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''Qigong'' (), ''qi gong'', ''chi kung'', ''chi 'ung'', or ''chi gung'' () is a system of coordinated body-posture and movement, breathing, and meditation used for the purposes of health, spirituality, and martial-arts training. With roots in
Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of action ...
,
philosophy Philosophy (from , ) is the systematized study of general and fundamental questions, such as those about existence, reason, knowledge, values, mind, and language. Such questions are often posed as problems to be studied or resolved. ...
, and
martial arts Martial arts are codified systems and traditions of combat practiced for a number of reasons such as self-defense; military and law enforcement applications; competition; physical, mental, and spiritual development; entertainment; and the preser ...
, ''qigong'' is traditionally viewed by the Chinese and throughout Asia as a practice to cultivate and balance '' qi'' (pronounced approximately as "chee"), translated as "life energy". ''Qigong'' practice typically involves moving meditation, coordinating slow-flowing movement, deep rhythmic breathing, and a calm meditative state of mind. People practice ''qigong'' throughout China and worldwide for recreation, exercise, relaxation, preventive medicine, self-healing,
alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and al ...
, meditation, self-cultivation, and training for martial arts.


Etymology

''Qigong'' (
Pinyin Hanyu Pinyin (), often shortened to just pinyin, is the official romanization system for Standard Mandarin Chinese in China, and to some extent, in Singapore and Malaysia. It is often used to teach Mandarin, normally written in Chinese fo ...
), ''ch'i kung'' ( Wade-Giles), and ''chi gung'' (
Yale Yale University is a private research university in New Haven, Connecticut. Established in 1701 as the Collegiate School, it is the third-oldest institution of higher education in the United States and among the most prestigious in the wor ...
) are
Romanized Romanization or romanisation, in linguistics, is the conversion of text from a different writing system to the Roman (Latin) script, or a system for doing so. Methods of romanization include transliteration, for representing written text, and ...
words for two Chinese characters: ''qì'' (/) and ''gōng'' (). '' Qi'' (or ''chi'') primarily means air, gas or breath but is often translated as a metaphysical concept of 'vital energy', referring to a supposed energy circulating through the body; though a more general definition is universal energy, including heat, light, and electromagnetic energy; and definitions often involve breath, air, gas, or the relationship between matter, energy, and spirit. ''Qi'' is the central underlying principle in traditional Chinese
medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
and
martial arts Martial arts are codified systems and traditions of combat practiced for a number of reasons such as self-defense; military and law enforcement applications; competition; physical, mental, and spiritual development; entertainment; and the preser ...
. ''Gong'' (or ''kung'') is often translated as cultivation or work, and definitions include practice, skill, mastery, merit, achievement, service, result, or accomplishment, and is often used to mean gongfu (kung fu) in the traditional sense of achievement through great effort. The two words are combined to describe systems to cultivate and balance life energy, especially for health and wellbeing. The term ''qigong'' as currently used was promoted in the late 1940s through the 1950s to refer to a broad range of Chinese self-cultivation exercises, and to emphasize
health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organ ...
and scientific approaches, while de-emphasizing spiritual practices,
mysticism Mysticism is popularly known as becoming one with God or the Absolute, but may refer to any kind of ecstasy or altered state of consciousness which is given a religious or spiritual meaning. It may also refer to the attainment of insight in ...
, and elite lineages.


History and origins

With roots in ancient Chinese culture dating back more than 2,000 years, a wide variety of ''qigong'' forms have developed within different segments of Chinese society: in
traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
for preventive and curative functions; in
Confucianism Confucianism, also known as Ruism or Ru classicism, is a system of thought and behavior originating in ancient China. Variously described as tradition, a philosophy, a Religious Confucianism, religion, a humanistic or rationalistic religion, ...
to promote longevity and improve moral character; in
Taoism Taoism (, ) or Daoism () refers to either a school of philosophical thought (道家; ''daojia'') or to a religion (道教; ''daojiao''), both of which share ideas and concepts of Chinese origin and emphasize living in harmony with the '' Ta ...
and
Buddhism Buddhism ( , ), also known as Buddha Dharma and Dharmavinaya (), is an Indian religion or philosophical tradition based on teachings attributed to the Buddha. It originated in northern India as a -movement in the 5th century BCE, and ...
as part of meditative practice; and in
Chinese martial arts Chinese martial arts, often called by the umbrella terms kung fu (; ), kuoshu () or wushu (), are multiple fighting styles that have developed over the centuries in Greater China. These fighting styles are often classified according to comm ...
to enhance self defending abilities. Contemporary ''qigong'' blends diverse and sometimes disparate traditions, in particular the Taoist meditative practice of "internal alchemy" ( Neidan ), the ancient meditative practices of "circulating ''qi''" (Xing qi ) and "standing meditation" ( Zhan zhuang ), and the slow gymnastic breathing exercise of "guiding and pulling" ( Daoyin ). Traditionally, ''qigong'' was taught by master to students through training and oral transmission, with an emphasis on meditative practice by scholars and gymnastic or dynamic practice by the working masses. Starting in the late 1940s and the 1950s, the mainland Chinese government tried to integrate disparate ''qigong'' approaches into one coherent system, with the intention of establishing a firm scientific basis for ''qigong'' practice. In 1949, Liu Guizhen established the name "Qigong" to refer to the system of life-preserving practices that he and his associates developed, based on Dao yin and other philosophical traditions. This attempt is considered by some
sinologists Sinology, or Chinese studies, is an academic discipline that focuses on the study of China primarily through Chinese philosophy, language, literature, culture and history and often refers to Western scholarship. Its origin "may be traced to the ex ...
as the start of the modern or scientific interpretation of ''qigong''. During the
Great Leap Forward The Great Leap Forward (Second Five Year Plan) of the People's Republic of China (PRC) was an economic and social campaign led by the Chinese Communist Party (CCP) from 1958 to 1962. CCP Chairman Mao Zedong launched the campaign to reconstr ...
(1958–1963) and the
Cultural Revolution The Cultural Revolution, formally known as the Great Proletarian Cultural Revolution, was a sociopolitical movement in the People's Republic of China (PRC) launched by Mao Zedong in 1966, and lasting until his death in 1976. Its stated goa ...
(1966–1976), ''qigong'', along with other traditional Chinese medicine, was under tight control with limited access among the general public, but was encouraged in state-run rehabilitation centers and spread to universities and hospitals. After the Cultural Revolution, ''qigong'', along with t'ai chi, was popularized as daily morning exercise practiced en masse throughout China. Popularity of ''qigong'' grew rapidly during the Deng and
Jiang Jiang may refer to: * ''Jiang'' (rank), rank held by general officers in the military of China *Jiang (surname), several Chinese surnames **Jiang Zemin (1926–2022), as general secretary of the Chinese Communist Party *Jiang River The Jiang Rive ...
eras after Mao Zedong's death in 1976 through the 1990s, with estimates of between 60 and 200 million practitioners throughout China. Along with popularity and state sanction came controversy and problems: claims of extraordinary abilities bordering on the supernatural,
pseudoscience Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable claim ...
explanations to build credibility, a mental condition labeled ''qigong'' deviation, formation of cults, and exaggeration of claims by masters for personal benefit. In 1985, the state-run National Qigong Science and Research Organization was established to regulate the nation's ''qigong'' denominations. In 1999, in response to widespread revival of old traditions of spirituality, morality, and mysticism, and perceived challenges to State control, the Chinese government took measures to enforce control of public ''qigong'' practice, including shutting down ''qigong'' clinics and hospitals, and banning groups such as Zhong Gong and Falun Gong. Since the 1999 crackdown, ''qigong'' research and practice have only been officially supported in the context of health and traditional Chinese medicine. The Chinese Health Qigong Association, established in 2000, strictly regulates public ''qigong'' practice, with limitation of public gatherings, requirement of state approved training and certification of instructors, and restriction of practice to state-approved forms. Through the forces of migration of the
Chinese diaspora Overseas Chinese () refers to people of Chinese birth or ethnicity who reside outside Mainland China, Hong Kong, Macau, and Taiwan. As of 2011, there were over 40.3 million overseas Chinese. Terminology () or ''Hoan-kheh'' () in Hokkien, ...
,
tourism in China Tourism in China is a growing industry that is becoming a significant part of the Chinese economy. The rate of tourism has expanded over the last few decades since the beginning of reform and opening-up. The emergence of a newly rich middle c ...
, and
globalization Globalization, or globalisation (Commonwealth English; see spelling differences), is the process of interaction and integration among people, companies, and governments worldwide. The term ''globalization'' first appeared in the early 20t ...
, the practice of ''qigong'' spread from the Chinese community to the world. Today, millions of people around the world practice ''qigong'' and believe in the benefits of ''qigong'' to varying degrees. Similar to its historical origin, those interested in qigong come from diverse backgrounds and practice it for different reasons, including for
recreation Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for enjoyment, amusement, or plea ...
,
exercise Exercise is a body activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons, to aid growth and improve strength, develop muscles and the cardiovascular system, hone athletic ...
, relaxation,
preventive medicine Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
, self-healing,
alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and al ...
,
self-cultivation Self-cultivation or personal cultivation () is the development of one's mind or capacities through one's own efforts. Self-cultivation is the cultivation, integration and coordination of mind and body. Although self-cultivation may be practiced ...
,
meditation Meditation is a practice in which an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm ...
,
spirituality The meaning of ''spirituality'' has developed and expanded over time, and various meanings can be found alongside each other. Traditionally, spirituality referred to a religious process of re-formation which "aims to recover the original shape ...
, and martial arts training.


Overview


Practices

''Qigong'' comprises a diverse set of practices that coordinate body (), breath (), and mind () based on Chinese philosophy. Practices include moving and still meditation, massage, chanting, sound meditation, and non-contact treatments, performed in a broad array of body postures. ''Qigong'' is commonly classified into two foundational categories: 1) dynamic or active ''qigong'' (''dong gong''), with slow flowing movement; and 2) meditative or passive ''qigong'' (''jing gong''), with still positions and inner movement of the breath. From a therapeutic perspective, ''qigong'' can be classified into two systems: 1) internal ''qigong'', which focuses on self-care and self-cultivation, and; 2) external ''qigong'', which involves treatment by a therapist who directs or transmits ''qi''. As moving meditation, ''qigong'' practice typically coordinates slow stylized movement, deep diaphragmatic breathing, and calm mental focus, with visualization of guiding ''qi'' through the body. While implementation details vary, generally ''qigong'' forms can be characterized as a mix of four types of practice: dynamic, static, meditative, and activities requiring external aids. * Dynamic practice : involves fluid movement, usually carefully choreographed, coordinated with breath and awareness. Examples include the slow stylized movements of T'ai chi ch'uan, Baguazhang, and Xing Yi Quan. Other examples include graceful movement that mimics the motion of animals in Five Animals ( Wu Qin Xi qigong), White Crane, and Wild Goose (Dayan) Qigong. As a form of gentle exercise, ''qigong'' is composed of movements that are typically repeated, strengthening and stretching the body, increasing fluid movement (blood, synovial, and lymph), enhancing balance and
proprioception Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons ...
, and improving the awareness of how the body moves through space. * Static practice : involves holding postures for sustained periods of time. In some cases this bears resemblance to the practice of
Yoga Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consciou ...
and its continuation in the Buddhist tradition. For example Yiquan, a Chinese martial art derived from xingyiquan, emphasizes static stance training. In another example, the healing form Eight Pieces of Brocade ( Baduanjin qigong) is based on a series of static postures. * Meditative practice : utilizes breath awareness, visualization,
mantra A mantra ( Pali: ''manta'') or mantram (मन्त्रम्) is a sacred utterance, a numinous sound, a syllable, word or phonemes, or group of words in Sanskrit, Pali and other languages believed by practitioners to have religious, ...
, chanting, sound, and focus on philosophical concepts such as ''qi'' circulation, aesthetics, or moral values. In traditional Chinese medicine and Daoist practice, the meditative focus is commonly on cultivating ''qi'' in dantian energy centers and balancing ''qi'' flow in meridian and other pathways. In various Buddhist traditions, the aim is to still the mind, either through outward focus, for example on a place, or through inward focus on the breath, a mantra, a
koan A (; , ; ko, 화두, ; vi, công án) is a story, dialogue, question, or statement which is used in Zen practice to provoke the "great doubt" and to practice or test a student's progress in Zen. Etymology The Japanese term is the Sino-Jap ...
, emptiness, or the idea of the eternal. In the Confucius scholar tradition, meditation is focused on humanity and virtue, with the aim of self-enlightenment. * Use of external agents : Many systems of ''qigong'' practice include the use of external agents such as ingestion of herbs, massage, physical manipulation, or interaction with other living organisms. For example, specialized food and drinks are used in some medical and Daoist forms, whereas massage and body manipulation are sometimes used in martial arts forms. In some medical systems a ''qigong'' master uses non-contact treatment, purportedly guiding ''qi'' through his or her own body into the body of another person.


Forms

There are numerous ''qigong'' forms. 75 ancient forms that can be found in ancient literature and also 56 common or contemporary forms have been described in a ''qigong'' compendium. The list is by no means exhaustive. Many contemporary forms were developed by people who had recovered from their illness after ''qigong'' practice. Most of the ''qigong'' forms come under the following categories: # Medical ''qigong'' # Martial ''qigong'' # Spiritual ''qigong'' # Intellectual ''qigong'' # Life nourishing ''qigong''


Development of "health ''qigong''"

In 1995, there was Qigong Talent Bank, an organization of Science Research of Chinese Qigong, functioning as network system of the senior Chinese qigong talents in China. In order to promote ''qigong'' exercises in a standardised and effective way with a scientific approach, The Chinese Health Qigong Association (CHQA) appointed panels of Qigong experts, Chinese medicine doctors and sport science professors from different hospitals, universities and ''qigong ''lineage across China to research and develop new sets of ''qigong'' exercises. In 2003 the CHQA officially promoted a new system called "health ''qigong''", which consisted of four newly developed health ''qigong'' forms: * Health Qigong Muscle-Tendon Change Classic (Health Qigong Yì Jīn Jīng ). * Health Qigong Five Animals Frolics (Health qigong Wu Qin Xi ). * Health Qigong Six Healing Sounds (Health Qigong Liu Zi Jue ). * Health Qigong Eight Pieces of Brocade (Health Qigong Ba Duan Jin ). In 2010, the Chinese Health Qigong Association officially introduced five additional health ''qigong'' forms: * Health Qigong Tai Chi Yang Sheng Zhang (): a tai chi form from the stick tradition. * Health Qigong Shi Er Duan Jin (): seated exercises to strengthen the neck, shoulders, waist, and legs. * Health Qigong Daoyin Yang Sheng Gong Shi Er Fa (): 12 routines from Daoyin tradition of guiding and pulling ''qi''. * Health Qigong Mawangdui Daoyin (): guiding ''qi'' along the meridians with synchronous movement and awareness. * Health Qigong Da Wu (): choreographed exercises to lubricate joints and guide ''qi''. Other commonly practised ''qigong'' styles and forms include: * Soaring Crane Qigong * Wisdom Healing Qigong * Pan Gu Mystical Qigong * Wild Goose (Dayan) Qigong * Dragon and Tiger Qigong * Primordial Qigong (Wujigong) * Chilel Qigong *Phoenix Qigong *Yuan Qigong *Zhong Yuan Qigong


Techniques

Whether viewed from the perspective of exercise, health, philosophy, or martial arts training, several main principles emerge concerning the practice of qigong: * Intentional movement: careful, flowing balanced style * Rhythmic breathing: slow, deep, coordinated with fluid movement * Awareness: calm, focused meditative state * Visualization: of ''qi'' flow, philosophical tenets, aesthetics * Chanting/Sound: use of sound as a focal point Additional principles: * Softness: soft gaze, expressionless face * Solid Stance: firm footing, erect spine * Relaxation: relaxed muscles, slightly bent joints * Balance and Counterbalance: motion over the center of gravity Advanced goals: * Equanimity: more fluid, more relaxed * Tranquility: empty mind, high awareness * Stillness: smaller and smaller movements, eventually to complete stillness The most advanced practice is generally considered to be with little or no motion.


Traditional and classical theory

Over time, five distinct traditions or schools of ''qigong'' developed in China, each with its own theories and characteristics: Chinese Medical Qigong, Taoist Qigong, Buddhist Qigong, Confucian Qigong, and Martial Qigong. All of these ''qigong'' traditions include practices intended to cultivate and balance ''qi''.


Traditional Chinese medicine

The theories of ancient Chinese ''qigong'' include the Yin-Yang and Five Phases Theory, Essence-''Qi''- Spirit Theory, Zang-Xiang Theory, and Meridians and ''Qi''-Blood Theory, which have been synthesized as part of Traditional Chinese Medicine (TCM). TCM focuses on tracing and correcting underlying disharmony, in terms of deficiency and excess, using the complementary and opposing forces of
yin and yang Yin and yang ( and ) is a Chinese philosophical concept that describes opposite but interconnected forces. In Chinese cosmology, the universe creates itself out of a primary chaos of material energy, organized into the cycles of yin and ya ...
(), to create a balanced flow of ''qi''. ''Qi'' is believed to be cultivated and stored in three main dantian energy centers and to travel through the body along twelve main meridians (Jīng Luò ), with numerous smaller branches and tributaries. The main meridians correspond to twelve main organs ) (Zàng fǔ ). ''Qi'' is balanced in terms of
yin and yang Yin and yang ( and ) is a Chinese philosophical concept that describes opposite but interconnected forces. In Chinese cosmology, the universe creates itself out of a primary chaos of material energy, organized into the cycles of yin and ya ...
in the context of the traditional system of Five Phases (Wu xing ). A person is believed to become ill or die when ''qi'' becomes diminished or unbalanced. Health is believed to be returned by rebuilding ''qi'', eliminating ''qi'' blockages, and correcting ''qi'' imbalances. These TCM concepts do not translate readily to modern science and medicine.


Taoism

In
Taoism Taoism (, ) or Daoism () refers to either a school of philosophical thought (道家; ''daojia'') or to a religion (道教; ''daojiao''), both of which share ideas and concepts of Chinese origin and emphasize living in harmony with the '' Ta ...
, various practices now known as Daoist ''qigong'' are claimed to provide a way to achieve
longevity The word " longevity" is sometimes used as a synonym for " life expectancy" in demography. However, the term ''longevity'' is sometimes meant to refer only to especially long-lived members of a population, whereas ''life expectancy'' is always ...
and
spiritual enlightenment Used in a religious sense, enlightenment translates several Buddhist terms and concepts, most notably '' bodhi'', '' kensho,'' and '' satori''. Related terms from Asian religions are '' kaivalya'' and ''moksha'' (liberation) in Hinduism, '' Ke ...
, as well as a closer connection with the natural world. For instance, the
Ming dynasty The Ming dynasty (), officially the Great Ming, was an Dynasties in Chinese history, imperial dynasty of China, ruling from 1368 to 1644 following the collapse of the Mongol Empire, Mongol-led Yuan dynasty. The Ming dynasty was the last ort ...
compendium '' Chifeng sui'', written by a Taoist ascetic, lists various ''qigong''-based "longevity methods".


Buddhism

In
Buddhism Buddhism ( , ), also known as Buddha Dharma and Dharmavinaya (), is an Indian religion or philosophical tradition based on teachings attributed to the Buddha. It originated in northern India as a -movement in the 5th century BCE, and ...
meditative practices now known as Buddhist ''qigong'' are part of a spiritual path that leads to
spiritual enlightenment Used in a religious sense, enlightenment translates several Buddhist terms and concepts, most notably '' bodhi'', '' kensho,'' and '' satori''. Related terms from Asian religions are '' kaivalya'' and ''moksha'' (liberation) in Hinduism, '' Ke ...
or
Buddhahood In Buddhism, Buddha (; Pali, Sanskrit: 𑀩𑀼𑀤𑁆𑀥, बुद्ध), "awakened one", is a title for those who are awake, and have attained nirvana and Buddhahood through their own efforts and insight, without a teacher to point o ...
.


Confucianism

In
Confucianism Confucianism, also known as Ruism or Ru classicism, is a system of thought and behavior originating in ancient China. Variously described as tradition, a philosophy, a Religious Confucianism, religion, a humanistic or rationalistic religion, ...
practices now known as Confucian ''qigong'' provide a means to become a Junzi () through awareness of
morality Morality () is the differentiation of intentions, decisions and actions between those that are distinguished as proper (right) and those that are improper (wrong). Morality can be a body of standards or principles derived from a code of co ...
.


Contemporary qigong

In contemporary China, the emphasis of ''qigong'' practice has shifted away from traditional philosophy, spiritual attainment, and folklore, and increasingly to health benefits, traditional medicine and martial arts applications, and a scientific perspective. ''Qigong'' is now practiced by millions worldwide, primarily for its health benefits, though many practitioners have also adopted traditional philosophical, medical, or
martial arts Martial arts are codified systems and traditions of combat practiced for a number of reasons such as self-defense; military and law enforcement applications; competition; physical, mental, and spiritual development; entertainment; and the preser ...
perspectives, and even use the long history of ''qigong'' as evidence of its effectiveness.


Contemporary Chinese medical qigong

''Qigong'' has been recognized as a "standard medical technique" in China since 1989, and is sometimes included in the medical curriculum of major universities in China. The 2013 English translation of the official Chinese Medical Qigong textbook used in China defines CMQ as "the skill of body-mind exercise that integrates body, breath, and mind adjustments into one" and emphasizes that ''qigong'' is based on "adjustment" (tiao , also translated as "regulation", "tuning", or "alignment") of body, breath, and mind. As such, ''qigong'' is viewed by practitioners as being more than common physical exercise, because ''qigong'' combines postural, breathing, and mental training in one to produce a particular psychophysiological state of being. While CMQ is still based on traditional and classical theory, modern practitioners also emphasize the importance of a strong scientific basis. According to the 2013 CMQ textbook, physiological effects of ''qigong'' are numerous, and include improvement of respiratory and cardiovascular function, and possibly neurophysiological function.


Conventional medicine

Especially since the 1990s, conventional or mainstream Western medicine often strives to heed the model of
evidence-based medicine Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of t ...
, EBM, which demotes medical theory, clinical experience, and physiological data to prioritize the results of controlled, and especially randomized, clinical trials of the treatment itself. Although some clinical trials support qigong's effectiveness in treating conditions diagnosed in Western medicine, the quality of these studies is mostly low and, overall, their results are mixed.


Integrative, complementary, and alternative medicine

Integrative medicine (IM) refers to "the blending of conventional and complementary medicines and therapies with the aim of using the most appropriate of either or both modalities to care for the patient as a whole", whereas complementary is using a non-mainstream approach together with conventional medicine, while alternative is using a non-mainstream approach in place of conventional medicine. ''Qigong'' is used by integrative medicine practitioners to complement conventional medical treatment, based on complementary and alternative medicine interpretations of the effectiveness and safety of ''qigong''.


Scientific basis

Scientists interested in ''qigong'' have sought to describe or verify the effects of ''qigong'', to explore mechanisms of effects, to form scientific theory with respect to ''qigong'', and to identify appropriate research methodology for further study. In terms of traditional theory, the existence of ''qi'' has not been independently verified in an experimental setting. In any case, some researches have reported effects on pathophysiological parameters of biomedical interest.Kevin Chen, Elizabeth R. Mackenzie & Master FaXiang Hou, "The benefits of qigong", in Elizabeth R. Mackenzie & Birgit Rakel, eds.,
Complementary and Alternative Medicine for Older Adults
' (New York: Springer, 2006).


Practitioners, uses and cautions


Recreation and popular use

People practice ''qigong'' for many different reasons, including for
recreation Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for enjoyment, amusement, or plea ...
,
exercise Exercise is a body activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons, to aid growth and improve strength, develop muscles and the cardiovascular system, hone athletic ...
and relaxation,
preventive medicine Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
and self-healing,
meditation Meditation is a practice in which an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm ...
and
self-cultivation Self-cultivation or personal cultivation () is the development of one's mind or capacities through one's own efforts. Self-cultivation is the cultivation, integration and coordination of mind and body. Although self-cultivation may be practiced ...
, and training for martial arts. Practitioners range from athletes to people with disabilities. Because it is low impact and can be done lying, sitting, or standing, ''qigong'' is accessible for people with disabilities, seniors, and people recovering from injuries.


Therapeutic use

Therapeutic use of ''qigong'' is directed by TCM, CAM, integrative medicine, and other health practitioners. In China, where it is considered a "standard medical technique", ''qigong'' is commonly prescribed to treat a wide variety of conditions, and clinical applications include
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high b ...
,
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pl ...
, peptic ulcers, chronic liver diseases,
diabetes mellitus Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...
,
obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's ...
, menopause syndrome,
chronic fatigue syndrome Chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis (ME) or ME/CFS, is a complex, debilitating, long-term medical condition. The causes and mechanisms of the disease are not fully understood. Distinguishing core symptoms are ...
,
insomnia Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, ...
, tumors and cancer, lower back and leg pain,
cervical spondylosis Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense it refers to spinal osteoarthritis, the age-related wear and tear of the spinal column, which is the most common cause of spondylosis. The degener ...
, and
myopia Near-sightedness, also known as myopia and short-sightedness, is an eye disease where light focuses in front of, instead of on, the retina. As a result, distant objects appear blurry while close objects appear normal. Other symptoms may includ ...
. Outside China ''qigong'' is used in
integrative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and al ...
to complement or supplement accepted medical treatments, including for relaxation, fitness,
rehabilitation Rehabilitation or Rehab may refer to: Health * Rehabilitation (neuropsychology), therapy to regain or improve neurocognitive function that has been lost or diminished * Rehabilitation (wildlife), treatment of injured wildlife so they can be retur ...
, and treatment of specific conditions. However, there is no high-quality evidence that ''qigong'' is actually effective for these conditions. Based on
systematic review A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on t ...
s of
clinical research Clinical research is a branch of healthcare science that determines the safety and effectiveness ( efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treat ...
, there is insufficient
evidence Evidence for a proposition is what supports this proposition. It is usually understood as an indication that the supported proposition is true. What role evidence plays and how it is conceived varies from field to field. In epistemology, evidenc ...
for the effectiveness of using ''qigong'' as a therapy for any medical condition.


Safety and cost

''Qigong'' is generally viewed as safe. No adverse effects have been observed in clinical trials, such that ''qigong'' is considered safe for use across diverse populations. Cost for self-care is minimal, and cost efficiencies are high for group delivered care. Typically the cautions associated with ''qigong'' are the same as those associated with any physical activity, including risk of muscle strains or sprains, advisability of stretching to prevent injury, general safety for use alongside conventional medical treatments, and consulting with a physician when combining with conventional treatment.


Clinical research


Overview

Although there is ongoing
clinical research Clinical research is a branch of healthcare science that determines the safety and effectiveness ( efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treat ...
examining the potential health effects of ''qigong'', there is little financial or medical incentive to support high-quality research, and still only a limited number of studies meet accepted medical and scientific standards of randomized controlled trials (RCTs). Clinical research concerning ''qigong'' has been conducted for a wide range of medical conditions, including bone density, cardiopulmonary effects, physical function, falls and related risk factors,
quality of life Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ...
,
immune function The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splin ...
,
inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
,
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high b ...
,
pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
, and
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
treatment.


Systematic reviews

A 2009 systematic review on the effect of ''qigong'' exercises on reducing pain concluded that "the existing trial evidence is not convincing enough to suggest that internal qigong is an effective modality for pain management." A 2010 systematic review of the effect of ''qigong'' exercises on
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
treatment concluded "the effectiveness of qigong in cancer care is not yet supported by the evidence from rigorous clinical trials." A separate systematic review that looked at the effects of qigong exercises on various physiological or psychological outcomes found that the available studies were poorly designed, with a high risk of bias in the results. Therefore, the authors concluded, "Due to limited number of RCTs in the field and methodological problems and high risk of bias in the included studies, it is still too early to reach a conclusion about the efficacy and the effectiveness of qigong exercise as a form of health practice adopted by the cancer patients during their curative, palliative, and rehabilitative phases of the cancer journey." A 2011 overview of
systematic reviews A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on t ...
of controlled clinical trials, Lee et al. concluded that "the effectiveness of qigong is based mostly on poor quality research" and "therefore, it would be unwise to draw firm conclusions at this stage." Although a 2010 comprehensive literature review found 77 peer-reviewed RCTs, Lee et al.'s overview of systematic reviews as to particular health conditions found problems like sample size, lack of proper control groups, with lack of blinding associated with high risk of bias. A 2015 systematic review of the effect of ''qigong'' exercises on cardiovascular diseases and
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high b ...
found no conclusive evidence for effect. Also in 2015, a systemic review into the effects on hypertension suggested that it may be effective, but that the evidence was not conclusive because of the poor quality of the trials it included, and advised more rigorous research in the future. Another 2015 systematic review of ''qigong'' on
biomarker In biomedical contexts, a biomarker, or biological marker, is a measurable indicator of some biological state or condition. Biomarkers are often measured and evaluated using blood, urine, or soft tissues to examine normal biological processes, p ...
s of cardiovascular disease concluded that some trials showed favorable effects, but concludes, "Most of the trials included in this review are likely to be at high risk of bias, so we have very low confidence in the validity of the results.


Mental health

Many claims have been made that ''qigong'' can benefit or ameliorate mental health conditions, including improved mood, decreased stress reaction, and decreased anxiety and depression. Most medical studies have only examined psychological factors as secondary goals, although various studies have shown decreases in
cortisol Cortisol is a steroid hormone, in the glucocorticoid class of hormones. When used as a medication, it is known as hydrocortisone. It is produced in many animals, mainly by the '' zona fasciculata'' of the adrenal cortex in the adrenal g ...
levels, a chemical hormone produced by the body in response to stress.


China

Basic and clinical research in China during the 1980s was mostly descriptive, and few results were reported in
peer-review Peer review is the evaluation of work by one or more people with similar competencies as the producers of the work ( peers). It functions as a form of self-regulation by qualified members of a profession within the relevant field. Peer revie ...
ed English-language journals. ''Qigong'' became known outside China in the 1990s, and clinical randomized controlled trials investigating the effectiveness of ''qigong'' on health and mental conditions began to be published worldwide, along with systematic reviews.


Challenges

Most existing clinical trials have small sample sizes and many have inadequate controls. Of particular concern is the impracticality of double blinding using appropriate sham treatments, and the difficulty of placebo control, such that benefits often cannot be distinguished from the
placebo effect A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures. In general ...
. Also of concern is the choice of which ''qigong'' form to use and how to standardize the treatment or amount with respect to the skill of the practitioner leading or administering treatment, the tradition of individualization of treatments, and the treatment length, intensity, and frequency.


Meditation and self-cultivation applications

''Qigong'' is practiced for
meditation Meditation is a practice in which an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm ...
and self-cultivation as part of various philosophical and spiritual traditions. As meditation, ''qigong'' is a means to still the mind and enter a state of consciousness that brings serenity, clarity, and bliss. Many practitioners find ''qigong'', with its gentle focused movement, to be more accessible than seated meditation. ''Qigong'' for self-cultivation can be classified in terms of traditional Chinese philosophy:
Taoist Taoism (, ) or Daoism () refers to either a school of philosophical thought (道家; ''daojia'') or to a religion (道教; ''daojiao''), both of which share ideas and concepts of Chinese origin and emphasize living in harmony with the '' Tao ...
,
Buddhist Buddhism ( , ), also known as Buddha Dharma and Dharmavinaya (), is an Indian religion or philosophical tradition based on teachings attributed to the Buddha. It originated in northern India as a -movement in the 5th century BCE, and ...
, and Confucian.


Martial arts applications

The practice of ''qigong'' is an important component in both internal and external style
Chinese martial arts Chinese martial arts, often called by the umbrella terms kung fu (; ), kuoshu () or wushu (), are multiple fighting styles that have developed over the centuries in Greater China. These fighting styles are often classified according to comm ...
. Focus on ''qi'' is considered to be a source of power as well as the foundation of the internal style of martial arts (Neijia). T'ai Chi Ch'uan, Xing Yi Quan, and Baguazhang are representative of the types of Chinese martial arts that rely on the concept of ''qi'' as the foundation. Extraordinary feats of martial arts prowess, such as the ability to withstand heavy strikes ( Iron Shirt, ) and the ability to break hard objects ( Iron Palm, ) are abilities attributed to ''qigong'' training.


T'ai Chi Ch'uan and ''qigong''

'' T'ai Chi Ch'uan'' (Taijiquan) is a widely practiced Chinese internal martial style based on the theory of taiji, closely associated with ''qigong'', and typically involving more complex choreographed movement coordinated with breath, done slowly for health and training, or quickly for self-defense. Many scholars consider t'ai chi ch'uan to be a type of ''qigong'', traced back to an origin in the seventeenth century. In modern practice, ''qigong'' typically focuses more on health and meditation rather than martial applications, and plays an important role in training for t'ai chi ch'uan, in particular used to build strength, develop breath control, and increase vitality ("life energy").


See also

* Taoist meditation * Taoist philosophy * Hua Tuo * Wushu * Kung fu * Jing, Qi & Shen * Neidan *
Neigong Neigong, also spelled ''nei kung'', ''neigung'', or ''nae gong'', refers to any of a set of Chinese breathing, meditation, somatics practices, and spiritual practice disciplines associated with Daoism and especially the Chinese martial arts. ...
* Paidagong * Silk reeling * Tao Yin * Yangsheng * Zhong Gong * Zhan Zhuang *
Traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
* Buddhist meditation *
Taoist Tai Chi Society The International Taoist Tai Chi Society (國際道家太極拳社) is an umbrella organization for the governance of its member associations around the world, which are dedicated to the teaching of Taoist Tai Chi. As of 2007, the organization ha ...
* World Tai Chi and Qigong Day * Asahi Health


References


External links

* * {{Authority control Chinese martial arts Chinese words and phrases Meditation Taoist philosophy Biofield therapies Traditional Chinese medicine Alternative medicine Healing