Qi Gong and Life

7/27/2019 Qi Gong and Life

1/9

2010 Natural Medicine Journal2(5), May 2010 | Page 7

An Evidence-based Review of Qi Gong by the

Natural Standard Research Collaboration

Authors/Editors: Catherine Ulbricht, PharmD (Massachusetts General Hospital); EthanBasch, MD (Memorial Sloan-Kettering Cancer Center); Stephen Bent, MD (Universityo Caliornia San Francisco); Wendy Chao, PhD (Natural Standard Research Collabora-tion); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Wendy-Diem Che,PharmD (Massachusetts College o Pharmacy); David Lee, PharmD (Massachusetts Collegeo Pharmacy); Richard Liebowitz, MD (Duke University); Huaihai Shan, Qigong Master,MD (Shanghai University, China); David Sollars, MAc, HMC (Merrimack College);ShainaTanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA(Natural Standard Research Collaboration).

Abstract

The objective of this study was to evaluate the scientic evidence on Qi gong, including expert opinion,

folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology,

and dosing. This review serves as a clinical support tool. Electronic searches were conducted in 10

databases, 20 additional journals (not indexed in common databases), and bibliographies from 50

selected secondary references. No restrictions were placed on the language or quality of the publica-

tions. All literature collected pertained to efcacy in humans, dosing, precautions, adverse effects, use

in pregnancy and lactation, interactions, alteration of laboratory assays, and mechanisms of action.

Standardized inclusion and exclusion criteria were used for selection. Grades were assigned using

an evidence-based grading rationale. The present study reports an abridged version of the complete

review (published at www.NaturalStandard.com) discussing the application of Qi gong in health prac-tice. Evaluation of the literature has revealed a small body of evidence supporting the use of Qi gong

as an adjunct to conventional therapy in the management of hypertension. Research concerning Qi

gongs efcacy in a number of other health indications remains inconclusive.

SYNONYMS/RELATED THERAPIESAST Chiro, chi, Chi Gong, Chi Kung, Chinese medicine, ChunDo Su Bup, Daoyin-Tuna Qi gong, external Qi gong, Falungong, hanyu pinyin, healing touch, hexiangzhuang (fying crane)Qi gong, imagery, internal Qi gong, meditation, Nei-Gong, PaTuan Jin, Pai Jer Tsuh Jih Gong, Qi gong, Qi gong emittedexternal Qi (QEQ), Qi gong Waiqi, Qi gong Yangsheng, Qigongizations, Reiki, tai chi, Therapeutic Touch, traditionalChinese medicine, visualization, Wai Qi Fa Gong, walking Qigong, Yan Jing Yi Shen Gong, Chan-Chuang qi-gong therapy.

CLINICAL BOTTOM LINE

Brief Background

Qi gong is one modality o traditional Chinese medicine(TCM) believed to be at least 4,000 years-old. Written recordsreerring to Qi and its eects are thought to be as old as 3,300

years (Shang dynasty oracle bones, Zhou dynasty inscriptions).The therapy is based on the traditional Chinese belie that thehuman body contains a network o energy pathways throughwhich vital energy, called Qi (also called chi or vital energy)circulates. In Mandarin Chinese, Qi gong means breath work/technique. Qi gong is the art o managing the breath to achieveand maintain good health, and especially in the martial arts, toenhance the leverage and stamina o the body in coordinationwith the physical process o respiration.

Qi gong is an umbrella term that subsumes a variety o energy-based healing practices based on Taoist philosophy and principleso Chinese medical theory. There are reported to be several thou-sand schools o Qi gong practice in its long history in China.

Martial arts is derived rom Qi gong, and Qi gong is consid-ered the oundation o the popular practice o tai chi. Qi gongputs a greater emphasis on internal processes, such as medita-

LITERATURE REVIEW


2/9


tion, visualization, and breathing, than tai chi, which empha-sizes outward movement. However, there is much overlap intechniques and principles.

There are 2 main types o Qi gong practice: internal andexternal. Internal Qi gong is the sel-directed practice o tech-niques used to cultivate the circulation Qi throughout the prac-titioners energy system. The practices involve meditation, subtlemovement, visualization, and breathing techniques. External

Qi gong is an interpersonal healing practice in which a practi-tioner projects Qi into another person in order to promote therecipients health or circulation o Qi.

Traditionally, Qi gong has been practiced regularly topromote health. In China it is common to see lay people inpublic parks practicing Qi gong in groups or alone, similar tothe common public practice o tai chi.

Because Qi gong is a historic cultural phenomenon, thereis no single standardized approach to training or credentialing.Many lineages are represented and promoted by individualswho, by consensus, are deemed masters based on years oexperience and demonstrated abilities.

Today, millions o people around the world regularly practiceQi gong to maintain their health. Qi gong and related disci-plines are still associated with the martial arts and meditationthat was taught by Taoists, Buddhist monks, martial artists,and their students. Qi gong, a practice that was once closelyguarded, is now widely available to the general public both inChina and around the world.

The strongest evidence or the use o internal Qi gong isas an adjunct therapy or the treatment o hypertension, andless strong but air evidence or the use in the management oanxiety associated with pain.

A number o other indications are under investigation, suchas atherosclerosis, angina pectoris, immune deciencies, gastritis,cancer, diabetes, Parkinsons disease, attention decit hyperac-tivity disorder, and cardiopulmonary endurance, although orthese, there is currently inadequate evidence or or against use. Qigong has also been suggested as a possible treatment or kidneydiseases; however, research is currently lacking in this area.

Historical or Theoretical Uses which Lack

Sufficient Evidence

Addiction, anti-aging, anticoagulant, anxiety, asthma, backpain, cardioprotection, cardiovascular diseases, congestive heartailure, depression, endurance (pilot), gastrointestinal disease,

headache, health and wellness, heart attack prevention, heartdisease, heart rate variability, improved sleep, improved work-place eciency, kidney disease, liver disease, mania, mentalillnesses, multiple sclerosis, neurological disorders, periph-eral vascular disease, psychosis, respiration, stroke prevention,suicide prevention, substance abuse, well-being.1

Strength of Expert Opinion and Historic/Folkloric Precedent

In traditional Chinese medicine (TCM), Qi gong is consideredbenecial or a large variety o medical conditions. Many prac-titioners believe there is a role or Qi gong in treating chronic

conditions (e.g. cancer, chronic atigue syndrome), osteoporosis,hypertension, gastric ulcers, and asthma. Most Western health-care proessionals, many practitioners o traditional Chinesemedicine, and the Chinese government view Qi gong as a set obreathing and movement exercises, with many possible benetsto health through stress reduction and exercise.

Internal Qi gong is cost eective and actively engages thepatient in his or her own healthcare. It is considered to be sae

in the general population when practiced in moderation, and itmay provide mental, emotional, and physical health benets asan adjunct treatment or a wide range o conditions.

Most reerences to the practice o Qi gong reer to internalQi gong (the sel-healing practice). External Qi gong (theprojection o Qi by one person to another) is an uncommonpractice, and it is considered to be an ability o people regardedas Qi gong masters.

In China, Qi gong is regarded as an ecacious interventionor cancer. In Shanghai there is a hospital devoted to treatingcancer with Qi gong methods, and most hospitals include Qigong (both internal and external) as part o their approach to

integrative care.Qi gong holds many parallels to Western behavioral medi-

cine in terms o its employment o visualization, meditation,and breathing exercises, as well as its reliance on regular practice.As with other mind/body and behavioral sel-help practices, thebenets o Qi gong are believed to require daily practice to accrue.

One o the major benets o Qi gong practice may be induc-tion o the relaxation response.

Some experts believe that the practice o Qi gongcan selec-tively enhance drug uptake although this remains to be scienti-cally proven.2

Qi gong is also claimed to infuence the fow o Qi. InternalQi gong involves deep breathing, concentration, and relaxationtechniques used by individuals or themselves. External Qi gongis perormed by Qi gong masters who claim to be able to curemany dierent medical conditions with energy released romtheir ngertips. However, current research has not providedevidence o paranormal powers and has ound some evidenceo deception.

Brief Safety Summary

Likely Sae: For all populations and medical conditions. Qigong is generally reported to be sae in the general popula-tion when practiced according to standard moderate principles

and when learned under the guidance o a qualied teacher.However, Qi gong should not delay the time o diagnosis orreplace more established treatments.

Possibly Unsae: Unguided exercises may exacerbate symp-toms in some patients with mental disorders.3

DEFINITION AND DESCRIPTION OF TECHNIQUESDefnition: Qi gong is a major branch o Chinese medicine thatdenotes methods used to cultivate, regulate, and harness Qi(vital energy, lie orce) or general sel-preservation and health,


3/9


healing, sel-deense, longevity, and spiritual development.4 Qigong may be dened as the way o working with lie energy.There are 3 branches o Qi gong: medical (used or healing),spiritual (or sel-awareness), and martial art (or sel-protection).Qi gong practice is by denition, harmonious with the naturalrhythms o time and season, and may be practiced daily orhealth maintenance and disease prevention. Medical Qi gongis an active (internal) or passive (externally applied Qi) non-

invasive practice or procedure that takes 5 steps in the healingprocess: meditation, cleansing, strengthening and recharging,circulating, and dispersing stagnated Qi (chi). Specic move-ments, meditations, and sounds are used or each step.

Types of Therapies

General: There are many dierent styles o perormingQi gong, and the Chinese government has reported morethan 5,000 types.

Internal Qi gong employs prescribed postures andsequences o visualization, breathing techniques, andmovements as a sel-healing or health-promotion prac-

tice. It is a orm o mind/body and behavioral medicinethat is completely dependent on requency and durationo practice. Individuals receive instruction in techniquesand then may practice on their own or with others.

Many techniques involve simply holding a prescribedposture, which, when accompanied by meditation, imagery,and breathing techniques, is believed to acilitate the circu-lation o energy through the meridians and energy centers.The posture may be either standing or sitting. Some methodsinvolve stationary holding o the posture, while others involveprescribed movements. In all cases, the mental intention is tocultivate the circulation o Qi (chi or vital energy) through

the practitioner. Vocal sounds are used in some techniques. Specic soundsare believed to be associated with specic meridians ororgan systems as dened in Taoist medical theory. Vocal-ization o the sounds (called the 6 healing sounds) isbelieved to aid the circulation o energy through thespecic organ networks.

Bone marrow Qi gong is a orm o internal Qi gongwhich comprises specic techniques targeting the circu-lation o Qi through the bone marrow, to strengthen theblood and immune system.

One paper qualitatively reviews 2 complementary thera-

pies; Qi gong and educational kinesiology (EK).5 Authorssuggest that Qi gong and EK may be united through aqualitative convergence and a shared underlying concept.The authors hypothesize that a coherent rationale can beormed through this conceptual synthesis and proposethat to some extent Qi gong movements and EK can beconsidered to work in unison with each other. The logicalsynthesis o these 2 therapies is being presented to iden-tiy Qi gong movements with concepts o brain gymnas-tics and also to explain how this new construct can bedeveloped and implemented into practice. When veried,

authors conclude this hypothesis will allow individualsto better understand Chinese health exercises rom themodern science perspective such as neuroanatomy, neuro-physiology, and psychoneuroimmunology.

External Qi gong is the delivery o Qi stimulation by ahealer or practitioner to a recipient, to infuence circula-tion o Qi and the wellbeing in the recipient. This is usuallydone rom several inches away rom the recipient, with the

practitioner sending Qi via the palms o the hands or thengers pointed at the recipient.

Medical Qi gong is the application o either internal orexternal Qi gong or healing rom specic illness. Thereare many traditions o medical Qi gong. A typical practicemight include 5 steps: meditation, cleansing, recharging/strengthening, circulating, and dispersing Qi. Each stepincludes specic exercises, meditations, and sounds.

Standardization

Qi gong studies vary widely in dosing (requency and dura-tion) o the interventions. Studies in internal Qi gong vary in

how requently subjects are told to practice, the duration o eachsession, duration o the intervention phase o the study, andsubject compliance with the instructions. In terms o internalQi gong, most training prescribes daily practice or 20 minutesor more on an ongoing basis to attain health benets. Studies inexternal Qi gong also vary widely in number o sessions deliv-ered, intervals between sessions, duration o each session, andduration o the intervention phase o the study.

Adverse Eects/Precautions/Contraindications

Adverse Effects/Post-Market Surveillance

General: Qi gong is generally considered to be sae in most

people when learned rom a qualied instructor. In theory,underlying psychiatric disorders may worsen with unsupervisedinternal Qi gong practice. The theoretical basis or this wouldbe that an increased circulation o Qi could induce the releaseo repressed emotions or thoughts. However, there is no docu-mentation o such occurrences. In cases o potentially seriousconditions, Qi gong should not be used as the only treatmentinstead o more proven therapies, and it should not delay thetime it takes to see an appropriate healthcare provider.

Abnormal psychosomatic responses or mental disorder maybe induced when Qi gong is practiced inappropriately, exces-sively, or when practiced unguided in predisposed individuals.

Dermatologic: Delayed cutaneous hypersensitivity reac-tions have been reported in 16 Qi gong trainees. Maximalantigen response time was aster (peak at 24 hour vs. 48 hour)and response antigen number higher (P


4/9


62% o abnormal psychological reactions to Qi gong practicewere in patients with pre-existing mental disorders o varyingdegrees, and disease onset appeared ater beginning exercises.9Reactions may take orm o emotional disturbances, depres-sion, anxiety, neurosis, or schizophrenia. Qi gong-triggereddisorders are usually transient and normalize ater practice isterminated.10 One case report describes a 57-year-old Chinese-American man with no previous psychiatric history who devel-

oped auditory hallucinations and delusions ollowing intensiveQi gong practice.11 In one case report, a male patient developedan acute and transient psychosis with polymorphic symptom-atology ater meditating.12 There have been other case reportsthat have dealt with either a relapse o a pre-existent psychoticdisorder or with a brie psychotic reaction in patients withouta psychiatric history.13Another report o abnormal psychiatricstate o Qi gong deviation exists.14

Precautions/Warnings/Contraindications: Unguided exer-cise (in absence o teacher) should be used cautiously in patientswith mental disorders or in patients not healthy enough orcertain exercises per their medical doctor.15

Pregnancy & Lactation: One study ound that Qi gongrelaxation exercise was sae and 90% eective in treating preg-nancy-induced hypertension (PIH), in women who exercised3 times daily until labor. However, Qi gong should be usedcautiously in this population, as there is limited evidence osaety in pregnant or breasteeding women.16

Review o the Evidence: Discussion

Problems in Research

Internal Qi gong: There are many varieties o training andinstruction in internal Qi gong, and there is no standardization.

Dierent teachers, by virtue o their own idiosyncratic dier-ences in training and experience, may even teach techniqueswhich are described or labeled with the same terms dierently.Intervention studies employing instruction in internal Qi gongmust describe in great detail the approach used, which still maynot be replicable by other researchers.

Studies in internal Qi gong are subject to the same challengesand limitations o other mind/body sel-healing techniquessuch as meditation, imagery, and relaxation training. Outcomesare highly dependent on compliance and dosing. Blinding isnot possible, so outcomes must be compared to those o usualcare or other interventions.

External Qi gong: Like internal Qi gong, there are manyapproaches to external Qi gong and no standardization. Also,external Qi gong is highly subject to individual dierences opractitioners who deliver the intervention in terms o skill levels,experience, background o training, and interpersonal qualitiesthat may infuence the recipients responses and receptivity.

Research with external Qi gong is subject to the same limi-tations as research with Reiki, Therapeutic Touch, HealingTouch, and other practitioner-delivered orms o energy medi-cine. Studies that employ multiple practitioners are needed to

produce evidence about what might be expected rom practi-tioners in general. However, no studies have yet been publishedemploying multiple practitioners. Thus the existing studiespresent data on single practitioners, which may not be represen-tative o other practitioners.

Dosing: Qi gong studies vary widely in dosing (requencyand duration) o the interventions. Studies in internal Qi gongvary in how requently subjects are told to practice, the dura-

tion o each session, duration o the intervention phase o thestudy, and subject compliance with the instructions. Studies inexternal Qi gong also vary widely in number o sessions deliv-ered, intervals between sessions, duration o each session, andduration o the intervention phase o the study.

Challenges in Research

Placebo control:Patient-rated dierences (intelligence, compe-tence, wisdom, insight, power) are not always distinguishedbetween actual and simulated Qi gong masters. The placeboeect has been ound to be benecial in some circumstances.17

Study sizes:To date, study populations have been small.

Technique:In external Qi gong healing, direct healing eect(Qi emission) varies rom one master practitioner to another. Ininternal Qi gong healing:

1. Persistent practice may be required or eects.182. Crossover design may not accurately assess technique,

as it assumes that once the active agent is removed, thenthe patient will revert to a previous state. In Qi gong, theassumption is that the person learns at each stage and theselearned abilities, however small, do not revert to their orig-inal state.19

3. Double-blind design may be inappropriate to assess tech-nique, as people exercising Qi gong are active in their treat-

ment, and masters are aware o what they are teaching.20

Defnitions:A clearly dened Qi gong style technique

would be useul or clinical decision-making, a large variety ostyles and techniques are used in practice and in clinical trials.

Recruitment:In the United States, recruitment may be nega-tively aected due to patient bias, prejudice, or ear. Educatedphysicians who show knowledge and approval to these tech-niques may overcome this diculty.

Evidence for Specic Medical Conditions

HypertensionSummary: Several studies suggest that internal Qi gong, partic-

ularly when combined with conventional medication, may bean eective strategy or reducing hypertension. Data are su-cient to recommend internal Qi gong as a sel-help adjunctiveactivity with medical treatment o hypertension. More studiesare needed to clariy optimal dosage (requency x duration opractice) and explore the role o individual dierences, to aidin determining realistic expectations. There is good evidencerom one controlled study, one case series, and one cohortanalysis to support the use o Qi gong as an adjunct therapy inthe treatment o hypertension. A randomized controlled trial oadequate statistical power would strengthen this case.


5/9


Ospina et al conducted a review to asses and synthesizethe state o research on a variety o meditation practices,including: the specic meditation practices examined; theresearch designs employed and the conditions and outcomesexamined; the ecacy and eectiveness o dierent medi-tation practices or the 3 most studied conditions; the roleo eect modiers on outcomes; and the eects o medita-tion on physiological and neuropsychological outcomes.21

Comprehensive searches were conducted in 17 electronicdatabases o medical and psychological literature up toSeptember 2005. Other sources o potentially relevantstudies included hand searches, reerence tracking, contactwith experts, and gray literature searches. A Delphi methodwas used to develop a set o parameters to describe medita-tion practices. Included studies were comparative, on anymeditation practice, had more than 10 adult participants,provided quantitative data on health-related outcomes,and published in English. Two independent reviewersassessed study relevance, extracted the data and assessedthe methodological quality o the studies. Five broad

categories o meditation practices were identied (mantrameditation, mindulness meditation, yoga, Tai Chi, andQi gong). Characterization o the universal or supple-mental components o meditation practices was precludedby the theoretical and terminological heterogeneity amongpractices. Evidence on the state o research in meditationpractices was provided in 813 predominantly poor-qualitystudies. The 3 most studied conditions were hyperten-sion, other cardiovascular diseases, and substance abuse.Sixty-ve intervention studies examined the therapeuticeect o meditation practices or these conditions. Meta-analyses based on low-quality studies and small numberso hypertensive participants showed that TranscendentalMeditation, Qi gong, and Zen Buddhist meditation signi-icantly reduced blood pressure. Yoga helped reduce stress.Yoga was no better than mindulness-based stress reduc-tion at reducing anxiety in patients with cardiovasculardiseases. No results rom substance abuse studies couldbe combined. The role o eect modiers in meditationpractices has been neglected in the scientic literature. Thephysiological and neuropsychological eects o meditationpractices have been evaluated in 312 poor-quality studies.Meta-analyses o results rom 55 studies indicated that

some meditation practices produced signicant changesin healthy participants. According to the review authors,uture research on meditation practices should be morerigorous in the design and execution o studies and in theanalysis and reporting o result.

Cheung et al randomized 88 patients with mild essentialhypertension to Guolin Qi gong or conventional exer-cise or 16 weeks.22 The main outcome measurementswere blood pressure, health status (SF-36 scores), andBeck Anxiety and Depression Inventory scores. In the Qigong group, blood pressure decreased signicantly rom

146.3+/-7.8/93.0+/-4.1 mmHg at baseline to 135.5+/-10.0/87.1+/-7.7 mmHg at week 16. In the exercise group,blood pressure also decreased signicantly rom 140.9+/-10.9/93.1+/-3.5 mmHg to 129.7+/-11.1/86.0+/-7.0mmHg. Heart rate, weight, BMI, waist circumerence,total cholesterol, renin and 24-hour urinary albuminexcretion signicantly decreased in both groups ater 16weeks. General health, bodily pain, social unctioning, and

depression also improved in both groups. No signicantdierences between Qi gong and conventional exercisewere ound. The authors conclude that Guolin Qi gongand conventional exercise have similar eects on bloodpressure in patients with mild hypertension.

Lee et al randomized 36 adults with hypertension to a Qigong group or a wait-listed control group.23 Blood pres-sures decreased signicantly ater 8 weeks o Qi gong,and levels o total cholesterol (TC), high-density lipo-protein (HDL), and Apolipoprotein A1 (APO-A1) werechanged signicantly in the Qi gong group post-treatmentcompared with beore treatment. The authors conclude

that Qi gong acts as an antihypertensive and may reduceblood pressure by the modulation o lipid metabolism.However, an inappropriate randomization method wasused (assignment based on geographic origin) and drop-outs were not described.

Lee et al randomized 36 adults with hypertension toeither a waiting list control or a Qi gong group that prac-ticed two 30-minute Qi gong programs per week or 8consecutive weeks.24 Systolic and diastolic blood pres-sure was signicantly reduced in members o the Qi gonggroup ater 8 weeks o exercise. Signicant improvementsin sel-ecacy and other cognitive perceptual ecacyvariables were also documented in the Qi gong groupcompared to controls.

Lee et al randomized 58 patients with hypertension toeither a Qi gong group (N=29), or a wait list controlgroup (N=29).25 In response to 10 weeks o Qi gong,systolic blood pressure (SBP), diastolic blood pressure(DBP), and rate pressure product (RPP) were decreasedsignicantly. There was a signicant reduction o norepi-nephrine, epinephrine, cortisol, and stress level in theQi gong group. The authors conclude that Qi gong mayreduce blood pressure and catecholamines via stabilizing

the sympathetic nervous system. Lee et al randomized 58 patients with hypertensionto either a Qi gong group (N=29), or a control group(N=29).26 Systolic blood pressure and diastolic blood pres-sure decreased signicantly in the Qi gong group such thatboth became signicantly lower ater 10 weeks in the Qigong than in the control group. Also, there was a signi-cant reduction o norepinephrine, metanephrine, andepinephrine compared to baseline values in the Qi gonggroup. The ventilatory unctions, orced vital capacity andorced expiratory volume per sec, were increased in the Qi


6/9


gong group but not the control. The authors conclude thatQi gong may stabilize the sympathetic nervous system, iseective in modulating levels o urinary catecholaminesand blood pressure positively, and improves ventilatoryunctions in mildly hypertensive middle-aged patients.

Li et al studied 45 patients with hypertension who werereceiving Traditional Chinese Medicine treatment.27 31patients also received external Qi gong treatments while

14 received niedipine therapy. Plasma 6-K-PGF1 alphawas increased and TXB2 as well as TXB2/6-K-PGF1 alpharatio were decreased in all subjects (P


7/9


and data are insucient to orm denitive conclusions. Morestudies are needed beore conclusions can be reached.

Stenlund et al randomized 95 patients (66 men and 29women) with documented coronary artery disease to anintervention group o group discussion and Qi gong prac-tice (N=48), mean age 77+/-3 (7382), or to a usual carecontrol group (N=47), mean age 78+/-3 (7384).33 Theintervention groups met weekly or 3 months. Physical

ability was assessed at baseline and ater the interven-tion. Patients in the intervention group increased theirsel-estimated level o physical activity (P=0.011), theirperormance in the one-leg stance test or the right leg(P=0.029), coordination (P=0.021), and the box-climbingtest or right leg (P=0.035). The authors conclude that acombination o Qi gong and group discussions appear tobe a promising rehabilitation or elderly cardiac patients interms o improving sel-reported physical activity, balanceand coordination. However, the eects o Qi gong and thegroup experience were not separated out, making conclu-sions about Qi gong impossible. Randomization was not

described but dropouts were explained. Pippa et al conducted a randomized, controlled trial toevaluate the eects o 16 weeks o a medically assisted Qigong training program on the physical rehabilitation opatients with stable chronic atrial brillation and preservedlet ventricular unction.34 Researchers conducted the trialbecause evidence indicates that low energy expenditureprotocols derived rom traditional Chinese medicine maybenet patients with cardiac impairment. Thirty men and13 women (mean age 68+/-8 years) were randomized toQi gong or to a waitlist control group. Qi gong trainingwas well-tolerated, and, compared to baseline, trainedpatients walked an average 114 meters more (27%) at theend o treatment (P


8/9


disturbance and drug uptake is markedly diminished. (-)Qi gong energy has completely the opposite eect andthereore has not been used, although there may be someas yet undiscovered application. Since the late 1980s theprincipal author has succeeded in storing (+) Qi gongenergy on a variety o substances including small sheets opaper, and recently has been able to intensiy this energyby concentrating it as it passes through a cone-shaped,

tapered glass or plastic object placed directly on the (+)Qi gong energy stored paper. Application o (+) Qi gongenergy stored paper on the cardiovascular representationarea o the medulla oblongata at the occipital area othe skull oten improved circulation and enhanced druguptake. I the drug-uptake enhancement was still notsucient or the drug to reach therapeutic levels in thediseased organ, direct application o (+) Qi gong rom thepractitioner's hand oten enhanced the drug uptake moresignicantly. However, this direct method oten results inthe practitioner developing intestinal microhemorrhagewithin 24 hours, which may or may not be noticed as mild

intestinal discomort with sot, slightly tarry stool. Forintensiying (+) Qi gong energy, one o the most ecientshapes is a cone with increased intensication occurringat an optimal height. However when the total mass andthe total distance rom base to peak are increased beyondan optimal limit, the power decreases. Clinical applicationo Intensied (+) Qi gong stored energy was evaluated inthis preliminary study, which indicated that intensied (+)Qi gong energy application on the heart representationarea o the middle nger on the hands markedly improvedcirculation in the corresponding organ and increaseddrug uptake and acetylcholine even more eectively thansome o the previously used drug enhancement methods(Shiatsu massage o the organ representation areas and/or application o (+) Qi gong energy stored paper to theoccipital area above the cardiovascular representation areao the medulla oblongata).

Quality o lieSummary: Qi gong may be benecial or improving the qualityo lie in cardiac and cancer patients; urther study is necessaryto make a rm conclusion.

A great number o clinical studies merging traditional

Chinese medicine (TCM) and Western medicine haveproved the complementary healing eects o Qi gong inmedical science.37 Traditional Chinese respiration exerciseshelp regulate the mind, body, and breathing and coor-dinate the internal organs, remove toxins, and enhanceimmunity. Domestic and oreign studies indicate that Qigong can relieve chronic pain, reduce tension, increaseactivities o phagocytes in coenocytes, improve cardio-pulmonary unction, improve eyesight, and infuence theindex o blood biochemistry. Due to the obvious healingeects o Qi gong therapy, through introducing Qi gong

concepts and related medical research, this paper aims toinspire healthcare workers to integrate Qi qong therapyinto medical treatments and nursing care, or to carry outurther studies in order to make good the shortall inprovision o holistic medicine and nursing in the interestso the quality o patient care.

TCM employs methods o treatment such as acupuncture,acupressure, and Qi gong (treatment based on medita-

tion).38 The nurse using TCM can aect rehabilitationpatient outcomes positively. With TCM training, nurseshave an opportunity to learn the nuances o the Orientalenvironment and integrate them into their skills to nursethe spirit, mind, and body o patients in a holistic manner.

Energy medicine techniques derive rom traditionalChinese medicine and are based on the concept thathealth and healing are dependent upon a balance o vitalenergy, a still mind, and controlled emotions.39 Physicaldysunctions result rom longstanding disordered patternso energy, and reversal o the physical problem requires areturn to balanced and ordered energy. Qi gong is a system

that teaches an individual to live in a state o energybalance. Shen Qi is a sophisticated orm o Qi gong thatrelies on no external physical interventions but rather relieson mind control to prevent illness, heal existing physicaland emotional problems, and promote health and happi-ness. This paper describes the use o these techniques withpeople who have long-term physical disabilities.

StressSummary: Preliminary study shows that Qi gong may be bene-cial or relieving stress, although more study is warranted inthis area.

Linder et al conducted a randomized controlled trial toassess the ability o Qi gong to relieve stress.40

Other publications that may be o interest include:Wagner,B. [Chinese meditation pattern. Qi gong: to learn rom tigersand bears. Series: relaxation technic 1. Centers o vital energy].Fortschr Med. 1999;117(8):55.

Reerences1 Ospina MB, Bond K, Karkhaneh M, et al. Meditation practices or health: state

o the research. Evid Rep Technol Assess (Full Rep). 2007;(155):1-263.

2 Omura Y, Losco M, Omura AK, et al. Common actors contributing to intrac-

table pain and medical problems with insucient drug uptake in areas to betreated, and their pathogenesis and treatment: part 1. combined use o medica-tion with acupunture, (+) qi gong energy-stored material, sot laser or electricalstimulation.Acupuncture & Electro-Therapeutics Res Int J. 1992;17(2a):107-148.

3 Kuijpers HJ, van der Heijden FM, Tuinier S, Verhoeven WM. Meditation-induced psychosis. Psychopathology.2007;40(6):461-464.

4 Jonas W, Levin J. Essentials of Complementary and Alternative Medicine. Philadel-phia: Lippincott Williams & Wilkins, 1999.

5 Posadzki P, Parekh S, ODriscoll ML, Mucha D. Qi gongs relationship to educa-tional kinesiology: A qualitative approach.J Bodyw Mov Ther. 2010;14(1):73-79.

6 Ryu H, Mo HY, Mo GD, et al. Delayed cutaneous hypersensitivity reactions inQigong (chun do sun bup) trainees by multitest cell mediated immunity.Am JChin Med. 1995;23(2):139-144.


9/9


7 Lim RF, Lin KM. Cultural ormulation o psychiatric diagnosis. Case no. 03.Psychosis ollowing Qi-gong in a Chinese immigrant. Cult Med Psychiatry.1996;20(3):369-378.

8 Hwang WC. Qi-gong psychotic reaction in a Chinese American woman. CultMed Psychiatry. 2007;31(4):547-560.

9 Shan HH. Culture-bound psychiatric disorders associated with qigong practicein China. Hong Kong J Psychiatry. 2000;10(3):12-14.

10 Ibid.

11 Lim RF, Lin KM. Cultural ormulation o psychiatric diagnosis. Case no. 03.Psychosis ollowing Qi-gong in a Chinese immigrant. Cult Med Psychiatry.

1996;20(3):369-378.

12 Kuijpers HJ, van der Heijden FM, Tuinier S, Verhoeven WM. Meditation-induced psychosis. Psychopathology. 2007;40(6):461-464.

13 Ibid.

14 Shan HH. [Abnormal psychiatric state o qi-gong deviation].Zhong Xi Yi Jie HeZa Zhi. 1988;8(12):717-718.

15 Kuijpers HJ, van der Heijden FM, Tuinier S, Verhoeven WM. Meditation-induced psychosis. Psychopathology. 2007;40(6):461-464.

16 Zhou MR, Lian MR. [Observation o qi-gong treatment in 60 cases o preg-nancy-induced hypertension].Zhong Xi Yi Jie He Za Zhi. 1989;9(1):16-25.

17 Wu WH, Bandilla E, Ciccone DS, et al. Eects o qigong on late-stage complexregional pain syndrome.Altern Ther Health Med. 1999;5(1):45-54.

18 Loh SH. Qigong therapy in the treatment o metastatic colon cancer.Altern TherHealth Med. 1999;5(4):111-112.

19 Reuther I, Aldridge D. Qigong Yangsheng as a complementary therapy inthe management o asthma: a single-case appraisal. J Altern Complement Med.1998;4(2):173-183.

20 Ibid.

21 Ospina MB, Bond K, Karkhaneh M, et al. Meditation practices or health: stateo the research. Evid Rep Technol Assess (Full Rep). 2007;(155):1-263.

22 Cheung BM, Lo JL, Fong DY, Chan MY, et al. Randomised controlled trialo qigong in the treatment o mild essential hypertension. J Hum Hypertens.2005;19(9):697-704.

23 Lee MS, Lee MS, Kim HJ, Choi ES. Eects o qigong on blood pressure, high-density lipoprotein cholesterol and other lipid levels in essential hypertensionpatients. Int J Neurosci. 2004;114(7):777-786.

24 Lee MS, Lim HJ, Lee MS. Impact o qigong exercise on sel-ecacy and othercognitive perceptual variables in patients with essential hypertension. J Altern

Complement Med. 2004;10(4):675-680.25 Lee MS, Lee MS, Kim HJ, Moon SR. Qigong reduced blood pressure and

catecholamine levels o patients with essential hypertension. Int J Neurosci.2003;113(12):1691-1701.

26 Lee MS, Lee MS, Choi ES, Chung HT. Eects o Qigong on blood pressure,blood pressure determinants and ventilatory unction in middle-aged patientswith essential hypertension.Am J Chin Med. 2003;31(3):489-497.

27 Li W, Xing Z, Pi D, Li X. [Infuence o qi-gong on plasma TXB2 and 6-keto-PGF1 alpha in two TCM types o essential hypertension]. Hunan Yi Ke Da XueXue Bao. 1997;22(6):497-499.

28 Li W, Xin Z, Pi D. [Eect o qigong on sympathetico-adrenomedullary unctionin patients with liver yang exuberance hypertension].Zhong Xi Yi Jie He Za Zhi.1990;10(5):261, 283-285.

29 Wang CX, Xu DH. [Infuence o qigong therapy upon serum HDL-C in hyper-tensive patients].Zhong Xi Yi Jie He Za Zhi. 1989;9(9):516, 543-544.

30 Wu Y, Wei L, and Deren P. [Laboratory study o qigong therapy or patients withessential hypertension]. Bulletin of Hunan Medical University. 1993;18(3):269-271.

31 Kuang AK, Wang CX, Zhao GS, et al. Long-term observation on qigong inprevention o strokeollow-up o 244 hypertensive patients or 18-22 years.JTradit Chin Med. 1986;6(4):235-238.

32 Zhou MR, Lian MR. [Observation o qi-gong treatment in 60 cases o preg-nancy-induced hypertension].Zhong Xi Yi Jie He Za Zhi. 1989;9(1):16-25.

33 Stenlund T, Lindstrom B, Granlund M, Burell G. Cardiac rehabilitation orthe elderly: Qi gong and group discussions. Eur J Cardiovasc Prev Rehabil.2005;12(1):5-11.

34 Pippa L, Manzoli L, Corti I, Congedo G, Romanazzi L, Parruti G. Func-tional capacity ater traditional Chinese medicine (qi gong) training in patientswith chronic atrial brillation: a randomized controlled trial. Prev Cardiol.2007;10(1):22-25.

35 Hui PN, Wan M, Chan WK, Yung PM. An evaluation o two behavioral rehabil-itation programs, qigong versus progressive relaxation, in improving the qualityo lie in cardiac patients.J Altern Complement Med. 2006;12(4):373-378.

36 Omura Y, Beckman SL. Application o intensied (+) Qi gong energy, (-) elec-trical eld, (S) magnetic eld, electrical pulses (1-2 pulses/sec), strong Shiatsumassage or acupuncture on the accurate organ representation areas o the handsto improve circulation and enhance drug uptake in pathological organs: clin-ical applications with special emphasis on the Chlamydia-(Lyme)-uric acidsyndrome and Chlamydia-(cytomegalovirus)- uric acid syndrome.AcupunctElectrother Res. 1995;20(1):21-72.

37 Li TY, Yeh ML. [The application o qi-gong therapy to health care]. Hu Li ZaZhi. 2005;52(3):65-70.

38 Sherwin DC. Traditional Chinese medicine in rehabilitation nursing practice.Rehabil Nurs. 1992;17(5):253-255.

39 Trieschmann RB. Energy medicine or long-term disabilities. Disabil Rehabil.1999;21(5-6):269-276.

40 Linder K, Svardsudd K. [Qigong has a relieving eect on stress]. Lakartidningen.2006;103(24-25):1942-1945.

Documents

Qi Gong and Life