Peer-Reviewed Research: Benefits of Qigong as an Integrative and Complementary Practice for Health
The systematic review conducted by Toneti et al. (2020) provides a comprehensive and methodologically rigorous exploration of the health benefits of Qigong practice among adult and elderly populations. With the growing interest in integrative and complementary practices (ICPs) globally, this paper makes a meaningful contribution by critically analyzing 28 clinical studies that assess Qigong’s efficacy across a broad spectrum of health outcomes, including chronic illness management, psychosocial wellbeing, and quality of life.
Context and Rationale
Toneti et al. position their study within the growing institutional and governmental interest in integrative health practices, particularly within Brazil’s national health system, the SUS. The authors outline how Traditional Chinese Medicine (TCM), including Qigong, has become increasingly recognized as a therapeutic modality capable of addressing both physical and psychological dimensions of health. The inclusion of Qigong as part of Brazil’s official National Policy on Integrative and Complementary Practices (PNPIC) underscores a national shift toward more holistic models of healthcare delivery. Against this backdrop, the authors aim to determine whether Qigong indeed delivers measurable health benefits, thereby justifying its inclusion in public health programs.
Methodology and Scope
The study adheres to PRISMA guidelines and employs a rigorous methodological framework, including a clearly defined PICO question: Does the practice of Qigong provide health benefits for adults and the elderly? Searches were conducted across five major databases (PubMed, CINAHL, LILACS, EMBASE, and Cochrane Library) using standardized MeSH and DeCS descriptors, with inclusion criteria targeting clinical trials (both randomized and non-randomized) published between 2008 and 2018 in English, Portuguese, or Spanish.
From an initial pool of 334 studies, 28 were ultimately included for qualitative synthesis. Importantly, studies were only included if they focused on internal Qigong (self-practice) rather than external Qigong (medical Qigong delivered by a practitioner), ensuring consistency in the intervention type analyzed.
Thematic Categories and Key Findings
The authors organized the results into five thematic categories: (1) health prevention, (2) psychosocial effects, (3) analgesic effects, (4) oncology applications, and (5) rehabilitation and chronic disease management. This categorization provides a helpful framework for understanding the breadth of Qigong’s potential impact.
1. Health Prevention
A standout study in this category demonstrated that Qigong practice improved lipid profiles, body fat percentage, and subjective measures of physical and mental well-being in adults with risk factors for coronary artery disease (CAD). Although biomarkers such as C-reactive protein and fasting glucose did not significantly change, the improvements in mental and physical health indicators support Qigong as a preventive health measure.
2. Psychosocial Effects
Three studies focused on the psychological and social dimensions of Qigong, revealing significant reductions in stress, anxiety, and depressive symptoms, especially among elderly or socially isolated individuals. Notably, one study showed improvements in cortisol regulation and self-efficacy in depressed elders, suggesting a psychoneuroendocrine pathway through which Qigong exerts its effects. Another trial reported expanded social networks among older adults, underscoring Qigong’s potential as a community-building tool that enhances emotional and social resilience.
3. Analgesic Effects
The review presents mixed but generally favorable results regarding pain management. Qigong was found to reduce pain and improve range of motion and functional disability in conditions like chronic neck pain, fibromyalgia, and nonspecific lower back pain. Some studies, however, failed to demonstrate significant differences compared to control or exercise therapy groups, highlighting the importance of protocol design and intervention duration. Nevertheless, the overall trend favors Qigong as a viable analgesic intervention, particularly when practiced over longer periods.
4. Oncology Applications
Seven studies evaluated Qigong in cancer patients or survivors, with consistent findings of reduced fatigue, improved sleep quality, and enhanced quality of life. For example, in breast cancer survivors, Qigong led to sustained improvements in cognitive function and reductions in BMI. Other studies in patients undergoing chemotherapy reported improved immune function, including increased white blood cell counts and hemoglobin levels. These results align with broader evidence suggesting that mind-body interventions can ameliorate the physiological and psychological burdens of cancer treatment.
5. Rehabilitation and Chronic Disease
This category, encompassing nearly half the studies, showcases Qigong’s utility in managing chronic illnesses such as COPD, Parkinson’s disease, fibromyalgia, tinnitus, and osteoarthritis. Improvements were noted in lung function, walking capacity, fatigue levels, and even biomarkers like telomerase activity in individuals with chronic fatigue syndrome. In COPD patients, Qigong was shown to maintain or enhance pulmonary function and reduce the frequency of exacerbations. Similar benefits were observed in fibromyalgia patients, where Qigong led to reductions in pain, improved sleep, and enhanced quality of life.
Critical Evaluation
While the review provides compelling evidence of Qigong’s health benefits, Toneti et al. are careful to highlight methodological limitations. A key concern across the studies was the high risk of bias, particularly in the blinding of participants and outcome evaluators. Given that Qigong is a behavioral intervention, blinding participants is inherently challenging; however, better trial designs with objective outcome measures could mitigate this issue.
Despite this limitation, all included studies were classified as Level II evidence (clinical trials), and 27 out of 28 were randomized, lending overall credibility to the conclusions. The diversity in study populations, ranging from younger adults to elders with multiple comorbidities, enhances the generalizability of the findings. However, heterogeneity in Qigong forms, session durations, and control conditions complicates direct comparisons and meta-analysis.
Interpretation and Mechanisms
The discussion section effectively integrates the findings with prior literature, suggesting several physiological mechanisms for Qigong’s efficacy. These include improvements in vagal tone, regulation of the hypothalamic-pituitary-adrenal (HPA) axis, and anti-inflammatory effects. The authors also propose that Qigong enhances self-awareness and interoception, fostering an internal state conducive to healing and resilience. These ideas align with contemporary neuropsychological models that emphasize mind-body integration.
Notably, the paper references studies linking Qigong to reduced activity in stress-related brain regions such as the amygdala, as well as reduced cortisol secretion—evidence that supports Qigong’s use for mental health and psychosomatic conditions. Additionally, the association with improved telomerase activity hints at potential anti-aging or cellular protective effects, although this area requires further exploration.
Implications for Nursing and Health Policy
A unique and commendable aspect of this review is its focus on nursing. By framing Qigong as a tool for nursing professionals within integrative health systems, the authors advocate for its inclusion in routine care—especially in Brazil’s public health framework. This is particularly relevant in aging populations and those living with chronic diseases where non-pharmacological interventions can reduce medication load and improve quality of life.
Moreover, the authors call for the development of standardized Qigong protocols and the incorporation of these practices into preventive health strategies, rehabilitation programs, and psychosocial support services. Their recommendation for future longitudinal and high-quality randomized trials is both timely and necessary.
Conclusion
In summary, Toneti et al.’s systematic review strongly supports the use of Qigong as a safe, effective, and multifaceted therapeutic intervention for adult and elderly populations. Whether used for prevention, rehabilitation, or emotional regulation, Qigong offers a low-cost, accessible, and culturally adaptable practice. While methodological limitations in the current body of research persist—chiefly related to blinding and protocol heterogeneity—the overall weight of evidence tilts decisively in favor of Qigong’s inclusion in integrative health programs. This review is a valuable resource for clinicians, researchers, and policymakers seeking to expand evidence-based integrative care.
Citation:
Toneti, B. F., Barbosa, R. F. M., Mano, L. Y., Sawada, L. O., Oliveira, I. G., & Sawada, N. O. (2020). Benefits of Qigong as an integrative and complementary practice for health: A systematic review. Revista Latino-Americana de Enfermagem, 28, e3317.
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Thank you for this beautiful summary of this recent research, it is much appreciated. I'm curious about the statement "Given that Qigong is a behavioral intervention". Is this something that you believe or that is assumed by the researchers? I'd love a further discussion. Thank you again.