Qigong: What You Need To Know
What is qigong and how does it work?
Qigong, pronounced “chi gong,” was developed in China thousands of years ago as part of traditional Chinese medicine. It involves using exercises to optimize energy within the body, mind, and spirit, with the goal of improving and maintaining health and well-being. Qigong has both psychological and physical components and involves the regulation of the mind, breath, and body’s movement and posture.
In most forms of qigong:
- Breath is slow, long, and deep. Breath patterns may switch from abdominal breathing to breathing combined with speech sounds.
- Movements are typically gentle and smooth, aimed for relaxation.
- Mind regulation includes focusing one’s attention and visualization.
Dynamic (active) qigong techniques primarily focus on body movements, especially movements of the whole body or arms and legs. Meditative (passive) qigong techniques can be practiced in any posture that can be maintained over time and involve breath and mind exercises, with almost no body movement.
Is qigong the same as tai chi?
Tai chi originated as an ancient martial art, but over the years it has become more focused on health promotion and rehabilitation. When tai chi is performed for health, it is considered a form of qigong and involves integrated physical postures, focused attention, and controlled breathing. Tai chi is one of the hundreds of forms of qigong exercises that was developed in China. Other forms of qigong include Baduanjin, Liuzijue, Hu Yue Xian, Yijin Jing, and medical qigong.
Can qigong reduce pain?
The research on qigong’s role in pain is conflicting. Three reviews from 2018 and 2019 that looked at only a small number of studies suggested that qigong may help to decrease pain in community-dwelling older adults (160 participants), neck pain (525 participants), and musculoskeletal pain in people 15 to 80 years old (1,787 participants). But a 2020 review that included 5 studies (576 participants) found conflicting results on qigong’s pain-reducing effects for low-back pain and neck pain.
Is qigong helpful for people with chronic diseases?
Frequent and consistent qigong practice may be helpful for people with fibromyalgia in areas like pain, sleep, and physical and mental function. This, however, is based on initial research that includes only a few small studies.
- A 2020 review looked at two small studies of qigong’s effects on people with fibromyalgia. The first study, which included 89 people, found that 6 months of qigong practice helped with pain, sleep quality, and physical and mental function. The second study, which included 57 people, found that 7 weeks of qigong practice resulted in decreased pain, less inconvenience from fibromyalgia, decreased anxiety, and improved quality of life.
- A 2017 review with 4 studies on qigong for fibromyalgia (201 participants) found that the amount of time people practice qigong made a difference. People with fibromyalgia who did diligent qigong practice—30 to 40 minutes daily for 6 to 8 weeks—experienced consistent benefits in pain, sleep, and physical and mental function. These benefits were still seen 4 to 6 months after the studies had completed.
Two small clinical trials (2019, 2020; total of 82 participants) that were not included in the above reviews also found similar positive results of qigong practice in people with fibromyalgia.
Chronic obstructive pulmonary disease (COPD)
A small amount of research suggests that using qigong as a complementary therapy may help with depression, anxiety, lung function, and physical function in people with COPD.
- A 2020 review of 31 studies (3,045 participants) looked at the effect of adding qigong to a primary treatment, such as drug therapy and respiratory training. The review found that adding qigong to the primary treatment helped improve lung function, quality of life, and ability to exercise in people with COPD.
- A 2019 review of 6 studies (415 participants) found that qigong reduced self-ratings of depression and anxiety in people with COPD when qigong was combined with standard treatment. The qigong programs lasted from 2 to 6 months.
- Another 2019 review found that 3 months of yoga, qigong, or tai chi helped improve lung function and the capacity for walking and physical activity in people with COPD. Twelve of the 18 studies focused on qigong and tai chi, either alone or combined. The programs ranged from 6 weeks to 6 months and included 30- to 90-minute sessions two to seven times a week.
The amount of research on qigong for Parkinson’s disease is small. A 2020 review of 7 studies (325 participants) suggested that qigong-based exercise helped improve movement, walking ability, and balance in people with Parkinson’s disease (more so in younger adults than older). The amount of improvement seen in movement and walking ability was similar to that seen with other forms of exercise, such as walking and using a stationary exercise bike. Improvements in balance, however, were greater with qigong than with the other types of exercise. The qigong exercise programs ranged from 8 to 48 weeks, with 30- to 120-minute sessions two to seven times per week.
High blood pressure
The amount of research on qigong for high blood pressure is small. Although a 2021 review of 7 studies (370 participants) suggested that qigong may help to reduce systolic and diastolic blood pressure, the authors indicated a lack of firm evidence for this beneficial effect. Five of the six studies that compared qigong to no intervention showed that qigong was better. The one study that compared qigong to conventional exercise showed no difference in benefit between the two. Qigong interventions ranged from 8 to 24 weeks and included 30- to 60-minute sessions two to seven times a week.
Chronic heart failure
A 2020 review of 33 studies (2,465 participants) looked at the rehabilitative effects of tai chi and qigong for people with chronic heart failure. Seventeen studies were on tai chi, 14 were on qigong, and 2 were on tai chi plus qigong. Compared to routine management alone (e.g., medicines and advice on diet and exercise), adding tai chi and qigong to routine management led to improvements in peak oxygen consumption (a measure of cardiorespiratory fitness), 6-minute walking distance (a measure of exercise tolerance), and quality of life. When compared to other forms of exercise paired with routine management, people who practiced tai chi or qigong had similar peak oxygen consumption levels and 6-minute walking distances and higher quality-of-life measures.
Can qigong help older adults?
The number of qigong studies that have included older adults is limited. Two 2019 reviews looked at the effects of qigong on the physical and psychological health of older adults. Some of the results were positive, suggesting a potential benefit of qigong for older adults.
- The first review considered 13 studies with a total of 1,340 community-dwelling older adults with chronic disease and found that qigong had a significant positive effect on quality of life but not on depressive symptoms.
- The second review looked at 14 studies of 1,282 older adults with depressive symptoms, frailty, or chronic illness. Seven of the studies were also evaluated in the first review, so there was some overlap. This second review found that qigong helped improve physical ability and may have positive effects on depression, balance, and functioning (the ability to do normal, everyday activities). But the researchers noted that more methodologically sound randomized controlled trials (studies in which participants are randomly assigned to an intervention group and control group) are needed to determine the efficacy of qigong on physical and psychological health in older adults.
Can qigong help prevent falls?
A 2019 survey of reviews found sufficient evidence to support qigong for balance training and fall prevention. When compared to more traditional interventions, qigong was found to have similar and sometimes better effects.
Will qigong help with knee osteoarthritis?
There is only a small amount of research on qigong’s effect on knee osteoarthritis.
- A 2020 review looked at 7 studies (424 total participants), but only 3 of the studies were adequately designed. The review found that qigong improved pain, stiffness, and physical function more than a waiting list control or a health education intervention. Because the evidence was weak, however, the authors said that qigong cannot be recommended until more high-quality studies are done.
- Clinical practice guidelines published in 2017 by the Ottawa Panel (an international group of researcher methods experts who develop evidence-based clinical practice guidelines) recommend using a tai chi qigong program for improving quality of life in people with knee osteoarthritis. The program includes 60-minute classes twice a week for 8 weeks. The guideline authors, however, based their recommendation on only one small high-quality study. They said that more evidence is needed to make stronger recommendations. The guideline authors suggested that the tai chi qigong program might also be beneficial for pain relief and improving physical function.
Can qigong help to manage symptoms in people with cancer?
- A 2019 review included 7 studies on qigong and/or tai chi, with a total of 915 people with different types of cancer. Most of the studies involved 60-minute sessions two to three times a week for 6 to 12 weeks. Qigong significantly improved symptoms of fatigue and sleep quality. Though not statistically significant, qigong and tai chi also had positive effects on anxiety, stress, depressive symptoms, and overall quality of life. The authors of the review indicated that more high-quality studies with longer follow-up periods are needed before definitive conclusions can be made.
- A 2017 review that looked at only qigong included 22 studies of 1,751 people with various cancers. Four of the studies were also in the 2019 review noted above. The review found that using qigong was promising for managing physical and psychological symptoms related to cancer and its treatment.
Can qigong improve cognition and memory?
Only a small amount of research has been done on qigong’s effect on cognition and memory.
- A 2020 review that included 13 studies of 893 people with mild cognitive impairment suggested that qigong improved cognition and memory after 3 and 6 months of practice. The qigong programs included 40- to 60-minute sessions three to six times per week. The benefits from qigong were similar to the benefits from combined cognitive-physical programs and other physical exercises. None of the studies followed up with participants afterwards, so the long-term effects of qigong are still difficult to predict. Also, it’s not clear whether qigong provides benefits for mild cognitive impairment resulting from all causes—such as stroke, diabetes, and older age—or only some causes.
- A 2019 review looked at the effects of meditation, tai chi, qigong, and yoga on cognition in adults 60 years of age and older. The review included 9 studies of qigong (about 650 participants), of which 3 studies were also in the 2020 review. Qigong was found to improve cognition and memory, but only when at least one of the following was true: the length of the program was longer than 12 weeks, exercise frequency was three to seven times per week, or the duration of each exercise session was 45 to 60 minutes.
Can qigong help with mental health in substance use disorders?
A 2020 review of 4 studies involving 593 individuals with substance use disorders found that qigong appeared to have a more positive effect on reducing anxiety than medication or no treatment. The review also found that qigong led to significant improvement in depressive symptoms when compared to no treatment. Because the studies were small and not of high quality, the authors indicated that more rigorous research is needed to provide reliable evidence.
Can qigong help people who have COVID-19?
The amount of research on qigong for COVID-19 is extremely limited. One 2021 review looking at the role of traditional Chinese medicine in COVID-19 indicated that qigong has not been well investigated as a treatment for COVID-19 and that there is a lack of high-quality evidence from well-designed randomized controlled trials.
Another 2021 review looking at complementary therapies and COVID-19 listed only two very small studies on qigong, totaling 49 participants. The studies suggested that qigong improved physical activity, perceptions of difficult breathing, quality of life, and some measures of inflammation in the body, but the studies were not randomized controlled trials.
The 2021 reviews did not include a small 2021 randomized controlled trial of 128 participants hospitalized with severe COVID-19 in China. This study found that adding a rehabilitation program of acupressure therapy and qigong exercise to standard care shortened hospital stays and improved lung function and symptoms such as shortness of breath and cough. Data were collected only while participants were in the hospital, which averaged 20.8 days for participants receiving standard care and 18.5 days for participants receiving the added rehabilitation program.
A 2020 review indicated that there are few studies on the effects of qigong on the acute phase of respiratory infections in general.
Is qigong safe?
Qigong appears to be a safe form of activity. Many studies have indicated no negative side effects in people practicing qigong, including people with chronic diseases and older adults. A review of adults with neck pain included two studies that found that qigong and other exercise groups had similar side effects, which occurred in less than 10 percent of the adults and included muscle pain, soreness, and headache.
Is it safe to do qigong during pregnancy?
There is no research on the safety of qigong during pregnancy and extremely limited research on practicing qigong while pregnant. Pregnant women should talk with their health care providers before starting qigong. Pregnant women may need to avoid or modify some qigong movements.
A small 2010 study of 70 healthy pregnant women in Korea found that adding a qigong-like practice to routine prenatal care resulted in several benefits: greater maternal/fetal interaction (a mother’s behaviors that set the stage for mother-child bonding before birth, such as gentle exercise, reading books out loud, or talking to the unborn child), fewer maternal depressive symptoms, and reduced maternal physical discomfort. The intervention, called Qi exercise, involved physical postures (various stretching, strengthening, and balancing exercises done while standing, sitting, or lying down), breathing techniques, and meditation. Women in the intervention group attended two 90-minute sessions weekly for 12 weeks. Certain practices that were contraindicated during a given period of pregnancy were avoided. There was no mention of adverse effects among any of the pregnant women during the study.
What kind of training, licensing, or certifications do qigong instructors need to practice?
Qigong instructors don’t have to be licensed, and the practice isn't regulated by the Federal Government or individual states. There’s no national standard for qigong certification. Various qigong organizations offer training and certification programs—with differing criteria and levels of certification for instructors.
Tips To Consider
- Don’t use qigong to postpone seeing a health care provider about a medical problem.
- Ask about the training and experience of the qigong instructor you’re considering.
- Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.
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NCCIH thanks Inna Belfer, M.D., Ph.D., and David Shurtleff, Ph.D., NCCIH, for their review of this 2022 publication.
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