External qigong for chronic pain.
ABSTRACT External qigong as a pharmacotherapy adjunct was investigated in 50 subjects with chronic pain (pain lasting > 3 months with pain score of > or = 3 on 0-10 numeric analog scale) who presented to a qigong healing center. Participants were randomized to receive either external qigong treatment (EQT) or equivalent attention time (EAT) in weekly 30-min sessions for four consecutive weeks. Outcomes were assessed before and after sessions. The primary outcome measure was intensity of pain by a 10-cm visual analog scale used to rate all pain severity measurements. At 8-week follow-up, participants were contacted by telephone and mailed a questionnaire. Most had experienced pain for > 5 years (66%); the rest, for > 3 to 5 years (8%), 1 to 3 years (10%), or < 1 year but > 3 months (10%). The most frequent concomitant diagnoses were multifactorial (26%), osteoarthritis (18%), and low back pain (12%). Most patients were also receiving other treatments (74%); none previously had EQT. Participants were randomly assigned to EQT (n = 26) or EAT (n = 24). These groups had no significant differences at baseline except for prior awareness of qigong (EQT 31% vs. EAT 63%; p = 0.025). Compared to the EAT group, EQT participants had a significant decrease in pain intensity in the 2nd (p = 0.003), 3rd (p < 0.001), and 4th weeks of treatment (p = 0.003). At week 8, these differences in overall decreased pain intensity persisted but were not statistically significant.
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ABSTRACT: The objective of this review was to summarize and critically evaluate the clinical evidence of the effect of qigong exercise on immunity and its efficacy in the prevention or treatment of infectious diseases. Thirteen databases were searched from their respective inceptions through January 2011, and all controlled clinical trials of qigong exercise on immunity and infections were included. Quality and validity of the included studies were evaluated using standard scales. Seven studies including two randomized controlled trials (RCTs), two controlled clinical trials (CCTs) and three retrospective observational studies (ROSs) met the inclusion criteria. One study focused on functional measures of immunity (antigen-induced immunity) and six studies on enumerative parameters of immunity. No study on clinical symptoms relevant to infectious diseases could be identified. Overall, the included studies suggested favorable effects of qigong exercise on immunity, but the quality of research for most of the studies examined in this review was poor. Further rigorously designed studies are required, which should adhere to accepted standards of methodology for clinical trials.The American Journal of Chinese Medicine 01/2012; 40(6):1143-56. · 2.63 Impact Factor
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ABSTRACT: In this paper, we carried out a randomized controlled clinical trial to explore the effect of 12-words-for-life-nurturing exercise on patients presenting with cervical spondylosis. After exercise intervention, the mean VAS and NDI scores of the patients decreased significantly and the scores of BP, VT, and MH in SF-36 Health Questionnaire were significantly higher. Exercise therapy showed significant effect on relieving pain and improving vitality and mental health. The 12-words-for-life-nurturing exercise may be a potential effective therapy for patients with cervical spondylosis.Evidence-based Complementary and Alternative Medicine 01/2014; 2014:961418. · 2.18 Impact Factor
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ABSTRACT: Qigong has been used as a complementary therapy to improve different health-related problems. This study aims to test the effects of Qigong on quality of life, pain and depressive symptoms in older hospitalized patients.Aging - Clinical and Experimental Research 06/2014; · 1.01 Impact Factor
External Qigong for Chronic Pain
Ann Vincent,*Jamia Hill,xKelly M. Kruk,y
Stephen S. Chazand Brent A. Bauer*
*Division of General Internal Medicine
yCollege of Medicine
zThe Division of Biomedical Informatics and Biostatistics
Mayo Clinic, Rochester, Minnesota
xThe Department of Epidemiology
University of Minnesota, Minneapolis, Minnesota
Abstract: External qigong as a pharmacotherapy adjunct was investigated in 50 subjects with
chronic pain (pain lasting > 3 months with pain score of ? 3 on 0–10 numeric analog scale)
who presented to a qigong healing center. Participants were randomized to receive either
external qigong treatment (EQT) or equivalent attention time (EAT) in weekly 30-min
sessions for four consecutive weeks. Outcomes were assessed before and after sessions. The
primary outcome measure was intensity of pain by a 10-cm visual analog scale used to rate
all pain severity measurements. At 8-week follow-up, participants were contacted by tele-
phone and mailed a questionnaire. Most had experienced pain for > 5 years (66%); the rest,
for > 3 to 5 years (8%), 1 to 3 years (10%), or < 1 year but > 3 months (10%). The most
frequent concomitant diagnoses were multifactorial (26%), osteoarthritis (18%), and low
back pain (12%). Most patients were also receiving other treatments (74%); none previously
had EQT. Participants were randomly assigned to EQT (n = 26) or EAT (n = 24). These
groups had no significant differences at baseline except for prior awareness of qigong (EQT
31% vs. EAT 63%; p ¼ 0:025). Compared to the EAT group, EQT participants had a
significant decrease in pain intensity in the 2nd (p ¼ 0:003), 3rd (p < 0:001), and 4th weeks
of treatment (p ¼ 0:003). At week 8, these differences in overall decreased pain intensity
persisted but were not statistically significant.
Keywords: Osteoarthritis; Pain; Pain Clinics; Pain, Intractable; Pain Measurement.
In contrast to acute pain, which is a protective mechanism, chronic pain can endure for
months or even years past the typical time needed to heal from an injury or illness
Correspondence to: Dr. Ann Vincent, Division of General Internal Medicine, Mayo Clinic, 200 First St SW,
Rochester, MN 55905, USA. E-mail: firstname.lastname@example.org
The American Journal of Chinese Medicine, Vol. 38, No. 4, 695–703
© 2010 World Scientific Publishing Company
Institute for Advanced Research in Asian Science and Medicine
(American Chronic Pain Association, 2009). The extent and impact of chronic pain on both
quality of life and the health care economy are significant. Chronic pain is estimated to be
the most common condition impairing quality of life (Bonica, 1990). The socioeconomic
impact of chronic pain in 1994 was estimated to be $15,000 to $24,000 per patient per year
(Latham and Davis, 1994).
Despite the availability of multiple modalities to address chronic pain, many patients
with chronic pain are still inadequately treated and turn to complementary and alternative
medicine therapies for management of symptoms (Rosenberg et al., 2008).
Qigong refers to several modalities from traditional Chinese medicine that deals with
energy exercises and treatments to regulate the flow of vital energy [qi (also known as
“chi”)] in the body. Qigong can be subdivided into internal and external qigong. Internal
qigong refers to individual practices and exercises to achieve optimal dynamic mind-body
integration. External qigong refers to practices in which a qigong practitioner directs energy
toward an individual to improve the flow of qi or to treat a condition. A recent systematic
reviewof external qigong for pain conditions reported preliminary positive observations and
highlighted the need for controlled clinical trials (Lee et al., 2007). The purpose of our study
was to evaluate the effectiveness of external qigong treatment (EQT) compared with
equivalent attention time (EAT) as an adjunct in the management of chronic pain.
Design and Setting
We conducted an 8-week randomized controlled clinical trial at a single site, after approval
by the institutional review board of the University of Minnesota. Participants were ran-
domized to receive four weekly 30-min sessions of EQT or EAT for four consecutive
weeks as an adjunct treatment for chronic pain.
All 50 participants were recruited from those who called the Spring Forest Qigong (SFQ)
Center, in Minneapolis, Minnesota, to make an initial appointment for external qigong. The
SFQ receptionist asked callers if they suffered from chronic pain. Those who responded
positively to the question were offered the opportunity to participate in the study and, with
the subject’s permission; their information was provided to one of the study personnel.
Study personnel contacted participants within 24 hours to explain the study, answer
questions, and assess whether they met the inclusion criteria.
Eligibility criteria included (1) age 18 years or older; (2) pain experienced for at least
3 months; (3) reported severity of ? 3 on a numeric analog scale for pain ranging from
0 to 10; (4) no active plans to change the pain management strategy over the next 2 to
3 months; (5) ability to read and understand English; and (6) agreement to participate in the
four weekly visits. All participants signed an informed consent form. Recruitment statistics
are summarized in Fig. 1.
696A. VINCENT et al.
The study used a stratified randomization technique. Prior to randomization, participants
were classified by pain intensity and sex. Pain intensity was measured using a visual analog
scale (VAS), with the subject asked to rate the severity of pain by drawing a mark across a
Figure 1. Recruitment statistics.aOne patient had emergency surgery before week 2 visit, and one failed to keep
appointments at weeks 2 and 3.bOne patient withdrew after randomization, and one was hospitalized for infection
before week 3 visit.
EXTERNAL QIGONG FOR CHRONIC PAIN 697
10-cm line; this self-reported pain was categorized as less severe (< 6cm) or more severe
pain (? 6cm), based on the length of the subject’s mark along the VAS line (from left to
right). Members of each stratum were then randomly assigned to one of two groups. The
EQT, or intervention group, was monitored before and after four weekly qigong therapies.
The EAT, or control group, was monitored before and after four weekly conversational
After participants were assigned to EQT or EAT, they completed baseline questionnaires
that elicited demographic information and information regarding their current illnesses,
medications, and treatment modalities. Blood pressure and pulse rate were also measured at
that time. The participants reported their current level of pain with the VAS, and they were
also asked to rate the average pain intensity they experienced during the past week. A
short-form McGill Pain Questionnaire (SF-MPQ) and a Profile of Chronic Pain Screening
Questionnaire (PCPS) were also administered. Four weekly visits were then set up for each
participant to come to the SFQ center for EQT or EAT. At each visit, the participant met
with a researcher for 15 min before and after the session during which data were collected;
these included medication changes, VAS score for current pain, blood pressure, and pulse
rate. Regardless of which group patients were randomized to, all participants received
a follow-up phone call and a mailed questionnaire approximately four weeks after their last
in-person assessment visit.
External Qigong Treatment
The intervention being evaluated was EQT. The qigong therapists were both certified
international qigong masters, one of whom is the founder and creator of SFQ. There are no
specific methods for EQT, in which the master uses his or her ability and knowledge to
improve the flow of qi for the client seeking help. Typically, the practitioner will lightly
touch the patient’s body, or simply pass his or her hands over the patient, using a technique
such as Bellows Palm to help guide the qi (International Institute of Medical Qigong,
Equivalent Attention Time
For the control group, an investigator engaged each participant in conversation and pro-
vided full attention to the participant for 25 to 30min. After completion of the four weeks
of assessment visits, the control group (which was both a matched time of attention group
and a delayed treatment group) received four weekly qigong sessions at SFQ. These visits
did not include any monitoring from the researcher.
698A. VINCENT et al.
In compensation for their time, each participant received a 50% discount off the usual fee
for EQT for each of their four qigong visits. This represented a discount of approximately
$200 for each participant.
The primary outcome measure was the VAS score for pain intensity. Additional outcome
measures included pain quality measurements (SF-MPQ and PCPS), blood pressure, and
pulse rate. These were measured at baseline, week 4, and week 8. Blood pressure and pulse
rate were also measured at baseline, as well as at the start and the end of each of the four
VAS pain severity, blood pressure, and pulse rate before and after intervention (EQT or
EAT) were compared between the treatment and the control groups, as was weekly average
pain over time. Changes in pain severity (VAS scores) were compared using the t-test.
Additionally, alterations in medication, dose, or frequency, any changes in reported treat-
ment modalities, and the Patient’s Global Impression of Change (PGIC) were noted and
compared between the two groups. Finally, changes in the SF-MPQ and PCPS were
the two groups in terms of pain quality, emotional burden, and pain-caused functional
limitations, as well as by treatment or medication changes during the course of the study.
The sample size (n ¼ 50) was selected to provide sufficient power to demonstrate statistical
significance for differences (in mean change of pain intensity scores) of ? 33% when the
two study groups (EQT and EAT) were compared. Changes in pain intensity scores of this
magnitude were deemed to be clinically significant.
The median age of the 50 participants, of whom 37 (74%) were women, was 56.5 years
(range, 27–86 years). Forty-nine were white; one was Hispanic. Most had pain for > 5
years (66%); 8%, for 3 to 5 years; and 10%, respectively for 1 to 3 years and < 1 year but
> 3 months. The most frequent diagnoses associated with chronic pain were: (1) multi-
factorial (26%), (2) osteoarthritis (18%), and (3) low back pain (12%). Most of the patients
were receiving other pain treatments (74%), and none had ever experienced EQT.
EXTERNAL QIGONG FOR CHRONIC PAIN699