal of Sports
Medicine http://bjsm.bmj.com/content/44/10/704.full.html ABSTRACT
Objectives To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose.
Design, Setting, and Participants A single group pre–post feasibility trial with 11 participants (3 male and 8 female; aged 42–65 years) with elevated blood glucose.
Intervention Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home.
Main Outcome Measures Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms.
Results There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference −1.05, p<0.001), waist circumference (−2.80 cm, p<0.05), and systolic (−11.64 mm Hg, p<0.01) and diastolic blood pressure (−9.73 mm Hg, p<0.001), as well as in HbA1c (−0.32%, p<0.01), insulin resistance (−0.53, p<0.05), stress (−2.27, p<0.05), depressive symptoms (−3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05).
Conclusions The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.
Attachment 2 Abstract of Findings published in the American Journal of
Preventive Medicine http://www.ajpmonline.org/article/S0749-3797(11)00264-9/abstract ABSTRACT
Background Previous studies have shown that qi-gong, a form of mind–body movement therapy, may be beneficial for people with type 2 diabetes; however, no controlled studies have been conducted to examine the predictors and mediators of qi-gong effects on indicators of diabetes control. This study examined the effects of qi-gong on diabetes control and identified the predictors and mediators of these effects. Design Randomized Controlled Trial Setting/participants The study included forty-one participants (16 men and 25 women; aged 41– 71 years) with elevated blood glucose levels. Interventions Participants were randomized to qi-gong intervention or a usual medical care control group. Physical and hematologic measures were assessed at baseline and after 12 weeks. Main outcome measures The outcomes were indicators of diabetes control (HbA1c, insulin resistance, fasting blood glucose and insulin, and 2-hour blood glucose and insulin) and potential mediators of these (body weight, waist circumference, and leg strength). Data were collected in 2006 and analyzed in 2007 to 2009. Results Linear regression analyses showed significant between-group differences in favor of the intervention group in weight (p<0.01); waist circumference (p<0.01); leg strength (p<0.01); HbA1c (p<0.05); insulin resistance (p<0.01); and fasting blood insulin (p<0.01) at 12 weeks. Logistic regression analyses showed that the qi-gong intervention was a significant predictor of reduced weight (odds for decreasing by –2 kg=11.14, p<0.01); waist circumference (by –5 cm=22.50, p<0.01); insulin resistance (by –0.2 unit=3.75, p<0.05); and improved leg strength (odds for increasing by 4 stands in 30 seconds=7.00, p<0.01). The effect of the qi-gong intervention on improved insulin resistance was mediated by reduced weight. Conclusions The qi-gong intervention was associated with improvements in weight, waist circumference, leg strength, and insulin resistance. The mediation analyses highlight the importance of weight reduction in the control of diabetes.
Attachment 3 Press release from University of Queensland, beyondblue and National Heart Foundation UQ revitalizes ancient art of Tai Chi to help people SMILE A University of Queensland study has revitalised an ancient martial art into a world-first Tai Chi- based exercise program that targets obese people suffering depression, anxiety and stress. UQ School of Medicine research scientist and mind-body therapy expert Dr Xin Liu said the program was the first to establish scientifically-significant benefits for the three common mental health conditions in people with fat around the waist. He said the research was funded by beyondblue and the National Heart Foundation and published in the journal, Evidence-based Complementary and Alternative Medicine. “Depression, anxiety and stress often co-exist, all are contributing factors to cardiovascular diseases and other health issues, including stroke, diabetes, cancer, arthritis, osteoporosis and obesity,” Dr Liu said. The study of the Sustainable Mastery of Innovative Lifelong Exercise (SMILE) program involved more than 200 participants aged between 19 and 77, suffering depression and obesity, with 65 per cent having a range of other chronic illnesses. Dr Liu said this program is effective for this group as it has been tailored as an enjoyable, therapeutic regime that is easily learned and targets specific internal organs. “The group’s level of severity of depression decreased by 32 per cent after three months of the program, and by nearly 40 per cent after six months,” Dr Liu said. “The study also showed significant improvements in anxiety (by 23 per cent) and stress levels (by 24 per cent) after a six-month intervention.” Dr Liu said the results also showed improvement in the participants’ leg strength, essential to increasing physical activity, adding to mental and heart health benefits. “The program could also be easily implemented in the workplace where there is high pressure causing stress and anxiety, thereby benefiting the wellness of staff and improving productivity.” beyondblue CEO Georgie Harman said finding something that reduces the severity of depression or anxiety through regular physical exercise and building social connections can be a huge challenge. “The research demonstrates that this form of exercise program may be an effective way for some people to manage their anxiety or depression, in concert with other treatment recommended by their GP,” Ms Harman said. Media: Dr Xin Liu, xin.liu@uqconnect.edu.au; Faculty of Medicine and Biomedical Sciences Media Manager Bernadette Condren, +61 7 3346 5309, b.condren@uq.edu.au or Reid Sexton, +61 3 9810 6187 or 0413 777 393 to arrange an interview with Ms Harman.
Clinical Evidence
Perceived benefits of participation in the program
Participants reported benefits of the program in terms of both physical health and mental health.
The most commonly reported physical benefits were
• Improved energy level and physical well being (“more energy”, “ more energetic”,
“stronger”, “improved fitness”, “faster energy recovery”, “more active”, “feel healthier”,
“program answer to many health problems like joint pain and stiffness”, “after the program
I feel normal and not sick and can do more”);
• Improved sleeping patterns and bladder function (“no or less urination at night”; “better
bladder control”);
• Weight and waist circumference reduction (“lost some of my ‘spare tyre’”, “lost a lot of
weight”, “clothes sized reduced”“1st time in 8 years that my weight is below 110 kg”,
“having tried other kinds of exercises this was the only kind of exercise that made a
difference”);
• Improved muscle (“muscle tone improved”, “no or less cramps”, “increased muscle”).
• Improved flexibility (“more supple and agile”).
Other reported physical benefits included:
• Improved endurance (“with gym program I got more exhausted as time went by, with the
program I feel better as time goes by”, “able to exercise in a way not achieved since trauma
in Jan ’96”, “possible to continue with training in spite of injury”);
• Reduced need for other therapies (“I don’t need to go to a physiotherapist to have ankles,
hips and shoulders mobilized”).
• Improved sensations (“skin feels better”, “less numbness of arms and fingers during the
night”);
• Reduced food cravings (“stop myself from eating more”, “ fewer sweet cravings”);
• Improved immunity (“less prone to infections”, “faster recovery to minor infection”);
• Lower blood pressure (“reduced/lower blood pressure”, “lower BP”);
• Lower blood glucose (“blood sugar is down”, “lower BSL”);
• Improved circulation in legs (“the program has improved circulation in left leg”, “improved
circulation”);
• Improved breathing capacity (“more breath capacity, walking up hills etc”, “occurrence
asthma minimal”);
• Improved nail growth (“nails longer and faster grown”);
• Pain reduction (“feel no longer pain”, “shoulder pain reduced to rarely”).
The most commonly reported mental health benefits were:
• Improved confidence, self-esteem and coping mechanisms (“more confident”, “feel more
confident, confidence has changed my personality and health”, “more focused”, “focused
on me”, “feel in charge and connected with my body for the first time”, “some well being
and balance in my life”, “a lot of stress at work and family I would not have managed it as
well as if I had not been doing the program”, “cope better with stress”, “cope better with
problems”);
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• Emotional improvements (“feel happier”, “less sad”, “emotional stronger”);
• Less stress (“feel peaceful”, “less stress”, “less irritable”, “stress levels reduced”, “calmer
and less moody”, “exercises helped me to deal with the stress and release the stress”).
Other reported mental health benefits included:
• Training motivation (“motivated to do the program”, “easier to develop training regime”);
• Change in life perspective (“I have a purpose to my physical training: long, healthier,
happier life”, “feel more positive in my outlook”).
• Improved social support (“it was helpful to have other people in the group to talk to”);
• Family harmony (“family members have commented on how much calmer and happier I am
now, I didn’t realize I was so difficult to deal with”).
Participants’ plans for physical activity after the intervention
All participants planned to continue with the SMILE program.
Thanks and appreciation from the participants
Participants expressed their appreciation for the opportunity to participate in the program, with
comments including:
• “I would like to tell you: thanks, I feel privileged to have taken part in what, for me, is
probably a life changing and life saving experience”;
• “I have really benefited from this program, this is something I can do all the time, no
special equipment required”;
• “This 12 weeks has made me form good habits, I walk and exercise daily, will not go back
to my old way of life”;
• “I found this an excellent program for me, I enjoyed it and I’m certain my health is now
improving”;
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• “I really appreciate being a part of this program. I feel so much better in so many ways. I
feel as though I have a change to have a new start with my health”;
• “Thank you for the program!!!, the program was excellent”.
More from the Following Randomized Controlled Clinical Trial:
Perceived benefits of participation in the program
Participants reported benefits of the program in terms of both physical health and mental health.
The most commonly reported physical benefits during the ‘instructor-led’ group training were:
• Improved energy level and physical well being (“I feel more energetic and a touch with my
physical body. I have a greater sense of well-being and generally feel my health is
improved”, “I feel that I want to do the exercise more and more. After the exercise, I tend to
get more energy”, “Now I am not so tired. I have a happy feeling doing the program with
the class. Gradually feel happier”, “I have more energy, especially after doing the
exercise”, “Yes. I feel healthier and doing active things easier than before”, “the program
helps me to concentrate my chi. It makes me aware of my internal organ where my chi
flows”, “improved strength”, “I feel so much better when I do the program. It energizes
me”, “I feel stronger more full of energy. I enjoy the exercise and feel healthier”, “It is the
type of exercise program I have been looking for a long time, apart from the health benefits,
the overall fitness is beneficial to keep your body strength”, “I feel I walk taller. I feel a new
strength in my abdomen, back and legs”);
• Improved sleeping patterns and bladder function (“I have slept better”, “I no longer need to
make 3 or 4 trips to the bathroom during the night. I do still go 1-2 times”, “I also do not
need to get up and go to the toilet so often during the night! A big plus”, “slept better while
exercising”, “the quantity of sleep has surprised me. I do not have to get up through the
night”);
• Weight and waist circumference reduction (“I appear to be losing weight”, “It has made me
exercise, lose weight”, “The activities have helped me lose weight”, “I have lost a little
weight and intend to continue so”, “I noticed that certain measurements of my body have
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decreased”);
• Improved flexibility (“body a little more supple”, “has made me a bit more flexible than
previously”, “I bend with more ease”);
• Improved muscle and balance (“Accompanied with the program, it helps with the general
health i.e. muscles and joints and fatty tissues get the movements (the exercise) that need it”,
“The stretching of the various muscles assist with prevention of future ailments i.e. kidney
trouble etc”, “Better balance”).
Other reported physical benefits during the ‘instructor-led’ group training included:
• Reduced pain (“Sciatic pain has gone”, “I suffer shocking diverticulitis. Always cramping.
In the third week of the program noted No Pain”);
• Improved health problem (“It has helped my arthritis”, “My Inflammation in my knee joint
is also better. I can lift my leg and bend back, feel so much better”);
• Improved endurance (“This is the first exercise program that I haven not had to give up due
to extreme reaction by previous injuries”);
• Improved diabetic symptom (“Well I would say I like the program. It has helped with
feeling in feet”, “little irritating things, like itchy feet, disappears”, “Improved my health
especially my feet”).
The most commonly reported physical benefits during the ‘self-led’ home training were:
• Improved energy level and physical well being (“I continue to feel good in my body and
mind and maintain a good level of physical Activity and Healthy Eating”, “I have felt great
improvements in my health and well-being, which I attribute to the program”, “Improved
my health”, “It left me feeling very good”, “When I do the program I feel more energized”,
“It has shown me a way to improve my health”, “even with limited participation. I feel I
have more energy”, “I can do more things”, “I feel the program has improved by health
and wellbeing, making me aware of the importance of regular exercise”, “I found it help me
to feel good Plus just over all well being”, “I believe the quality of life is much better and 13
general well being feels whole lot better and I believe I am more fitter and stronger as a
result. I do have withdrawn if I miss too many days of the exercise”, “I have not felt so fit
for years. I am sleeping better and my back is the best it has been for years”, “I feel
generally I have more energy”, “I was feeling stronger and stronger and healthier”,
“Having been accepted to the program I feel my general health and well being has benefited
immensely”, “I feel better in myself doing these exercises. I feel stronger and healthier”,
“The program has made such a difference to me. I feel so much better physically and
mentally”);
• Improved muscle and flexibility (“I feel my muscles and bones are improving - able to kneel
down and bend easier”, “I seem to notice my muscle tone has improved. I feel this indicates
there have been some health benefits”, “I think my muscle tone has improved and my range
of movement”, “I enjoyed the classes and felt that I gained some flexibility”, “It has shown
me a way to improve flexibility”, “I could move more easily”).
Other reported physical benefits during the ‘self-led’ home training were:
• Improved sleeping patterns (“sleep better”, “I am sleeping better”);
• Reduced pain (“I have no pain from diverticulitis and no cramping pain”, “I can do more
things and some of the pain had gone”);
• Improved health problems (“I have no pain from diverticulitis and no cramping pain”, “My
inflammation in my knee joint is also better”, “my back is the best it has been for years”);
• Weight and waist circumference reduction (“Yes very much - has helped me also lose
weight!!!”).
diabetic feet:
• “When I rubbed my hands, for the last time i.e. the third time, my hands felt like those of a 8
years old boy whereas previously I felt they were the hands of a 58 year old man”;
• “Before I started this program, I had the feelings of pins and needles in the sole of my feet 14
for over a year and half. The short time I was able to do this course there was a change for
the better and I felt a lot happy with this improvement. There was a change in the next two
weeks after attending the class as this pins and needles started to get better. In the past six
weeks, it has stayed the same improvement”).
The most commonly reported mental health benefits during the ‘instructor-led’ group training were:
• Improved confidence, self-esteem and coping mechanisms (“Confident that I can personally
continue to look after my health without looking for the most appropriate activity”, “feel
that my emotional, physical and intellectual attributes are in greater harmony”, “I feel
more confident than before”, “feel better about myself”, “exercise and focus and more
calmness at end”, “Secure”, “Provided new way of thinking about exercise and diabetes”);
• Emotional improvements (“I am generally feeling a lot more positive”, “Feel mentally
healthier”, “I feel happier! I feel better about myself”, “I have been more positive and able
to handle stress problems”, “I feel it has help me to get out and do things”, “I feel
extremely happy”, “I behave a bit calmer and my mood may possibly be a little better”, “I
feel happier and more optimistic”);
• Less stress (“Slightly more relaxed”, “the program clears my mind”, “I also feel calmer”,
“Very good program. Helps with stress”, “relaxation”, “I feel calmer and more balanced
and temperate in my moods”, “I feel more tolerant and less stressed about daily grind”, “I
have been more positive and able to handle stress problems”, “Less tense, more relaxed and
calm”);
• Training motivation (“The program has also motivated me to do other things to improve my
health, e.g. more exercise etc.”, “I am keener to do exercise”, “The exercise is addictive
and one can do it anywhere and not dependent on any sport equipment one gets committed.
And enjoy it immensely”, “I look forward to doing the program – sometimes twice a day.
The exercise program is more interesting and demanding than other forms of exercise. I
found I have to concentrate more, synchronize my breathing styles and get the benefit of an
exercise regime that I can do for the rest of my life”, “It is a holistic exercise which should
be of great benefit. I would like it to be a part of my lifestyle”);
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• Change in life perspective (“More positive attitude”, “I am happy and peaceful most of the
time, because I know will be able to exercise whenever or wherever I will be; and thus
regulate my general health and diabetes mellitus”, “It gives confidence and hope for the
future, it is in fact for me”, “The Gift of Life”, “I have learned skills that I can do easily
ANYWHERE (without equipment) for the rest of my life. It works and I intend to keep it up,
perfecting it in the years to come. I liked the fact that I exercise the whole of my body and
my mind. You can not beat that”, “I feel much better, have a better outlook (more positive)
and look forward to the future”, “It has shown me a way to improve my own health and this
has given me new hope for a healthier future”).
Other reported mental health benefits during the ‘instructor-led’ group training included:
• Family harmony (“It has also calmed me down and able to cope with my home life (invalid
husband)).
The most commonly reported mental health benefits during the ‘self-led’ home training were:
• Improved confidence, self-esteem and coping mechanisms (“I feel mental and physical
healthier”, “I am more conscious of my weight and general well – being. I am aware that I
have to do the program to prevent me from early type II Diabetes. It is a constant reminder
to me that health is so important”, “Improved my feeling about myself, i.e. more capable”,
“opened up another aspect of my life”, “the program has made me aware of the different
part of the body where the 'Chi' will flow”, “it does make me feel healthier physically and
mentally”, “It left me feeling very good”, “I have generally continued to feel much better
about myself, both physically and emotionally”, “I feel the program has improved by health
and wellbeing, making me aware of the importance of regular exercise”, “It is a holistic
exercise which I believe will help me if I can persevere”);
• Training motivation (“I believe that I will continue to do the program because of the benefit
and well being it promotes in oneself. It feels like a ‘knowledge’ or contentment–Whatever”,
“I think the program has been a great help”, “helps with focus and exercise”, “I think of
my health more often”, “the program has helped me personally. It has given me some
regular exercise which I did not have prior to the program”, “Only that I will not go a day
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without doing my exercise program”);
• Emotional improvements (“I do feel more positive usually”, “I am happier”, “I feel very
relaxed and clam”, “My mood has improved”, “It has got me feeling and thinking better”,
“The program has made such a difference to me. I feel so much better physically and
mentally”);
• Less stress (“I am a lot calmer within myself”, “I feel calm”, “has helped me with stress
problems”, “I also handle stress better now”).
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Participants expressed their appreciation for the opportunity to participate in the program, with
comments including:
• “At this stage, I feel that I would like to do the program as part of my lifestyle, so that I can
maintain my weight and health well-being. I would like to continue to do more the program
if there is any further research. I feel very privileged to be in the program. Much thanks”;
• “I am so glad I am on this program and will be continuing the life-style changes I have
made”;
• “I thought the whole program was EXCELLENT. 1. The instructor is very professional and
a good teacher. One of the best I have seen. I have been a teacher/ educator for over 30
years. 2. I have experienced a good, purposeful, selection of ancient exercise – tried and
proven - that will help anybody to exercise their whole body and mind. Very good. 3. I have
noticed some great benefits as a result of this program. i.e. I sleep better, I sleep less but
awake sharp and refreshed, the exercise regime makes me feel energetic for a long while, I
concentrate better, I have lost weight and centimeters of my waist, I feel more positive, I like
the exposure to ancient Chinese medicinal skills”;
• “I liked the fact that the teacher did every exercise EVERY time we worked together and
that he took the time to carefully explain, explain, explain any little thing we wanted to know
as many times as we wanted. He was very good, very knowledgeable, professional and
clearly very highly skilled”;
• “I would like to thank the University of Queensland people of the SMILE program”;
• “I haven not done the program much over the last 6 weeks and I have put on weight, sleep is
not as good, do not have the energy I had when I was doing the program, get tingling in my
feet (which went away when I was doing the program during the 12 weeks of class) and
generally do not feel as good as I did when I was at the program. I now realize how useful
the program is to me and I am going to pick it up again. I feel better, eat better, sleep better
and little irritating things, like itchy feet, disappear. I believe the program is very subtle, but
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effective and can be deceptive in that you do not think it is making much of a difference –
until you stop – then you suddenly see what it was doing. It is a MUST program and a wise
investment in oneself. Program participants would benefit from a follow on maintenance
program”;
• “I think the program has greatly added to my quality of life and I intend to continue with the
exercises. But I would greatly appreciate being able to attend more sessions. I think there
should be a follow up weekly sessions to enable the students in the program to build on our
healthy success. It was a pleasure to participate in this study”;
• “I am grateful for the opportunity of participating in this program. I know that had I been
part of a group after the medical procedure, I would have found it easier to overcome the set
back. Six week program is too short”;
• “I feel very lucky having met our teacher and being introduced to the program. I feel it is
very beautiful for my health and wellbeing. I hope to be able to increase the number of
sessions I do at home, and hopefully join a program if there are any organized at the
university”;
• “Health wise I have gained benefits due to this program. My body has loosened up which
gives me more energy”;
• “My feeling about myself has improved. My feet are back to normal. I miss the classes - our
teacher gave of himself totally and helped us in any we asked when doing the classes as well
as making himself available for queries before and after the class. I feel privileged to have
been part of the study”;
• “Only having 6 weeks I feel our teacher is wonderful and very understand but feel short
changed expecting 12 weeks. After 6 weeks, I can bend, lift my leg, and no pain from my
diverticulitis - What would have 12 weeks done. I will keep it up at home and I am so
grateful. Thank you”;
• “My doctor was so pleased he did a lot of tests all were better than before the diabetes
program”;
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• “I have appreciated the opportunity to participate in this program. Our teacher was a very
good teacher who related very well to students. He made the sessions relaxed and enjoyable
and was able to generate a good feeling in the group”;
• “the program has broadened my knowledge of health and the importance of the program. I
am very impressed with the expertise from our instructor. I am very fortunate to be able to
join this research program”.
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Attachment 5: Benefits and Comments from Previous 2 Days Weekend Course
Participants:
My feedback:
• Cost, Venue, Meals, Facilities on site and nearby parking – EXCELLENT
• "SMILE PROGRAM" on arrival made to feel very welcomed - EXCELLENT
• Introduction & background to SMILE program informative, this clearly spelt out for me
that SMILE was clearly focussed on my Type II Diabetes issues – EXCELLENT
• Presentation and use of Aids to deliver knowledge and skills/technique very easy to follow,
very good use of time during course presentation and timing of breaks, 2 day duration for
course was appropriate – EXCELLENT
• Design of SMILE content very user friendly, it's low impact on the body, it's centralised to
one spot (either standing or sitting) and personal health gains will increase through
proficiency - EXCELLENT, Personal responsibility = Personal health gains.
Participant 2:
• Thank you so much for the Smile Program at weekend.
• I admire your high standard of Chinese Wushu, knowledge in medicine, your teaching
method, your interacting way with people and your beautiful personality.
• It was a wonderful workshop and I enjoyed very much.
• I felt that this program is going to be very effective.
• Because of the nature of my health and depression I have tried everything I could to improve
my condition but sometimes not very successful because my body often reacted very
intensely. I have been learning community Tai Chi but I felt your program is much more
effective. I attended Qigong exercise in park too, but it was too intense for me; I was too
tired and felt too bloated with Qi afterwards. Your exercise was very gentle, easy and
enjoyable. After the workshop yesterday, I felt as if I had hot spring bath; I felt warm and
comfortable. I slept soundly without taking a sleeping pill, I did not feel bloated although I
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could feel Qi which stayed quietly and comfortably at Dantian. I haven't felt so comfortable
for long time since I became depressed. Other people may not be able to feel the effect so
quickly, but after continuing for a few months I am sure everyone will feel the benefit.
• I definitely would love to continue with this program and to learn more.
Participant 3:
• After the Saturday class, I went home pleasantly tired but feeling very uplifted in spirits and
not as stressed.
• I slept well that night, without the extreme discomfort I had been experiencing in my feet
lately and having only one trip to the toilet at about 3.40am. (Believe me this was an
absolute blessing.)
• Sunday morning I woke up feeling lighter in spirit and with more bounce in my step and
eagerly looking forward to the next class.
• I also found I could remember quite a few of the moves from the day before and that my
concentration wasn't quite as lacking as it usually is.
• I also noticed a decline in the number of times I went to the toilet on Sunday in comparison
to Saturday.
• I could really feel the effects of improved circulation in my body. Found the exercises easy
to do without aching all over.
• Slept well Sunday night, again, without any discomfort with my feet and only one trip to the
toilet.
• Extremely grateful that I was given this opportunity to participate in these classes and the
fact that I was aware of and could feel improvements in my health, especially just after the
first day.
• The course was well run, easy to follow and good fun. I look forward to the next stage.
Participant 4:
• I found the weekend very good and will be joining you for the 3 times a week course if you
can keep me informed
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• I thoroughly enjoyed the program. I think however that it could be condensed into 1.5 days-
just shorten the breaks for M & A/Tea and lunch.
• I find the DVD ok, but would prefer weekly classes-the energy is better. I look forward to
classes starting soon.
Participant 6:
• Personally, I thoroughly enjoyed last weekend attending the Smile Program and came away
feeling empowered that I now have the knowledge to really make a difference in controlling
my Type 2 Diabetes.
• Dr LIU Xin's ability to impart his knowledge in such a succinct and relaxed manner soon
had everyone participating in such a friendly way. I am sure that once we experience
improvements in our own health, word will automatically spread throughout the community
regarding the health benefits of the Smile program.
Participant 7:
• Thank you and Dr Liu for such a fantastic weekend. I would highly recommend this to
anyone not just those with medical problems.
• I did not attend with a view to fixing any of the mentioned medical issues as I do not have
any of them. However, I have been attending Dr Liu’s classes here at UQ St Lucia and
found that they gave me a mental focus (and relief) that benefited me immensely at a time
when stress levels at work were extremely high. I wished to explore this further.
• As a result of the often very hard physical work I have done over the years and still do, and
as I get older, I find I do not recover as well as I used to and often can be relatively stiff and
inflexible due to overworked muscles and old injuries combined with my 8hrs of mainly
sitting for work.
• After Dr Liu’s weekend I felt renewed. My body ‘flowed’ once again instead of feeling like
all the joints and muscles needed lubricating before they could work properly. Everything
had loosened. I felt like I had done a great workout – tired, but everything was back in sync.
I am finding it hard to put in words, but both my mind and body can remember the feeling of
being extremely fit and pushing to the limit – it was like Dr Liu’s program brought this
connection back to life. When I walk I can feel my body working again – I can feel my
muscles working together, feel the seamless connections instead of hesitations because of
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twinges, etc. I can stretch my entire body first thing in the morning without cramping in a
number of places. The word I have finally thought of is that my body and brain felt satiated.
Participant 8:
• I thoroughly enjoyed the weekend SMILE program and definitely wish to do the 3 month
follow-up program (Mon, Wed & Fri nights) throughout August-October and then to
complete the train-the-trainer program, as I would really love to be involved in making this
great program available to as many people as possible as soon as possible.
• In terms of other feedback, I loved the great sandwiches and fruit provided, but was
disappointed by the morning and afternoon tea offerings of muffins, biscuits and high-sugar
muesli bars. In fact I was quite shocked that these were the only options provided and no
healthy options were available, in light of the aims of the SMILE program!
• Please put my name on the list for the Aug-Oct SMILE program, as I can't wait to practise
what I learned with the benefit of group energy and to learn more so I can teach it to others
for their better health too.
Participant 9:
• I am one of the Mungindi Three and thoroughly enjoyed the weekend. I think that it was
well-structured and inspiring enough for me to continue doing the program. Indeed, I think it
has had a big impact on my mental well-being.
Participant 10:
• I really enjoyed the workshop with Dr Liu and am interested in participating his next
sessions (trial program).
Participant 11:
• I did enjoy the workshop very much and got a lot out of it, thanks to Dr Liu.
Participant 12:
• I really enjoyed participating in the smile program at the weekend and got a great deal out of
it. The Dr was a great teacher and conveyed the course with a degree of professionalism and
friendliness.
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Participant 13:
• The Smile Program weekend course at the PA Hospital on 30 June/1 July conducted by Dr
Liu Xin was very enjoyable and informative, and offers me definite health benefits.
• I would be keen to participate in the proposed 3 sessions per week for 3 months as
mentioned by Dr Liu Xin for future follow up.
Participant 14:
• Thank you very much for your help. I really enjoyed the weekend, and we played the DVD
through last night. Dr. Liu Xin is an excellent teacher and has produced a DVD that is so
easy to follow.
Participant 15:
• I would like to thank you for the special training weekend and I will now try to explain the
very positive effects my body experienced as a consequence of the course. I had a lot more
energy on the following Monday and to my surprise I noticed my right knee wasn't stiff and
painful while putting my flipper on in the water. This usually stiff knee has been good all
week.
• My back and shoulders feel loose and free and much easier to move. On Tuesday and
Wednesday I felt a little good sore in my back and thighs. This was a big change from
feeling stiff and sore all over as I used to feel before the weekend.
• I was amazed learning part one warm up 1 -7 in a weekend. All the extra tips made such a
difference, e.g. strengthening the bladder during trembling.
• The weekend was a wonderful taste of the program's benefits but I really need a lot of group
training to master part 3 patting and the cooling down massage. I look forward to hearing
from you regarding the new 3 month program on Monday, Wednesday and Friday.
Participant 16:
• I'd like to say what a thoroughly enjoyable week-end it proved to be and ask if you could
please email me copies of the papers that were available for reading at the course?
Participant 17:
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• I firstly want to say big thanks (with a smile) for a wonderful weekend. I am still feeling the
free flowing chi, and my liver is calmly humming. Also I am quite profoundly aware of the
depth and integrity of the system and its capacity to heal on many levels.
• As you know I am very very interested in the Instructor Training course, and await the
details of the weekly classes starting in July.
Participant 18:
• Dr Liu is an amazing individual with a wonderful program to share and I enjoyed learning
the program.
Participant 19:
• We enjoyed a very stimulating and enjoyable week-end with Dr Liu Xin and a nice group of
other people, so please convey my thanks for that.
Many more…
Attachment 6: Benefits and Comments from Previous 3 Months Course
Participants:
SMILE 3 Months Course
• I have been able to have my main medication for blood glucose control reduced by 75%
and have been able to completely cease another medication prescribed for Gastro-
Oesophageal Reflux Disease
• My energy level has been greatly increased
• My weight has been reduced considerably and I have been able to keep it at a stable level
• Digestion is so improved that I am now completely free of any symptoms of GORD
• I am much more motivated to accomplish more, such as tasks, “to do lists” and better
lifestyle management etc.
• My muscles, Lower Leg especially, have improved in strength and tone.
• Balance and co-ordination also improved
• I very much enjoy my weekly classes with the other participants and greatly appreciate the
professional tuition of Dr. Liu Xin.
• The three month program has been more beneficial than I ever could have expected. I
experienced major improvement in how I feel ever day including more sleep and the loss of
8 kg.
• I found that I was able to do the exercises and slowly but progressively felt stronger from
head to toe. I feel I’m standing taller, straighter and stronger.
• As I progressed through the program I slowly experienced the following:
o Increased energy which enabled increase in exercises such as swimming
o Flexibility
o Slow but gradual weight loss
o A reduction in the amount of fluid in my feet
o I am now walking further and longer than what I was previously able to do
o A lot less sleeping during the day
o I developed a tolerance to minor sore muscles following classes
o I now can tolerate sweating a lot from the exercises
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• The different parts of my body were impacted as follows:
o SLEEPING – Before I started the program I always felt too tired to care passed what I
had to do and what I had to do was a real effort. Because I am sleeping so much better
and only going to the toilet once a night instead of 3 – 4 times a night I am not so tired.
Now I feel like doing extra things that interest me. I just feel happier all the time.
o BREATHING – I have found that I have stopped holding my breath, a bad habit I didn’t
realize I was doing a lot of the time. My breathing has become a lot deeper and stronger
rather than being shallow most of the time.
o LEGS – I feel lighter and I stand stronger instead of wanting to sit down all the time.
o FEET – I can now do the whole program in no shoes. This is a huge improvement for me
because my feet normally cause me pain and discomfort and I have to wear runner with
arch support everywhere. I can now bend over to do up shoe laces now. Before the
program I had to put my foot up on a chair etc to reach the laces.
o NECK – My neck now moves freely and I can not remember my neck ever being so
flexible. My neck used to always be stiff and I was continually frightened to move
fearing it would seize up. I always suffered lots of head arches and now I hardly get any.
o BODY - I can roll over in bed and not feel stiff and so sore all the time. Little jobs like
bending into low cupboards are a lot easier.
o BACK – I can move again and turn easily to check traffic while driving. Before the
program I felt my back could easily seize up.
o ARMS – My arms feel lighter and so much stronger especially holding up for a long time
during the carry water exercise.
o APPETITE and CRAVINGS – I now don’t want for as much food and drink.
o BODY SHAPE – I now feel a slight change by being able to feel muscles in my upper
arms and bottom and my legs pass each other easier.
o WAIST – I can feel the muscles working when I move.
o BLOOD PRESSURE – My blood pressure has been very high for a long time it came
down after the first and subsequent SMILE courses but my doctor was concerned at how
high the diastolic pressure was so he put me on a higher grade blood pressure pill
coincidentally at the start of the last course. My blood pressure readings at the start of the
last course averaged 137 / 99 and my pulse was 70. The new blood pressure pills had an
immediate impact however my blood pressure has continued to decrease and I am sure
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this is due to doing the SMILE Program. My average readings are now 115 / 78 and my
pulse is 73.
• The people on the Smile Program are all very friendly / happy lot. Everyone feels part of the
group and they are happy to share their positive stories with each other e.g. weight loss,
body shape changes, taking less prescription pills and feeling so much better for it. I can feel
huge class energy when Dr Liu Xin is watching everyone. I still have a long way to go with
weight loss but I never expected to feel this good ever again especially with my current
weight. Thank you DR Liu Xin for sharing your years of experience by helping all the class
with their individual needs. I look forward to pushing myself for the next 3 month program.
Once again thank you so much for what you have done for me.
• Since my participation in the SMILE Program, I’ve noticed some positive changes in my
health, Diabetes and my general well-being:
o Firstly, my Diabetes management outcomes are more positive and easier to manage with
my doctor being very happy with my results in HbA1c and other areas of my condition
o Secondly, I’ve lost about 3-4kgs and my waist size has reduced around 5cm
o Thirdly, my leg and arm strength has improved considerably
o Fourthly, my general health and outlook on my diabetes is improved
• Week 1-4
I realized that I hadn't been involved in any routine exercise program for years, due to being time
poor & running my own business and that the Smile program was the perfect way to get my body
back into shape as it is a gentle routine & the music is relaxing. The first few weeks I felt quite tired
throughout the day & was yawning several times throughout the routine. I also moved house in the
first week, when I became stressed I was able to focus on relaxing through breathing slowly &
focusing my thoughts, which I had learnt on the weekend course.
My appetite started to decrease around the 2nd week I also started to concentrate on keeping my PH
levels balanced and increased my water intake, and dropped back on coffee and alcohol intake.
My knee had been swollen for a few months prior, I had receiving Acupuncture but had no relief,
by the fourth week of class the swelling had gone down & the ache was subsiding
Week 4-8
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By the 4th week I had lost 3kg, mainly around the waist & bottom half as I went down a size in
pants. As I became familiar with the routine I focused on lengthening & pulling up throughout the
lesson & now can feel my muscles tightening & building in my arms, legs & stomach...feels great.
It's amazing that the exercise feels simple and yet the physical rewards are so beneficial. My energy
level has increased; my headspace is light and content.
Week 8-12
My knee has stopped aching so I walk up and down the stairs to each lesson, I have discovered I
have biceps developing (could be the chairs we move!). I am sleeping through the night, have more
energy, I enjoy parking in the furthest spot at shops and walking. My acupuncturist is impressed
with the improvement of my energy levels. Overall I'm feeling great.
The class energy is a bonus as everyone enjoys turning up and working hard, and we all leave
happy to have come to class and exercised, at the end of the week you realise how important it is to
dedicate a minimum of 4.5hrs a week to focus on yourself and only you.
I think if there are to be trainers that it would be good to work in some form of unity with a clear
vision of the SMILE Program in place, I feel there is a great benefit in running it as a 3 month
program rather than a fitness class that you attend on odd occasions, as throughout this time people
can become aware of the physical / emotional changes that occur and there is also the gentle
reminders and positive input that change can occur with persistence. Re-education takes time.
In the 3 months I have noticed friendships have started to develop which can then form a network of
ongoing support.
The 3 months program has proven results in place, with growth of this format of class throughout
Brisbane / Aus... It would produce further positive results. This could grow into stronger
community support which may produce greater recognition with medical practitioners, Diabetes
Australia & hopefully federal government for funding opportunities.
• It has been a positive change for me just to commit to an exercise program for three sessions
a week and to attend them. I feel that I do have more energy and feel motivated to walk
more but I also know that I still have a long way to go. The program still challenges me in
many ways. I still need to modify some of the arm movements but there is progress. The 30
rehabilitation has been slow following the surgery but I have noticed the right arm gradually
getting stronger with program.
• My leg muscles and joints have strengthened from movements such as ‘trembling’ and
‘walking on the mountain’, and the massage techniques.
• My overall balance has improved for the whole body.
• My lower stomach muscles definitely feel stronger and more toned.
• Consciously, being more aware of breathing ‘in and out’ during exercise is helping
relaxation and lowering stress levels.
• Consciously, being more aware of breathing ‘in and out’ during exercise is helping
relaxation and lowering stress levels.
• I find the visualization of moving and strengthening internal organs in the program is a
positive incentive in improving health, and targeting specific areas.
• Greater flexibility – much easier to perform simple task like tying shoelaces
• Greater stability / balance – much easier to perform tasks at ground level that require
bending or reaching down
• Have lost 4 kilos – 2 notches on the belt – much thinner in the face
• Feel great – not as stressed – handling conflict situations easier - more relaxed about a lot of
things
• Sleeping better
• Seems easier to maintain diet
• I feel I am slightly more toned, I don’t have as much ‘back to grasp’ as I used to. My blood
sugar levels haven’t changed significantly but they are more stable.
• Most noticeable for me is the fact that I don’t need to go to bed at 8:30pm because of
fatigue. So I guess my energy levels have improved.
• The SMILE program relieves my stress and tight knots especially sitting at my desk for the
whole day in the university. I feel very relax and happy after each lesson. After 12 weeks
of SMILE program, I lost about 3kg without any major changes in my diet. I do realize my
appetite becomes smaller and lesser tendency to overeat nowadays. As I have been
sedentary for more than a year, the gentle movements are great to get me back to exercise. I
can feel my leg muscles are toning up after 8 weeks into the program.
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• As I used to train competitively in tai chi during my younger days, the techniques taught
by Dr Liu in SMILE program makes what I have learnt in the past more wholesome. The
knowledge imparted by Dr Liu makes me understand better how our body works and
how certain movements can be beneficial to our body. Dr Liu conducts the class in a
friendly and relax manner which promotes good learning. He revives my good old days and
makes me want to pick up where I have stopped. I really enjoyed the class and wish to
continue to learn from Dr Liu if there is an opportunity.
• I continue to thoroughly enjoy your teaching and have felt a significant positive change in
feeling more focused and grounded. My massage clients and Yoga Chi Gung
participants are all enjoying (and noticing) the benefits.
• Although diagnosed with osteoarthritis (have had a full hip replacement) and borderline
osteoporosis I have no symptoms of these conditions. I have excellent blood pressure,
cholesterol levels and I am very energetic for my age. In addition I am fortunate enough to
have a great sense of wellbeing. I attribute this to participating in Dr. Liu’s program. The
program has obviously improved my muscular strength, flexibility and aerobic fitness which
have allowed me to maintain good health. It has also enhanced my mental and physical
relaxation which has led to my sense of wellbeing.
• I have enjoyed the exercise and have noticed and increased fitness and I feel stronger
physically.
• It has been enjoyable to participate in a supportive group and to learn some theory behind
the practice of the program.
• I feel more relaxed and able to cope better with stress situations at work.
• I look forward to the Train the Trainer course and ultimately being able to help others
experience the benefits of the program.
• I am more relaxed and enjoying more feeling of sex.
Many more…
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ABSTRACT
ABSTRACT
Background Previous studies have shown that qi-gong, a form of mind–body movement therapy, may be beneficial for people with type 2 diabetes; however, no controlled studies have been conducted to examine the predictors and mediators of qi-gong effect...
Design Randomized Controlled Trial
Setting/participants The study included forty-one participants (16 men and 25 women; aged 41–71 years) with elevated blood glucose levels.
Interventions Participants were randomized to qi-gong intervention or a usual medical care control group. Physical and hematologic measures were assessed at baseline and after 12 weeks.
Main outcome measures The outcomes were indicators of diabetes control (HbA1c, insulin resistance, fasting blood glucose and insulin, and 2-hour blood glucose and insulin) and potential mediators of these (body weight, waist circumference, and leg st...
Results Linear regression analyses showed significant between-group differences in favor of the intervention group in weight (p<0.01); waist circumference (p<0.01); leg strength (p<0.01); HbA1c (p<0.05); insulin resistance (p<0.01); and fasting blood...