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 is 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, alternatively, "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 a supposed 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 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 relationships to the martial arts traditions of East Asia, but, like Tai Chi, it has been adapted primarily for health rather than 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. The present-day Qigong master Li Hongzhi can, reportedly, 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.
Mainstream scientists do not accept the concept of "Qi," but internal Qigong can be seen merely as a form of exercise and studied as such. External Qigong, however, does not strike most scientists as plausible; it has nonetheless undergone some study.
To date, 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 be kept in the dark ("blind") regarding which group is which. Without blinding, the placebo effect and other confounding factors will inevitably and significantly skew the results. (For detailed information on how this occurs see Why Does This Database Rely on Double-blind Studies?)
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 do so without letting them know 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 if they gained such knowledge it would destroy the necessary deception. Such a complex feat would be challenging to achieve! Perhaps it would be more practical to compare Qigong exercises against 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. Since 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 tells us 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 the above caveats, here is a summary of the evidence as it exists so far:
In controlled studies, use of internal Qigong has shown at least a hint of potential benefit for:
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, non-specific neck pain.19 However, some benefits were found when Qigong was combined with movement exercises in a review of 27 randomized trials with 3,005 adults chronic neck pain. Most of the trials reviewed had biases that may have affected the final results.29
A review of nine clinical trials and observational studies found insufficient evidence to support Qigong for treatment of type 2 diabetes.22
A review of seven randomized trials and one nonrandomized trial with 540 chronic heart disease patients found improvements in physical symptoms, functional capacity, blood pressure and/or electrocardiographic findings in those using quigong exercises either alone or with other treatments for cardiac rehabilitation.27
One study reported that, as compared to placebo treatment, external Qigong affects heart rate in a positive way.15 External Qigong also reduced symptoms of PMS in another study.16 However, both of these studies suffered from problems in statistical analysis.
Another randomized trial compared the effects two Qigong practitioners and a sham practitioner (administering fake or placebo Qigong) on 106 patients with osteoarthritis of the knee. Interestingly, compared to the sham group, only those subjects treated by one of the true Qigong practitioners showed significant improvement.21 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 to date. In a 3-month trial, 50 people with chronic pain (from osteoarthritis and other causes) were randomized to receive either external Qigong or equivalent amount of attention time without Qigong, along with any ongoing treatment.24 Those in the Qigong group experienced a signicantly greater reduction in their pain immediately following the sessions, but the effect did not last.
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, and/or with insufficient or inept guidance. However, it has been reasonably 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.17
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22. Lee MS, Chen KW, Choi TY, et al. Qigong for type 2 diabetes care: a systematic review. Complement Ther Med. 2009;17:236-42.
23. Oh B, Butow P, Mullan B, et al. Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol. 2010 Mar;21(3):608.
24. Vincent A, Hill J, Kruk KM, Cha SS, Bauer BA. External qigong for chronic pain. Am J Chin Med. 2010;38(4):695-703.
25. Chan AW, Lee A, Suen LK, Tam WW. Tai chi Qigong improves lung functions and activity tolerance in COPD clients: a single blind, randomized controlled trial. Complement Ther Med. 2011;19(1):3-11.
26. Ng BH, Tsang HW, Jones AY, So CT, Mok TY. Functional and psychosocial effects of health qigong in patients with COPD: a randomized controlled trial. J Altern Complement Med. 2011;17(3):243-251.
27. Chan CL, Wang CW, Ho RT, et al. A systematic review of the effectiveness of qigong exercise in cardiac rehabilitation. Am J Chin Med. 2012;40(2):255-267.
28. Ding M, Zhang W, et al. Effectiveness of t'ai chi and qigong on chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Altern Complement Med. 2014;20(2):79-86.
29. Gross A, Kay TM, Paquin JP, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015;1:CD004250.
Last reviewed September 2014 by EBSCO CAM Review Board
Last Updated: 5/4/2015
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