Research on Health and Qigong/Taijiquan

One of my personal passions is finding high quality statistically valid research on the benefits (or not) of Taijiquan/Qigong.  The problems regarding finding high quality non-biased research that can truly distinguish the healthful practices from the hogwash are many.  Unfortunately those who are passionate about the subject often ignore the bias that exists in much of the "so called" research that has been published over the past five decades. That makes it very hard for those of us who are assessing real scientific evidence of the benefits of qigong and/or taijiquan to separate the chafe (biased studies) from the wheat (unbiased studies).  This bias makes it more difficult for the benefits of Qigong and Taijiquan to be accepted by the medical community. 

A few months ago I was attending a swearing-in ceremony for a state Senator who is a friend of mine, and I was seated next to a medical doctor who was the CEO of a huge health network with several hospitals and thousands of doctors.  I asked him what would it take to get him to look at Taijiquan and Qigong as a treatment for health issues.  He answered "When it appears in the New England Journal of Medicine".  At the time I didn't know it, but that article had already appeared.  Ma, Lijun sent me the references and noted...

"I just wanted to mention this study and an editorial comment that were published in New England Journal of Medicine (NEJM) last year. Because this is the first time that studies related to Taijiquan and its health benefit can be recognized and published in this highest level of Medical journal.

 

1) A randomized trial of tai chi for fibromyalgia. Wang C, Schmid CH, Rones R, Kalish R, Yinh J, Goldenberg DL, Lee Y, McAlindon T., N Engl J Med. 2010 Aug 19;363(8):743-54.

2) Prescribing tai chi for fibromyalgia--are we there yet? Yeh GY, Kaptchuk TJ, Shmerling RH. N Engl J Med. 2010 Aug 19;363(8):783-4. "

This is great, but there are two sides to this "win".  One of my doctors still thinks that fibromyalgia is a "psychosomatic" illness and should not be treated the same as "real" illnesses.  I can see that many doctors would simply lump this solution along with the disease itself as hogwash.  I would like to see randomized controlled studies for measurable items such as lowering blood pressure, increasing lung capacity, increasing immune response, shrinking tumors, balancing thyroid hormones or blood sugar, etc., etc., etc. [That is, if - indeed - these practices can produce those results reliably.  Can they?]

I believe that that we need to be extremely diligent regarding studies of these integrative health practices.  There are many in the medical community who are looking at integrative health practices these days - for many reasons not the least of which is that healthcare costs are skyrocketing, the population is aging, and chronic deseases rates are exploding. The lifestyle of the modern world is NOT necessarily the best for our bodies, and our general ill-health and incidents of obesity show it.  Everyone is looking for answers - even in alternative, complementary, and integrative health practices (or whatever we want to call it).

 

Sources of Current Research

There are many high caliber researchers who have focused on high quality non-biased studies.  Most of these people were on the Academic Committee of the the ground-breaking world-class International Taijiquan Symposium of 2009:
http://taichisymposium.com/pages/viewPage9c8a.html?id=23 

Dr. Yang Yang has been involved in a number of high quality studies, and has dedicated his life to demonstrating the benefits of Taijiquan and Qigong to the medical community.  You can see some of his research work here: http://www.chentaiji.com/research/CTS_EBTstudies.pdf 

Dr. Peggy Klein and her students at D’Youville College have published a meta-analylsis on recent research here:
http://paceminvita.com/Files/TCqigong_Oct2010_Klein.pdf

Dr. Shin Lin was part of a team that combed through over 11,000 studies on Meditation Health practices such as Qigong, Taiji, and Yoga in order to evaluate the overall direction.  Their results can be found here: http://www.ahrq.gov/downloads/pub/evidence/pdf/meditation/medit.pdf

Dr. Thom Krapu aggregates Tai Chi research on his page here: http://www.krapu4.com/taichi/research/tairesum.htm

There are many other sources of slightly less than a western-science focus (and therefore may require some additional diligence in interpreting results).

National Qigong Association has many studies published on their website: http://nqa.org/resources/articles/

A lot of research references from the Qigong Institute can be found on their web page: http://www.qigonginstitute.org/html/papers.php

Bill Douglass has gathered thousands of studies on his World Tai Chi and Qigong page:
http://www.worldtaichiday.org/WTCQDHlthBenft.html

There are also, of course, thousands of references in MedLine and other health and medical research databases: http://www.ncbi.nlm.nih.gov/pubmed

Of course, both the Mayo Clinic and Harvard Medical Center have also advocated these things, as described on our benefits page: http://taijiquanenthusiasts.org/content.aspx?page_id=22&club_id=335754&module_id=85614

 

Agenda: Call on Researchers to Study Integrative Health

Those of us who have experienced, first hand, the healing benefits of integrative health practices have a tendancy to want everyone else to get the same benefits that we did.  The problem is that our firm belief that such practices will be beneficial will interfere with the scientific method of study that might prove it.  I call on all those who are in this field and/or able and willing to work on research to focus on those studies which will increase our understanding of exactly how integrative health practices such as meditation, qigong, taijiquan, and yoga work.  I feel like screaming every time I read a research study that simply says that people did "Taijiquan" or "Qigong".  We need a movement by movement, thought by thought, and breath by breath accounting of exactly what they did because there are thousands of qigong and taijiquan forms and methods.  At this point there are enough highly documented integrative health practices that research can utilize these standardized behaviors in order to distinguish exactly what about them works (and what doesn't).  We should eliminate the terminology that separates and mystifies integrative health practices, and instead focus on the actual, measurable, describable behaviors within.   

One potential framework with which to start is the movement, breath, intention structure.  Whether we are talking about yoga, taijiquan, qigong, or meditation, there are certain movements, certain breathing, certain intention (i.e. thoughts or images) that fully describe the practices.  

One problem often cited in research is the difficulty of establishing a double-blind protocol.  In a double-blind protocol, neither the person measuring the outcome, nor the person receiving the treatment, knows which treatment they are receiving.  It has been said that this problem makes it impossible to study Taijiquan, for example, because the subject can easily tell if they are being taught Taijiquan or Yoga.  However, if we eliminate the terminology differences, we can establish that Treatment 1 is (for example) following the highly-documented movements of the Evidence-Based Taijiquan form developed by Dr. Yang Yang, and Treatment 2 is a set of yoga postures (also highly documented as specifically as the EBT form regarding movement, breath, and intention).  As long as the terminology is only Treatment (i.e. the subjects are not told if they are following treatment 1 or treatment 2, and they are definitely not told which each treatment is based upon), they would be blind to which group they are in.  Of course, we would also require another group, Treatment 3, which might do nothing at all or just sit in a room as a control. 

Consequently, when the outcomes are measured (for example, blood pressure or immune response or pain levels) then the person who is asking the questions or measuring the outcome does not know which treatment the person was in.  Viola - a double blind, reproducable verifiable research study that will actually further the agenda of improved health for everyone.

Furthermore, when we start actually using the framework of movement, breathe, and intention, we start quantifying items in such a way that they could, eventually be prescribed.  "Go do Taijiquan" or "Go do Yoga" is not a prescription.  "Perform the EBT form three times a day for 10 minutes, seven days a week" is a prescription.  If the goal is to improve people's health, being able to quantify exactly how much they need to do how often is critical - and it is something sadly lacking in our current state of research. 

The only problem with this research scenario is the cost; such double blind studies cost a tremendous amount of money to set up and implement.  Drug studies generally pay for themselves (if the drug ever gets to market) because of the millions of dollars the pharmeceutical companies eventually gain when selling the drug.  Unlike a drug, which needs to be purchased to be taken regularly, an integrative health practice can be learned once and practiced independently like physical therapy.  The dollars for such practices are limited.  And since the current business model for Taijiquan and Qigong are based upon values such as lineage and spirituality (both of which are useless in prescriptive mode) rather than health benefits, I see many obstacles to seeing this research become a reality.  

However - if we could get the resources of all integrative health practices joined together, and compare the treatment costs of the most common chronic health disfunctions using traditional drugs/surgery/rehab to the cost of treating the same chronic health discfunctions using integrative health practices, we could establish a business model that would decrease the health costs for insurance companies and government agencies.  That could be the source of funding for further refinements and research. 

But first we must prove, beyond a shadow of a doubt, of the efficacy, efficiency, and effectiveness of integrative health practices,

I will continue pressing this agenda in what little free time I have between my "real" jobs and responsibilities.  I call on you (yes, you) to do what you can to encourage, support, and perhaps even demand high quality research on integrative health practices.  Let me know what you have done, and are planning to do, to further this agenda.  Perhaps, together, we can make some headway.

In any case, thanks for listening.

Sincerely
CJ Rhoads
CJRhoads@PacemInVita.org