Qigong and Multicomponent Exercise in Panic Disorder

The Mini-Balance Assessment Systems Test will be used for clinical balance assessment.

Functional Walking Assessment will be used to assess postural stability and balance during various walking tasks.

Activity-Specific Balance Confidence Scale will be used to evaluate functional balance-mobility-walking performance. For each question, the score ranges from 0% (no confidence) to 100% (full confidence). The values across all activities are summed and the average calculated. Measurement results range from 0% to 100%, with a higher average score indicating higher confidence. A score above 80% on this scale indicates that the balance is reliable.

The 5-Repetition Sit-to-Stand Test will be used to measure overall stability and functional lower extremity muscle strength.

The Sedentary Behavior Questionnaire is a questionnaire developed to assess the time spent performing 11 sedentary behaviors on a typical weekday and weekend day. The questionnaire has nine response options: "Never," "15 minutes or less," "30 minutes," "1 hour," "2 hours," "3 hours," "4 hours," "5 hours," and "6 hours or more." Before scoring, the time spent on each behavior is converted to hours (for example, a 15-minute response is recorded as 0.25 hours). For a total score, the behavioral durations in hours are summed separately for weekdays and weekends. To obtain the average sedentary behavior duration for weekdays and weekends, the total time spent during the week is multiplied by 5, and the total time spent on weekends is multiplied by 2. When calculating the total time spent on sedentary behavior during the weekdays and weekends, scores higher than 24 hours/day are reduced to 24 hours/day and recorded.

The Baecke Habitual Physical Activity Questionnaire will assess participant's habitual physical activities over the last 12 months. This questionnaire consists of 16 questions regarding three main areas of individual physical activity in the last 12 months: occupational (items 1-8), sports (items 9-12), and recreational (items 13-16). Scores for each area range from 1 to 5; higher scores indicate higher physical activity.

The Exercise Benefits/Barriers Scale will be used to measure the perceived benefits of exercise and the perceived barriers to exercise. Each participant will be asked to rate perceived benefits and perceived barriers on a 4-point Likert scale ("Strongly Agree," "Agree," "Disagree," and "Strongly Disagree"). Possible scores on the benefits scale range from 29 to 116, with higher scores indicating greater perceived benefits. Possible scores on the barriers scale range from 14 to 56, with higher scores indicating greater perceived barriers. The total score ranges from 43 to 172. The higher the score, the more positively perceived physical activity benefits are relative to physical activity barriers.

Cognitive functions will be assessed with the Montreal Cognitive Assessment Scale. The scale, which can be administered quickly, presents the individual with eight different cognitive tasks. Developed to assess mild cognitive impairments, this scale assesses various cognitive abilities, including executive functions, visual-spatial skills, memory, language, attention and concentration, abstract thinking, calculation, and orientation. The maximum score possible from the test battery is 30, but scores of 21 or higher are considered normal.

Sleep quality will be evaluated with the Pittsburgh Sleep Quality Index. The index is a 19-item self-report measure that assesses sleep quality and disturbances over the past month. The 19 individual items form a score of seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping pills, and daytime dysfunction. Each component is rated on a 0-3 scale. The sum of the seven components provides the total scale score. The sum of the seven component scores ranges from 0 to 21; higher scores represent poorer subjective sleep quality.

The Modified Fatigue Impact Scale will be used to evaluate the participant's fatigue status in the last month. The scale consists of 21 questions assessing the physical, cognitive, and social effects of fatigue. Each item is scored from 0 (no problem) to 4 (maximum problem). Higher scores indicate increased fatigue exposure, and lower scores indicate a lower degree of fatigue.

The Nordic Musculoskeletal Questionnaire will be used to measure musculoskeletal pain. This survey consists of three main sections. The first section addresses any distress (such as pain, aching, discomfort, or numbness) experienced by the participant over the past 12 months. The second section asks the same question, but it addresses any distress experienced by the participant over the past 7 days. The final section addresses any injuries caused by distress experienced over the past 12 months. Data collected in each section relates to different anatomical areas: neck, shoulders, back, elbows, hands/wrists, waist, hips/thighs, knees, and feet/ankles. The survey primarily inquires about the presence of pain in nine body areas. Responses are recorded as binary options ("yes" or "no"). If the participant answers "yes," the relevant subquestions are discussed.

Quality of life will be assessed with Short Form-36. The SF-36 questionnaire measures health status by considering physical functioning and exercise, emotional and physical role functioning, overall mental health, social role functioning, bodily pain, and general health. The 36 items in the scale give it its name. This scale consists of eight subscales. It includes subparameters for pain, physical and social functioning, fatigue, health perception, emotional state, emotional problems, and limitations due to physical problems. The scale considers the last four weeks. Questions are scored from 0 to 100.