Talk:Qigong/Archive 5

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Reorganisation needed

This

Meditation and self-cultivation applications	

and similar subsections should be moved to the "Uses/Aims" one to avoid duplication.

I have edited one heading only, as it would take too much time to reorder.

Zezen (talk) — Preceding undated comment added 13:51, 25 February 2020 (UTC)

Inconclusive

It seems to me that the recent copyediting to the lead section remains accurate but that the sentence could be improved. The previous one also could be, so I'll enumerate and suggest another version, welcoming others to also do:

• Old version:

Because clinical research on qigong for its potential benefit in treating various diseases – such as hypertension, pain, and cancer – has been inconclusive due to poor quality, there remains no evidence that qigong has any therapeutic effect, as of 2016.

• New version:

Clinical research on qigong to treat various health problems and diseases, such as hypertension, pain, and cancer, has been mostly inconclusive, possibly via poor quality, and as of 2016, there remains no compelling scientific evidence that qigong is effective treatment of the medical conditions studied.

• PaleoNeonate suggestion 1

While some clinical research was done to test if qigong benefited patients suffering from various diseases, low quality methodology and inconsistent results provided no conclusive evidence that qigong is effective to treat any condition.

Thanks, —PaleoNeonate – 21:33, 20 August 2020 (UTC)

Adding a comment in relation to the edit summary: the lack of compelling scientific evidence is not the same as "no evidence" it means "no conclusive evidence". —PaleoNeonate – 04:59, 22 August 2020 (UTC)

Sounds like another job for "There is no good evidence that ...". Alexbrn (talk) 12:13, 22 August 2020 (UTC)

PaleoNeonate suggestion 2: "There is no reliable evidence that Qigong is effective for the treatment of any condition." —PaleoNeonate – 03:50, 24 August 2020 (UTC)

This was applied for now, —PaleoNeonate – 09:13, 27 August 2020 (UTC)

I'd support that[1] as a nice pithy summary. Alexbrn (talk) 18:23, 28 August 2020 (UTC)

Again, we have a false epistemic: Western, popular reading mistakes EBM's "scientific evidence" for all evidence or all "conclusive"/"good"/"reliable" evidence, still untenably presuming omniscience of all evidence, but now even as to all conditions. Even the sentence's sources limit the medical scope (select diagnoses), evidence type (clinical trials), and conclusion level (broad overview) [1,2]. The NIH source, most pointedly says, "Several clinical trials have evaluated the effects of tai chi and qi gong in people with various health conditions." "Tai chi and qi gong may ease fibromyalgia pain and promote general quality of life. Qi gong may reduce chronic neck pain, but study results are mixed."[1] The other source, assessing systematic reviews, clarifies, "To be included, systematic reviews had to be concerned specifically with the effectiveness of qigong and include evidence from at least two controlled clinical trials."[2] Merely, their examined evidence taken together is not compelling. But whether none of that supporting evidence is "reliable"—let alone whether no supporting evidence in the world is "reliable"—is a finer conclusion that the sources sensibly avoid.

EBM, evidence-based medicine, not defining a priori all evidence that is "conclusive"/"good"/"reliable", merely sets a pragmatic hierarchy for clinicians, when making treatment decisions, to sort and prioritize types of clinical evidence [3–5]. (Each of these three, cited sources slightly varies the hierarchy's lowest tiers.) Not its godfather, who may be David Sackett, but EBM's main leader, Gordon Guyatt, and colleagues, pose, "What is the nature of evidence in EBM? We suggest a broad definition: any empirical observation about the apparent relationship between events constitutes evidence. Thus, the unsystematic observations of the individual clinician constitute one source of evidence, and physiologic experiments another." "Given the limitations of unsystematic clinical observations and physiologic rationale," however, "EBM suggests a hierarchy of evidence," whereby "any statement to the effect that there is no evidence addressing the effect of a particular treatment is a non sequitur. The evidence may be extremely weak—the unsystematic observation of a single clinician, or generalization from only indirectly related physiologic studies—but there is always evidence."[5]

Guyatt et al. explain, "Clinical research goes beyond the unsystematic clinical observation in providing strategies that avoid or attenuate the spurious results."[5] EBM's gold standard, atop the hierarchy, taken as generally most reliable, is the large randomized controlled trial, the RCT [3]. Still, Guyatt et al. clarify, "This hierarchy is not absolute. If treatment effects are sufficiently large and consistent, for instance, observational studies provide more compelling evidence than most RCTs. Observational studies have allowed extremely strong inferences about the efficacy of insulin in diabetic ketoacidosis or hip replacement in patients with debilitating hip osteoarthritis." "At the same time, instances in which RCT results contradict consistent results from observational studies reinforce the need for caution." "Defining the extent to which clinicians should temper the strength of their inferences when only observational studies are available remains"—that is, remains—"one of the important challenges of EBM."[5] In fact, anecdotal evidence often replaces any clinical evidence, rendering clinical trials moot [7]. Meanwhile, major versions of EBM's hierarchy omit, of all things, basic science, biological findings, namely, physiologic data [3,4].

Perhaps strangely to a scientist, Tenny & Varacallo even declare, "Scientific evidence includes study outcomes and opinions."[4] Unlike Guyatt et al., they favor an EBM hierarchy that omits physiologic data and closes with "Level IV: expert opinions from respected authorities on the subject based on their clinical experience."[4] Thereupon, Tenny & Varacallos explain, "All clinical studies or scientific evidence can be classified into one of the above categories. The clinician must then use their professional, clinical experience to extrapolate the scientific evidence as it applies to the specific patient."[4] Meanwhile, Tenny & Varacallo note, "Not all clinical questions can be effectively or ethically studied with a randomized controlled study."[4] In fact, to avoid "spurious results" [5], RCTs are designed to mask patients' individual differences, why case reports sometimes provide better evidence [6]. Qigong, having numerous variations, is thousands of years old, and its primary context is Traditional Chinese Medicine, which has its own diagnoses and endpoints whereby interventions are tailored to each patient [9–11]. Based on a different paradigm, modern Western medicine's premise, rather, is that each diagnosis is its own entity that would merit the same treatment in any patient.

So I've revised the article's sentence, There is no reliable evidence that Qigong is effective for the treatment of any condition, to closely paraphrase its cited sources: "In testing qigong to treat several conditions diagnosed in Western medicine, clinical trials have been mostly of low quality and have produced mixed results, consistently positive only for hypertension, whereby no firm conclusion can be drawn" [diff, 09:55, 28 Aug 2020]. The sources don't concern all conditions and all reliable evidence, which are grand questions and riddles beyond the source's knowledge scope. Liberati & Vineis clarify "that EBM does not, and cannot, answer all the epistemological and practical questions surrounding the practice of medicine. On the contrary, it is important that expectations of EBM are appropriate in order to prevent conceptual and practical mistakes."[8] Further, "views of it which are too narrow have created avoidable confrontations with those who may be concerned that an 'EBM-dominated view' can do more harm than good. As efforts by methodologists have chiefly focused on how to design, conduct, and interpret studies aimed at assessing the eficacy/effectiveness of drugs, EBM is today mostly 'evidence based therapy' with robust tools—that is, randomised controlled trials—especially for assessing the worth of relatively simple interventions. The fact that we currently have limited ability to reliably assess complex interventions, preventive care in general, and diagnosis as well as prognosis, should be seen not only as the result of the greater intrinsic complexity of these areas but also as the consequence of lower intellectual investments. This is a reflection, in turn, of the more limited commercial interests at stake here" [8]. — Occurring (talk) 15:34, 28 August 2020 (UTC)

1) "Tai chi and qi gong: In depth", National Center for Complementary and Integrative Health, US NIH, Oct 2016.

2) Lee MS, Oh B & Ernst E, "Qigong for healthcare: An overview of systematic reviews", JRSM Short Rep, 2011 Feb;2(2):7.

3) Lundberg GD, "Evidence-based medicine or faith-based medicine?", MedGenMed, 2004;6(4):32.

4) Tenny S & Varacallo M, "Evidence based medicine (EBM)" @ NIH.gov (Treasure Island, FL: StatPearls Publishing, 2020).

5) Guyatt GH, Haynes RB, Jaeschke RZ, Cook DJ, Green L, et al., "XXV, Evidence-based medicine: Principles for applying the Users' Guides to patient care", Users' Guides to the Medical Literature, in JAMA, 2000;284(10):1290-96, quoting pp 1292–3.

6) Jefferson T, "More cases, doctor? Yes please!", Cases J, 2008 Jul 16;1(1):38.

7) Gordon C S Smith & Jill P Pell, "Parachute use to prevent death and major trauma related to gravitational challenge: Systematic review of randomised controlled trials", BMJ, 2003 Dec 20;327(7429):1459–61.

8) Liberati A & Vineis P, "Introduction to the symposium: What evidence based medicine is and what it is not", J Med Ethics, 2004 Apr;30(2):120-1.

9) Kevin Chen, Elizaebth R. Mackenzie & Master FaXiang Hou, "The benefits of qigong", in Elizabeth R. Mackenzie & Birgit Rakel, eds., Complementary and Alternative Medicine for Older Adults (New York: Springer, 2006).

10) Master Hong Liu & Paul Perry, The Healing Art of Qi Gong: Ancient Wisdom from a Modern Master (New York: Warner Books, 1997).

11) Roger Jahnke, Linda Larkey, Carol Rogers, Jennifer Etnier & Fang Lin, "A comprehensive review of health benefits of qigong and tai chi", Am J Health Promot, 2010 Jul–Aug;24(6):e1–e25.

TLDR. (but the parachute use systematic review of randomised controlled trials has potential. What would the control be?) -Roxy the inedible dog . wooF 15:39, 28 August 2020 (UTC)

The claim about hypertension would definitely need better sourcing to be included. Brunton (talk) 17:16, 28 August 2020 (UTC)

When I look, I see that you're correct about that. And although there is a better source in the article for that very claim, and there are other sources elsewhere, I don't think it really matter. — Occurring (talk) 17:33, 28 August 2020 (UTC)

• It seems to me that the current version by Brunton is also better than the original: "Because clinical research on qigong for its potential benefit in treating disease has been inconclusive, there remains no evidence that qigong has any therapeutic effect, as of 2016." I would suggest removing the unnecessary "as of 2016" though. I disagree with Occurring's summary "We can simply paraphrase the sources accurately, without our opinions", since while the summary was very short, it remained fair overall, it was the logical conclusion of the sources. —PaleoNeonate – 23:50, 28 August 2020 (UTC)

  I'll lose the "Because", since it makes it seem the reason there's no good evidence is because of the quality of research, while in reality the explanation might be simpler (there is no evidence to be found). I'll also change "remains" to "is" since "because" sort of implies there's an obstacle to be removed. And yup, the "as of" clause is redundant since there's no reason to think this is time limited. Alexbrn (talk) 06:11, 29 August 2020 (UTC)

  No objection from me, —PaleoNeonate – 10:45, 29 August 2020 (UTC)

The “as of 2016” should also go on the grounds of WP:NOTCRYSTAL, we report the current consensus by default.

At the moment, though, that paragraph of the lead is effectively saying the same thing twice, and managing to imply that the lack of evidence is some sort of artifact of poor research. I think that “There is no reliable evidence that Qigong is effective for the treatment of any condition” summarises the situation adequately. If people want to find out why or see more detail, they can go to the relevant sections of the article. Brunton (talk) 15:10, 29 August 2020 (UTC)

Subject: Chi Energy from the Earth and Sky?

Didn't Indian and Chinese philosophy that some Chi energy comes up from Earth and some Chi energy comes down from Heaven [into the Yoga/Tai Chi poses ]? Need clarification for this point which came up recently in one of my groups. I have references in English, but not the original Qigong sources. Thank You D ? PS.1. Sincerely, thank you for your feedback. I do not have all the answers. The electrical theory of Chi and Chinese acupuncture has not been accepted by the Western scientific community. The electrical theory of Chi and Chinese acupuncture is being investigated by the Chinese scientific and medical community. Bearing in mind that not everyone agrees with Dr. Yang's electrical theory of Chi and Chinese acupuncture, or Chi at all, I will add those pro and con references that seem useful to discussion.Dewi7 (talk)

Anything you add to this article needs to be supported by reliable sources. Feel free to propose sources and changes, but maybe take a moment to read WP:FRINGE. Girth Summit _(blether) 14:40, 8 August 2021 (UTC)

Peraplegia patients

I m peraplegia patient since last 2 year can u help me for walk again 27.62.229.102 (talk) 07:17, 27 November 2021 (UTC)

• Wikipedia is an encyclopedia, it does not provide medical service.Tatewaki (talk) 01:36, 14 September 2022 (UTC)

Hi there, This text, while a translation, describes Wujishi standing breathing exercises.

This is not any kind of promotion - My son gave me a copy of the book to study.

Wujishi Breathing Exercises from the teachings of Cai Songfang ISBN 978 1 939278 00 5 USA Plum Publications Santa Cruz California https://www.plumpub.com/kaimen/wujishi/ b'art homme 10:02, 6 September 2023 (UTC) — Preceding unsigned comment added by B'art homme (talk • contribs)

US-centric?

It seems odd that an article about an ancient Chinese practice has, as its first picture, an event in Manhattan, New York. One might be led to think that Wikipedia has a US-centric view of the world. 86.185.71.236 (talk) 21:32, 10 January 2024 (UTC)

This is a good point. Other images should be added in order to create a more worldwide view of the subject; these should be trivial for you to find and add. OverzealousAutocorrect (talk) 19:08, 6 February 2024 (UTC)

Theraputic Use section too broadly stated?

This one line entry seems to my layman's eyes at odds with it's reference, probably from being so broadly stated as any medical condition. Particularly it's first reference to NIH website does not seem like a functional reference for this statement. Additionally, one could take away from this, particularly read/quoted in a vacuum, that the physical motion or meditative elements provide no benefit at all, which I think the intent is to say that qi-gong has no shown benefit beyond the benefits we already know from which the elements of which is is made.

Would the article not be better served by adding caveats similar to the ones Safety and cost section has (e.g. "Typically the cautions associated with qigong are the same as those associated with any physical activity") and/or referencing the Clinical research section to drive the reader to a fuller understanding of insufficiencies in evidence for efficacy? — Preceding unsigned comment added by 174.6.117.242 (talk) 01:27, 16 February 2024 (UTC)

This line caught my attention too at a first skim of the article. There needs to be an elaboration on the reported/anecdotal benefits at least, vs. clinical proven benefits, and the research involved in assessing each. I will further look into the sources and expand this one liner into a more constructive summary. TheIntrospectorsfacts (talk) 17:22, 16 February 2024 (UTC)

From China to the world

Although the paragraph did not cite any sources, it's prudent to tag it "citation needed" instead of a straight deletion. Qigong's influence did extended beyond the border of China in terms of practice and clinical research. TheIntrospectorsfacts (talk) 14:56, 20 February 2024 (UTC)

Read like fluffy brochure language. See WP:V. Bon courage (talk) 15:48, 20 February 2024 (UTC)

Indeed the language and the statements need a revamp supported by quality sources. As to your point, there are other fluffy elements in the article that requires a trim. The contemporary qigong section may be further developed and strengthened citing Palmer's Qigong Fever. TheIntrospectorsfacts (talk) 16:10, 20 February 2024 (UTC)