The word “Qigong” is a combination of two concepts: “Qi,” the vital energy of the body, and “gong,” the skill of working of the Qi. Together, Qigong (or Chi Kung) means cultivating energy [
Qigong exercises consist of a series of orchestrated practices including body posture, movement, breathing, and meditation, all of which have been designed to enhance Qi function—that is, to draw upon natural forces to optimize and balance energy within, through the attainment of deeply focused and relaxed states [
As a form of complementary and
Several Qigong review articles have been published, which mainly focus on the effects of Qigong on specific medical conditions such as hypertension [
Since many Qigong studies were conducted in China and published only in Chinese language journals, the authors included three researchers from China and five researchers from the U.S. Electronic relevant publications from both Chinese and English databases were reviewed. Two reviewers searched and screened the titles and abstracts of the studies identified by the search against the eligibility criteria for English databases independently. One reviewer searched and screened the studies in Chinese. For potentially eligible studies, the full text publications were obtained and criteria reapplied. Disagreement was resolved by discussion. A professional librarian was consulted in our search process.
Research articles published in English on the effects of Qigong on mood and depression were identified from the following databases: from the inception to 2011 on Medline, PubMed, PsycINFO, Cochrane Reviews, Ovid, EBSCOhost, and all of the journals in the Harvard Countway Library of Medicine. Research articles published in Chinese on the effects of Qigong on mood and depression were identified from the following Chinese databases: from the inception to 2011 on CNKI, Wan Fang Med Online, and VMIS. For English databases, the key words used included a combination of MeSH and free text terms: “Qigong/Qi Gong/Gong, Qi/Ch’i Kung/Kung, Ch’i”, “mood,” “depression,” “anxiety,” “emotional well-being,” and “psychological well-being” as main subject headings, text words in titles, and abstracts. For Chinese databases, the key words used included equivalent Chinese terms as main subject headings, text words in titles, and abstracts.
According to the selection criteria, interventions were restricted to Qigong. Other psychological interventions such as yoga and meditation were excluded; mixed interventions (e.g., acupuncture and Qigong in combination) were excluded (as described in Figure
Flow chart of the study selection process.
To be included in the meta-analyses, studies needed to have either a randomized controlled trial (RCT) or quasi-experimental (Q-E) design. The process of study selection was described in Figure
We assessed the characteristics of the original research and extracted data accordingly. Some basic information was collected based on date of publication, study sites, language of study, and clinical domains (see Table
Summary of Qigong studies reviewed.
No. of studies | Study ID no. | |
---|---|---|
Date of publication | ||
2001–2005 | 4 | 16, 32, 35, 41 |
2006–2011 | 13 | 28, 29, 30, 31, 33, 34, 36, 37, 38, 39, 40 |
Study sites | ||
US | 1 | 33 |
China and Hong Kong | 11 | 28, 29, 30, 31, 32, 36, 37, 40, 41 |
Others (Sweden, Australia, Korea) | 5 | 16, 34, 35, 38, 39 |
Language of study | ||
Chinese | 6 | 28, 29, 30, 31, 36, 37 |
English | 11 | 16, 32, 33, 34, 35, 38, 39, 40, 41 |
Clinical domains | ||
Chronic physical illnesses | 1 | 41 |
Cancer | 1 | 38 |
Depression | 1 | 40 |
Type II diabetes | 4 | 28, 30, 31, 36 |
Hypertension | 2 | 16, 32 |
No medical condition | 8 | 29, 33, 34, 35, 37, 39 |
Methodological quality of Qigong studies reviewed.
Lead author | Adequate sequence generation | Allocation concealment | Blinding | Completeness of outcome data | Selective reporting | Other potential biases |
---|---|---|---|---|---|---|
Cheung [ |
Y | Unclear | Y | Y | Unclear | Y |
Griffith [ |
Y | Unclear | Unclear | Y | Unclear | Unclear |
Huo [ |
Y | Unclear | Unclear | Y | Unclear | Unclear |
Jin [ |
Unclear | Unclear | Unclear | Unclear | Unclear | Unclear |
Johansson [ |
Unclear | Unclear | Unclear | Y | Unclear | Unclear |
Lee [ |
N | Unclear | Unclear | Y | Unclear | Unclear |
Lee [ |
Y | Unclear | Y | Y | Unclear | Unclear |
Lin [ |
Y | Y | Unclear | N | N | Unclear |
Liu [ |
Unclear | Unclear | Unclear | Unclear | Unclear | Unclear |
Oh [ |
Y | Unclear | Unclear | Y | Unclear | Unclear |
Skoglund [ |
Unclear | Unclear | Unclear | N | Unclear | Unclear |
Tsang [ |
Unclear | Unclear | Y | Y | Unclear | Y |
Tsang [ |
Unclear | Unclear | Unclear | Unclear | Unclear | Unclear |
Wang [ |
Unclear | Unclear | Unclear | Unclear | N | Unclear |
Zhang [ |
Y | Y | Unclear | N | Y | Unclear |
Findings of 15 studies were tabulated regarding sample characteristics (i.e., total sample size, age, gender, number of participants in Qigong group), duration, intervention style, design of control measures being used, and main outcomes (Table
Summary of Qigong studies reviewed 2.
Group | Lead author | Sample size | Age (y) | Intervention (Qigong) and controls | Duration | Psychological well-being related measures | Psychological well-being related outcomes |
---|---|---|---|---|---|---|---|
Griffith [ |
|
Mean age 51 | G1 Qigong practice |
6 weeks | Perceived Stress Scale, SF-36 | Qigong improved perceived stress and social interaction subscale of the SF-36 versus control. | |
Jin [ |
|
60–69 | G1 Health qigong |
12 weeks | SDS, SAS, SRHMS | SAS reduced significantly in G1, G1, G3. SDS reduced significantly in G1, G3. | |
Healthy subjects | Johansson [ |
|
Mean age 50.8 |
G1 Qigong |
4 days intensive | POMS, STAI | POMS-depression, anger, fatigue, STAI-state anxiety scores reduced significantly in G1. |
Lee [ |
|
Mean age 26 |
G1 Qigong (Korean Qi-therapy) |
70 minutes | The Spielberger Anxiety Inventory-State, MT | Qigong improved anxiety versus control. | |
Liu [ |
|
College students | G1 eight-section Brocade qigong |
12 weeks | SCL-90 | Qigong improved SOM, O-C, I-S and PAR versus control. SOM, O-C, DEP, ANX, HOS, other symptoms and mean score reduced significantly in G1. | |
Skoglund [ |
|
42–54 |
G1 Qigong (Shuxingpingxegong) |
6 weeks | Questionnaire about health state, health grading and grading of stress, a visual analogue scale (similar to a thermometer), |
The health related quality of life was improved significantly after Qigong. | |
| |||||||
Cheung [ |
|
Mean age 54 |
G1 Goulin qigong |
16 weeks | SF-36, BAI, BDI | No significant difference found between the two groups. | |
Huo [ |
|
Mean age 64.2 |
G1 Eight-Section Brocade qigong |
12 weeks | SDS, DMQLS | Qigong improved SDS, total score, physiological dimension, satisfactory dimension of quality of life versus control. SDS, total score, physiological dimension, satisfactory dimension of QOL reduced significantly in G1. | |
Lee [ |
|
40–65 |
G1 Qigong exercise |
8 weeks | The general self-efficacy scale, |
Self-efficacy and other cognitive perceptual efficacy variables improved significantly in G1. | |
Subjects |
Lin [ |
|
37–70 |
G1 eight-section Brocade qigong |
4 months | MMPI, SCL-90, DSQL | MMPI: SI, difference of Pd in G3, difference of Pd, Pt and Sc in G2 were improved versus control. Pd, Pt and Sc reduced significantly in G2. Hy, Pd and Pa reduced significantly in G3; Pd, Sc increased significantly in G4. |
Oh [ |
|
31–86 |
G1 modified qigong |
10 weeks | Functional Assessment of Cancer |
Qigong improved QOL, fatigue and mood disturbance versus control. | |
Tsang [ |
|
≥65 |
G1 eight-section Brocades qigong |
12 weeks | GDS, Perceived Benefit Questionnaire, WHOQOL-BREF[HK], ASSEI | Physical health, activity level, psychological health, social relationship, and health in general improved significantly in G1. | |
Wang [ |
|
41–70 |
G1 eight-section Brocade qigong |
4 months | SCL-90 | Qigong improved O-C, DEP, ANX and HOS versus control 2 months later. HOS reduced significantly in G1 4 months later. | |
Zhang [ |
|
37–69 |
G1 eight-section Brocade and relaxation qigong |
4 months | SCL-90, DSQL | SCL-90: SOM and PSY in G2 were improved versus control. Difference of SOM and PSY in G1, G2 were improved versus control. GSI, mean score and SOM reduced significantly in G1, G2. PST and DEP reduced significantly in G1. I-S, HOS and PSY reduced significantly in G2. QOL: physical score in G1, G2 were improved versus control. Psychological and social score reduced significantly in G2. Social score reduced significantly in G3. | |
| |||||||
Subjects |
Tsang [ |
|
≥65 |
G1 Qigong practice |
16 weeks | GDS, CGSS, PWI, GHQ-12, ASSEI, Perceived Benefit Questionnaire | Qigong improved mood, self-efficacy, personal well-being, physical and social domains of self-concept versus control 8 weeks later. 16 weeks later, the improvement generalized to the daily task domain of the self-concept. |
Total Sample Size (
If substantial clinical, methodological, or statistical heterogeneity existed, study results were not combined by means of meta-analysis. Clinical heterogeneity usually came from patients’ characteristics (age, gender, etc.). Methodological heterogeneity refers to differences between studies in terms of methodological factors, such as sequence generation and concealment of allocation [
Because all 15 studies we reviewed had small samples, funnel plots were used in an exploratory analysis to assess the potential existence of small study bias if 9 or more studies were included in one meta-analysis. If less than 9 studies were included in the meta-analysis, we considered that a potential risk of selective reporting existed [
Since all outcomes were continuous variables, if the same measurement was used across studies, effect size (ES) was determined by calculating the mean difference between groups. If the same underlying concept was measured but different outcome measurements were used, ES was determined by calculating the standardized mean difference between groups.
Because of the different trials implemented various styles of Qigong, if any trials with three or more treatment arms were identified, we made two assumptions for the analysis. Firstly, if the trial was comparing two or more styles of Qigong versus control, then the data for those Qigong arms were combined to give one comparison of Qigong intervention versus control for that trial.
Secondly, if the trial was comparing Qigong versus two or more controls, then the data for those control arms were kept separate, and the data for that trial were included in the appropriate control categories.
Overall outcome was assessed by pooling the ES of each study. In view of the heterogeneity, random-effects model was used for pooling. All analyses were conducted using Review Manager 5 (Version 5.0; The Chinese Cochrane Centre, The Cochrane Collaboration; Chengdu, China). We assessed the quality of the outcome of measures using GRADE profiler version 3.
Fifteen studies published between 2001 and 2011 were included in this systematic review. Of these, 6 were published in Chinese and identified from Chinese databases [
Only one of these studies was conducted in the United States; the majority (
Table
Seven studies described the randomization process. One study reported that the randomization was performed by a statistician who had prepared a randomization list before the study started [
Blinding was described in only three studies. One study adopted a single blind run-in period [
Five studies described the methods to evaluate the adherence of patients to intervention [
Table
The durations of the interventions ranged from 70 minutes to 4 months. Interventions of 3-4 months’ duration appeared to be the norm for demonstrating changes while maximizing study enrollment and adherence. Among the Qigong intervention studies, the most popular form was the “Eight Section Brocade Exercise.” During and outside of group practice sessions, peer learning and discussions to facilitate social interaction and mutual support were encouraged since these may be important therapeutic ingredients. In most of the studies, control groups received treatment as usual and routine medical check-up. Three studies utilized a waitlist as the control group [
While all included studies reported on psychological outcomes, only the study by Tsang et al. targeted participants with a psychiatric disorder [
The most frequently reported psychological benefits were decreased depressive symptoms and improved mood, reported in seven studies [
Participants in the intervention groups also demonstrated reduced anxiety [
Three studies reported statistically significant improvements in somatic symptoms among the intervention group as evidenced by scales such as the Symptom Checklist-90 and Somatization Scale [
Some studies employed measures of physical health and biomarkers, including blood pressure [
Improvement of overall quality of life (QOL) was the second most frequently mentioned benefit reported in six studies [
Self-efficacy was generally assessed in the RCTs as a secondary outcome related to the problem area under investigation (e.g., efficacy to manage a disease or pain symptom, or in the case of falls among the elderly, feeling more confident that one will not fall). The perceived ability to handle stress or novel experiences [
We categorized the studies into three groups based on the type of subjects for further analysis as follows: (1) healthy subjects, (2) subjects with chronic illnesses, and (3) subjects with depression. Only one RCT recruited subjects with depression [
Eight RCTs were included in the group of studies of patients with chronic illnesses [
After assessment of heterogeneity and consideration of the choices of varying control groups used in different studies, meta-analysis of outcomes related to depression measured by Symptom Checklist 90 (SCL-90) were performed on the remaining three RCTs of patients with type II diabetes [
Results of trials included in meta-analysis on symptoms of SCL-90 and psychological health of DSQL in subjects with chronic illnesses.
Wang et al. 2008 [ |
Lin 2007 [ |
Zhang 2008 [ | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Baseline | Endpoint | Baseline | Endpoint | Baseline | Endpoint | |||||||
G1 ( |
G2 ( |
G1 ( |
G2 ( |
G1 ( |
G2 ( |
G1 ( |
G2 ( |
G1 ( |
G2 ( |
G1 ( |
G2 ( |
|
SCL-90 | ||||||||||||
Total score | 131.0 (32.2) | 142.3 (50.1) | 121.4 (38.3) | 143.4 (34.7) | 139.2 (43.4) | 145.1 (45.7) | 126.8 (33.4) | 145.1 (45.7) | 50.7 (7.7) | 48.6 (7.2) | 51.1 (8.0) | 55.0 (10.5) |
Somatization | 0.7 (0.5) | 0.7 (0.8) | 0.6 (0.6) | 0.7 (0.5) | 1.7 (0.7) | 2.0 (0.7) | 1.6 (0.5)* | 2.0 (0.7) | 41.3 (12.4) | 40.8 (14.4) | 33.6 (9.5) | 39.9 (15.1) |
Obsessive-compulsive | 0.7 (0.4) | 0.7 (0.7) | 0.5 (0.5)* | 0.8 (0.5) | 1.9 (0.6) | 1.8 (0.5) | 1.7 (0.5) | 1.8 (0.5) | 38.9 (11.5) | 36.5 (11.6) | 35.9 (8.7) | 38.5 (10.4) |
Interpersonal sensitivity | 0.4 (0.4) | 0.4 (0.6) | 0.3 (0.6) | 0.5 (0.5) | 1.5 (0.6) | 1.6 (0.5) | 1.4 (0.5) | 1.6 (0.5) | 31.7 (14.5) | 29.8 (10.3) | 27.6 (8.6) | 30.6 (10.2) |
Depression | 0.5 (0.4) | 0.4 (0.6) | 0.4 (0.5)* | 0.7 (0.5) | 1.7 (0.6) | 1.6 (0.6) | 1.5 (0.5) | 1.6 (0.6) | 38.6 (12.0) | 34.7 (8.2) | 34.7 (7.4) | 36.2 (8.7) |
Anxiety | 0.3 (0.4) | 0.3 (0.7) | 0.3 (0.4)* | 0.5 (0.4) | 1.4 (0.6) | 1.5 (0.5) | 1.4 (0.5) | 1.5 (0.5) | 33.0 (16.1) | 29.7 (13.6) | 26.2 (8.4) | 30.1 (13.2) |
Anger-hostility | 0.6 (0.5) | 0.7 (0.7) | 0.3 (0.5)* | 0.7 (0.6) | 1.5 (0.5) | 1.6 (0.7) | 1.4 (0.4) | 1.6 (0.7) | 35.6 (10.2) | 36.9 (14.7) | 31.7 (7.5) | 35.5 (9.9) |
Phobic anxiety | 0.2 (0.2) | 0.5 (0.7) | 0.2 (0.3) | 0.4 (0.4) | 1.3 (0.6) | 1.4 (0.5) | 1.2 (0.5) | 1.4 (0.5) | 29.3 (14.7) | 26.8 (9.1) | 25.4 (8.9)* | 26.3 (7.9) |
Psychotism | 0.3 (0.4) | 0.5 (0.6) | 0.2 (0.4) | 0.4 (0.5) | 1.3 (0.5) | 1.4 (0.3) | 1.2 (0.4) | 1.4 (0.3) | 31.2 (13.8) | 28.1 (8.7) | 25.4 (9.0) | 30.8 (9.9) |
Paranoid ideation | 0.3 (0.4) | 0.4 (0.5) | 0.2 (0.4) | 0.4 (0.6) | 1.3 (0.5) | 1.4 (0.4) | 1.3 (0.4) | 1.4 (0.4) | 31.8 (9.6) | 29.1 (9.1) | 30.7 (7.3) | 33.0 (9.1) |
DSQL | ||||||||||||
Psychological health | 35.0 (19.0) | 35.2 (17.2) | 30.6 (15.9)* | 41.6 (19.3) | 32.7 (19.0) | 36.4 (19.3) | 26.7 (17.0)* | 36.5 (21.8) |
Note: Qigong group (G1); control group (G2). Outcomes were reported by mean (SD). *The difference between the scores of the two groups was significant (
We found significant differences between groups (
Effects of Qigong on symptoms of SCL-90 and psychological health of DSQL in subjects with chronic illnesses.
Besides depression and anxiety, meta-analysis of other symptoms of SCL-90 were also performed in the same three studies. We found significant differences between groups in total SCL-90 score (
Two RCTs were included in the meta-analysis of psychological health measured by Diabetes Specific Quality of Life Scale (DSQL) [
We also found significant differences between groups (
Quality assessment of outcome measures in subjects with chronic illnesses.
Quality assessment | Summary of findings | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of patients | Effect | Quality | Importance | |||||||||
No. of studies | Design | Limitations | Inconsistency | Indirectness | Imprecision | Other considerations | Qigong | Control | Relative (95% CI) | Absolute | ||
Total score (measured with: total score of Symptom Checklist 90 at end of treatment; range of scores: 0–450; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Somatization (measured with: somatization score of Symptom Checklist 90 at end of treatment; range of scores: 0–48; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Obsessive-compulsive (measured with: obsessive-complusive score of Symptom Checklist 90 at end of treatment; range of scores: 0–40; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Interpersonal sensitivity (measured with: interpersonal sensitivity score of Symptom Checklist 90 at end of treatment; range of scores: 0–36; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Depression (measured with: depression score of Symptom Checklist 90 at end of treatment; range of scores: 0–52; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Anxiety (measured with: anxiety score of Symptom Checklist 90 at end of treatment; range of scores: 0–40; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Anger-hostility (measured with: anger-hostility score of Symptom Checklist 90 at end of treatment; range of scores: 0–24; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Phobic anxiety (measured with: phobic anxiety score of Symptom Checklist 90 at end of treatment; range of scores: 0–28; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Psychotism (measured with: psychotism score of Symptom Checklist 90 at end of treatment; range of scores: 0–40; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Paranoid ideation (measured with: paranoid ideation score of Symptom Checklist 90 at end of treatment; range of scores: 0–24; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious1 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias2 | 145 | 72 | — | MD 0 |
|
Important3 |
| ||||||||||||
Psychological health (measured with: psychological score of Diabetes Specific Quality of Life Scale at end of treatment; range of scores: 0–40; better indicated by less) | ||||||||||||
| ||||||||||||
3 | Randomised trial | Serious4 | No serious inconsistency | No serious indirectness | No serious imprecision | Reporting bias5 | 120 | 52 | — | MD 0 |
|
Important3 |
1Wang et al. 2008 [
The studies in this paper demonstrated that Qigong may have beneficial effects for a variety of populations on a range of psychological well-being measures, including mood, anxiety, depression, general stress management, quality of life, and exercise self-efficacy. The movements of Qigong is relatively easy to learn, when compared to other mind body traditions [
This systematic review highlights the mood and psychological effects of Qigong in addition to its physical effects. The outcomes of the three selected studies showed improvements in psychological well-being, especially when the control intervention does not include active interventions such as exercise. These studies used SCL-90 to measure the pre- and post-outcomes related to Qigong intervention. While SCL-90 is a widely used and well validated measure for psychological outcomes, it is important to point out that it does not provide information on clinical diagnoses of anxiety of depressive disorders. Due to the small number of studies available in this area, and the diverse outcomes used, we limited meta-analysis on patients with diabetes. With more relevant studies in the future, it will be informative to review separately, the anxiety and depressive outcomes among healthy subjects, patients with specific chronic illness (e.g., fibromyalgia, tension headache, etc.), and for patients with specific psychiatric disorders (e.g., generalized anxiety disorder, panic disorder, major depressive disorder, etc.).
Qigong practice usually involves doing Qigong (movements with breathing exercises and visualization), plus peer learning, social support, and positive expectation. All these could have beneficial effects to psychological well being and so all these are encouraged in Qigong practice. We have acknowledged that the outcomes of studying such Qigong practices will not provide us with the information on the question whether Qigong (movements with breathing exercise and visualization) alone is beneficial to psychological well being. Positive expectations or social interactions may add to effects related to the Qigong intervention, to form a multi-component mind-body practices instead of a single (Qigong) intervention.
In this paper, we included studies both from the Chinese and in English databases. We consider this approach a strength as many Qigong studies continue to be originated in China and published in Chinese language. While only one researcher performed literature search in Chinese which may lead to some biases, early Qigong research findings published before 2003 (in English), respectively, 2000 (in Chinese) have not been considered. This approach has substantially limited the literature base for the present review and consequently also its findings. The findings of this study should be interpreted in light of the methodological limitations of the studies reviewed. In both of the English and Chinese studies included in the review, most of them used treatment as usual (and one used a waitlist) for the control group. This may lead to bias since positive outcomes from the study could be due to positive expectations or social interactions rather than to the Qigong intervention. A sham treatment which offers social interaction and positive expectations from receiving an intervention could be a better control for these studies. It will also be important in future studies to control for what has been called the frustrebo effect (i.e., negative effects emanating from subject frustration in not receiving the kind of intervention they feel they need) [
The majority of these RCTs were pilot studies on patients with chronic illnesses conducted to collect preliminary data on the efficacy of a group intervention to estimate the effect size needed for a larger, more definitive study. While the studies provided valuable data regarding feasibility and clinical efficacy, the use of a small sample could lead to instability of the outcomes, making it harder to generalize to other populations. In addition, many studies used inadequate blinding of the intervention, which could lead to more favorable responses among the Qigong intervention groups. Most of the cited studies did not provide data on whether participants continued to practice Qigong after the intervention period. Subsequently, long-term psychological effects of Qigong are unclear.
Generally, Qigong practices are considered safe, and there have been few published adverse events [
The authors declare that they have no competing interests and no financial benefits to the authors. Each author’s contribution to this paper is as follows: H. Benson and G. Fricchione obtained funding from the U.S. Centers for Disease Control and Prevention for the study. W. Wang obtained funding from the Ministry of Science and Technology of the People’ Republic of China for the study. A. S. Yeung designed the study. F. Wang, J. K. M. Man, and E. Lee conducted the research. F. Wang conducted the meta-analysis. E. Lee, F. Wang, J. K. M. Man, and A. S. Yeung wrote the first draft of the paper. F. Wang, J. K. M. Man, E. Lee, T. Wu, and A. S. Yeung participated in the revision of subsequent drafts. All authors read and approved the final paper.
The research was partly funded by the following two projects: (1) U.S. Centers for Disease Control and Prevention: Grant no. 5R01DP000339. (2) The Ministry of Science and Technology of the People’ Republic of China: Grant no. 2008DFA32010. F. Wang and J. K. M. Man are cofirst authors; W. Wang and A. S. Yeung are cosenior authors.