Therapeutic indications of Qi Gong

Little research on the applications of Qi Gong conforms to strict modern scientific protocols. Moreover, 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 is 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 randomisation or of a placebo intervention limit the scope of the conclusions. Further studies will therefore be needed to confirm the results.

Reducing hypertension. The use of Qi Gong in the treatment of hypertension is one of the best documented topics. A systematic review published in 2007 identified 12 randomised clinical trials9 . 9 These trials, involving a total of over 1000 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.

Reducing stress.

A cross-over study of 10 healthy students assessed the effect of a master's Qi release (external Qi Gong) on experienced stress, cortisol (stress hormone) levels and brain waves10 . Students alternated between participating in a 60-minute real or simulated Qi Gong session. They experienced significantly more satisfaction, calmness and relaxation with the real Qi Gong than with the simulated Qi Gong. The results also show 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 students either participated in 2 weekly sessions of Qi Gong exercises or were in the control group. The authors observed reduced levels of stress and psychological distress, as well as improved self-image in the children in the Qi Gong group, compared to the children in the control group. In addition, the students' school wellness ratings decreased in the control group, while they remained stable in the Qi Gong group.

Reducing chronic pain.

Two systematic reviews have been published on chronic pain. One was on internal Qi Gong, practised by oneself12 , and the other on external Qi Gong, delivered by a master13. The first review (internal Qi Gong) concluded that the available evidence was unconvincing due to the small number of studies identified (only 4 randomised clinical studies) and especially the poor methodological quality. For the second review (master-taught Qi Gong), the results seem more promising. The 5 studies reviewed have better methodological quality and suggest some effectiveness of Qi Gong in pain management compared to control groups (placebo Qi Gong or usual care).

In 2010, a new randomised clinical trial of 50 people with chronic pain 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 to the control group, participants in the Qi Gong group showed a significant decrease in pain intensity after the 4 weeks of treatment. One month later, the improvements were still present, but were no longer statistically significant.

Improving the quality of life of people with cancer.

In 2007, a systematic review evaluated the effectiveness of Qi Gong practice alone or in combination with other treatments in improving the quality of life of people with cancer15 . Nine studies (including 4 randomised 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, a research on the effects of Qi Gong was conducted with 162 cancer patients16 . They were divided into 2 groups: Qi Gong (15 minutes of health discussion, 45 minutes of exercise and 30 minutes of meditation, twice a week, for 10 weeks) and a control group receiving standard care. The results indicate that at the end of the treatment, the quality of life, fatigue, mood and measured inflammation parameters of the people in the Qi Gong group had improved compared to 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 release of Qi by masters or regular practice of Qi Gong 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 the majority of authors, further research seems justified.

Reducing premenstrual syndrome (PMS) symptoms.

Two randomised clinical trials evaluated the effect of Qi emission on premenstrual symptoms in young women with 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 performed, for 2 cycles. Compared to the control women, those who received Qi reported a significant decrease in pain, fluid retention, negative feelings and general PMS symptoms.

In the second study, 23 young women were assigned to a Qi Gong group (9 sessions of 10 minutes of Qi emission by a master, spread over 2 menstrual cycles), and 23 others 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 indicate a significant decrease in pain and fluid retention in the women who received Qi compared to the control group.

Improving the quality of life of the elderly.

A study published in 2003 analysed the effect of Qi emission on anxiety, fatigue, depression, pain and blood pressure in 94 elderly people34 . The participants were randomly separated into two equal groups. Those in the first group received a 10-minute Qi broadcast. In the other group, the teacher applied the same procedure, but without Qi emission. In the Qi Gong group, only the level of anxiety reported by the subjects decreased significantly compared to the placebo group, although the other parameters also decreased slightly (depression, fatigue, pain and blood pressure).

Improving the quality of life of people with heart problems.

A recent study compared the effectiveness of Qi Gong practice and a progressive relaxation programme in improving the quality of life of 65 people with various heart conditions35 . The participants, who were referred by a specialist, completed four 20-minute sessions of each therapy, alternating between them. The results indicate that Qi Gong significantly improved the results of 7 of the 8 parameters chosen to assess quality of life, compared with only one for progressive relaxation.

Contribute to cardiac rehabilitation.

Rehabilitation programmes are often recommended following a heart problem. Two studies have evaluated the value of Qi Gong in this area. A first randomised clinical study investigated the effect of Qi Gong combined with focus groups on the physical skills of 95 people aged 73 years and older with coronary artery disease36 . Half of them participated in weekly meetings consisting of 1 h of Qi Gong exercises and 2 h of discussions on different topics related to their condition. The others received the usual care. The results showed significant improvements in reported physical activity, coordination and balance in the Qi Gong-discussion group.

A second randomised clinical study investigated 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 indicate a significant improvement in functional ability 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.

Reducing symptoms associated with Parkinson's disease.

Two randomised clinical trials were published in 2006. They show conflicting results. The first evaluated the effects of group Qi Gong exercises (90 minutes per week for 2 months) compared to 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 study, a cross-over study, compared aerobic training with Qi Gong in 26 elderly people with Parkinson's disease39 . Three times a week, for 7 weeks, the subjects participated in 45-minute sessions of either aerobics or Qi Gong. They were then off work for 2 months before undergoing the opposite treatment. The results showed significant improvements for the aerobic intervention, but not for the Qi Gong intervention.

Helping with heroin withdrawal.

A single randomised clinical trial, published in 2002, explored the effectiveness of Qi Gong during heroin withdrawal40 . During the first 10 days of detoxification, 86 men were divided into 3 groups: Qi Gong (2 to 2.5 hours of Qi Gong per day in a group, and 10 to 15 minutes of Qi delivered by a master); medication (withdrawal protocol with lofexidine-HCL); and control group (basic care and medication only to manage severe symptoms). Results showed that participants in the Qi Gong group had an accelerated detoxification process and a significant reduction in anxiety levels and withdrawal symptoms. The authors conclude that Qi Gong could be beneficial in heroin withdrawal, in addition to having the advantage of not inducing side effects.

Helping to manage symptoms associated with diabetes.

In 2009, a systematic review identified 9 clinical studies, including 3 randomised clinical trials, relating to diabetes. They compared the combination of Qi Gong sessions and standard care to standard care alone41. The methodological quality of the randomised 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 of 32 people with diabetes was conducted in 2010. The participants were divided into 3 groups: Qi Gong, physical exercise (2 hours per week in both cases) and a control group42. After 12 weeks, the results indicate that regular Qi Gong practice led to a significant decrease in blood glucose levels in diabetic patients.

Various ailments. Since 2009, Qi Gong has been the subject of small studies with people suffering from tinnitus43 , metabolic syndrome44 , burnout45 and chronic fatigue46. Despite some promising results, the effect of Qi Gong on these health problems needs to be analysed in further studies before we can say whether it is effective.

Therapeutic Applications Section

Research and writing: Estelle Vallée, M.Sc. Chair in Integrated Approach to Health, Université Laval.

Scientific review: Claudine Blanchet, PhD, Chair in Integrated Approach to Health, Université Laval.

(November 2010)