Skip to main content

Advertisement

SpringerLink
Log in

Effects of external qigong therapy on osteoarthritis of the knee

A randomized controlled trial

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The objective of our study was to assess the efficacy of external qigong therapy (EQT), a traditional Chinese medicine practice, in reducing pain and improving functionality of patients with knee osteoarthritis (OA). One hundred twelve adults with knee OA were randomized to EQT or sham treatment (control); 106 completed treatment and were analyzed. Two therapists performed EQT individually, five to six sessions in 3 weeks. The sham healer mimicked EQT for the same number of sessions and duration. Patients and examining physician were blinded. Primary outcomes were Western Ontario MacMaster (WOMAC) pain and function; other outcomes included McGill Pain Questionnaire, time to walk 15 m, and range of motion squatting. Results of patients treated by the two healers were analyzed separately. Both treatment groups reported significant reduction in WOMAC scores after intervention. Patients treated by healer 2 reported greater reduction in pain (mean improvement −25.7 ± 6.6 vs. −13.1 ± 3.0; p < 0.01) and more improvement in functionality (−28.1 ± 9.7 vs. −13.2 ± 3.4; p < 0.01) than those in sham control and reduction in negative mood but not in anxiety or depression. Patients treated by healer 1 experienced improvement similar to control. The results of therapy persisted at 3 months follow-up for all groups. Mixed-effect models confirmed these findings with controlling for possible confounders. EQT might have a role in the treatment of OA, but our data indicate that all EQT healers are not equivalent. The apparent efficacy of EQT appears to be dependent on some quality of the healer. Further study on a larger scale with multiple EQT healers is necessary to determine the role (if any) of EQT in the treatment of OA and to identify differences in EQT techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Arthritis Foundation (2006) Arthritis brochure. http://www.arthritis.org

  2. CDC (2002) Prevalence of self-reported arthritis or chronic joint symptoms among adults—United States 2001. MMWR 51:948–950

    Google Scholar 

  3. Hunter D, Felson D (2006) Osteoarthritis. Br Med J 332:639–642

    Article  Google Scholar 

  4. Bjordal JM, Ljunggren AE, Klovning A, Slordal L (2004) Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomized placebo controlled trials. BMJ 329:1317

    Article  PubMed  CAS  Google Scholar 

  5. McGettigan P, Henry D (2006) Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA 296:1633–1644

    Article  PubMed  CAS  Google Scholar 

  6. Berman B, Lao L, Langenberg P, Lee WL, Gilpin A, Hochberg M (2004) Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med 141:901–910

    PubMed  Google Scholar 

  7. Meihanmer E, Linde K, Lao L, Bouter LM, Berman BM (2007) Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med 146(12):868–877

    Google Scholar 

  8. Admed S, Anuntiyo J, Malemud CJ, Haqqi TM (2005) Biological basis for the use of botanicals in osteoarthritis and rheumatoid arthritis: a review. Evid Based Complement Alternat Med 2(3):301–308

    Article  Google Scholar 

  9. Perlman AI, Sabina A, Williams AL, Njike VY, Katz DL (2006) Massage therapy for osteoarthritis of the knee. Arch Intern Med 166:2533–2538

    Article  PubMed  Google Scholar 

  10. Brismee JM, Paige RL, Cjyu MC, Boatridght JD, Hagar JM, McCaleb JA et al (2007) Group and home-based tai chi in elderly subjects with knee osteoarthritis: a randomized controlled trial. Clin Rehabil 21(2):99–111

    Article  PubMed  Google Scholar 

  11. Lee MS, Pittler MH, Ernst E (2007) Tai chi for osteoarthritis: a systematic review. Clin Rheumatol 27:211–218 Sept 14. Cited in Epub pre-print; PMID: 17874172

    Article  PubMed  Google Scholar 

  12. Deng Y (1994) Qigong and tui na therapy for treating knee arthritis. J Mod Med 1994(2):72

    Google Scholar 

  13. Chen K, Liu T (2004) Effects of qigong therapy on arthritis: a review and report of a pilot trial. Medical Paradigm 1(1):36–48

    Google Scholar 

  14. Yang JM (1996) Arthritis: the Chinese way of healing and prevention. YMAA Publication Center, Jamaica Plain

    Google Scholar 

  15. Liu TJ (ed) (2005) In: Qigong studies in Chinese medicine (textbook used in universities and colleges in China). China Publisher of Chinese Medicine, Beijing

  16. Lee MS, Pittler MH, Ernst E (2007b) External qigong for pain conditions: a systematic review of randomized clinical trials. J Pain 8:827–831 Aug 7. Cited in Epub preprint; PMID: 17690012

    Article  PubMed  Google Scholar 

  17. Weng ZS (1998) 60 cases of rheumatoid arthritis in late stage treated by medicine fumigation and washing combined with Qi-conducting pressing acupoints and tui na. China’s Naturopathy 10(5):12

    Google Scholar 

  18. Machi Y, Liu C (1999) Measurements of physiological effects of internal qigong: the six-word practice. J Intl Soc Life Info Science 17(1):32–47

    Google Scholar 

  19. Xiaohai Y, Songxiang D (1997) Rheumatoid arthritis treated by qigong combined with herb meals. Practical Journal of Integrating Chinese with Modern Medicine 10(15):1506

    Google Scholar 

  20. Litscher G, Wenzel G, Niederwieser G, Schwarz G (2001) Effects of qigong on brain function. Neurology Research 25(3):501–505

    Article  Google Scholar 

  21. Lawrence RC, Helmick CG, Arnett FC et al (1998) Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 41:778–799

    Article  PubMed  CAS  Google Scholar 

  22. Lin Z, Li Y, Guo Z, Shen Z, Zhang H, Zhang T (2000) Qigong: Chinese medicine or pseudoscience? Prometheus Books, New York

    Google Scholar 

  23. Altman R, Asch E, Bloch G et al (1986) Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum 29:1039–1049

    Article  PubMed  CAS  Google Scholar 

  24. Chen K, He B, Rihacek G, Sigal HL (2003) Qigong treatment for arthritis pain: a pilot study. J Clin Rheumatol 9(5):332–335

    PubMed  Google Scholar 

  25. Qigong Institute (2004–2005) Guideline for selecting qigong healers in scientific research of qigong. http://www.qigonginstitute.org/html/papers.php#Selecting. Accessed September 2007

  26. Zhang PY (1997) The experts confirmed the achievement of Qigong anti-cancer therapy: Chinese Taiji five-element qigong is one of effective means to defeat cancer. China Qigong Sciences 8–10, March

  27. Bellamy N, Buchnan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. J Orthop Rheumatol 1:95–108

    Google Scholar 

  28. Bellamy N (2004) WOMAC osteoarthritis index: user guide VII. CONROD The University of Queensland, Herston

    Google Scholar 

  29. Melzack R (1987) The short-form McGill Pain Questionnaire. Pain 30:191–197

    Article  PubMed  CAS  Google Scholar 

  30. Spielberger CD (1983) State-trait anxiety inventory for adults (Form Y). Mind Garden, Menlo Park

    Google Scholar 

  31. Radoff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  32. Paterson C, Dieppe P (2005) Characteristic and incidental (placebo) effects in complex interventions such as acupuncture. BMJ 330(7501):1202–1205 May 21

    Article  PubMed  Google Scholar 

  33. Wu WH, Bandilla E, Ciccone DS, Yang J, Cheng SS, Carner N et al (1999) Effects of qigong on late-stage complex regional pain syndrome. Altern Ther Health Med 5(1):45–54

    PubMed  CAS  Google Scholar 

  34. Chen K, Shiflett SC, Ponzio NM, He B et al (2002) A preliminary study of the effect of external qigong on lymphoma growth in mice. J Altern Complement Med 8(5):615–621

    Article  PubMed  Google Scholar 

  35. Chen X, Li Y, Liu G, He B (1997) The inhibitory effects of Chinese Taijing five-element qigong on transplanted hepatocarcinoma in mice. Asian Med 11:36–38

    Google Scholar 

  36. Chen KW, Hassett AL, Hou F, Staller J, Litchbroun A (2006) A pilot study of external qigong therapy for patients with fibromyalgia. J Altern Complement Med 12(9):851–856

    Article  PubMed  Google Scholar 

  37. Chen K (2004) An analytic review of studies on measuring effects of external qi in China. Altern Ther Health Med 10(4):38–50

    PubMed  Google Scholar 

  38. Wang JS, Lin HS, Li CR, Zhang MW (1994) Experimental studies of analgesia effect of Qigong. In: Zhang ZH (ed) Encyclopedia of Chinese qigong. United Publisher, Beijing, pp 320–323

    Google Scholar 

  39. Zhang JM, Chen YF, He JH, Xian T, Yi Y (1990) Analgesic effect of emitted Qi and the preliminary study of its mechanism. In: Proceedings of the Third National Academic Conference on Qigong Sciences. Nov; 37; Guangzhou, China

Download references

Acknowledgement

This study was supported by a research grant (1R21AT02531) from the National Center of Complementary and Alternative Medicine, National Institutes of Health to Kevin Chen (PI).

We sincerely thank Binhui He and Faxiang Hou for working as qigong healers in this study. Without their collaboration and hard effort, this study would not have been possible. We also thank Sophie Shen, Kara Moeller, Lei Zhong, Yanzhi Hu, Yufei Li, and Yunqiang Qi for their help in data collection and carrying out the proposed trial.

Conflict of Interest

None.

Author information

Authors and Affiliations

  1. UMDNJ—Robert Wood Johnson Medical School, Piscataway, NJ, USA

    Kevin W Chen, Alex Lam, Joy Staller & Leonard H. Sigal

  2. Center for Integrative Medicine, University of Maryland School of Medicine, 2200 Kernan Drive, Kernan Hospital Mansion, Baltimore, MD, 21207-6697, USA

    Kevin W Chen

  3. UMDNJ—School of Health Related Profession, Newark, NJ, USA

    Adam Perlman

  4. Drexel University School of Public Health, Philadelphia, PA, USA

    Jason G. Liao

Authors
  1. Kevin W Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adam Perlman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jason G. Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alex Lam
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joy Staller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leonard H. Sigal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin W Chen.

Additional information

Trial registration: clinicaltrials.gov identifier: NCT00104156

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chen, K.W., Perlman, A., Liao, J.G. et al. Effects of external qigong therapy on osteoarthritis of the knee. Clin Rheumatol 27, 1497–1505 (2008). https://doi.org/10.1007/s10067-008-0955-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-008-0955-4

Keywords

Search

Navigation