What is qigong?

Overview

The term qigong refers to various systems of breathing exercises and physical postures that are thought to improve general health by following the principles of traditional Chinese medicine. More precisely, this practice is known as internal qigong, or qigong practiced by a person for his or her own benefit. Expert qigong practitioners may also use their training to treat other people, a practice called external qigong, or qi therapy.

Internal qigong is said to increase one’s overall vitality and health by facilitating the free flow of qi in the body. The term qi refers to the underlying “energy” in the body, as conceptualized in the ancient medical systems of East Asia. (There is no scientific evidence for the existence of qi.) Those who practice external qigong claim to have developed so much mastery of qi that they can project it into others.

Methods related to modern qigong are mentioned in Chinese texts dating back more than three millennia. Qigong bears a close relationship to the martial arts traditions of East Asia, but like Tai Chi, it has been adapted primarily for health rather than for fighting. Qigong also has strong historical connections with metaphysical and religious traditions, but it has become popular more recently as a purely secular exercise. This evolution is similar to that of yoga.

Cults may form around practitioners of external qigong. Reportedly, the present-day qigong master Li Hongzhi can turn invisible, levitate, teleport himself through space, and control people’s thoughts. His tens of millions of followers, known collectively as the Falun Gong, have achieved sufficient political power in China to have been banned.

Scientific Evidence

Mainstream scientists do not accept the concept of qi, but internal qigong can be considered a form of exercise and studied as such. External qigong, however, does not strike most scientists as plausible; it has nonetheless undergone some study.

All of the research published on either type of qigong suffers from significant flaws. This is to some extent the fault of researchers who may possess a type of personal devotion to qigong that impairs scientific objectivity. However, even with the best of intentions and the most implacable dedication to objectivity, a researcher will find it difficult to properly study qigong. This results from a problem intrinsic to the treatment: It is difficult, if not impossible, to conduct a true double-blind, placebo-controlled study of qigong.

For the results of a study to be truly reliable, some participants must receive real treatment (the active group), while others receive placebo treatment (the control group). In addition, both participants and researchers must not know which group is which. Without this “blinding,” the placebo effect and other confounding factors will inevitably and significantly skew the results.

When conducting studies of herbs, supplements, or drugs, it is relatively easy to achieve blinding: Some participants receive the real treatment in a capsule, while others receive a fake treatment in an identical capsule, and neither researchers nor participants know which is which. The capsules are coded, and the code is not broken until after the study has been completed. With qigong exercises, however, as with many other alternative therapies, there is no simple equivalent.

Consider internal qigong. While some participants can be assigned fake qigong exercises, it is difficult to make sure they do not know that the exercises they are practicing are fake. One would need to first train a group of people to teach the fake exercises, and to do so without letting this group know that the exercises are fake; in turn, they would teach the participants in the placebo group. However, the duped participants and duped teachers would have to be prevented from learning about real qigong, because such knowledge would destroy the necessary deception. Such a complex feat would be challenging to achieve. Perhaps it would be more practical to compare qigong exercises with an equally impressive but ineffective intervention, such as fake ultraviolet laser acupuncture or fake ultrasound treatment. However, a review of the literature failed to find any such study of qigong.

External qigong presents a somewhat different but related challenge. Because qi is said to be invisible, a practitioner of external qigong could simply convey qi to certain participants and only pretend to convey it to others. However, practitioners would know what they themselves were doing, and the history of medical research indicates that by subtle, even unconscious, cues these practitioners would convey emotional confidence when providing real therapy and lack of confidence when providing fake therapy. In turn, this “confidence differential” would create placebo effects and other confounding factors. One proposed method to overcome this problem involves using actors to confidently provide a fake therapy; however, again, no such study could be found in the published literature. Given these caveats, a summary of the evidence is provided here.

Internal qigong. In controlled studies, the use of internal qigong has shown some potential benefit for asthma, cancer treatment support, depression, fibromyalgia, hypertension, Parkinson’s disease, and enhancing general wellness. However, consistent and convincing evidence of effectiveness is lacking for all of these conditions.

In one study, qigong was no more effective than conventional physical therapy exercise techniques in the treatment of chronic, nonspecific neck pain. A review of nine clinical trials and observational studies found insufficient evidence to support qigong for the treatment of type 2 diabetes.

External qigong. One study reported that, compared with placebo treatment, external qigong affects heart rate in a positive way. Another study reported that, compared with placebo treatment, external qigong reduces symptoms of premenstrual syndrome. Both of these studies had problems in statistical analysis. A third randomized trial compared the effects of two qigong practitioners and a sham practitioner (administering fake or placebo qigong) on 106 persons with osteoarthritis of the knee. Compared with the sham group, only those persons treated by one of the true qigong practitioners showed significant improvement. This suggests that something other than the qigong itself imparted benefit. Intuitively, it would seem that internal qigong would be a better choice for osteoarthritis, though there is no scientific support for this belief.

Safety Issues

Qigong, when practiced in moderation, is most likely generally safe. However, people with severe heart or lung conditions may put themselves through excessive stress by attempting vigorous breathing exercises.

There are numerous anecdotes in which practitioners of qigong have developed serious mental problems (“qigong psychosis”) as a result of practicing the method to an extreme or with insufficient or inept guidance. However, it has been suggested that some people with latent mental illnesses have been drawn to extreme forms of qigong, rather than that the qigong practice itself caused the mental illness.

Bibliography

Chen, K. W., et al. “Effects of External Qigong Therapy on Osteoarthritis of the Knee.” Clinical Rheumatology 27 (2008): 1497-1505.

Guo, X., et al. “Clinical Effect of Qigong Practice on Essential Hypertension.” Journal of Alternative and Complementary Medicine 14 (2008): 27-37.

Hui, P. N., et al. “An Evaluation of Two Behavioral Rehabilitation Programs, Qigong Versus Progressive Relaxation, in Improving the Quality of Life in Cardiac Patients.” Journal of Alternative and Complementary Medicine 12 (2006): 373-378.

Lansinger, B., et al. “Qigong and Exercise Therapy in Patients with Long-Term Neck Pain.” Spine 32 (2007): 2415-2422.

Lee, M. S., M. K. Kim, and H. Ryu. “Qi-Training (Qigong) Enhanced Immune Functions: What Is the Underlying Mechanism?” International Journal of Neuroscience 115 (2005): 1099-1104.

Lee, M. S., et al. “Qigong for Type 2 Diabetes Care.” Complementary Therapies in Medicine 17 (2009): 236-242.

Lee, T. I., H. H. Chen, and M. L. Yeh. “Effects of Chan-Chuang Qigong on Improving Symptom and Psychological Distress in Chemotherapy Patients.” American Journal of Chinese Medicine 34 (2006): 37-46.

Mannerkorpi, K., and M. Arndorw. “Efficacy and Feasibility of a Combination of Body Awareness Therapy and Qigong in Patients with Fibromyalgia.” Journal of Rehabilitative Medicine 36 (2004): 279-281.

Oh, B., et al. “Impact of Medical Qigong on Quality of Life, Fatigue, Mood, and Inflammation in Cancer Patients.” Annals of Oncology 21 (2010): 608.

Witt, C., et al. “Qigong for Schoolchildren.” Journal of Alternative and Complementary Medicine 11 (2005): 41-47.