This investigation found medical qigong effective in reducing stress in hospital staff over the course of a 6-week trial. As this medical qigong course was taught during work hours, with subjects utilizing their lunch times to participate, class participation was subject to the usual interruptions associated with working in a hospital environment. Thus, the study results suggest that medical qigong can be effective in reducing perceived stress under typical hospital work conditions.
The results of the regression analysis did not indicate a dosage effect for qigong treatment. However, the fact that changes in PSS score were not significantly related to baseline PSS scores in the control group indicates that the changes in PSS scores among the active group cannot simply be attributed to regression toward the mean. Rather, the results indicate that the effects of qigong may be more dichotomous, such that practicing at or above a critical amount will produce a relatively consistent positive effect, while practicing below that critical amount will produce little or no effect. Once the critical amount of activity is achieved, the benefits become a function of how distressed the patient feels.
The basis of qigong's
impact on stress reduction likely involves multiple mechanisms. Exercise is known to reduce stress, and the particular set of medical qigong
employed in this study provides exercise of moderate intensity.20
Concentration meditation, a component of qigong
practice, also decreases stress.21,22
The practice of slow, deep breathing patterns similar to those employed in this qigong
set have been demonstrated effective in reducing blood pressure in both mild hypertensive and normotensive subjects, through a mechanism thought to be related to decreased sympathetic activity.23
Finally, stress-related endogenous chemicals, including norepinephrine11
were reported to be reduced by qigong
There are many different forms of qigong
exercise, and in this study we use the general term qigong
to include t'ai chi
, a standard practice in many qigong
traditions. The medical qigong
set utilized in this study emphasizes precise movements intended to create a sensation of pressure or stretching of muscle and/or connective tissue at targeted acupuncture points. Although the long-term impact of medical qigong
designed to stimulate specific acupuncture points is yet to be studied, reports from the acupuncture literature suggest that stimulation of acupuncture points can generate effects unique to that point. For example, acupuncture stimulation at heart governor 6 has consistently been demonstrated to be antiemetic.25
Furthermore, a recent report on the effects of capsaicin plaster stimulation at stomach 36 found it superior to placebo plaster and capsaicin plaster stimulation at a nonacupuncture point in reducing quantities of morphine required for postoperative pain.26
Thus, further inquiry is needed to determine whether qigong
practices such as The Basic Eight©
, which provide specific acupuncture point stimulation, provide unique therapeutic effects that distinguish it from different qigong
forms and other mind–body methods.
In addition to demonstrating a reduction of perceived stress, those with pain in the qigong
group had a significant reduction of pain intensity. The failure to find a significant difference in pain reduction between groups may have been related to the small sample size evaluated, and requires further studies designed to specifically address pain. One recent qigong
study reported that elderly patients who practiced qigong
reported significant reductions of pain and had significant improvements of cell-mediated immunity.27
The social function subscale of the SF-36 was significantly improved in qigong
practitioners. Previous studies have analyzed the impact of qigong
on social function and also reported that qigong
improved this parameter.12,28
On other SF-36 quality-of-life subscales, as well as sleep and vital sign measurements, there were no significant changes between groups over the course of the study. Other investigations have reported that qigong
practice decreased blood pressure and pulse rate.13,14,29
Limitations of this study include the relatively small size of the sample, which may have generated a type II error in quality of life and vital sign measures. In addition, a lengthier exposure to qigong may have produced additional differences between the qigong and control groups; however, the majority of qigong studies on stress and stress-related disorders have been 6–8 weeks in duration. Given that a growing literature is now demonstrating qigong to be effective in reducing stress, future evaluations of qigong will benefit by head-to-head comparisons with other mind–body techniques to determine which approaches are most effective for given populations and treatment settings.
In summary, a randomized, waiting-list controlled, 6-week trial of medical qigong demonstrated a significant reduction in perceived stress in hospital staff. Teaching this technique appears to be feasible even in a high-intensity hospital setting.