Spring Forest QiGong: More deceptively presented scientific research on External Qi Healing

Posted on by

Drinking tea with local young man who reminds me much of myself twenty years ago, the concept of External Qi Healing came up.  He was under the impression that research has verified the ability of healers to emit energy and have a definite effect upon disease at a distance.  Since I’ve spent quite a bit of time and money exploring this issue, and have written about it in some detail (I have a longer piece in draft form analyzing even more External Qi Healing research), I shared my own skeptically inquisitive view with him.  I encouraged him to e-mail me the link to the research he had seen.

It didn’t take long to look at, and my recent reading of _Snake Oil Science_ and _Trick or Treatment_ were very helpful for evaluating the research structure and claims.  Here’s my response to him, followed by some more thoughts this triggered:
It’s a shame they didn’t put the full abstract of the study on their site.  I found it on pubmed.com, the best online resource for research abstracts.  Here’s the link: http://www.ncbi.nlm.nih.gov/pubmed/20626055.  Here’s the end result:
“At week 8, these differences in overall decreased pain intensity persisted but were not statistically significant.”
Here’s what they put on their promotional site where they sell their courses:
“Subjects with chronic pain who received external qigong experienced reduction in pain intensity following each qigong treatment. This is especially impressive given the long duration of pain (>5 years) in the most of the participants,” writes lead author Ann Vincent, MD, MBBS, Mayo Clinic, Rochester, Minnesota.
I suspect you can see the problem with that sort of deceptive presentation.  The research not only failed to prove the existence of external Qi healing, but was ultimately shown to be no different than the “Equivalent Attention Time” placebo group.  The differences in reported pain just after the External Qi treatment are probably due to the more convincing healing ritual of External Qi movements and attitude over the ‘EAT’ group.  If anything, this study shows that it doesn’t work.  Bummer.  If they put the whole study text there, we could learn more about what the EAT group did.
My post on the External Qi for Knee pain “research” is very revealing about the deceptive conclusions proponents draw from research that actually shows no effect or is poorly designed.
One of my local people gave me a copy of the Spring Forest QiGong course she bought.  She died of cancer a couple years ago.  I don’t know if she was relying on QiGong or other “natural” therapies for her cancer.
Here’s the abstract (same as the above link):

 Am J Chin Med. 2010;38(4):695-703.

External qigong for chronic pain.

Source

Mayo Clinic, Rochester, Minnesota 55905, USA. vincent.ann@mayo.edu

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.
The studies on internal Qi practice should show difference, as meditation and gentle exercise have well-known positive effects, especially if someone believes they will help their health.  Self-reports of improvement by people with serious mental illnesses are not the most objective measure of how effective something is, and it shows nothing about the existence of external Qi.
The last study they use on that page has not been published in a decent journal (i.e. it’s not on Pubmed) which often means it was poorly done.  However, they did put an abstract up there.  It involved 39 people, but they don’t say how big the various groups were (showing that at minimum it was a poorly written up study).  But the last line, where they report on the differences between the group that just did internal Qi exercises and the group that also got external Qi transmission, is the important conclusion:

ABSTRACT

A pilot study with 39 subjects suffering from DSM-IV diagnosis of Major Depression, Dysthymia or Bipolar Disorder were treated with the Eastern Traditional Chinese Medicine technique of qigong. Treatment included qi emission treatment by qualified practitioners, and subjects were required to practice qigong exercise for a two-month period. Significant improvement was observed, especially in the first month on the measurements of Beck’s Depression Index-Revised (BDI-R) (.0000) and Symptom Checklist -90 R (SCL-90-R) Depression Index (.00003), Interpersonal Sensitivity (.00003). SCL-90 Somaticism indexes as well as three criteria from DSM-IV guidelines are also reported on indicating an overall trend of improvement over time. All subjects improved over the treatment period and it is determined that the qigong exercise is a highly effective complementary and alternative treatment modality for depression and should be considered as an adjunct to psychotherapy treatment. No significant difference was seen in those subjects treated with qi emission.

So from this page, the 2 studies which actually looked at external Qi healing both actually concluded that there was no real effect from it.  Temporary effects in the first study were most likely from an unconvincing placebo (this is called poor blinding in a study, if the subjects figure out that they are in the ‘placebo’ vs ‘active’ group).
Feel free to send me more links/abstracts to look at!
I just finished reading a few great books on research design specific to acupuncture and alternative medicines.  Very interesting and enlightening stuff.
Regards,
Kevin
—
This led me to look around on some other sites that came up promoting External Qi emission therapy as backed by research.  One of this is the Institute of Medical Qi Gong.  Jerry Alan Johnson has published some very thick textbooks of Medical Qi Gong, so it seems he would have some good research links.

Dear Jerry/Medical QiGong Institute,

I’m an acupuncturist and have been certified to teach 2 different types of Qi Gong after much study (Soaring Crane with Professor Chen Hui-Xian and Mantak Chia’s system).  Yet I remain unconvinced of the reality of Qi Emission, and most of the research I’ve seen has been negative, of poor quality, or not detailed enough to evaluate or reproduce the methods.
I looked at your research resources page, but virtually all of the research links are dead:
Could you please direct me to (or e-mail me) the best research available supporting the existence of the Qi Emission phenomenon?
I have no doubt about the benefits of standard internal Qi Gong exercises.  I am writing about the history, philosophy, and research around Taoism and Chinese medicine, and may reference your institute, books, or e-mailed responses if I find useful info from them.
Thanks!
Kevin
I’ll let you know when I hear back from them.
I surfed around Spring Forest Qi Gong some more.  Here are a few snippets of what they’re about:
Of course it’s interesting to know what the cost is for learning these miraculous techniques which are unfortunately not supported by any research showing they work:
Going back to their research page, I see they have a PDF of Qi Gong research abstracts.  That’s worth a lock, let’s check it out (at first I didn’t realize how long this PDF was, so the rest of this post is just the first part):
The first study concludes:

The active exercise and the meditation aspects of SFQ are effective self-care modalities for persons with perceived chronic physical pain and/or emotional distress.

CONCLUSIONS: Subjects (n = 86) demonstrated significant improvement both statistically and anecdotally during the study period. Clinical relevance : Findings indicate that health care providers could promote this promising evidenced-based modality for adults to actualize health promotion practices.

Critical notes:  This didn’t compare Spring Forest Qi Gong to anything else.  It’s unsuprising that exercise and meditation helps stress and chronic pain.  This hardly qualifies the whole Spring Forest Qigong system to be called “evidence-based” when it also teaches “energy operations” with a “Message knife” apparently for cancers, etc.
The second study:

Qigong versus exercise versus no therapy for patients with chronic neck pain: a randomized controlled trial…

 

RESULTS: A total of 123 patients (aged 46 ± 11 years,
88% women) suffering from chronic neck pain for 3.2 (SD ± 1.6) years were included. After 6 months, a significant difference was seen between the qigong and waiting
list control groups (VAS mean difference: -14 mm [95%CI = -23.1 to -5.4], P = 0.002). Mean improvements in the exercise group were comparable to those in the qigong group (difference between groups -0.7 mm [CI = -9.1 to 7.7]) but failed to show statistical significance (P = 0.092). Neck pain and disability, and SF-36 results also yielded superiority of qigong over no treatment and similar results in the qigong and exercise therapy groups.

CONCLUSION: Qigong was more effective than no treatment in patients with chronic neck pain. Further studies could be designed without waiting list control and should use a larger sample to clarify the value of qigong compared to exercise therapy.

 Critical notes:  What this study actually concluded is that regular exercise is just as effective as Qigong exercises for neck pain.  The subjects got no extra benefit from visualizing energy or accepting the other belief systems packaged together with Spring Forest Qigong.  See how their conclusion skewed this finding to promote Qigong?
The third study:

Tai chi Qigong improves lung functions and activity tolerance in COPD clients: a single blind, randomized controlled trial…

NTERVENTION: In total, 206 COPD clients were randomly assigned into one of the three groups, namely, TCQ, exercise, and control group. Subjects in the TCQ group received a TCQ program consisting of two 60-min sessions each week for three months. Subjects in the exercise group

were taught to practice breathing techniques combined with walking as an exercise. Subjects in the control group were instructed to maintain their usual activities. Data collection was performed at baseline and at the 6-week and 3-month marks…

CONCLUSION: Tai chi Qigong was able to improve respiratory functions and activity tolerance level in COPD clients. The breathing and walking exercise helped maintain lung functions and slow down disease progression.

Critical notes:  This study showed that no exercise is bad for your breathing ability, walking and deep breathing are better, and Tai Chi exercises are better than just walking.  This is unsurprising, and it seems like the effort it took to do this research could have looked at a more useful question, like perhaps a group taught to do Tai Chi movements without internal energy visualizations and another group who also did the internal energy Qigong with the same Tai Chi movements.

The fourth study:

Effects of Qigong in Promoting Health of the Wheelchair-Bound Older Adults in Long-Term Care Facilities…

Study design was quasi-experimental, pre-post test, nonequivalent control group. Participants comprised a convenience sample of
72 wheelchair-bound older adults (qigong = 34; control
= 38). The qigong group exercised 35 min/day, 5 days/ week for 12 weeks…

Notes:  This compared the effects of doing exercises (and getting the attention and social interaction that went along with being in the active group) against not doing exercises or getting attention.  Again, totally unsurprising that the exercises and attention led to health benefits.  Once more, this shows absolutely nothing special about Qi Gong or external Qi healing.  The study wasn’t really designed to produce any new or useful insights, it only was done to promote Qigong.

The fifth study:

Functional and psychosocial effects of health qigong in patients with COPD: a randomized controlled trial…

PARTICIPANTS: Eighty (80) patients with COPD receiving conventional PRP pulmonary rehabilitation program were randomized to the HQG intervention group (n = 40) and control group (n = 40)…

RESULTS: Intention-to-treat analysis identified trends of improvement in all outcome measures in the HQG group, whereas lesser improvement and trends of deteriorations were identified in the control group. Ancillary analysis using a per-protocol method, however, identified significantly better improvements in functional capacity measures among the HQG at the 6-month FU.

Critical notes:  This abstract doesn’t note if the control group was taught any ‘normal’ exercises to do or if they just sat around.  This is an example of why a “three arm” study design is now considered essential to get any useful data:  one group is control/nothing, one group is the intervention being studied, and the third group is a placebo designed to mimic the intervention but missing some important piece (such as internal energy visualizations).  However, the setup for this study suggested that compliance in maintaining an exercise therapy is an issue in continuing results.  I wouldn’t be surprised if patients (especially in an Asian culture) were more likely to continue with a fun, exciting exercise therapy than a boring, stale routine.  Some types of Qigong are too rigid and repetitive or too complicated to memorize.  Teachers who caution their students that doing the routines wrong is harmful may be scaring them away from continuing the practice.  Fun, easy exercise routines without superstitious warnings are going to be better for mental and physical health.

The sixth study:

The qigong of 18 Luohan Hands and yoga for prevention of low back pain: A conceptual synthesis…

This article presents a conceptual integration of yoga and qigong when considering the congruence of beneficial effects for various systems of the body and prevention of low back pain (LBP)…

This isn’t a study, it’s an article about combining Qi Gong and Yoga.  By including it in this PDF, it makes me think they couldn’t find any actual research proving any of the extraordinary claims of Qi Gong.

The seventh study:

A pilot study of qigong practice and upper respiratory illness in elite swimmers…

Participants were 27 of the 55 members of the University of Virginia Swim Team in the Virginia Athletic Department. Main outcomes were measures of aggregated cold/flu symptoms and Qigong practice. Survey completion was 100%, with no missing data, and reliability of the instrument was acceptable. Cold and flu symptoms showed a significant non-linear association with frequency of qigong practice (R(2) = 0.33, p < 0.01), with a strong, inverse relationship between practice frequency and symptom scores in swimmers who practised qigong at least once per week (R(2) = 0.70, p

< 0.01). Qigong practitioners did not differ from non- practitioners in demographic or lifestyle characteristics, medical history, supplement or medication use, or belief in qigong. These preliminary findings suggest that qigong practice may be protective against URIs among elite swimmers who practice at least once per week.

Critical notes:  I’d like to see the whole study and more data.  This is interesting.  However, the total participants were 27 people and there is not note about how big the control group was or how it was randomized…  If we assume it was 50/50, that’s just about 13 people per group, which is pretty tiny.  Did the Qi Gong practitioners stay home alone doing Qi Gong whereas the other group went out with friends and were exposed to more germs in public places?  If it wasn’t randomized right, the people with a higher interest in preventative self-care may have joined the Qi Gong group, but also had a better adherance to washing their hands well.  It would take a lot bigger study with a lot more detail and a few different control groups before we could determine that it was the Qi Gong exercises that decreased the incidence of colds.  For example, another control group should spend the same amount of time isolated from others as the Qi Gong group.

The eighth study:

Effect of medical Qigong on cognitive function, quality of life, and a biomarker of inflammation in cancer patients: a randomized controlled trial…

This study evaluates the effects of medical Qigong (MQ; combination of gentle exercise and meditation) on CF, QOL, and inflammation in cancer patients.

METHODS: Eighty-one cancer patients recruited between October 2007 and May 2008 were randomly assigned to two groups: a control group (n = 44) who received the usual health care and an intervention group (n = 37) who participated in a 10-week MQ program…

CONCLUSIONS: Results suggest that MQ benefits cancer patients’ self-reported CF, QOL, and inflammation. A larger randomized controlled trial including an objective assessment of CF is planned.

Critical notes:  Once again, “usual care” vs. a 10 week program of gentle exercise and meditation (of which positive social interaction is a significant component) isn’t going to tell us anything new or specific about Qi Gong.  It would be stunning if there wasn’t a significant difference between the groups.

The ninth study:

A Critical Review of the Effects of Medical Qigong on Quality of Life, Immune Function, and Survival in Cancer Patients.

…

METHODS: The literature was searched for reported effects of MQ in improving QOL, immune function, and survival in cancer patients.

RESULTS: Although many studies possessed methodological limitations and small sample sizes, encouraging evidence was found for the effects of MQ
on these health-related outcomes. More robust evidence in the form of randomized controlled trials with larger sample sizes also reflected positive results for the role of MQ in improving QOL, mood and fatigue parameters, and reducing inflammation…

Notes:  This critical review shares my awareness of the problems of poor methodology and small sample sizes, but concludes that the evidence is encouraging for Medical Qigong.  So far, there has been no research that has convincingly showed that any form of Qigong is better than a similar type of exercise without the Qigong visualizations or belief systems, and none have even begun to suggest that the farther out claims of Qigong are true.

The tenth study:

Effect of Qigong on quality of life: a cross-sectional population-based comparison study in Taiwan…

RESULTS: Compared with either sedentary individuals
or individuals practicing other types of exercise, the Waitankung group scored higher for eight and five out
of ten SF-36 components, respectively. The Waitankung group scored better in general health, vitality, and physical component summary compared to individuals participating in other types of exercise, even when considering the energy expended by exercise.

Notes:  It’s funny that Wai Tan Kung most likely means “External Elixir Work” which references using silver, gold, cinnabar, and herbs along with meditation.  It makes me want to know more about this group–do they eat a better diet?  Spend more time meditating or doing deep breathing exercises in addition to physical exercises?  When they say that the Waitankung group scored higher than other types of exercise on 5 out of 10 measured components, doesn’t that mean that the non-Kung group scored higher on 5 out of 10 components?  In other words, for that part of the reporting, the Qigong group did no better than the “other exercise” group.  It was the self-reporting of other health measures that led to the conclusion that the Waitankung group was healthier.  This raises the issue of blinding:  Did the Waitunkung group know they were being compared to others in order to evaluate the system they believe in and practice?  This shows why self-reporting in a non-blinded study is unreliable for any objective conclusions.

The eleventh study:

Subjective experiences of older adults practicing taiji and qigong…

Participants not only reported simple benefits along five dimensions of experience (physical, mental, emotional, social and spiritual) but also described complex multidimensional experiences. Overall findings indicate that participants derived a very wide variety of perceived benefits, the most meaningful being a felt sense of body- mind-spirit integration.

Notes:  Well, at least they’re not pretending this was an objective study of anything.  It’s nice to know that many people who practice Taiji and Qigong are happy customers.

The twelfth study:

Qigong: an innovative intervention for rural women at risk for type 2 diabetes…

Perceived healthiness and a belief in one’s ability to make lifestyle changes may exert influence on individual health behaviors and outcomes. The purpose of this study was to determine the relationship of qigong exercise with perception of healthiness as well as with selected serum laboratory measures and blood pressure in women at

risk for type 2 diabetes. Perception of healthiness was favorably affected; however, no significant differences
were noted in serum laboratory measures or blood pressure. The centuries-old traditional Chinese medicine practice of qigong has potential to improve perceptions of healthiness, as well as physiologic measurements of health, among women at risk for type 2 diabetes.

Critical notes:  Huge fail here for Qigong and for the author of the abstract!  The study showed that the women thought they were healthier, but weren’t.  Then the author went ahead and claimed that the women thought they were healthier and were healthier based on the measurements of blood serum and blood pressure.  I’m surprised that they didn’t have lower blood pressure, as most forms of exercise will help people who are at risk for diabetes (who are often overweight and sedentary).

The thirteenth study:

Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial…

BACKGROUND: Substantial numbers of cancer patients use complementary medicine therapies, even without a supportive evidence base. This study aimed to evaluate in a randomized controlled trial, the use of Medical Qigong (MQ) compared with usual care to improve the quality of life (QOL) of cancer patients…

Notes:  Yes, the Qigong group had better quality of life than the “usual care” group.  Once more, totally unsurprising that gentle exercise, meditation, and positive social interaction have effects.  Once more, a wasted opportunity to show that Qigong is better than a similar type of exercise without energy visualizations, etc.

The fourteenth study:

Effects of Qigong on Glucose Control in Type 2 Diabetes. A randomized controlled pilot study…

The purpose of the present study was to investigate the effects of Qigong relative to physical exercise or standard care on glucose control in adults with type 2 diabetes…

Two hundred fifty-one potential subjects were phone screened, 46 individuals were further evaluated at Bastyr University, and 32 eligible participants enrolled in the study. Age- and sex-matched participants were randomly assigned to one of three groups: group 1 (n =

11) received the Qigong intervention, group 2 (n = 10) served as the control group, and group 3 (n = 11) received the progressive resistance training (PRT) intervention as
an active comparator…

Participants attended weekly Qigong or PRT group sessions (60 min per week) conducted by certified instructors in addition to practicing twice a week at home for 30 min per session. The study protocol was approved by Bastyr University Institutional Review Board, and informed consent was obtained from all participants…

Fasting plasma glucose, insulin, and A1C were measured before and after the 12-week intervention…

Qigong therapy for 12 weeks resulted in significant reductions in fasting glucose levels in patients with type 2 diabetes and demonstrated trends toward improvement in insulin resistance and A1C. These results suggest that Qigong may be an effective complementary therapy for individuals with type 2 diabetes.

Notes:  This appears to have been a well-done study.  It found that there was a significantly significant difference for the plasma glucose levels in the Qigong group over the Progressive Resistance Training group.  The other factors, insulin and A1C, were not statistically significant, though the conclusion made it sound like they were.  With such a small group, non-significant variations can’t reasonably be used to make conclusions.  For the difference in plasma glucose levels, we may find the reason is attached to the importance of deep breathing, the adherance to home-practice, or some other physical differences between Qigong exercises and resistance training.  While this study did show Qigong to be better than the other type of exercise, it still didn’t verify any of the extraordinary claims about Qigong.

15th:

Qi Gong’s relationship to educational kinesiology: A qualitative approach.

This isn’t a study, just a concept.

16th:

Perceived benefits of meditative movement in older adults…

The purpose of this review is to report the perceived psychosocial benefits and health outcomes of meditative movement such as Tai chi (TC) and Qigong to inform clinicians on what interventions “work” under what conditions and for whom.

This abstract doesn’t even tell us what they found.  They weren’t looking for anything other than subjective reports, essentially just asking “do you like doing Taiji and Qigong?”

17th:

Effectiveness of a Tai chi Qigong program in promoting health-related quality of life and perceived social support in chronic obstructive pulmonary disease clients…

METHODS: This study employed a single-blind, randomized controlled trial. Two hundred and six COPD clients were randomly assigned into three groups, namely, TCQ group, exercise group, and control group. Subjects in the TCQ group received a TCQ program, consisting
of two 60-min sessions each week for 3 months. Subjects in the exercise group were taught to practice breathing techniques combined with walking as an exercise. Subjects in the control group received their usual care…

RESULTS: The TCQ group showed greater improvements in the symptom (F (4, 404) = 3.351, P = 0.010) and activity domains (F (4, 404) = 2.611, P = 0.035). No differences were detected in perceived social support among the three groups.

Notes:  It looks like the Taiji group had 2 classes per week for 6 months and the other exercise group was just told to go for walks and breathe deeply.  I’m surprised that the Taiji group didn’t report better social support.  I’m not surprised that the better exercise of Taiji (includes stretching, more range-of-motion, balance training, and deeper breathing) did better than just walking.

18th:

Diaphragmatic Breathing Reduces Exercise-induced Oxidative Stress.

Notes:  Focussing on deep breathing for an hour was found to lower cortisol and increase melatonin after heavy exercise more than sitting around for an hour without doing deep breathing.  This is neat but also not revolutionary.  Since it didn’t include any internal energy visualizations, it almost suggests that the benefits of Qigong meditation are more from the breathing than the visualizing.  But the study didn’t look at that…

Holy deep-breathing cow!  I thought I was almost done with this PDF review project, but I’ve barely started!  I’ll have to continue it at another time, as we’re going to a library fundraiser.

 

Ancient Way Acupuncture & Herbs, Inc.
Kevin O’Neil, Licensed Acupuncturist
541-884-6377
@ancientwaykevin

Leave a Reply