JMIR Publications

ABSTRACT

Background:

Baduanjin qigong is a traditional mind-body exercise effective for improving physical balance and health in older adults. However, age-related proprioceptive decline makes it difficult for older adults to maintain accurate postures without expert guidance.

Objective:

This study quantitatively evaluated the effects of a 2D skeleton-based real-time visual feedback system on the kinematic accuracy and training adherence of older adults practicing Baduanjin qigong.

Methods:

Twenty-eight older adults were randomly assigned to either a real-time visual feedback (F) group (n=14) or a non-feedback control (NF) group (n=14) for a 6-week Baduanjin training program. Kinematic angular errors of eight major joints were calculated using a 2D skeleton tracking algorithm via a single webcam. Independent t-tests were conducted to analyze weekly error trends, joint-specific errors, and mean errors across the 10 Baduanjin sequence steps.

Results:

Over the 6-week period, the standard deviation (SD) of postural error in the NF group increased (±4.47°), indicating degraded training consistency, whereas the F group maintained a narrow error variance (±2.55°), preventing error drift. Joint-specific analysis revealed that the F group exhibited significantly higher accuracy in the right elbow (P=.029), right shoulder (P=.044), and right knee (P=.032) compared to the NF group. Notably, during Form 3 (Separating Heaven and Earth)—a high-difficulty movement requiring asymmetric upper-body coordination—the F group (24.09±1.99°) demonstrated a drastic reduction in kinematic error compared to the NF group (27.79±3.34°) (P=.001).

Conclusions:

Real-time visual feedback effectively compensates for diminished somatosensory function in older adults, significantly improving complex, multidirectional, and asymmetric postural control. Additionally, visual anchors help maintain correct movement trajectories during long-term practice, thereby ensuring qualitative training adherence. By enabling the quantitative evaluation and real-time correction of traditional qigong using a standard webcam, this system demonstrates substantial potential for contactless tele-rehabilitation and home healthcare applications for the aging population.