Efficacy of abdominal vibration technique in Tuina in reducing depression, anxiety, and stress in patients with prediabetes

Abstract

BACKGROUND

Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress. Conventional pharmacological treatments for prediabetes have limitations, including adverse effects and poor patient compliance. Tuina’s abdominal vibration technique, a traditional non-pharmacological intervention, has shown promising results in glycemic regulation. However, its effects on psychological well-being remain largely unexplored.

AIM

To investigate efficacy of abdominal vibration at varying frequencies in Tuina for alleviating psychological and metabolic effects in prediabetes patients.

METHODS

A prospective cohort study (April 2025 to April 2026) at Dongfang Hospital of Beijing University of Chinese Medicine included 120 prediabetes patients. Participants were allocated to three groups based on vibration frequency: (1) Low-frequency (400 times/minute, n = 40); (2) Medium-frequency (500 times/minute, n = 40); and (3) High-frequency (600 times/minute, n = 40). All participants received 30-minute sessions three times weekly for 3 months, with follow-up at 6 months and 12 months. Primary outcomes included changes in depression (Beck Depression Inventory-II), anxiety (State-Trait Anxiety Inventory), and stress (Perceived Stress Scale) levels.

RESULTS

After a 3-month intervention period, with follow-ups at 6 months and 12 months, patients in all three groups showed significant improvements in depression, anxiety, and stress scores compared to baseline (P < 0.001). The high-frequency group demonstrated the most substantial psychological improvements (mean reduction in depression scores: 9.2 ± 2.3 points; anxiety: 8.7 ± 2.1 points; stress: 10.4 ± 2.5 points). These psychological improvements correlated significantly with reductions in insulin resistance (r = 0.68, P < 0.001). The high-frequency group also showed the most significant improvements in glycemic parameters, with mean reductions in fasting plasma glucose, 2-hour postprandial glucose, and glycosylated hemoglobin concentrations of 0.92 mmol/L, 1.87 mmol/L, and 0.51%, respectively. Correlation analysis revealed significant associations between improved psychological parameters and enhanced glycemic control.

CONCLUSION

Tuina’s abdominal vibration technique, especially at high frequency reduces depression, anxiety, and stress in prediabetes patients, correlating with enhanced glycemic control and insulin sensitivity, suggesting a bidirectional relationship between psychological and metabolic health.

Keywords: Prediabetes; Impaired glucose tolerance; Abdominal vibration technique; Tuina; Depression; Anxiety; Stress; Insulin resistance; Psychological well-being; Complementary therapy

Core Tip: This study explored the impact of different frequencies of abdominal vibration in Tuina on psychological well-being and insulin resistance (IR) in patients with prediabetes. The findings shows that all vibration frequencies significantly reduce depression, anxiety, and stress, with the high-frequency group showing the greatest improvements. These psychological benefits were strongly associated with better glycemic control and reduced IR, highlighting a potential bidirectional relationship between psychological health and metabolic outcomes in prediabetes management.