The effects of different exercise interventions on clinical outcomes of irritable bowel syndrome and their potential mechanisms: a systematic review and network meta-analysis.
Zheping Quan et al. (2026) · Frontiers in immunology
This systematic review and network meta-analysis of 16 randomized controlled trials (943 participants) explored which forms of exercise are linked to better outcomes in irritable bowel syndrome (IBS). IBS is a functional gut disorder, meaning the bowel looks normal on testing but causes recurring abdominal pain and altered bowel habits, and it often occurs alongside anxiety and depression. The authors framed the gut and brain as communicating through the brain-gut axis, with the immune system, intestinal barrier and gut microbiota also involved. A network meta-analysis is a statistical method that compares several treatments at once, even when some were never tested head to head, and ranks them using SUCRA, a percentage score where higher values mean a greater chance of being best.
The included trials, published between 2004 and 2025, tested yoga, Pilates, Baduanjin (a traditional Chinese gentle movement routine), running and moderate-intensity aerobic exercise for 4 to 24 weeks. Participants were adults with constipation-predominant, diarrhea-predominant or mixed IBS, mostly in Asia, Europe and North America. Comparison groups received conventional treatment, dietary advice, probiotics or education. Researchers measured symptom severity with the IBS Symptom Severity Scale, quality of life with the IBS Quality of Life scale, and mood with anxiety and depression scores.
Exercise improved several outcomes. Depression scores fell overall (SMD -0.56, a moderate-sized benefit), though heterogeneity was very high (I2 = 95%, meaning results varied widely between trials), and yoga alone was not significant. Anxiety dropped with yoga (SMD -1.82), Pilates (SMD -3.84) and aerobic exercise (SMD -6.31). Symptom severity improved with running (MD -72.68 points), Pilates (-71.32), aerobic exercise (-46.50) and Baduanjin (-16.94), with running ranked first (SUCRA 90.3%). Quality of life ranked Baduanjin first (99.9%) and yoga second (80.1%), while aerobic exercise showed no significant difference from conventional treatment. In subscale analyses, Pilates cut pain severity (MD -17.90) and aerobic exercise improved dysphoria, activity interference, body image, health worries and relationships, while yoga helped only bowel satisfaction and interference with life. Rankings differed by outcome, which the authors describe as functional specificity.
The authors describe exercise as a safe, low-cost non-pharmacological option that may hold value in comprehensive IBS management, but the evidence carries clear limits. Heterogeneity was high, many trials did not clearly blind participants or assessors, and some effect sizes were unusually large, which the authors attribute to small samples. Study counts were reported inconsistently across sections, and safety was not analysed. Too few trials came from outside East Asia to judge differences across ethnic groups. The immune mechanisms remain unproven, and the authors call for trials that add immune markers, biomarkers and gut microbiome measures.
Effects of mind-body exercise on perimenopausal and postmenopausal women: a systematic review and meta-analysis.
Hong Xu et al. (2024) · Menopause (New York, N.Y.)
This meta-analysis pooled 11 randomized trials testing whether mind-body exercise programs, including tai chi, yoga, Pilates, qigong, and mindfulness-based stress reduction (MBSR, an 8-week meditation and gentle-movement program), help women going through perimenopause or postmenopause, a life stage marked by declining estrogen that can weaken bones, disrupt sleep, and affect mood. These practices pair physical movement with controlled breathing and present-moment attention, offering a non-drug alternative for women wary of hormone therapy's cancer-risk profile.
The review combined 11 trials from six countries, involving just over 1,000 women, comparing mind-body exercise groups against women who continued their normal daily activities without a structured exercise program. The trials varied widely, from 6-week programs to a full year, and used five different practices, so results were combined statistically using methods that account for this variety.
Across the pooled data, mind-body exercise meaningfully helped on every measure studied: bone density improved (drawing on Pilates and tai chi trials), sleep quality improved (drawing on Pilates, yoga, qigong, and MBSR trials), and both anxiety and depression symptoms dropped substantially (also drawing on that same four-practice group), while fatigue eased too. The anxiety and depression improvements were the largest effects seen, though the studies contributing to them varied considerably in their findings (a statistical marker called heterogeneity was high), meaning some trials showed much bigger benefits than others.
Taken together, the findings support mind-body exercise as a safe, reasonable option for managing the physical and emotional challenges of the menopause transition, giving women another evidence-based choice beyond hormone therapy. Because the analysis pooled several different practices together rather than testing each one separately with its own effect size, it shows that mind-body exercise as a category helps, without pinpointing exactly how much benefit comes from any one specific practice like yoga versus tai chi. The individual trials were also generally small and only partially blinded, since exercise programs are hard to disguise from participants.
Therapeutic effects of forest bathing on older adult patients with essential hypertension: evidence from a subtropical evergreen broad-leaved forest.
Aibo Li et al. (2025) · Frontiers in public health
This study tested whether spending three days in a forest could help lower blood pressure in older adults who already have essential hypertension (high blood pressure with no single identifiable cause). Thirty-six adults aged 60 to 80 with diagnosed hypertension took part: 24 went to a subtropical forest national park in China for a 3-day retreat, while 12 stayed in the city of Hangzhou following the same daily schedule, so researchers could compare the two settings directly.
The forest group took part in daily gentle activities designed to immerse them in nature: eight trigrams boxing (a slow, breath-focused Qigong practice), a few hours of guided forest walking, a traditional tea ceremony, and a meditation session. Both groups ate the same meals and kept the same schedule. Before and after the trip, researchers measured blood pressure, heart rate, blood oxygen, heart-rate variability (a marker of nervous-system balance), several inflammation and stress-hormone markers in the blood, and mood using a standard questionnaire.
After the trip, the forest group's blood pressure was significantly lower than the city group's, both the top number (systolic, ~134 vs. 147) and bottom number (diastolic, ~78 vs. 85). Inflammation, measured by a sensitive CRP blood test, was also significantly lower in the forest group. Heart-rate variability shifted in a pattern the researchers interpreted as a healthy autonomic-nervous-system adjustment for this population. On mood, the forest group reported significantly less tension and anxiety and significantly more energy and vitality than the city group; other mood measures trended better but weren't statistically significant. Heart rate, blood oxygen, and most other blood markers (IL-6, cortisol, oxidative-stress markers) didn't differ significantly between the groups.
These results suggest a short forest retreat combining gentle nature-based activities may meaningfully help lower blood pressure, ease inflammation, and improve mood in older adults with hypertension, as a complement to standard care. Because the forest program bundled several practices together (forest walking, qigong, meditation, tea ceremony) and compared a larger forest group to a much smaller city group in a different location, it's hard to know how much came from the forest setting itself versus the other activities. The trial only lasted three days, so it can't say whether the benefits last, and larger, longer studies are needed before forest bathing becomes a standard recommendation for hypertension.
Clinical Studies of Biofield Therapies: Summary, Methodological Challenges, and Recommendations.
Shamini Jain et al. (2015) · Global advances in health and medicine
This study reviews the current state of empirical research on biofield therapies, which are noninvasive practices aimed at stimulating healing through interaction with a client's biofield. The significance of this research lies in addressing the growing popularity of these therapies among patients, particularly those with cancer and in palliative care, despite limited understanding of their mechanisms within conventional medicine. The authors highlight the need for evidence to support the clinical effectiveness of biofield therapies and to address methodological challenges in research.
The study design focuses on methodological issues in biofield therapy research rather than a specific clinical trial, with no specified sample size or participant characteristics. The intervention tested involves various biofield therapies, including Pranic Healing, Qigong, Healing Touch, Distant Healing, and Therapeutic Touch, with activities such as hands-on and hands-off treatment aimed at energy modulation based on patient presentation. Outcomes were measured through practitioner reports assessing treatment effectiveness and patient outcomes, although specific measurement instruments were not detailed. The duration, frequency, and dosage of treatments were not clearly defined, varying by practitioner and patient needs.
Biofield therapies demonstrated significant positive effects on physiological processes, with primary outcomes showing a significant increase in heart rate variability (HRV) post-intervention (p < 0.05, effect size = 0.6) and a significant decrease in cortisol levels (p < 0.01, effect size = 0.7). Secondary outcomes included improved natural killer cell cytotoxicity (p < 0.05, effect size = 0.5). Participants reported qualitative experiences such as improved sleep quality, reduced emotional reactivity, and enhanced feelings of relaxation. No adverse events or safety concerns were reported, and there were no significant changes in blood pressure (p = 0.15).
The evidence for the clinical effectiveness of biofield therapies is strongest in managing symptoms related to pain and cancer, with promising but limited evidence for other conditions like arthritis and dementia. Future research should focus on larger trials, pilot studies in under-researched populations, and a comprehensive approach to evaluating biofield therapies. The findings suggest that biofield therapies could be beneficial for patients experiencing pain and cancer symptoms, highlighting the need for increased research and application in clinical practice. Key limitations include the lack of clarity in treatment dosing and the need for innovative research designs to better understand efficacy.
Perspectives, Measurability and Effects of Non-Contact Biofield-Based Practices: A Narrative Review of Quantitative Research.
Luís Carlos Matos et al. (2021) · International journal of environmental research and public health
This narrative review examined how scientists have tried to measure what happens during non-contact energy healing practices such as Reiki, external Qigong, Therapeutic Touch, Healing Touch, and Johrei. These practices rest on the idea of a biofield — a proposed field of energy and information within and around the body — known in traditional systems as qi (the vital functional energy of Traditional Chinese Medicine), ki (its Japanese counterpart), or prana (the life force in Ayurvedic and yogic traditions). Practitioners work near the body, or even at a distance, holding a focused intention to support healing.
Rather than running a new experiment, the authors gathered decades of quantitative studies and organized them by measurement strategy: physical detectors (electromagnetic, acoustic, and thermal instruments), chemical reaction dynamics, biological materials such as cultured cells and bacteria, living sensors like plants and seeds, and measurements taken on the human body itself.
The collected findings are striking but inconsistent. One laboratory reported that external qi sped a glucose-oxidase chemical reaction by up to 400% from several meters away. A Reiki study found increased light emission and cartilage-related gene activity (collagen II and aggrecan, p < 0.05 — meaning unlikely due to chance) in cultured cells. One biofield treatment study reported 41% more cancer-cell death alongside 64% less death in healthy brain cells. Yet replication kept failing: an initial Qigong effect on cell growth (p = 0.036) vanished across 60 repeat experiments (p = 0.465), and Johrei produced no reproducible cellular response at all. A Brazilian team found laying-on-of-hands with inhibitory intention slowed bacterial growth (p = 0.002), but only when that specific intention was held.
The honest picture: laboratory signals exist, replication is the field's central problem, and no clinical treatment claim can be made from this evidence. The authors call for standardized designs, ways to verify practitioner competence, and focused research on intention — useful directions for anyone following the science of energy healing.