The world is sick
I don't teach you anything if I tell you that the world is sick. And I’m not talking about Covid-19. The world was sick way before the pandemic. According to the World Health Organization (WHO), global spending on health more than doubled in real terms over the past two decades, reaching US$ 8.5 trillion in 2019[1]. And there is no reason for this rising to stop since people worldwide are living longer. By 2050, the world’s population of people aged 60 years and older will double from 12% to 22%, and the number of persons aged 80 years or older is expected to triple between 2020 and 2050 to reach 426 million[2]. In the USA, the figures are not better. In 2019, the country spent about 3.6 $ trillion on overall health expenditure, whose only 3% of it was used for preventive care[3].
According to the National Ambulatory Care Survey[4] conducts in 2018, 60% of people aged 45 and over visiting their doctor have one or more chronic conditions. Hypertension is the most prevalent chronic disease in the USA with 30.5% of all physician's office visits. Next, comes hyperlipidemia (an abnormally high concentration of fats or lipids in the blood which can lead to hypertension or cardiovascular disease) with 19.4% of visits. Among other chronic conditions for which people visit their doctor, there is diabetes mellitus with 13.9%, arthritis with 11.4%, and depression with 10.6% of all visits.
We know for many years now that the majority of all illnesses sending people to doctors are caused by stress and poor lifestyle such as sedentary, lack of sleep, having an unhealthy diet, and being disconnected from the natural world. This means that many, if not most, chronic diseases are within our own hands to change.
More and more analyses are conducted to see the effectiveness of mind-body practices and complementary and alternative medicine like Qigong to treat chronic diseases and help people to gain a better quality of life. But specific scientific research into qigong’s potential benefits is relatively new. However, despite the little available literature, it appears that qigong may help with certain aspects of health. This article aims to talk about the benefits of resorting to Qigong and provide some scientific-based evidence for it.
Scientific Evidence
If you have practiced Qigong before or received a Qigong therapy session, you have experienced firsthand the sensation of well-being that arise from the regulation of the flow of Qi within the body. In the early age of Qigong, this practice was known to bring balance to the energy flow of the body and was believed to provide longevity. For me, the fact that this practice is still available after more than 4 000 years is proof in itself that there are certainly benefits to gain from it.
From a basic physical point of view, slow gentle qigong movements warm tendons, ligaments, and muscles; It also tonifies vital organs and connective tissue; and promote circulation of body fluids like blood, synovial, and lymph. When we stand in Wuji posture (the basic posture used in Qigong) we learn to get to a relaxed state of mind while keeping the body still. Wuji posture is tonifying in nature and allows the flow of Qi to be easily regulated and increased. Standing Wuji posture also helps to build up our constitution, enhance our strength, normalize our blood pressure and calm the heart. It, therefore, means that even when we practice a quiescent Qigong, we engage our whole physical body and strengthen our general physical abilities. When we transition to a more dynamic Qigong, using the arms and the whole body to move the energy, more muscles, ligaments, tendons, tissues, and organs are deeply activated.
A meta-analysis of six studies showed significant beneficial effects of Qigong on physical balance, muscular strength, and flexibility[5]. According to the results from this meta-analysis, the beneficial effects of Qigong can be observed with training programs. For example, “these studies have consistently found positive effects of Tai Chi Chuan (Author’s note: Tai Chi Chuan is a form of Qigong) on balance, emphasizing it as an appropriate modality for individuals with balance impairment”. The results also suggest that Qigong may be an equally effective alternative for individuals desiring to improve balance. The meta-analysis also indicates that Qigong practice can significantly enhance trunk flexibility and improve handgrip strength which is one way to verify muscular strength.
It seems obvious that moving, regardless of the intensity, is good for the body. But what about reversing a chronic condition, a disease. Can Qigong really make a difference?
Hypertension
As mentioned above, hypertension ̶ or elevated blood pressure ̶ has been a global public health problem. It is a serious medical condition that significantly increases the risks of heart, brain, kidney, and other diseases in addition to being a major cause of premature death worldwide. This is concerning when we know that an estimated 46% of adults with hypertension worldwide are unaware that they have the condition[6].
Because of the importance of this chronic condition, more research is available trying to prove the efficacity of Qigong practice in lowering blood pressure. One of them was published in 2021[7] and another one was published in 2020[8] and arrived at the same conclusion that “qigong does reduce systolic and diastolic blood pressure and it can be a viable complementary therapy in the somewhat complicated management of hypertension”. Additional large trials with a low risk of bias are warranted to promote qigong as an effective strategy to augment the blood pressure control of hypertensive patients, but these latest results confirm other past analyses and are very interesting and promising.
Another meta-analysis[9] published in 2021 concluded that not only Qigong can effectively reduce blood pressure levels but that “Moreover, according to the subgroup analysis of the total Qigong exercise amount, there may be a dose-response relationship between Qigong exercise amount and blood pressure level in hypertension patients”. On the same concept, the results of this review and meta-analysis published in 2017[10], “suggest that a minimum of three sessions of 30–60 minutes of practice is necessary for improving blood pressure and that twelve weeks was the shortest intervention duration for observing benefits on systolic and/or diastolic blood pressure”. They also concluded that patients with hypertension should follow regular drug treatment in conjunction with Qigong practice.
In his book Chinese Medical Qigong Therapy, Volume 3: Differential Diagnosis, Clinical Foundations, Treatment Principles and Clinical Protocols[11], Professor Jerry Allan Johnson refers to literature from China which reveals “ample evidence that the effect of treatments utilizing a combination of Medical Qigong prescription exercises and Western pharmaceutical drugs is superior to that of taking drugs by themselves”. He cites one specific research presented in 1996 conducted on hypertension and cancer patients.
In Qigong theory, the mind guides the Qi, and the Qi guides the blood. When we practice Qigong and use our intention, and our mind to move the Qi in our body, it also affects the flow of blood, oxygen, and other nutrients as well. Furthermore, our practice usually includes both purging exercises which promote the removal of waste products from the cells of the body, and tonifying exercises which increase Qi flow and blood circulation and help nourish diseased or stressed tissue. Dr. Johnson says that “this mechanism suggests that Medical Qigong also could promote drug uptake to tissue and cells via increased blood circulation”.
Diabetes
According to the World Health Organization (WHO)[12], the number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation. In 2019, diabetes was the direct cause of 1.5 million deaths and 48% of all deaths due to diabetes occurred before the age of 70 years.
This chronic disease occurs either when the pancreas does not produce enough insulin (Type 1 diabetes) or when the body cannot effectively use the insulin it produces (Type 2 diabetes). Type 1 diabetes requires daily administration of insulin. Neither its cause nor the means to prevent it are known. However, more than 95% of people with diabetes have type 2 diabetes which is largely the result of excess body weight and physical inactivity.
Without surprise, many studies on Diabetes report better effects of qigong on metabolic control and body composition indicators than clinical conventional therapy. Moreover, one of them indicated that compared to aerobic exercise, "tai chi had benefits over and above aerobic exercise for lowering A1C (average long-term blood sugar levels) and raising hdl (the “good” cholesterol)”[13].
According to Traditional Chinese Medicine (TCM), diabetes is a blood disorder caused mostly by Spleen Qi deficiency and blood deficiency. In TCM, the spleen is central to digestion and is considered a vital organ. The spleen is said to pull Qi from all the foods we eat and deliver the refined food energy to the rest of the body via the blood. If the spleen is deficient and can’t provide the blood with proper nutrients, the consequence will be a blood deficiency. And blood deficiency will in turn affect the liver and eventually cause the accumulation of what is called toxic heat in the body.
Purging Qigong exercises draw down the extra heat out of the body whereas the tonifying Qigong exercises increased the quantity of Qi available in the body or a specific organ such as the spleen. In doing so, the organs are brought back to balance and can therefore function properly. A functional spleen will produce sufficient and nutritious blood.
Depression
Besides the great suffering of people and the impaired functioning in daily life, the burden of mental disorders has significant health, social, and economic consequences in all countries of the world. Depression is a common mental disorder and one of the main causes of disability worldwide. Globally, the estimated number of incident cases of major depressive disorder worldwide increased from 162 million in 1990 to 280 million in 2019 representing an overwhelming increase of 73%. And this was before the Covid-19 pandemic. Since then, The Lancet journal reports anxiety and depression skyrocketed by nearly 30% in the USA whereas other countries see their rate increase by more than 38%[14].
Mental health has an impact on physical health and vice versa. For example, individuals experiencing chronic pain or conditions have higher rates of depression than those who are healthy. Additionally, untreated depression in individuals with chronic conditions can negatively affect its outcome. Depression and other mental health disorders are definitely major public health issues.
A study published in 2019 shows that qigong is effective in reducing symptoms of depression by activating the parasympathetic nervous system[15]. The parasympathetic nervous system is part of the body's autonomic nervous system and controls the body's ability to relax.
Another study published in 2020 this time reveals “preliminary evidence that Tai Chi training can therapeutically affect both somatic (vitality) and mood (depression) symptoms in Major Depressive Disorder (MDD)” [16]. Among those symptoms, fatigue is one of the main problems faced by people affected by the condition. The research highlights that fatigue is not a consequence of low mood, but rather is an independent symptom. “Given that fatigue is not alleviated by antidepressants, this provides strong evidence for the utility of adding Tai Chi as a complementary treatment for Mood Disorder”. Put another way, mind-body practices like Tai Chi and Qigong can provide the same antidepressant benefits as pharmaceuticals yet with side effects only a sense of a better quality of life and an improvement in fatigue level.
Insomnia and sleep disorder are not only caused by depression but often the two are linked to each other. In this Meta-Analysis[17], in addition to concluding that “Qigong is beneficial for quality of life”, the results show that “Qigong is effective in improving sleep quality”. These results are confirmed by a UCLA research[18] showing that in treatment for insomnia “tai chi, a form of slow-moving meditation, is just as effective as cognitive behavioral therapy, which has been considered the “gold standard” treatment, with both showing enduring benefits over one year”.
From a Traditional Chinese Medicine (TCM) perspective, depression is often the result of the suppression of anger. This suppression will cause the circulation of Qi to become obstructed mainly in the liver as a result of Liver Qi stagnation. As blood and Qi move together, chronic Liver Qi stagnation will in turn causes blood stagnation. And blood stagnation is the root cause of certain metabolic process disorders. Moreover, always according to the TCM philosophy, the underlying causes relating to hypertension are Liver Qi stagnation. Liver Qi stagnation manifests from lack of exercise, excessive stress, and unbalanced emotions. This is one of the most common patterns of disharmony observed in Medical Qigong clinics.
As a body-mind-spirit modality, the emphasis of Qigong is on mental, emotional, energetic, and spiritual approaches to healing. Because of that, Medical Qigong therapy has been clinically successfully combined as a complementary treatment for depression.
One of the purposes of Qigong practice is to allow the Qi to circulate freely in the body and therefore dissolve stagnation. From this perspective, it is easy to understand the effectiveness of Qigong in the improvement of depression as shown in the studies described above.
And ...
Many other studies, research, and meta-analysis have been done to prove the effectiveness of Qigong for many different conditions such as menopause, musculoskeletal pain, chronic fatigue, cancer, fibromyalgia, arthritis, Parkinson’s disease, cognitive impairment, and chronic heart failure. Most of them show that the practice of Qigong produces positive results on health, mainly in the medium and long term. However, more rigorous research is needed to provide more reliable evidence to convince concerned people in the field of health to use these complimentary practices with modern medicine.
Qigong in the future
So, the world is sick, but we have the tools required to reduce our suffering. A lot of what we experience as pain, discomfort, disease, and illnesses are the results of our bad choices regarding our lifestyle. If we engage in new healthy behaviors that alleviate the stressful routines of modern life, we can reduce the impacts on our quality of life.
Including Qigong practice in our day-to-day rituals can help us to manage our emotions, boost our immune system and keep us from developing many of the diseases and conditions mentioned in this article. And, even if we do already have diabetes, heart disease, arthritis, or other chronic condition, it can help us better manage the illness, avoid complications and prolong our life.
Energy medicine and other mind-body practices like Qigong “offer potential cost savings, non-invasive diagnosis and treatment, and often better recovery for patients[19]”. According to the National Qigong Association[20], it is already recommended by numerous organizations such as The Harvard Medical School, The Mayo Clinic, The National Council on Aging (NCOA), The National Institute of Health (NIH NCCIH), The American College of Sports Medicine (ACSM) and many physicians.
For me, Qigong doesn’t need any proof. Each moment practicing and feeling the gentle flow of Qi through my body and the global sense of well-being spreading through my mind is sufficient evidence. And testimonies from my students confirm it constantly. And it reminds me of this saying from many teachers: We don’t do Qigong, Qigong does us!
[1] Global expenditure on health: public spending on the rise? Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
[2] https://www.who.int/news-room/fact-sheets/detail/10-facts-on-ageing-and-health
[3] https://apps.who.int/nha/database/ViewData/Indicators/en
[4] Santo L, Okeyode T. National Ambulatory Medical Care Survey: 2018 National Summary Tables. Available from: https://www.cdc.gov/nchs/data/ahcd/namcs_summary/ 2018-namcs-web-tables-508.pdf.
[5] Liye Zou, Jeffer Eidi Sasaki, Huiru Wang, Zhongjun Xiao, Qun Fang, Mark Zhang, "A Systematic Review and Meta-Analysis of Baduanjin Qigong for Health Benefits: Randomized Controlled Trials", Evidence-Based Complementary and Alternative Medicine, vol. 2017, Article ID 4548706, 17 pages, 2017. https://doi.org/10.1155/2017/4548706
[6] https://www.who.int/news-room/fact-sheets/detail/hypertension
[7] Ching SM, Mokshashri NR, Kannan MM, Lee KW, Sallahuddin NA, Ng JX, Wong JL, Devaraj NK, Hoo FK, Loo YS, Veettil SK. Effects of qigong on systolic and diastolic blood pressure lowering: a systematic review with meta-analysis and trial sequential analysis. BMC Complement Med Ther. 2021 Jan 6;21(1):8. doi: 10.1186/s12906-020-03172-3. PMID: 33407414; PMCID: PMC7789757.
[8] Liu D, Yi L, Sheng M, Wang G, Zou Y. The Efficacy of Tai Chi and Qigong Exercises on Blood Pressure and Blood Levels of Nitric Oxide and Endothelin-1 in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2020 Jul 30;2020:3267971. doi: 10.1155/2020/3267971. PMID: 32802122; PMCID: PMC7414352.
[9] Xiaosheng Dong, Zhenguo Shi, Meng Ding, Xiangren Yi, "The Effects of Qigong for Hypertension: A Meta-Analysis of Randomized Controlled Trials", Evidence-Based Complementary and Alternative Medicine, vol. 2021, Article ID 5622631, 10 pages, 2021. https://doi.org/10.1155/2021/5622631
[10] [10] Liye Zou, Jeffer Eidi Sasaki, Huiru Wang, Zhongjun Xiao, Qun Fang, Mark Zhang, "A Systematic Review and Meta-Analysis of Baduanjin Qigong for Health Benefits: Randomized Controlled Trials", Evidence-Based Complementary and Alternative Medicine, vol. 2017, Article ID 4548706, 17 pages, 2017. https://doi.org/10.1155/2017/4548706
[11] JOHNSON, Jerry A., Chinese Medical Qigong Therapy, Volume 3: Differential Diagnosis, Clinical Foundations, Treatment Principles and Clinical Protocols, The International Institute of Medical Qigong, 2002, 568 pages
[12] https://www.who.int/news-room/fact-sheets/detail/diabetes
[13] Guo S, Xu Y, Qin J, Chen Y, You Y, Tao J, Liu Z, Huang J. Effect of tai chi on glycaemic control, lipid metabolism and body composition in adults with type 2 diabetes: A meta-analysis and systematic review. J Rehabil Med. 2021 Mar 22;53(3):jrm00165. doi: 10.2340/16501977-2799. PMID: 33594445; PMCID: PMC8814847.
[14] Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic
DOI: https://doi.org/10.1016/S0140-6736(21)02143-7
[15] So WWY, Cai S, Yau SY, Tsang HWH. The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for Depression: A Systematic Review and Meta-Analysis. Front Psychiatry. 2019 Nov 18;10:820. doi: 10.3389/fpsyt.2019.00820. PMID: 31824346; PMCID: PMC6880657.
[16] Xu Anna, Zimmerman Chloe S., Lazar Sara W., Ma Yan, Kerr Catherine E., Yeung Albert
Distinct Insular Functional Connectivity Changes Related to Mood and Fatigue Improvements in Major Depressive Disorder Following Tai Chi Training: A Pilot Study ; Frontiers in Integrative Neuroscience; VOLUME 14 ; 2020; https://www.frontiersin.org/article/10.3389/fnint.2020.00025 DOI=10.3389/fnint.2020.00025 ISSN=1662-5145
[17] Liye Zou, Jeffer Eidi Sasaki, Huiru Wang, Zhongjun Xiao, Qun Fang, Mark Zhang, "A Systematic Review and Meta-Analysis of Baduanjin Qigong for Health Benefits: Randomized Controlled Trials", Evidence-Based Complementary and Alternative Medicine, vol. 2017, Article ID 4548706, 17 pages, 2017. https://doi.org/10.1155/2017/4548706
[18] https://newsroom.ucla.edu/releases/tai-chi-relieves-insomnia-in-breast-cancer-survivors
[19] Schuldt, Hartwig. "Bio-energetic medicine is sufficiently mature to be incorporated into standard medical practice." Townsend Letter for Doctors and Patients, no. 228, July 2002, pp. 78+. Gale Academic OneFile, link.gale.com/apps/doc/A87719994/AONE?u=anon~ea7269f7&sid=googleScholar&xid=5d215ca6. Accessed 5 May 2022.
[20]https://www.nqa.org/index.php?option=com_dailyplanetblog&view=entry&year=2018&month=05&day=01&id=7:tools-for-teachers-what-is-qigong-handout
