Therapeutic indications of Qi Gong

Very little research into Qi Gong applications conforms to strict modern scientific protocols. What's more, the research, mostly conducted in China or Korea over the past 25 years, is rarely published in the West. That said, here are the conclusions of the main studies available.

It's important to note that, for most of them, the researchers point out that factors such as the small number of studies available, the limited number of participants, the absence of random allocation or of a placebo intervention limit the scope of the conclusions. Further studies are therefore needed to confirm the results.

Reducing hypertension. The use of Qi Gong in the treatment of hypertension is one of the best-documented subjects. A systematic review published in 2007 identified 12 randomized clinical trials9.

These trials, involving a total of over 1,000 participants, compared Qi Gong practice (alone, with medication or with conventional therapy) with various conditions (medication alone, deferral on a waiting list, exercise and progressive muscle relaxation combined with conventional therapy). The results suggest that regular Qi Gong practice may have positive effects on lowering blood pressure.

Reduce stress.

A cross-over study involving 10 healthy students assessed the effect of Qi emission by a master (external Qi Gong) on stress levels, cortisol (a hormone associated with stress) concentrations and brain waves10. Students participated alternately in a real or simulated 60-minute Qi Gong session. They experienced significantly more satisfaction, calm and relaxation with real Qi Gong than with simulated Qi Gong. The results also showed a significant reduction in indicators of stress levels: lower cortisol, lower beta waves and higher alpha waves.

In 2010, a Swedish study showed similar results to the previous study11. For 8 weeks, 147 late primary school pupils either took part in 2 weekly sessions of Qi Gong exercises, or were in the control group.

The authors observed a reduction in levels of stress and psychological distress, as well as an improvement in self-image in children in the Qi Gong group, compared with children in the control group. In addition, the assessment of students' level of well-being at school decreased in the control group, while it remained stable in the Qi Gong group.

Reduce chronic pain.

Two systematic reviews have been published on the subject of chronic pain. One focused on internal, self-practised Qi Gong12 , the other on external, master-issued Qi Gong13. The first review (internal Qi Gong) concluded that the available data were unconvincing, due to the small number of studies identified (only 4 randomized clinical trials) and, above all, the poor methodological quality.

For the second review (master-taught Qi Gong), the results seem more promising. The 5 studies identified were of better methodological quality, and suggested some efficacy of Qi Gong in pain management compared with control groups (placebo Qi Gong or usual care).

In 2010, a new randomized clinical trial involving 50 chronic pain sufferers compared the effect of 4 weekly 30-minute external Qi Gong sessions with an equivalent amount of participant follow-up time14. The majority of participants (74%) were receiving another source of treatment during the experiment.

Compared with the control group, participants in the Qi Gong group showed a significant reduction in pain intensity after the 4-week treatment period. One month later, the improvements were still present, but were no longer statistically significant.

Improving quality of life for cancer sufferers.

In 2007, a systematic review assessed the effectiveness of Qi Gong practice alone or in combination with other treatments in improving quality of life in cancer patients15. Nine studies (including 4 randomized clinical trials) with a total of 346 participants were identified.

Two of these trials suggested that Qi Gong could prolong the life of cancer patients. But the authors concluded that, mainly due to the poor quality of the studies, it was not possible to conclude that Qi Gong was effective in cancer.

Subsequently, in 2010, research into the effects of Qi Gong was carried out on 162 cancer patients16. They were divided into 2 groups: Qi Gong (15 minutes of health talk, 45 minutes of exercise and 30 minutes of meditation, twice a week, for 10 weeks) and a control group receiving standard care. Results showed that, at the end of treatment, quality of life, fatigue, mood and measured inflammation parameters in the Qi Gong group had improved compared with the control group.

Strengthen the immune system.

Numerous in vitro and in vivo studies have examined the effect of Qi Gong on various parameters of immunity. Several have indicated that the emission of Qi by masters or regular Qi Gong practice can have a measurable effect on the production of various immune cells, such as monocytes, lymphocytes, natural killer cells (NK cells), neutrophils, etc.1,4,17-31 Although these results are encouraging, their clinical significance is still limited. But according to most authors, further research seems justified.

Reduce symptoms of premenstrual syndrome (PMS).

Two randomized clinical trials evaluated the effect of Qi emission on premenstrual symptoms in young women suffering from PMS. The first study involved 36 women: half of them received 10-minute sessions of Qi applied by a master; for the others, the master reproduced the same gestures, but without emitting Qi32.

Four sessions per menstrual cycle were carried out, for 2 cycles. Compared with women undergoing control treatment, those who received Qi reported a significant reduction in pain, water retention, negative feelings and general PMS symptoms.

In the second study, a Qi Gong group (9 sessions of 10-minute Qi emission by a master, spread over 2 menstrual cycles) was assigned to 23 young women, and a further 23 were placed on a waiting list33. Sixty minutes after the interventions, the authors noted a significant short-term effect on pain, anxiety and depression.

In the longer term, the results show a significant reduction in pain and water retention in women who received Qi compared with those in the control group.

Improving quality of life for the elderly.

A study published in 2003 analyzed the effect of Qi emission on anxiety, fatigue, depression, pain and blood pressure in 94 elderly people34.

Participants were randomly divided into 2 equal groups. Those in the first group received a 10-minute Qi program. In the other group, the master applied the same procedure, but without Qi emission.

In the Qi Gong group, only self-reported anxiety levels were significantly lower than in the placebo group, although other parameters (depression, fatigue, pain and blood pressure) were also slightly reduced.

Improving quality of life for people with heart problems.

A recent study compared the effectiveness of Qi Gong and a progressive relaxation program in improving the quality of life of 65 people with various cardiac disorders35.

Participants, who were referred by a specialist, completed 4 alternating 20-minute sessions of each therapy. The results showed that Qi Gong significantly improved scores on 7 of the 8 parameters chosen to assess quality of life, compared with only one for progressive relaxation.

Contribute to cardiac rehabilitation.

Rehabilitation programs are often recommended following a heart problem. Two studies have evaluated the value of Qi Gong in this field. A first randomized clinical trial studied the effect of Qi Gong combined with discussion groups on the physical skills of 95 people aged 73 and over with coronary artery disease36 .

Half of them took part in weekly meetings comprising 1 h of Qi Gong exercises and 2 h of discussions on various themes related to their condition. The others received the usual care. Results showed significant improvements in reported physical activity, coordination and balance in the Qi Gong-discussion group.

A second randomized clinical trial examined the effect of 16 weeks of Qi Gong on the physical rehabilitation of people with atrial fibrillation (a heart rhythm disorder)37 . The 43 participants were randomly assigned to either the control group (waiting list) or the Qi Gong group (twice 90 minutes of exercise per week).

The results showed a significant improvement in functional capacity in the Qi Gong group, both at the end of the exercises and 16 weeks later. Participants in the control group showed no significant change.

Reduce symptoms associated with Parkinson's disease.

Two randomized clinical trials were published in 2006. The results were contradictory. The first evaluated the effects of group Qi Gong exercises (90 minutes per week for 2 months) against a control group of 56 people with Parkinson's disease38 . The results showed a significant improvement in motor symptoms after 3 and 6 months in the Qi Gong group.

In addition, the incidence of several non-motor symptoms (constipation, pain, sleep disturbance and daytime sleepiness) was reduced. The authors concluded that Qi Gong could be a promising treatment.

The second, cross-over study compared aerobic training with Qi Gong in 26 elderly Parkinson's patients39 . Three times a week, for 7 weeks, the subjects took part in 45-minute sessions of either aerobics or Qi Gong. They were then discharged for 2 months before undergoing the opposite treatment.

Results showed significant improvements for the aerobic intervention, but not for the Qi Gong.

Help with heroin withdrawal.

A single randomized clinical trial, published in 2002, explored the efficacy of Qi Gong during heroin withdrawal40. During the first 10 days of detoxification, 86 men were divided into 3 groups: Qi Gong (sessions of 2 h to 2 h 30 of Qi Gong per day in a group, and 10 to 15 minutes of Qi emitted by a master); medication (withdrawal protocol with lofexidine-HCL); and control group (basic care and medication only to manage severe symptoms).

According to the results, participants in the Qi Gong group had an accelerated detoxification process, as well as a significant reduction in their anxiety levels and symptoms associated with withdrawal. The authors conclude that Qi Gong could be beneficial in heroin withdrawal, as well as having the advantage of not inducing side effects.

Help manage symptoms associated with diabetes.

In 2009, a systematic review identified 9 clinical studies, including 3 randomized clinical trials, relating to diabetes. They compared the combination of Qi Gong sessions and standard care with standard care alone41. The methodological quality of the randomized studies was very low. Despite some improvements in blood conditions, the authors concluded that there was insufficient evidence to suggest that Qi Gong is an effective treatment for diabetes.
A new study involving 32 people with diabetes was conducted in 2010. Participants were divided into 3 groups: Qi Gong, physical exercise (2 h per week in both cases) and a control group42. After 12 weeks, the results showed that regular Qi Gong practice significantly reduced blood glucose levels in diabetic patients.

Various ailments. Since 2009, Qi Gong has been the subject of small studies involving people with tinnitus43 , metabolic syndrome44 , burnout45 and chronic fatigue46 . Despite some promising results, the effect of Qi Gong on these health problems will need to be analysed in further studies before we can comment on its efficacy.
Therapeutic applications section
Research and writing: Estelle Vallée, M.Sc., Chair in Integrated Approach to Health, Université Laval.
Scientific review: Claudine Blanchet, PhD, Chaire en approche intégrée en santé, Université Laval.
(November 2010)