|Qigong practitioners at World Tai Chi and Qigong Day event in Manhattan, New York City, USA.|
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Qigong, chi kung, or chi gung (simplified Chinese: 气功; traditional Chinese: 氣功; pinyin: qìgōng; Wade–Giles: chi4 gong1; literally "Life Energy Cultivation") is a practice of aligning breath, movement, and awareness for exercise, healing, and meditation.1 With roots in Chinese medicine, martial arts, and philosophy, qigong is traditionally viewed as a practice to cultivate and balance qi (chi) or what has been translated as "intrinsic life energy".2 Typically a qigong practice involves rhythmic breathing coordinated with slow stylized repetition of fluid movement, a calm mindful state, and visualization of guiding qi through the body.3 Qigong is now practiced throughout China and worldwide, and is considered by some to be exercise, and by others to be a type of alternative medicine or meditative practice.4 From a philosophical perspective qigong is believed to help develop human potential, allow access to higher realms of awareness, and awaken one's "true nature".5
The overall evidence for the health effects of qigong has been largely inconclusive or contradictory. Because the underlying clinical trials have been poorly designed and the data of poor quality, it is not possible to come to any firm conclusions as to the health effects of qigong.6
Qi (or chi) is usually translated as life energy, lifeforce, or energy flow, and definitions often involve breath, air, gas, or relationship between matter, energy, and spirit.7 Qi is the central underlying principle in traditional Chinese medicine and martial arts. 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. (see MDBG dictionary entry) The two words are combined to describe systems to cultivate and balance life energy, especially for health.1
Although the term qigong (氣功) has been traced back to Taoist literature of the early Tang Dynasty (618-907 AD), 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 and scientific approaches, while de-emphasizing spiritual practices, mysticism, and elite lineages.8910
With roots in ancient Chinese culture dating back more than 4,000 years, a wide variety of qigong forms have developed within different segments of Chinese society:11 in traditional Chinese medicine for preventive and curative functions,12 in Confucianism to promote longevity and improve moral character,1 in Taoism and Buddhism as part of meditative practice,5 and in Chinese martial arts to enhance fighting abilities.913 Contemporary qigong blends diverse and sometimes disparate traditions, in particular the Taoist meditative practice of "internal alchemy" (Neidan 內丹术), the ancient meditative practices of "circulating qi" (Xing qi 行氣) and "standing meditation" (Zhan zhuang 站桩), and the slow gymnastic breathing exercise of "guiding and pulling" (Tao yin 導引). Traditionally, knowledge about qigong was passed from adept master to student in elite unbroken lineages, typically with secretive and esoteric traditions of training and oral-mind transmission.14
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. This attempt is considered by some sinologists as the start of the modern or scientific interpretation of qigong.151617 During the Great Leap Forward (1958–1963) and the Cultural Revolution (1966–1976), qigong, along with other traditional Chinese medicine, was encouraged in state-run rehabilitation centers and spread to universities and hospitals, but was under tight control with limited access among the general public. 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 eras of the 1970s through 1990s, with estimates of between 60 and 200 million practitioners throughout China. In 1985, the state-run "National Qigong Science and Research Organization" was established to regulate all of the nation's qigong denominations.18 In 1999, in response to widespread revival of old traditions of spirituality, morality, and mysticism, the Chinese government took measures to enforce control of public qigong practice, including banning groups such as Zhong Gong and Falun Gong.1920
Through the forces of migration of the Chinese diaspora, tourism in China, and globalization, 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 exercise, recreation, preventive medicine, self-healing, self-cultivation, meditation, and martial arts training.
Qigong comprises breathing, physical, and mental training methods based on Chinese philosophy.21 While implementation details vary, all qigong forms can be characterized as a mix of four types of training: dynamic, static, meditative, and activities requiring external aids.
- Dynamic training
- 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.22 Other examples include graceful movement that mimics the motion of animals in Five Animals,23 White Crane,24 and Wild Goose (Dayan) Qigong.2526
- Static training
- involves holding postures for sustained periods of time.27 In some cases this bears resemblance to the practice of Yoga and its continuation in the Buddhist tradition.28 For example Yiquan, a Chinese martial art derived from xingyiquan, emphasizes static stance training.29 In another example, the healing form Eight Pieces of Brocade (Baduanjin qigong) is based on a series of static postures.30
- Meditative training
- utilizes breath awareness, visualization, mantra, and focus on philosophical concepts such as qi circulation.31 For example, in the Confucius scholar tradition meditation is focused on humanity and virtue, with the aim of self-enlightenment. 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, emptiness, or the idea of the eternal. In Taoist and traditional Chinese medicine practice, the meditative focus is on cultivating qi in dantian energy centers and balancing qi flow in meridian and other pathways.11
- Use of external agents
- Many systems of qigong training include the use of external agents such as ingestion of herbs, massage, physical manipulation, or interaction with other living organisms.5 For example, specialized food and drinks are used in some medical and Taoist 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.32
People practice qigong for many different reasons, including for exercise and recreation, prevention and self-healing, meditation and self-cultivation, and training for martial arts.
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, and building awareness of how the body moves through space.3 In recent years a large number of books and videos have been published that focus primarily on qigong as exercise and associated health benefits. Practitioners range from athletes to the physically challenged. Because it is low impact and can be done lying, sitting, or standing, qigong is accessible for disabled persons, seniors, and people recovering from injuries.
As a healing art, qigong practitioners focus on prevention and self-healing, traditionally viewed as balancing the body's energy meridians and enhancing the intrinsic capacity of the body to heal.12 Qigong has been used extensively in China as part of traditional Chinese medicine, and is included in the curriculum of Chinese Universities.33 Qigong is now recognized as a form of complementary and alternative medicine.3435
There are three main forms of qigong used to complement medical treatment: 1) Qigong exercises (also called "internal Qigong") performed by individuals for general health or treatment of disease, 2) Qigong massage by a trained Qigong practitioner to treat specific injuries and illnesses (e.g. autism);36 and 3) External qigong in which a trained practitioner focuses healing energy on patients without touching them.37
Qigong is practiced for meditation 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.5 Many practitioners find qigong, with its gentle focused movement, to be more accessible than seated meditation.4
Qigong for self-cultivation can be classified in terms of traditional Chinese philosophy:
The practice of qigong is an important component in both internal and external style Chinese martial arts.5 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, and Baguazhang are representative of the types of Chinese martial arts that rely on the concept of qi as the foundation. 42 Extraordinary feats of martial arts prowess, such as the ability to withstand heavy strikes (Iron Shirt, 鐵衫) 43 and the ability to break hard objects (Iron Palm, 铁掌) 44 45 are abilities attributed to qigong training.
In 2003, the Chinese Health Qigong Association officially recognized four health qigong forms:46
- Muscle-Tendon Change Classic (Yì Jīn Jīng 易筋经).4748
- Five Animals (Wu Qin Xi 五禽戲).49
- Six Healing Sounds (Liu Zi Jue 六字訣).50
- Eight Pieces of Brocade (Ba Duan Jin 八段錦).51
In 2010, the Chinese Health Qigong Association officially recognized five additional health qigong forms:52
- Tai Chi Yang Sheng Zhang (太极养生杖): a tai chi form from the stick tradition.
- Shi Er Duan Jin (十二段锦): seated exercises to strengthen the neck, shoulders, waist, and legs.
- Daoyin Yang Sheng Gong Shi Er Fa (导引养生功十二法): 12 routines from Daoyin tradition of guiding and pulling qi.
- Mawangdui Daoyin (马王堆导引术): guiding qi along the meridians with synchronous movement and awareness.
- Da Wu (大舞): choreographed exercises to lubricate joints and guide qi.
Other commonly practiced qigong styles and forms include the following:
- Soaring Crane Qigong53
- Wisdom Healing Qigong54
- Pan Gu Mystical Qigong55
- Wild Goose Qigong56
- Dragon and Tiger Qigong57
- Primordial Qigong (Wujigong)5859
Traditionally, the central focus of qigong practice is to cultivate and balance qi as it affects mind (心), body (身), and spirit (靈).1160 In Chinese philosophy, the concept of qi as a form of pervasive life energy includes original qi that a person has at birth, and qi a person acquires from air, water, food, sunlight, and interaction with the environment.6162 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.
Traditional Chinese medicine focuses on tracing and correcting underlying disharmony, in terms of deficiency and excess, using the complementary and opposing forces of yin and yang, 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, 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 in the context of the traditional system of Five Phases (Wu xing 五行).1112 These traditional concepts do not translate readily to modern science and medicine.
- 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
- 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
- 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.
Similar to the subject of efficacy of Traditional Chinese medicine, the chasm between the Eastern tradition of qi and the Western scientific viewpoints is not insurmountable if the analysis is limited to the effect of qigong practice on biological processes without demanding a material interpretation of qi. Some have argued for an interpretation of qi as a metaphor for biological processes 6364 or as part of the field of energy medicine.65
Qigong has been purported to enhance health and well-being with many benefits, including improving cardiovascular function, healing specific acute diseases, and increasing longevity.1 Many of these claims are supported only by anecdotal evidence, traditional lore, and teachings in master/student lineages.14 Research examining health benefits of qigong is increasing, but there is little financial incentive to support research and still only a limited number of studies meet accepted medical and scientific standards of randomized controlled trials (RCT).66 Overall, the evidence for the health effects for qigong has been largely inconclusive or contradictory, with almost all evidence based on poor quality data, making any firm conclusions impossible to reach.6
A systematic review of the effect of qigong exercises on hypertension found that the available studies were encouraging for the exercises to lower systolic blood pressure. However, an analysis of the studies that found these results showed that they were of relatively poor quality, with the lack of blinding raising the possibility of bias in the results, so no definitive conclusions could be reached.67
A 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." 68 Another systematic review which focused on external qigong and its effect on pain, concluded "that evidence for the effectiveness of external qigong is encouraging, though further studies are warranted" due to the small number of studies and participants involved which precluded any firm conclusions about the specific effects of qigong on pain.69
A systematic review of the effect of qigong exercises on cancer treatment concluded "the effectiveness of qigong in cancer care is not yet supported by the evidence from rigorous clinical trials."70 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 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."71
A 2010 literature review of qigong and tai chi exercises found positive results for qigong and tai chi in nine categories, including bone density, cardiopulmonary effects, physical function, falls and related risk factors, quality of life, self efficacy, patient reported outcomes, psychological symptoms, and immune function and inflammation. Studies that compared qigong and tai chi with other physical exercises found similar effects, and greatest effects were found in studies that compared qigong and tai chi to effects in low activity or inactive participants. Unlike the above systematic reviews, this study did not assess for the quality of the underlying trials.66
Many claims have been made that qigong can benefit or ameliorate mental health conditions,6672 including improved mood, decreased stress reaction, and decreased anxiety and depression. Most medical studies have only examined psychological factors as secondary goals, however various studies have shown significant benefits such as decrease in cortisol levels, a chemical hormone produced by the body to manage stress.66 There are also claims that in some cases, in particular with improper teaching or improper technique, the practice of qigong can result in a mental condition known as Zou huo ru mo (走火入魔) or "qigong deviation" (氣功偏差), which, among other symptoms, can lead to a perception of an uncontrolled flow of qi in the body during or after practice.737475
There is little controversy concerning the benefit of qigong when the definition of qigong is limited to a series of physical movements and a set of relaxation exercises. Conflict has arisen when the claims made by proponents of qigong border on the supernatural.876
Some researchers have labeled the subject matter of qigong as a pseudoscience.77 In addition, some claim that the origin and nature of qigong practice has led to misconceptions and misuses,78 including psychiatric problems17 and the formation of cults8
Skepticism towards qigong is also applied to the field of Traditional Chinese medicine, and extended to the broader subject of alternative medicine. The basic problem is that the information available from those fields does not fit scientific acceptability or medical interpretation. 77787980 81 82 Skeptics contend that most of the benefits derived from Alternative medicine are, at best, derived from a placebo effect.83 84
The main arguments from the view of skeptics against the correlation between qigong practices and health-related results are:
- The existence of qi, or any form of vitalism, has not been independently verified in an experimental setting. Such a concept is not recognized in the biological sciences.85
- Demonstrations in martial arts such as breaking hard objects with strikes can be fully explained using physics, without reference to the concept of qi.8687
- Reported claims of supernatural abilities appear to be tricks more suited to magic shows than to any genuine scientific discipline.88889909192
- Personal benefits for some qigong masters might have provided them with an incentive to exaggerate their claims.8
Traditionally, qigong training has been esoteric and secretive, with knowledge passed from adept master to student in lineages that maintain their own unique detailed interpretations and methods.14 Over the centuries, a diverse spectrum of qigong forms developed in different segments of Chinese society,9 with emphasis on meditative practice by scholars, and gymnastic or dynamic practice by the working masses.93 Disparate approaches to qigong were merged as part of the cultural change that occurred as China modernized.15 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.810
Qigong is now practiced by millions worldwide, primarily for its health benefits, though many practitioners have also adopted traditional philosophical, medical, or martial arts perspectives, and even use the long history of qigong as evidence of its effectiveness.411
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