Comparative effects of Health Qigong and closed motor exercise on the physical and mental health of female drug rehabilitation participants: a randomized controlled trial

Abstract

Background

Drug rehabilitation is a challenging process that impacts both the physical and mental health of individuals. Traditional martial arts, such as Health Qigong, and closed motor exercises, such as power cycling, have shown potential benefits in improving health outcomes. This study aims to compare the effects of Health Qigong, closed motor exercises, and their combination on the physical and mental health of female drug rehabilitation participants.

Methods

In this randomized controlled trial, female participants from the Jilin Province Women’s Compulsory Isolation Drug Rehabilitation Center were randomly assigned to three groups: Health Qigong (QigongG), Closed Motor Exercise (ClosedG), and Combined Health Qigong and Closed Motor Exercise (CombinedG). Measurements were taken at baseline, mid-intervention, and post-intervention and included resting heart rate, vital capacity, choice reaction time, sleep quality, and relapse tendency.

Results

At the study’s conclusion, the ClosedG group showed significant improvements in relapse tendency, vital capacity, and sleep quality compared to baseline. The QigongG showed significant improvements in relapse tendency, sleep quality, and choice reaction compared to baseline. The CombinedG group demonstrated significant improvements in relapse tendency, vital capacity, sleep quality, and choice reaction time, outperforming the ClosedG groups in reaction time, and outperforming QigongG groups in vital capacity. The CombinedG group exhibited the most notable overall improvements.

Conclusion

The combined intervention of Health Qigong and closed motor exercises is more effective in improving physical and mental health metrics among female drug rehabilitation participants than either intervention alone. These findings suggest that incorporating a combination of traditional martial arts and closed motor exercises could enhance rehabilitation programs for drug rehabilitation.

Trial registration

ClinicalTrials.gov NCT06454565. The date of registration is 2024.07.11 (Retrospectively registered).

Introduction

Drug addiction is a chronic, relapsing disorder marked by compulsive drug-seeking and use, leading to significant adverse consequences cami2003drug. It disrupts brain chemistry, particularly glutamate signaling, which is critical in addictive behaviors, and causes severe physical health issues such as cardiovascular complications, lung damage, and increased risks of infectious diseases like HIV and hepatitis C. Beyond health, drug addiction imposes societal burdens. For instance, Korea reported 24 drug-related deaths in 2022, with six caused by acute overdoses [1]. Colombia saw a 30% rise in overdose deaths between 2019 and 2020 [2], while in the U.S., drug overdose deaths among African American males aged 65 and above were nearly seven times higher than their White counterparts in 2020. Drug abuse also correlates with higher rates of violence and property crime, such as burglary and vehicle theft [3]. These stark disparities and the broad societal impacts highlight the urgent need for effective intervention strategies.

Drug rehabilitation encompasses a diverse array of methodologies aimed at aiding individuals in overcoming substance abuse and addiction. At the forefront of these strategies is medication-assisted treatment (MAT). Key pharmacological treatments include methadone and buprenorphine for opioid addiction and naltrexone, acamprosate, and disulfiram for alcohol dependence. These medications are pivotal in managing rehabilitation symptoms, reducing cravings, and blocking the euphoric effects of addictive substances, thereby enhancing recovery outcomes and diminishing the likelihood of relapse. Besides, behavioral therapies are equally integral to the rehabilitation process, which have demonstrated high efficacy when customized to individual needs. Cognitive Behavioral Therapy (CBT) [4], Motivational Enhancement Therapy [5], Contingency Management [6], and Family Behavior Therapy [7] are among the techniques employed to modify drug-related attitudes and behaviors, bolster life skills, and address co-occurring mental health issues. In this context, these conventional approaches are increasingly being complemented by non-traditional methods, including physical activity, which is gaining recognition as an adjunctive treatment in drug rehabilitation. A meta-analysis has demonstrated that illicit drug users exhibit greater improvements in abstinence rates than individuals using other substances [8].

The therapeutic benefits of physical activity in addiction lie primarily in its capacity to promote neuroplasticity and restore balance to neurotransmitter systems disrupted by substance abuse [9]. Beyond its physiological benefits, exercise also provides psychological advantages essential for sustained recovery. Research supports the effectiveness of several exercise modalities: aerobic exercises are proven beneficial [10,11,12], and programs combining aerobic with strength training have shown similar success [13, 14]. Additionally, high-intensity interval training [15] and activities like tai chi and qigong, which focus on meditation and relaxation, have yielded positive results [16,17,18]. However, the outcomes of physical exercise programs are not consistently positive. For example, a 12-week varied exercise program for heroin addicts in rehabilitation failed to significantly improve stress, anxiety, or quality of life [19]. This indicates that the specific type, intensity, volume, and frequency of the exercise are critical factors in determining the effectiveness of these programs in promoting recovery.

However, previous research largely ignores the differential impact of various exercise modalities on neuroplasticity and neurotransmitter modulation, which may lead to underestimating the nuanced effects of exercise on addiction recovery. Therefore, investigating qigong, closed exercise modalities, and their hybrid is a promising resolution for addressing this gap. Qigong, a traditional Chinese exercise, focuses on controlled breathing, meditation, and gentle movements. It is known for promoting relaxation, mental clarity, and emotional balance. These elements of qigong can aid in neuroplasticity and cognitive recovery, crucial for individuals recovering from drug addiction. The meditative practice helps regulate neurotransmitter levels, supporting overall mental health. Closed motor exercises characterized by movements that are predictable and occur within a defined range, play a critical role in improving physical and mental health outcomes. These exercises involve controlled environments where the body or its parts perform movements against resistance or in a fixed trajectory [20]. Examples include cycling [21], which offers repetitive, low-impact motion that can enhance cardiovascular endurance, muscle strength, and lung function while minimizing injury risks. The physiological effects of closed motor exercises, such as improved respiratory efficiency, neuromuscular coordination, and mental focus, have been well-documented, underscoring their potential in structured rehabilitation frameworks. A hybrid approach that integrates the principles of qigong with closed exercise combines the benefits of both modalities. Participants engage in structured physical activity while incorporating the mindfulness and breathing techniques from qigong. This hybrid approach can enhance both physical fitness and mental resilience, providing a comprehensive regimen that supports therapeutic outcomes in addiction recovery.

Our research contrasts the rehabilitative effects of qigong, closed exercises and the hybrid on individuals recovering from drug addiction. We hypothesize that the hybrid exercise .

Methods

The research was approved by the Ethics Committee of Northeast Normal University (Approval Number: 202402031). This study was registered with ClinicalTrials.gov (ID: NCT06454565). Informed consent was obtained from all participants in the study.

Participants

The participants in this study were female drug rehabilitation patients from the Jilin Province Women’s Compulsory Isolation Drug Rehabilitation Center in 2024, which is the only facility in Jilin Province dedicated to the detoxification and rehabilitation of female drug users. The primary substances of abuse among the participants in this study are marijuana and methamphetamine. Prior to their admission to the Jilin Province Women’s Compulsory Isolation Drug Rehabilitation Center, all individuals had undergone a mandatory one-month detoxification period. During this initial detoxification phase, participants were administered medications to aid in the rehabilitation process. Only after completing this initial detoxification were the participants transferred to the rehabilitation center for further treatment and integration into the study. This preliminary detoxification ensures that by the time participants enter the rehabilitation center and begin the study, they have already passed the most acute withdrawal stages. As a result, the interventions tested in this study focus on longer-term physical and mental health improvements rather than immediate detoxification effects. This setup allows for a clearer assessment of the benefits of Health Qigong and closed motor exercises on their rehabilitation journey.

The inclusion and exclusion criteria for this study were as follows: Inclusion Criteria: (1) Currently undergoing drug rehabilitation: Participants must be females undergoing drug rehabilitation treatment at the Jilin Province Women’s Compulsory Isolation Drug Rehabilitation Center, ensuring they are actively undergoing the rehabilitation process. (2) Agreement to participate in the study and signing of an informed consent form. Exclusion Criteria: (1) History of hip or knee surgery : Participants with a history of hip or knee surgery, regardless of the time elapsed since surgery, will be excluded. This was because such surgeries may affect their ability and effectiveness in participating in power cycling exercises. (2) Not taking any special medications: Participants must not take any special medications during the experiment that affect central nervous system function or have significant impacts on the cardiovascular system, such as sedatives or cardiovascular drugs. Routine vitamin supplements and essential therapeutic medications are exceptions, subject to confirmation by the research team. (3) Not participating in other physical exercise programs: Participants must not actively engage in other physical exercise programs during the experiment to avoid the influence of other physical activities on the experimental results. (4) Severe cardiovascular diseases, respiratory system diseases, or other serious health problems: Participants with severe cardiovascular diseases, respiratory system diseases, or other serious health problems that make this type of exercise inappropriate were excluded. (5) Mental health problems or cognitive impairments: Participants with severe mental health problems or cognitive impairments were excluded because these conditions may affect their ability to effectively participate in and understand the experimental interventions. Finally, in this study, a total of 96 female participants were initially enrolled and randomly assigned into three groups: QigongG (n=31), ClosedG (n=33), and CombinedG (n=32).

Study design

We conducted a statistical power analysis using G*Power 3.1 software to determine the sample size. Key parameters were set as follows: an $\alpha$ level of 0.05, power (1-$\beta$) of 0.80, and a medium effect size (Cohen’s f = 0.25), informed by similar studies on rehabilitation interventions. With three independent groups and repeated measures at three time points, the required sample size per group was calculated to be 17 participants. To account for a potential 20% dropout rate, the sample size was increased to 21 participants per group, resulting in a total of 63 participants.

All participants will be randomly assigned to the following three groups: Health Qigong group (QigongG), Closed Motor Exercise group (ClosedG), and Combined Health Qigong Exercises and Closed Motor Exercise group (CombinedG) were randomly allocated to different groups using a random number generator to reduce bias and ensure the reliability and fairness of the study results. The QigongG group had 31 participants, the ClosedG group had 33 participants and the CombinedG group had 32 participants. The overall study is shown in Fig. 1.

Fig. 1

Research flow chart

Trial groups

 

• Health Qigong group (QigongG) Participants practiced the Health Qigong 12-Step Daoyin Health Preservation Exercises, a set of exercises guided by Chinese medicine principles, integrating physical exercise and mental cultivation. The intervention lasted six months and included two phases: Phase 1 (First Month): Exercise learning and consolidation. Each session lasted 45 minutes, with the first 10 minutes for warm-up and the last 5 minutes for relaxation. Sessions were held once daily. Phase 2 (Next Five Months): Formal practice phase. Each session lasted 45 minutes, held once daily.

• Closed Motor Exercise group (ClosedG) Participants engaged in cycle ergometer exercise. The intervention lasted six months and included two phases: Phase 1 (First Month): Exercise learning and consolidation. Each session lasted 45 minutes, with the first 10 minutes for warm-up and the last 5 minutes for relaxation. Sessions were held once daily. Phase 2 (Next Five Months): Formal practice phase. Each session lasted 45 minutes, held once daily.

• Combined Health Qigong Exercises and Closed Motor Exercise group (CombinedG) Participants practiced a combination of Health Qigong Preservation Exercises and cycle ergometer exercise. The intervention lasted six months and included two phases: Phase 1 (First Month): Exercise learning and consolidation. Each session lasted 45 minutes, with the first 10 minutes for warm-up and the last 5 minutes for relaxation. Sessions were held once daily. Phase 2 (Next Five Months): Formal practice phase. Each session lasted 45 minutes, held once daily.

Indicator measurements

Measurements were taken at three points: before the experiment, during the experiment, and after the experiment. To minimize bias, outcome assessors were blinded to group allocation. Assessments were conducted independently by assessors who were not involved in administering the interventions. Standardized protocols were used to ensure consistency in measurement procedures across all groups. While participants were aware of their assigned interventions, every effort was made to limit expectancy effects through uniform instructions and procedures. The following indicators were measured:

• Resting Heart Rate Resting heart rate was measured to assess the cardiovascular condition of the participants. Participants were instructed to sit quietly for at least 5 minutes before the measurement. Using a digital heart rate monitor, the heart rate was recorded in beats per minute (bpm). Measurements were taken two times, with a 1-minute interval between each reading, and the average of the two readings was used for analysis.

• Vital Capacity Vital capacity was assessed using a spirometer to measure changes in lung capacity. Participants were instructed to take a deep breath and then exhale forcefully into the spirometer as completely as possible. The procedure was repeated two times, with the highest value recorded for analysis. Participants were given a brief rest period between each attempt to prevent fatigue.

• Choice reaction time Choice reaction time was tested using the standards from the "Chinese National Physical Fitness Measurement Standards Manual". Reaction time reflects the coordination between the nervous and muscular systems and the ability to respond quickly was tested using the Reaction Time Tester. During the test, the subject keeps their middle finger on the "start button" while awaiting the signal. Upon any signal key emitting both light and sound, the participant must promptly press the corresponding key. Once the signal ceases, the middle finger returns to the "start button," ready for the next signal. This sequence is repeated for a total of five signals. After responding to the fifth signal, all signal keys light up and sound simultaneously, marking the end of the test. The procedure was conducted twice, and the best reaction time was used. After recording the participants’ choice reaction times, use Table 1 to compare their age and reaction time to assign scores for this metric, where faster reaction times correspond to higher scores, reflecting superior coordination and response ability.

• Sleep quality Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), a widely used self-report questionnaire that assesses sleep quality over a one-month time interval. It is a valuable tool for assessing sleep quality as it captures multiple dimensions of sleep, including both subjective experiences and objective parameters. Each component score of the PSQI ranges from 0 to 3, with 3 indicating the greatest dysfunction or disturbance. The seven component scores are then summed to obtain a global PSQI score, which ranges from 0 to 21. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties.

• Relapse tendency Relapse tendency was assessed using the "Relapse Tendency Questionnaire". This questionnaire consists of 20 items, each scored on a scale from 0 to 5, where 0 indicates the least severity and 5 indicates the greatest severity. Each item addressed different aspects of relapse tendency, including cravings, emotional stability, and social support. The scores for each item were summed to provide a total score, with higher scores indicating a greater tendency towards relapse. To mitigate social desirability bias, participants were assured of the confidentiality and anonymity of their responses. Standardized instructions were provided before administering the questionnaire to emphasize the importance of honest and accurate self-reporting.

Table 1 Choice reaction time scoring table

Statistical analysis

The data in this study were processed and analyzed using python with version 3.9 and statistical package pingouin with version 0.5.4. All data in this study were continuous variables with no outliers. Therefore, the mean and standard deviation (Mean ± SD) were used to represent the data. Single-factor analysis of variance (ANOVA) and repeated measures ANOVA were used to compare the differences in central tendency among the three groups before and after the experiment. The Kolmogorov-Smirnov (K-S) test was used to assess the normality of all continuous variables. If the data did not follow a normal distribution, logarithmic transformation was applied to normalize the distribution. When the data did not meet the assumption of sphericity according to the Mauchly’s sphericity test, the results of the corrected Pillai’s Trace in multivariate analysis of variance (MANOVA) were used. A significance level of p < 0.05 was considered as the threshold for determining statistical significance. This value was used to interpret the results of the statistical tests conducted in the study.

Results

The initial and final sample sizes for each group in the study were as shown in Fig. 2.

Fig. 2

Participants in the experiment. Health Qigong group (QigongG), Closed Motor Exercise group (ClosedG), and Combined Health Qigong Exercises and Closed Motor Exercise group (CombinedG)

Initially, there were 31 participants in QigongG and by the end of the study, the number of participants decreased to 29. There were 33 participants in ClosedG and by the end of the study, the number of participants decreased to 25. There were 32 participants in CombinedG, by the end of the study, the number of participants decreased to 26.

Demographic statistic

A summary of participant demographics at baseline is presented in Table 2, which presents the demographic characteristics of participants at baseline, divided into three groups: QigongG, ClosedG, CombinedG. The table compares sex distribution, age, weight, and height among the groups, along with the associated p-values to assess statistical significance. Age (years): The mean age is 25.62 ± 4.10 years for QigongG, 25.24 ± 3.37 years for ClosedG, and 25.65 ± 4.31 years for CombinedG, with a p-value of 0.917, showing no significant difference. Weight (kg): The mean weight is 65.47 ± 8.90 years for QigongG, 64.12 ± 8.31 years for ClosedG, and 65.46 ± 8.90 years for CombinedG, with a p-value of 0.817, indicating no significant difference. Height (cm): The mean height is 165.47 ± 6.87 cm for QigongG, 164.68 ± 7.29 cm for ClosedG, and 165.46 ± 6.86 cm for CombinedG, with a p-value of 0.898, indicating no significant difference. The results indicate that the demographic characteristics of the participants are comparable across the three groups.

Table 2 Demonstration of participants at baseline

Results of two-way repeated measurement ANOVA

 

• Relapse Tendency Within-Group Results: The QigongG group showed a significant decrease in relapse tendency scores from the baseline (74.03 ± 11.06) to the end of the study (64.14 ± 12.51). The ClosedG group also showed a significant reduction from baseline (71.2 ± 11.69) to the end of the study (58.68 ± 13.37). The CombinedG group experienced a significant decrease in relapse tendency from baseline (73.38 ± 9.28) to the end (66.92 ± 11.80). Between-Group Results: At the medium time point, the CombinedG group had a significantly higher relapse tendency score compared to the QigongG group. At the end of the study, the relapse tendency score was significantly different between the ClosedG and CombinedG groups.

• Vital Capacity Within-Group Results: The ClosedG group showed a significant increase in vital capacity from baseline (2625.08 ± 138.66 ml) to the end of the study (2748.92 ± 165.26 ml). The CombinedG group also showed a significant increase from baseline (2586.19 ± 142.74 ml) to the end (2726.69 ± 186.11 ml). Between-Group Results: At the medium and the end time point, the ClosedG group had a significantly higher vital capacity compared to the QigongG. At the end of the study, the CombinedG group had a significantly higher vital capacity compared to the QigongG group.

• Resting Heart Rate Within-Group Results: There were no significant changes in resting heart rate for the QigongG group (baseline: 74.31 ± 5.81 bpm, end: 73.38 ± 6.71 bpm). Similarly, the ClosedG group did not show significant changes in resting heart rate (baseline: 74.92 ± 5.84 bpm, end: 75.20 ± 6.45 bpm). The CombinedG group also had no significant changes in resting heart rate (baseline: 73.27 ± 5.40 bpm, end: 72.62 ± 5.99 bpm). No significant between-Group Results differences in resting heart rate were observed between the groups at any time point.

• Sleep Quality The QigongG group showed a significant improvement in sleep quality from baseline (14.97 ± 1.90) to the end of the study (12.69 ± 4.24). The ClosedG group also showed significant improvement from baseline (14.84 ± 2.13) to the end (11.08 ± 3.91). The CombinedG group experienced a significant improvement from baseline (16.00 ± 2.33) to the end (13.27 ± 5.18). No significant between-Group Results differences in resting heart rate were observed between the groups at any time point.

• Choice Reaction Time Within-Group Changes: The choice reaction time in QigongG increased from baseline (2.41 ± 1.02) to the medium time point (2.83 ± 0.85) and further at the end (2.97 ± 0.82). The increase at the end point compared to baseline is statistically significant. The choice reaction time in ClosedG remained relatively stable, increasing from baseline (2.56 ± 0.96) to the medium time point (2.64 ± 0.86) and slightly more at the end (2.84 ± 0.69). The changes observed within this group are not statistically significant. The choice reaction time in CombinedG increased from baseline (2.65 ± 0.85) to the medium time point (3.12 ± 0.77), and further at the end (3.50 ± 0.99). The increase at the end point compared to baseline is statistically significant. Between-Group Results: At the medium and end time point, the CombinedG group had a significantly higher score compared to the Closed group.

In summary, at the end of the trial, the study results indicated significant changes in several metrics for the groups involved: Relapse Tendency: All groups showed significant reductions. The ClosedG group had a significant difference with CombinedG at the end (The Closed group is better). Vital Capacity: Both the ClosedG and CombinedG groups experienced significant increases, QigongG have no significant increases. The CombinedG group and ClosedG had a significant difference with the QigongG group at the end(the QigongG group is the lowest). Resting Heart Rate: No significant changes were observed in any group. No significant between-Group Results differences in resting heart rate were observed between the groups at any time point. Sleep Quality: All groups showed significant improvements (The Closed group have a earlier improvement at the medium time). No significant between-Group Results differences were observed between the groups at any time point. Choice Reaction Time: Significant improvement were observed in the QigongG and CombinedG groups. The CombinedG group had a better Choice Reaction score than those two other at the end (Table 3) (Fig. 3).

Table 3 Comparison of intervention effects between groups

Fig. 3

Box Plot of intervention effects between groups for a Relapse Tendency; b Vital Capacity; c Sleep Quality; d Choice Reaction Time. Symbols indicate statistical significance as follows: *: Significant difference between the sixth month and baseline. a: Significant difference between the third month and baseline. $\dagger$: Significant difference between the Close and Control groups. $\clubsuit$: Significant difference between the Close and Control groups. $\spadesuit$: Significant difference between the Close and Open groups

Discussion

To the best of our knowledge, the study is the first to compare the effects of Health Qigong, closed motor exercises, and their combination on the physical and mental health of female drug rehabilitation participants. The ClosedG and CombinedG with closed exercise demonstrated superior improvements in vital capacity compared to the Qigong group, the combined exercise group showed the best performance in choice reaction time than those two, and the closed exercise group experienced the earliest improvement in sleep quality.

The significant increase in vital capacity observed in the ClosedG and CombinedG groups, compared to the QigongG group, highlights the role of aerobic exercise in enhancing lung function. Cycle ergometer exercise involves sustained, rhythmic breathing, which increases the demand on the respiratory muscles [22], such as the diaphragm and intercostal muscles [23]. This sustained activity leads to hypertrophy and improved endurance of these muscles, allowing for greater lung expansion and more efficient ventilation [24]. Additionally, aerobic exercise enhances pulmonary blood flow, which can improve gas exchange and overall lung function. The relatively low intensity of Qigong does not provide the same level of respiratory muscle engagement, resulting in less pronounced improvements in vital capacity. In addition, the early improvement in sleep quality observed in the ClosedG group can be explained by the immediate physical fatigue and stress relief provided by power cycling. Aerobic exercises like cycling increase the production of endorphins, which are natural mood elevators and stress relievers [25]. Additionally, exercise induces the release of neurotransmitters such as serotonin and norepinephrine, which play a role in regulating sleep-wake cycles [26].

The superior choice reaction time in the CombinedG group can be attributed to the synergistic effects of cognitive and physical exercises. Qigong exercises involve mental focus, coordination, and controlled breathing, which enhance neural efficiency and cognitive function. This mental engagement can lead to increased activation of the prefrontal cortex, which is involved in decision-making and attention. The study [27] investigated differences in brain activation during meditation between meditators and non-meditators and found that meditators showed stronger activations in the rostral anterior cingulate cortex and the dorsal medial prefrontal cortex bilaterally, compared to controls. When combined with the physical benefits of power cycling, such as improved cardiovascular fitness and muscle strength, participants in the CombinedG group experienced comprehensive improvements in both cognitive and motor functions. Power cycling enhances synaptic plasticity and neurogenesis, particularly in the hippocampus, which is crucial for learning and memory. Suwabe et al. [28] used functional MRI in healthy young adults to assess the immediate impact of a short bout of mild exercise on the brain mechanisms supporting memory processes and demonstrated that acute very light exercise improves hippocampal memory function, especially DG-mediated pattern separation. This combination of cognitive and physical stimulation leads to better neural integration and faster reaction times.

The absence of significant changes in resting heart rate across all groups showed in our study can be primarily attributed to the profound physiological impacts of drug abuse on the cardiovascular system. Chronic substance abuse, especially with drugs like cannabis and methamphetamine, exerts several detrimental effects on the body that complicate cardiovascular recovery and adaptation [29, 30]. And various drugs, especially intravenous drugs, have been shown to impact the immune and lymphatic systems, potentially influencing processes relevant to Notch 4 signaling [31]. Methamphetamine induces oxidative stress and inflammation, causing damage to lymphatic tissues and promoting immune dysregulation [32]. Notch 4, known for its unique role in lymphangiogenesis and lymphatic vessel maintenance [33], could be crucial in understanding the recovery of lymphatic integrity and immune function in individuals recovering from drug dependency. Interventions such as Qigong and closed motor exercises, which have restorative and immune-modulating effects, may play a role in enhancing lymphangiogenesis and immune stability, supporting a more comprehensive recovery approach. In addition, the damaged heart muscle and compromised vascular health reduce the ability of the cardiovascular system to respond to exercise stimuli. Besides, drugs overstimulate the sympathetic nervous system, leading to chronic stress on the heart and blood vessels. This overactivation can result in a persistently elevated resting heart rate and diminished parasympathetic tone, the branch of the autonomic nervous system responsible for promoting relaxation and recovery [34]. The neural pathways responsible for heart rate regulation may be so adversely affected by drug use that moderate exercise alone cannot restore normal autonomic nervous system function within the study’s timeframe. These factors collectively hinder the ability of the cardiovascular system to recover and adapt, even with structured exercise interventions. For future interventions, a more extended and intensive rehabilitation program might be necessary to overcome these deep-seated physiological challenges.

While this study provides valuable insights, it has several limitations. The sample size was relatively small, which might limit the generalizability of the findings. The study duration, while sufficient to observe some changes, might not be long enough to capture the full extent of physiological adaptations, particularly for heart rate. Additionally, the reliance on self-reported measures for sleep quality and relapse tendency could introduce social desirability bias, potentially affecting the accuracy of these findings. Future research should consider larger, more diverse samples and longer intervention periods to validate these findings and further explore the mechanisms underlying the observed benefits. Incorporating external validation measures, such as objective sleep tracking and staff reports, could also enhance the robustness of future studies.

Conclusions

This study demonstrates that integrating both Health Qigong and closed motor exercises into rehabilitation programs offers significant health benefits for individuals undergoing drug rehabilitation. The combined approach leverages the holistic, meditative benefits of traditional martial arts alongside the physiological improvements driven by closed motor exercises, resulting in comprehensive enhancement of physical and mental well-being. This finding underscores the potential for blending traditional and modern exercise methods to optimize rehabilitation outcomes. Rehabilitation centers may consider adopting this integrated approach to better address the diverse needs of recovering individuals undergoing drug rehabilitation, promoting not only physical health improvements but also mental resilience and relapse prevention. This innovative model serves as a foundation for future research and clinical application, particularly in designing tailored, evidence-based interventions for vulnerable populations.