Tai Chi or Qigong

Our assessments of evidence for each medical benefit fall into one of these categories:

• Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
• Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
• Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
• Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
• Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
• Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

Learn more about how we research and rate therapies and practices in How We Rate Therapies ›

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on tumor size among women with breast cancer treated with external qigongalso known as medical qigong or external qi emission therapy, a practice in which a therapist provides “emitted” energy known as qi to promote healing in a small trial

• No evidence of an effect on tumor size among women with pathologically confirmed breast cancer awaiting surgery treated with 5 consecutive days of external qigong for 2 to 5 minutes in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design¹Cohen L, Chen Z et al. External qigong therapy for women with breast cancer prior to surgery. Integrative Cancer Therapies. 2010 Dec;9(4):348-53.

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower body weight among people with cancer who practice qigong or tai chi

• Lower body weight among people with cancer practicing qigong or tai chi compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 9 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complementary Therapies in Medicine. 2014 Feb;22(1):173-86.

Qigong

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on body mass index among people with cancer practicing a particular type of qigong (Baduanjin) in a small trial

• No evidence of an effect on body mass index among people with breast cancer practicing Baduanjin qigong exercise 3 days a week at hospital and another 4 days a week at home for 6 months compared to controls in a small RCT³Ying W, Min QW et al. The health effects of Baduanjin exercise (a type of Qigong exercise) in breast cancer survivors: a randomized, controlled, single-blinded trial. European Journal of Oncology Nursing. 2019 Apr;39:90-97.

Good evidence of lower measures of body weight among people with metabolic disorders who practice fitness qigong

• Smaller waist circumference and body mass index among people with metabolic syndromea cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels practicing fitness qigong (Baduanjin or Wuqinxi) compared to controls in a meta-analysis of 8 RCTs⁴Li S, Wang P, Wang J, Zhao J, Wang X, Liu T. Effect of mind-body exercise on risk factors for metabolic syndrome including insulin resistance: a meta-analysis. Frontiers in Endocrinology (Lausanne). 2024 Jan 26;15:1289254.
• Lower waist circumference and waist-hip ratio but no evidence of an effect on body weight or body mass index among obese, middle-aged, females with diabetes practicing 8 new Baduanjin qigong exercises for 24 weeks compared to controls in a small RCT⁵Liu T, Bai S, Zhang RC. [Effects of Health Qigong Baduanjin on diabetes related indexes in middle-aged obese women]. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2018 Jan 8;34(1):19-22. Chinese.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower measures of body fat among adults practicing qigong

• Lower body weight and body mass index among female college freshmen who practiced qigong Baduanjin exercise 1 hour a day 3 days a week for 12 weeks compared to controls in a small RCT⁶Zhang Y, Jiang X. The effect of Baduanjin exercise on the physical and mental health of college students: a randomized controlled trial. Medicine (Baltimore). 2023 Aug 25;102(34):e34897.
• Better percentage of body fat at 6 and 12 weeks but not 16 weeks among community-dwelling adults diagnosed with risk factors for coronary artery disease participating in a 60-minute qigong group session 3 times a week for 3 months compared to controls in a mid-sized RCT⁷Hung HM, Yeh SH, Chen CH. Effects of qigong exercise on biomarkers and mental and physical health in adults with at least one risk factor for coronary artery disease. Biological Research for Nursing. 2016 May;18(3):264-73.
• Lower body fat among middle-aged women practicing Muscle/Tendon Change Classic (MTCC) qigong for 8 weeks compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁸Tsai YK, Chen HH, Lin IH, Yeh ML. Qigong improving physical status in middle-aged women. Western Journal of Nursing Research. 2008 Dec;30(8):915-27.

Tai chi

Good evidence of comparable improvements in body mass index among people with breast cancer either practicing tai chi or receiving conventional supportive care interventions

• Comparable improvements in body mass index among people with breast cancer either practicing tai chi or receiving conventional supportive care interventions in a meta-analysis of 16 RCTs⁹Liu L, Tan H, Yu S, Yin H, Baxter GD. The effectiveness of tai chi in breast cancer patients: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2020 Feb;38:101078.

Good evidence of smaller waist circumference and lower body mass index among people with or at risk of metabolic syndrome who practiced tai chi

• Greater reductions in waist circumference and body mass index (BMI) among people with or at risk of metabolic syndrome practicing tai chi compared to controls in a meta-analysis of 20 RCTs¹⁰Chau JPC, Leung LY et al. Effects of tai chi on health outcomes among community-dwelling adults with or at risk of metabolic syndrome: a systematic review. Complementary Therapies in Clinical Practice. 2021 Aug;44:101445.

Qigong

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of better markers of blood sugar and preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better insulin sensitivity among people with metabolic disorders practicing qigong

• Lower blood glucose levels among people with metabolic syndromea cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels practicing fitness qigong (Baduanjin or Wuqinxi) compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 8 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹¹Li S, Wang P, Wang J, Zhao J, Wang X, Liu T. Effect of mind-body exercise on risk factors for metabolic syndrome including insulin resistance: a meta-analysis. Frontiers in Endocrinology (Lausanne). 2024 Jan 26;15:1289254.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on fasting plasma glucose, a marker of blood sugar (HbA1c levels), or a marker of insulin resistance (C-peptide levels) among middle-aged and older adults with type 2 diabetes practicing qigong compared to controls in a small RCT¹²Li X, Si H, Chen Y, Li S, Yin N, Wang Z. Effects of fitness qigong and tai chi on middle-aged and elderly patients with type 2 diabetes mellitus. PLoS One. 2020 Dec 17;15(12):e0243989.
• Lower fasting blood glucose and HbA1ca form of hemoglobin, a protein in red blood cells, that is bound to sugar (glycated hemoglobin). Levels of HbA1c in the blood indicate the average level of blood sugar during the prior two to three months. levels among obese, middle-aged, females diabetes practicing 8 new Baduanjin qigong exercises for 24 weeks compared to controls in a small RCT¹³Liu T, Bai S, Zhang RC. [Effects of Health Qigong Baduanjin on diabetes related indexes in middle-aged obese women]. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2018 Jan 8;34(1):19-22. Chinese.
• Better markers of blood sugar and insulin sensitivity (HbA1c, insulin resistance, and fasting blood insulin) among people with elevated blood glucose levels practicing qigong for 12 weeks compared to usual care in a small RCT¹⁴Liu X, Miller YD, Burton NW, Chang JH, Brown WJ. Qi-gong mind-body therapy and diabetes control. A randomized controlled trial. American Journal of Preventive Medicine. 2011 Aug;41(2):152-8.
• Better (lower) fasting glucose and a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower insulin resistance (HOMA-IR) among adults with type 2 diabetes practicing group qigong once a week for 60 minutes plus a 30-minute session at home twice a week compared to controls in a small RCT¹⁵Sun GC, Lovejoy JC et al. Effects of qigong on glucose control in type 2 diabetes: a randomized controlled pilot study. Diabetes Care. 2010 Jan;33(1):e8.

Preliminary evidence of lower blood sugar levels among people with high blood pressure (hypertension) but no evidence of an effect of among people with risk factors for coronary artery disease practicing qigong

• Lower fasting blood glucose among people with essential hypertension practicing Ba duan jin qigong 5 times a week for 6 months compared to controls in a small RCT¹⁶Xiao C, Yang Y, Zhuang Y. Effect of Health Qigong Ba Duan Jin on blood pressure of individuals with essential hypertension. Journal of the American Geriatrics Society. 2016 Jan;64(1):211-3.
• No evidence of an effect on HbA1c or fasting plasma sugar among community-dwelling adults diagnosed with risk factors for coronary artery disease participating in a 60-minute qigong group session 3 times a week for 3 months compared to controls in a mid-sized RCT¹⁷Hung HM, Yeh SH, Chen CH. Effects of qigong exercise on biomarkers and mental and physical health in adults with at least one risk factor for coronary artery disease. Biological Research for Nursing. 2016 May;18(3):264-73.

Tai chi

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower insulin but no evidence of an effect on insulin-related proteins among people with breast cancer recently completing cancer treatment practicing tai chi chuan

• A weak trend toward lower insulin but no evidence of an effect on insulin-related proteins among people with breast cancer recently completing cancer treatment practicing tai chi chuan compared to non-activity controls treated with psychosocial support therapy in a small RCT¹⁸Janelsins MC, Davis PG et al. Effects of tai chi chuan on insulin and cytokine levels in a randomized controlled pilot study on breast cancer survivors. Clinical Breast Cancer. 2011 Jun;11(3):161-70.

Good evidence of lower blood sugar and insulin resistance among people with elevated blood glucose or type 2 diabetes practicing tai chi

• Lower blood glucose level and insulin resistance among people with elevated blood glucose or type 2 diabetes practicing tai chi compared to controls in a meta-analysis of 20 RCTs¹⁹Chau JPC, Leung LY et al. Effects of tai chi on health outcomes among community-dwelling adults with or at risk of metabolic syndrome: a systematic review. Complementary Therapies in Clinical Practice. 2021 Aug;44:101445.
• Higher HbA1C and a lower marker of insulin resistance (C-peptide levels) but no evidence of an effect on fasting plasma glucose among middle-aged and older adults with type 2 diabetes practicing tai chi compared to controls in a small RCT²⁰Li X, Si H, Chen Y, Li S, Yin N, Wang Z. Effects of fitness qigong and tai chi on middle-aged and elderly patients with type 2 diabetes mellitus. PLoS One. 2020 Dec 17;15(12):e0243989.
• Lower HbA1c levels among people with type 2 diabetes participating in tai chi compared to controls in a meta-analysis of 5 RCTs²¹Pai LW, Li TC et al. The effectiveness of regular leisure-time physical activities on long-term glycemic control in people with type 2 diabetes: a systematic review and meta-analysis. Diabetes Research and Clinical Practice. 2016 Mar;113:77-85.

Metabolism hormones: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher levels of adiponectina hormone and signaling protein involved in regulating glucose levels and fatty acid breakdown—important in regulating glucose levels and fatty acid breakdown—among females with chronic fatigue syndrome (CFS)-like illness participating in 16 separate 90-minute lessons of Baduanjin qigong

• Higher plasma adiponectin levels among females with chronic fatigue syndrome (CFS)-like illness participating in 16 separate 90-minute Baduanjin qigong lessons over 9 weeks compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²²Chan JS, Li A et al. Adiponectin potentially contributes to the antidepressive effects of Bbaduanjin qigong exercise in women with chronic fatigue syndrome-like illness. Cell Transplantation. 2017 Mar 13;26(3):493-501.

Stress hormones

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cortisol levels among people with cancer practicing qigong or tai chi

• Lower cortisol levels among people with cancer practicing qigong or tai chi compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 9 RCTs²³Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complementary Therapies in Medicine. 2014 Feb;22(1):173-86.

Qigong: good evidence of lower cortisol levels among people with cancer practicing qigong

• Better (lower) cortisol levels among people with cancer after practicing qigong compared to controls in a combined analysis of 11 RCTs²⁴Klein PJ, Schneider R, Rhoads CJ. Qigong in cancer care: a systematic review and construct analysis of effective qigong therapy. Supportive Care in Cancer. 2016 Jul;24(7):3209-22.
• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower cortisol among adolescents participating in a laughing qigong program for 45 minutes once a week for 8 weeks in a small RCT²⁵Chang C, Tsai G, Hsieh CJ. Psychological, immunological and physiological effects of a laughing qigong program (LQP) on adolescents. Complementary Therapies in Medicine. 2013 Dec;21(6):660-8.

Tai chi: good evidence of lower levels of the stress hormone cortisol among people with cancer practicing tai chi

• Lower cortisol levels among people with cancer practicing tai chi compared to controls in a meta-analysis of 22 RCTs with moderate-level evidence²⁶Ni X, Chan RJ et al. The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis. Supportive Care in Cancer. 2019 Oct;27(10):3701-3716.

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of a small increase in levels of immune cells among people practicing tai chi or qigong

• A small increase in the levels of immune cells among people practicing tai chi or qigong compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 19 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²⁷Oh B, Bae K et al. The effects of tai chi and qigong on immune responses: a systematic review and meta-analysis. Medicines (Basel). 2020 Jun 30;7(7):39.

Qigong: good evidence of higher markers of cancer-specific immune function among people with cancer practicing qigong

• Higher markers of cancer-specific immune function among people with cancer practicing qigong compared to controls in a combined analysis of 11 RCTs²⁸Klein PJ, Schneider R, Rhoads CJ. Qigong in cancer care: a systematic review and construct analysis of effective qigong therapy. Supportive Care in Cancer. 2016 Jul;24(7):3209-22.

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less inflammation among people practicing tai chi or qigong

• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less inflammation among people practicing tai chi or qigong compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 19 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²⁹Oh B, Bae K et al. The effects of tai chi and qigong on immune responses: a systematic review and meta-analysis. Medicines (Basel). 2020 Jun 30;7(7):39.

Qigong: insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs. no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on markers of inflammation among people practicing qigong

• Lower levels of proinflammatory cytokines interleukin (IL) 6 and 1β among people with both depressive symptoms and sleep disturbance participating in 8 weekly qigong sessions compared to controls in a mid-sized RCT³⁰Ng SM, Yin MXC et al. Impact of mind-body intervention on proinflammatory cytokines interleukin 6 and 1β: a three-arm randomized controlled trial for persons with sleep disturbance and depression. Brain, Behavior, and Immunity. 2022 Jan;99:166-176.
• A lower marker of inflammation (peripheral IL-6 levels) among cognitively healthy older people practicing qigong for 12 weeks compared to physical stretching exercise in a small RCT³¹Qi D, Wong NML et al. Qigong exercise enhances cognitive functions in the elderly via an interleukin-6-hippocampus pathway: a randomized active-controlled trial. Brain, Behavior, and Immunity. 2021 Jul;95:381-390.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on markers of inflammation (TNF and IL-6) among Chinese female survivors of intimate partner violence participating in Baduanjin qigong group training (weeks 1-6: 2-hour sessions biweekly; weeks 7-22: 1-hour follow-up sessions weekly) and self-practice (30 minutes per day for 22 weeks) compared to controls in a mid-sized RCT³²Cheung DST, Deng W et al. Effect of a qigong intervention on telomerase activity and mental health in Chinese women survivors of intimate partner violence: a randomized clinical trial. JAMA Network Open. 2019 Jan 4;2(1):e186967.
• No evidence of an effect on a marker of inflammation (C-reactive protein) among community-dwelling adults diagnosed with risk factors for coronary artery disease participating in a 60-minute qigong group session 3 times a week for 3 months compared to controls in a mid-sized RCT³³Hung HM, Yeh SH, Chen CH. Effects of qigong exercise on biomarkers and mental and physical health in adults with at least one risk factor for coronary artery disease. Biological Research for Nursing. 2016 May;18(3):264-73.
• A lower marker of inflammation (IL-6) among middle-aged women participating in a Baduanjin qigong training program for 12 weeks compared to controls in a small RCT³⁴Chen HH, Yeh ML, Lee FY. The effects of Baduanjin qigong in the prevention of bone loss for middle-aged women. American Journal of Chinese Medicine. 2006;34(5):741-7.

Tai chi: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of small reductions in markers of inflammation among people practicing tai chi

• Small reductions in markers of inflammation among people practicing tai chi, especially with higher amounts of practice, compared to either controls or baseline in a meta-analysis of 9 RCTs³⁵Shu C, Feng S, Cui Q, Cheng S, Wang Y. Impact of tai chi on CRP, TNF-alpha and IL-6 in inflammation: a systematic review and meta-analysis. Annals of Palliative Medicine. 2021 Jul;10(7):7468-7478.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower markers of oxidative stress among sedentary middle-aged and elderly women with type 2 diabetes practicing qigong

• Lower markers of oxidative stress and better antioxidant/oxidant balance among sedentary middle-aged and elderly women with type 2 diabetes participating in 8-week qigong exercise training compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial³⁶Klarod K, Singsanan S et al. Effects of qigong training on muscle strengths, flexibility, cardiopulmonary fitness, and antioxidant/oxidant responses in sedentary middle-aged and elderly type 2 diabetes mellitus women: a quasi-experimental design, placebo-controlled study. Journal of Integrative and Complementary Medicine. 2024 Mar;30(3):288-296.

Five-element gymnastics combining qigong, xiang gong, and martial arts with gymnastics: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of a lower marker of blood sugar among people with type 2 diabetes practicing five-element gymnastics at home

• A lower marker of blood sugar (HbA1c) among people with type 2 diabetes practicing five-element gymnastics at home for 16 weeks compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial³⁷Huang CL, Tai YK, Yang YH, Wang RH. Efficacy of five-element gymnastics in glucose and lipid control in Taiwanese patients with type 2 diabetes. Research in Nursing & Health. 2012 Aug;35(4):419-29.

• Small-to-moderate relief from anxiety symptoms among people with cancer practicing tai chi or qigong compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 23 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects³⁸Sun F, Li L, Wen X, Xue Y, Yin J. The effect of tai chi/qigong on depression and anxiety symptoms in adults with cancer: a systematic review and meta-regression. Complementary Therapies in Clinical Practice. 2024 Aug;56:101850.
• Lower anxiety levels among people with lung cancer participating in mind-body exercises compared to controls in a meta-analysis of 4 RCTs³⁹Sun J, Chen D, Qin C, Liu R. The effect of mind-body exercise in lung cancer patients: a meta-analysis of RCTs. Supportive Care in Cancer. 2023 Oct 23;31(12):650.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety among people with cancer practicing qigong compared to controls in a meta-analysis of 3 RCTs⁴⁰Zeng Y, Xie X, Cheng ASK. Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Current Oncology Reports. 2019 Apr 6;21(6):48.
• Less anxiety among people with cancer practicing qigong or tai chi compared to controls in a meta-analysis of 9 RCTs⁴¹Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complementary Therapies in Medicine. 2014 Feb;22(1):173-86.

Qigong

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety after surgery among people with breast cancer practicing Baduanjin qigong

• Substantially less anxiety after surgery among people with breast cancer practicing Baduanjin qigong exercise compared to controls in a meta-analysis of 3 RCTs⁴²Ye XX, Ren ZY et al. Effectiveness of Baduanjin exercise on quality of life and psychological health in postoperative patients with breast cancer: a systematic review and meta-analysis. Integrative Cancer Therapies. 2022 Jan-Dec;21:15347354221104092.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower anxiety among people with breast cancer practicing qigong

• Moderately lower anxiety among people with breast cancer practicing qigong compared to controls in a meta-analysis of 5 clinical trials⁴³Meng T, Hu SF et al. Qigong for women with breast cancer: an updated systematic review and meta-analysis. Complementary Therapies in Medicine. 2021 Aug;60:102743.

Tai chi: good evidence of less anxiety among people with cancer practicing tai chi

• Lower anxiety symptoms among people with breast cancer practicing tai chi compared to controls in a meta-analysis of 2 RCTs⁴⁴Cai Q, Cai SB et al. Tai chi for anxiety and depression symptoms in cancer, stroke, heart failure, and chronic obstructive pulmonary disease: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2022 Feb;46:101510.
• Less anxiety (lower scores) during chemotherapy or radiotherapy among middle-aged and elderly people with cancer practicing tai chi compared to controls in a mid-sized RCT⁴⁵Cheng D, Wang X et al. Effect of tai chi and resistance training on cancer-related fatigue and quality of life in middle-aged and elderly cancer patients. Chinese Journal of Integrative Medicine. 2021 Apr;27(4):265-272.
• Moderately less anxiety among people with breast cancer practicing 12 weeks of tai chi chuan compared to non-exercise therapy in a meta-analysis of 15 RCTs⁴⁶Luo XC, Liu J et al. Effect of tai chi chuan in breast cancer patients: a systematic review and meta-analysis. Frontiers in Oncology. 2020 Apr 23;10:607.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of a smaller decrease in white blood cell counts and hemoglobin from chemotherapy among people with non-Hodgkin lymphoma or breast cancer participating in a Chan-Chuang qigong program

• Less decrease in white blood cell counts and hemoglobin after the first course of chemotherapy among people with non-Hodgkin lymphoma participating in a 21-day Chan-Chuang qigong program compared to controls in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁴⁷Chuang TY, Yeh ML, Chung YC. A nurse facilitated mind-body interactive exercise (Chan-Chuang qigong) improves the health status of non-Hodgkin lymphoma patients receiving chemotherapy: randomised controlled trial. International Journal of Nursing Studies. 2017 Apr;69:25-33.
• Less leukopeniaan abnormally low number of white cells in the blood, leading to increased susceptibility to infection during chemotherapy among people with breast cancer participating in Chan-Chuang qigong therapy for 21 days compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁴⁸Yeh ML, Lee TI, Chen HH, Chao TY. The influences of Chan-Chuang qi-gong therapy on complete blood cell counts in breast cancer patients treated with chemotherapy. Cancer Nursing. 2006 Mar-Apr;29(2):149-55.

Preliminary evidence of fewer blood clots (venous thrombosis) during the intermission of chemotherapy among people with malignant tumors and a peripherally inserted central catheter (PICC) practicing simplified tai chi exercises

• Fewer blood clots (venous thrombosis) during the intermission of chemotherapy among people with malignant tumors and a peripherally inserted central catheter practicing 24 simplified tai chi exercises compared to grip strength exercise for 3 months in a small RCT⁴⁹Ding Y, Ji L, Hu Y. Effects of tai chi on catheter management and quality of life in tumor patients with PICC at the intermission of chemotherapy: a non-inferiority randomized controlled trial. Annals of Palliative Medicine. 2020 Sep;9(5):3293-3303.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of more bone formation and less bone resorption among people with breast cancer practicing tai chi chuan

• More bone formation and less bone resorption among people with breast cancer who had completed treatment within 30 months practicing tai chi chuan 3 times per week, 60 minutes per session for 12 weeks compared to standard support therapy in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵⁰Peppone LJ, Mustian KM et al. Effects of a structured weight-bearing exercise program on bone metabolism among breast cancer survivors: a feasibility trial. Clinical Breast Cancer. 2010 Jun;10(3):224-9.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on breathlessness among people with advanced cancer participating in meditative movement (yoga, tai chi, or qigong) in a combined analysis of studies

• No evidence of an effect on breathlessness among people with advanced cancer participating in meditative movement (yoga, tai chi, or qigong) compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 3 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵¹Nolan CM, Brighton LJ et al. Meditative movement for breathlessness in advanced COPD or cancer: a systematic review and meta-analysis. European Respiratory Review. 2023 Jun 21;32(168):220243.

Qigong

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of comparable improvements in lung function among people with non-small cell lung cancer either practicing qigong or participating in routine lung rehabilitation

• Comparable improvements in lung function among people with non-small cell lung cancer either practicing Baduanjin qigong for 12 weeks or participating in routine lung rehabilitation training in a mid-sized RCT⁵²Xu J, Li X et al. Effect of Baduanjin qigong on postoperative pulmonary rehabilitation in patients with non-small cell lung cancer: a randomized controlled trial. Supportive Care in Cancer. 2023 Dec 30;32(1):73.

No evidence of an effect on lung capacity among people with breast cancer practicing qigong

• No evidence of an effect on lung capacity among people with breast cancer practicing Baduanjin qigong exercise 3 days a week at hospital and another 4 days a week at home for 6 months compared to controls in a small RCT⁵³Ying W, Min QW et al. The health effects of Baduanjin exercise (a type of Qigong exercise) in breast cancer survivors: a randomized, controlled, single-blinded trial. European Journal of Oncology Nursing. 2019 Apr;39:90-97.

Preliminary evidence of less cough among people with lung cancer practicing qigong

• Less cough among people with lung cancer after practicing qigong more than 6 weeks compared to usual care in a mid-sized RCT⁵⁴Molassiotis A, Vu DV, Ching SSY. The effectiveness of qigong in managing a cluster of symptoms (breathlessness-fatigue-anxiety) in patients with lung cancer: a randomized controlled trial. Integrative Cancer Therapies. 2021 Jan-Dec;20:15347354211008253.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better measures of cardiovascular health among people with nasopharyngeal cancer participating in a tai chi qigong training program

• Better measures of cardiovascular health (higher diastolic blood flow velocity and lower arterial blood flow resistance) among people with nasopharyngeal cancer participating in a tai chi qigong training program for 6 months compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁵⁵Fong SS, Ng SS et al. Effects of a 6-month tai chi qigong program on arterial hemodynamics and functional aerobic capacity in survivors of nasopharyngeal cancer. Journal of Cancer Survivorship. 2014 Dec;8(4):618-26.

Preliminary evidence of better heart rate variability among people with breast cancer practicing Baduanjin qigong

• Better heart rate variability among people with breast cancer practicing Baduanjin qigong exercise 3 days a week at hospital and another 4 days a week at home for 6 months compared to controls in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵⁶Ying W, Min QW et al. The health effects of Baduanjin exercise (a type of Qigong exercise) in breast cancer survivors: a randomized, controlled, single-blinded trial. European Journal of Oncology Nursing. 2019 Apr;39:90-97.

Also see substantial evidence of better markers of cardiopulmonary function not specific to people with cancer below in Side effects not specific to cancer.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on cognitive performance among people with breast cancer practicing Qigong and Tai Chi Easy in a small study

• No evidence of an effect on cognitive performance (Functional Assessment of Cancer Therapy-Cognitive Function scores) among people with breast cancer practicing Qigong and Tai Chi Easy compared to sham qigong for 12 weeks in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵⁷Larkey LK, Roe DJ, Smith L, Millstine D. Exploratory outcome assessment of Qigong/Tai Chi Easy on breast cancer survivors. Complementary Therapies in Medicine. 2016 Dec;29:196-203.

Qigong: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better cognitive function among people with cancer practicing qigong

• Less chemotherapy-related cognitive impairment among people with breast cancer practicing qigong compared to psychotherapy in a network meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 8 RCTs⁵⁸Liu Y, Liu JE, Chen S, Zhao F, Chen L, Li R. Effectiveness of nonpharmacologic interventions for chemotherapy-related cognitive impairment in breast cancer patients: a systematic review and network meta-analysis. Cancer Nursing. 2023 Sep-Oct 01;46(5):E305-E319.
• Better cognitive function during chemotherapy among people with gastrointestinal cancer participating in 5 sessions of qigong in addition to conventional treatment each week compared to conventional treatment alone in a small RCT⁵⁹Yang LH, Duan PB, Hou QM, Wang XQ. Qigong exercise for patients with gastrointestinal cancer undergoing chemotherapy and at high risk for depression: a randomized clinical trial. Journal of Alternative and Complementary Medicine. 2021 Sep;27(9):750-759.
• Better mental function among people with cancer, chronic fatigue, or other conditions practicing qigong compared to controls in a meta-analysis of 4 RCTs⁶⁰Wang R, Huang X, Wu Y, Sun D. Efficacy of qigong exercise for treatment of fatigue: a systematic review and meta-analysis. Frontiers in Medicine (Lausanne). 2021 Jun 22;8:684058.
• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward better cognitive function among people with cancer practicing qigong compared to controls in a meta-analysis of 3 RCTs⁶¹Zeng Y, Xie X, Cheng ASK. Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Current Oncology Reports. 2019 Apr 6;21(6):48.
• Greater improvement in self-reported cognition among people with breast cancer who had completed chemotherapy and radiation therapy between 2 months to 8 years prior practicing qigong for 8 weeks compared to either gentle exercise or survivorship support in a small RCT⁶²Myers JS, Mitchell M et al. Qigong intervention for breast cancer survivors with complaints of decreased cognitive function. Supportive Care in Cancer. 2019 Apr;27(4):1395-1403.
• Better self-reported cognitive function, perceived cognitive abilities, and impact of perceived cognitive impairment on quality of life among people with cancer practicing medical qigong compared to usual health care in a small RCT⁶³Oh B, Butow PN et al. Effect of medical qigong on cognitive function, quality of life, and a biomarker of inflammation in cancer patients: a randomized controlled trial. Supportive Care in Cancer. 2012 Jun;20(6):1235-42.

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less reported depression among people with cancer practicing tai chi or qigong

• Small-to-moderate relief from depression symptoms among people with cancer practicing tai chi or qigong compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 33 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶⁴Sun F, Li L, Wen X, Xue Y, Yin J. The effect of tai chi/qigong on depression and anxiety symptoms in adults with cancer: a systematic review and meta-regression. Complementary Therapies in Clinical Practice. 2024 Aug;56:101850.
• Less reported depression among people with cancer practicing tai chi or qigong compared to all controls, and a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less depression compared to active controls (participating in other movement activities) in a meta-analysis of 8 RCTs and controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁶⁵Wayne PM, Lee MS et al. Tai chi and qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. Journal of Cancer Survivorship. 2018 Apr;12(2):256-267.
• A weak trend toward less depression among people with cancer practicing qigong or tai chi compared to controls in a meta-analysis of 9 RCTs⁶⁶Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complementary Therapies in Medicine. 2014 Feb;22(1):173-86.

Qigong: good evidence of less depression among people with cancer practicing qigong

• Lower depression among people with breast cancer participating in Baduanjin or other qigong compared to controls in a network meta-analysis of 32 RCTs⁶⁷Geng L, Duan Y et al. Comparative efficacy of mind-body exercise for depression in breast cancer survivors: a systematic review and network meta-analysis. Worldviews on Evidence-Based Nursing. 2023 Dec;20(6):593-609.
• Moderately less depression after surgery among people with breast cancer practicing Baduanjin qigong exercise compared to controls in a meta-analysis of 2 RCTs⁶⁸Ye XX, Ren ZY et al. Effectiveness of Baduanjin exercise on quality of life and psychological health in postoperative patients with breast cancer: a systematic review and meta-analysis. Integrative Cancer Therapies. 2022 Jan-Dec;21:15347354221104092.
• Lower depression among people with breast cancer practicing qigong compared to controls in a meta-analysis of 6 clinical trials⁶⁹Meng T, Hu SF et al. Qigong for women with breast cancer: an updated systematic review and meta-analysis. Complementary Therapies in Medicine. 2021 Aug;60:102743.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on depression among people with cancer practicing qigong compared to controls either immediately after the intervention (4 studies) or 3 months after stopping qigong (2 studies), in meta-analyses of RCTs⁷⁰Cheung DST, Takemura N et al. Effect of qigong for sleep disturbance-related symptom clusters in cancer: a systematic review and meta-analysis. Sleep Medicine. 2021 Sep;85:108-122.
• No evidence of an effect on depression among people with cancer practicing qigong compared to controls in a meta-analysis of 4 RCTs⁷¹Zeng Y, Xie X, Cheng ASK. Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Current Oncology Reports. 2019 Apr 6;21(6):48.

Tai chi

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower depression symptoms among people with cancer practicing tai chi

• A very weak trend toward lower depression symptoms among people with breast cancer practicing tai chi compared to controls in a meta-analysis of 4 RCTs⁷²Cai Q, Cai SB et al. Tai chi for anxiety and depression symptoms in cancer, stroke, heart failure, and chronic obstructive pulmonary disease: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2022 Feb;46:101510.
• Less depression (lower scores) during chemotherapy or radiotherapy among middle-aged and elderly people with cancer practicing tai chi compared to controls in a mid-sized RCT⁷³Cheng D, Wang X et al. Effect of tai chi and resistance training on cancer-related fatigue and quality of life in middle-aged and elderly cancer patients. Chinese Journal of Integrative Medicine. 2021 Apr;27(4):265-272.

Good evidence of comparable improvements in depression among people with breast cancer either practicing tai chi or receiving conventional supportive care interventions

• Comparable improvements in depression among people with breast cancer either practicing tai chi or receiving conventional supportive care interventions in a meta-analysis of 16 RCTs⁷⁴Liu L, Tan H, Yu S, Yin H, Baxter GD. The effectiveness of tai chi in breast cancer patients: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2020 Feb;38:101078.

Also see some evidence of worse depression among people with breast cancer practicing tai chi in Safety and precautions ›

Without regard to treatment phase

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less fatigue among people with cancer practicing tai chi or qigong without regard to treatment phase

• Less fatigue among people with cancer practicing qigong compared to controls immediately after the intervention (8 studies), although no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. 3 months after stopping qigong (4 studies), in meta-analysesstatistical analyses that combine the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁷⁵Cheung DST, Takemura N et al. Effect of qigong for sleep disturbance-related symptom clusters in cancer: a systematic review and meta-analysis. Sleep Medicine. 2021 Sep;85:108-122.
• Moderately less fatigue among people with cancer practicing tai chi or qigong compared to controls in a meta-analysis of 7 RCTs⁷⁶Zeng Y, Xie X, Cheng ASK. Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Current Oncology Reports. 2019 Apr 6;21(6):48.
• Substantially less reported fatigue among people with cancer practicing tai chi or qigong compared to all controls or to active controls (participating in other movement activities) in a meta-analysis of 12 RCTs and controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁷⁷Wayne PM, Lee MS et al. Tai chi and qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. Journal of Cancer Survivorship. 2018 Apr;12(2):256-267.

Qigong: good evidence of less fatigue, including cancer-related fatigue, among people with cancer practicing qigong without regard to treatment phase

• Comparable benefits regarding cancer-related fatigue among women either practicing qigong for 10 weeks or participating in an intervention combining strength and aerobic exercise, plant-based nutrition, and health/psycho-education in a small RCT⁷⁸Zimmerman CS, Temereanca S et al. A randomized controlled pilot trial comparing effects of qigong and exercise/nutrition training on fatigue and other outcomes in female cancer survivors. Integrative Cancer Therapies. 2023 Jan-Dec;22:15347354231162584.
• Lower fatigue scores among people with non-small cell lung cancer practicing Baduanjin qigong for 12 weeks compared to routine lung rehabilitation training in a mid-sized RCT⁷⁹Xu J, Li X et al. Effect of Baduanjin qigong on postoperative pulmonary rehabilitation in patients with non-small cell lung cancer: a randomized controlled trial. Supportive Care in Cancer. 2023 Dec 30;32(1):73.
• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less fatigue among people with breast cancer practicing qigong compared to controls in a meta-analysis of 6 clinical trials⁸⁰Meng T, Hu SF et al. Qigong for women with breast cancer: an updated systematic review and meta-analysis. Complementary Therapies in Medicine. 2021 Aug;60:102743.
• Less intense cancer-related fatigue among people with cancer practicing qigong compared to controls in a meta-analysis of 4 RCTs⁸¹Wang R, Huang X, Wu Y, Sun D. Efficacy of qigong exercise for treatment of fatigue: a systematic review and meta-analysis. Frontiers in Medicine (Lausanne). 2021 Jun 22;8:684058.
• Lower incidence of moderate to severe cancer-related fatigue among people practicing Baduanjin qigong exercise compared to controls in a meta-analysis of 5 RCTs⁸²Kuo CC, Wang CC et al. Clinical effects of Baduanjin qigong exercise on cancer patients: a systematic review and meta-analysis on randomized controlled trials. Evidence-Based Complementary and Alternative Medicine. 2021 Apr 8;2021:6651238.

Tai chi: good evidence of less fatigue among people with cancer practicing tai chi without regard to treatment phase

• Less fatigue among people with breast cancer participating in 8 weeks of tai chi compared to routine care in a small RCT⁸³Yao LQ, Kwok SWH et al. The effect of an evidence-based tai chi intervention on the fatigue-sleep disturbance-depression symptom cluster in breast cancer patients: a preliminary randomised controlled trial. European Journal of Oncology Nursing. 2022 Dec;61:102202.
• Comparable improvements in fatigue among people with breast cancer either practicing tai chi or receiving conventional supportive care interventions in a meta-analysis of 16 RCTs⁸⁴Liu L, Tan H, Yu S, Yin H, Baxter GD. The effectiveness of tai chi in breast cancer patients: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2020 Feb;38:101078.
• Less cancer-related fatigue among people with cancer practicing tai chi compared to controls in a meta-analysis of 22 RCTs with moderate-level evidence⁸⁵Ni X, Chan RJ et al. The effects of tai chi on quality of life of cancer survivors: a systematic review and meta-analysis. Supportive Care in Cancer. 2019 Oct;27(10):3701-3716.
• Less cancer-related fatigue during the intervention among people with breast cancer or lung cancer but no evidence of an effect among people with prostate cancer practicing tai chi, and greater benefits with a longer intervention time (8-12 weeks), compared to controls in a meta-analysis of 6 RCTs⁸⁶Song S, Yu J et al. Ameliorative effects of tai chi on cancer-related fatigue: a meta-analysis of randomized controlled trials. Supportive Care in Cancer. 2018 Jul;26(7):2091-2102.

During treatment 

Qigong: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less moderate-to-severe cancer-related fatigue during chemotherapy among people with colorectal cancer practicing qigong

• Less moderate-to-severe cancer-related fatigue during chemotherapy among people with colorectal cancer practicing Baduanjin qigong for 24 weeks compared to routine care in a small RCT⁸⁷Lu Y, Qu HQ et al. Effect of Baduanjin qigong exercise on cancer-related fatigue in patients with colorectal cancer undergoing chemotherapy: a randomized controlled trial. Oncology Research and Treatment. 2019;42(9):431-439.

Tai chi: good evidence of less fatigue during cancer treatment among people participating in supervised tai chi

• Less fatigue during cancer treatment among people participating in 40–60 minutes of supervised tai chi 3 times a week for 8–12 weeks compared to controls in a systematic review of 13 RCTs and 1 controlled trial⁸⁸Yang L, Winters-Stone K et al. Tai chi for cancer survivors: a systematic review toward consensus-based guidelines. Cancer Medicine. 2021 Sep 17.
• Less cancer-related fatigue during chemotherapy or radiotherapy among middle-aged and elderly people with cancer practicing tai chi compared to baseline and apparently less fatigue compared to controls in a mid-sized RCT⁸⁹Cheng D, Wang X et al. Effect of tai chi and resistance training on cancer-related fatigue and quality of life in middle-aged and elderly cancer patients. Chinese Journal of Integrative Medicine. 2021 Apr;27(4):265-272.

After cancer treatment: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less cancer-related fatigue after cancer treatment among people practicing tai chi

• Less fatigue after cancer treatment among people participating in 40–60 minutes of supervised tai chi 3 times a week for 8–12 weeks compared to controls in a systematic review of 13 RCTs and 1 controlled trial, with low quality of evidence⁹⁰Yang L, Winters-Stone K et al. Tai chi for cancer survivors: a systematic review toward consensus-based guidelines. Cancer Medicine. 2021 Sep 17.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on arm circumference among people with advanced cancer participating in meditative movement in a combined analysis of studies

• No evidence of an effect on arm circumference among people with advanced cancer participating in meditative movement (yoga, tai chi, or qigong) compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 3 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁹¹Nolan CM, Brighton LJ et al. Meditative movement for breathlessness in advanced COPD or cancer: a systematic review and meta-analysis. European Respiratory Review. 2023 Jun 21;32(168):220243.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of smaller arm circumference after surgery among people with breast cancer practicing qigong

• Smaller arm circumference after surgery among people with breast cancer practicing qigong compared to controls (resting) in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁹²Tao W, Luo X et al. Practice of traditional Chinese medicine for psycho-behavioral intervention improves quality of life in cancer patients: a systematic review and meta-analysis. Oncotarget. 2015 Nov 24;6(37):39725-39.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer neuropathic symptoms among women with metastatic breast cancer practicing medical qigong

• Fewer neuropathic symptoms among women with metastatic breast cancer practicing medical qigong (integration of gentle exercise and meditation) compared to meditation alone in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁹³Oh B, Butow PN et al. Effects of qigong on quality of life, fatigue, stress, neuropathy, and sexual function in women with metastatic breast cancer: a feasibility study. 2014 ASCO Annual Meeting I.

Without regard to treatment phase

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on pain among people with cancer practicing tai chi or qigong without regard to treatment phase in a combined analysis of studies

• No evidence of an effect on pain among people with cancer practicing tai chi or qigong compared to all controls or to active controls (participating in other movement activities) in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 4 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects and controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁹⁴Wayne PM, Lee MS et al. Tai chi and qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. Journal of Cancer Survivorship. 2018 Apr;12(2):256-267.

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less pain among people with breast cancer practicing tai chi chuan without regard to treatment phase

• Less pain among people with breast cancer practicing tai chi chuan compared to non-exercise therapy in a meta-analysis of 15 RCTs⁹⁵Luo XC, Liu J et al. Effect of tai chi chuan in breast cancer patients: a systematic review and meta-analysis. Frontiers in Oncology. 2020 Apr 23;10:607.

During cancer treatment

Qigong: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less cancer-related pain during chemotherapy among people with cancer practicing qigong

• Less cancer-related pain during chemotherapy among people with breast cancer practicing qigong compared to controls in a small controlled trial⁹⁶Lee TI, Chen HH, Yeh ML. Effects of chan-chuang qigong on improving symptom and psychological distress in chemotherapy patients. American Journal of Chinese Medicine. 2006;34(1):37-46.

Tai chi: no evidence of an effect on pain during chemotherapy among people with cancer practicing tai chi in a small trial

• No evidence of an effect on pain during the intermission of chemotherapy among people with malignant tumors and a peripherally inserted central catheter practicing 24 simplified tai chi exercises compared to grip strength exercise for 3 months in a small RCT⁹⁷Ding Y, Ji L, Hu Y. Effects of tai chi on catheter management and quality of life in tumor patients with PICC at the intermission of chemotherapy: a non-inferiority randomized controlled trial. Annals of Palliative Medicine. 2020 Sep;9(5):3293-3303.

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of better physical function among people with lung cancer participating in mind-body exercises

• Better 6-minute walk distance among people with lung cancer participating in mind-body exercises compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 4 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁹⁸Sun J, Chen D, Qin C, Liu R. The effect of mind-body exercise in lung cancer patients: a meta-analysis of RCTs. Supportive Care in Cancer. 2023 Oct 23;31(12):650.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better neck mobility but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on temporomandibular joint or shoulder joint mobility among people with nasopharyngeal cancer receiving tai chi qigong training

• Better neck (cervical) side flexion but no evidence of an effect on temporomandibular joint or shoulder joint mobility among people with nasopharyngeal cancer receiving tai chi qigong training for 1.5 hours per session, 4 sessions per week including self-practice for 6 months compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁹⁹Fong SS, Ng SS et al. The effects of a 6-month tai chi qigong training program on temporomandibular, cervical, and shoulder joint mobility and sleep problems in nasopharyngeal cancer survivors. Integrative Cancer Therapies. 2015 Jan;14(1):16-25.

Preliminary evidence of greater shoulder mobility among people with breast cancer participating in regular tai chi qigong training

• Greater shoulder mobility among people with breast cancer participating in regular tai chi qigong training compared to sedentary controls in a small observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study¹⁰⁰Fong SS, Ng SS et al. Shoulder mobility, muscular strength, and quality of life in breast cancer survivors with and without tai chi qigong training. Evidence-Based Complementary and Alternative Medicine. 2013;2013:787169.

Qigong: good evidence of better physical function among people with lung or breast cancer practicing qigong

• Better physical function among people with stage 1–4 lung cancer practicing Guolin qigong for an hour at least twice a week for 3 months compared to usual care in a small controlled trial¹⁰¹Xing R, Wang R et al. Effects of qigong exercise on physical fitness and patient-reported health outcomes in lung cancer survivors. Supportive Care in Cancer. 2024 Jan 12;32(2):99.
• Better FACT-B scores for physical (3 studies) and functional (4 studies) well-being, and better SF-36 scores for role-physical (2 studies) and vitality (2 studies), plus a weak trend toward better general health, after surgery among people with breast cancer practicing Baduanjin qigong exercise compared to controls in meta-analyses of RCTs¹⁰²Ye XX, Ren ZY et al. Effectiveness of Baduanjin exercise on quality of life and psychological health in postoperative patients with breast cancer: a systematic review and meta-analysis. Integrative Cancer Therapies. 2022 Jan-Dec;21:15347354221104092.
• Better physical function during chemotherapy among people with gastrointestinal cancer participating in 5 sessions of qigong in addition to conventional treatment each week compared to conventional treatment alone in a small RCT¹⁰³Yang LH, Duan PB, Hou QM, Wang XQ. Qigong exercise for patients with gastrointestinal cancer undergoing chemotherapy and at high risk for depression: a randomized clinical trial. Journal of Alternative and Complementary Medicine. 2021 Sep;27(9):750-759.
• Better functional well-being over time among people with lung cancer practicing qigong in a mid-sized RCT¹⁰⁴Molassiotis A, Vu DV, Ching SSY. The effectiveness of qigong in managing a cluster of symptoms (breathlessness-fatigue-anxiety) in patients with lung cancer: a randomized controlled trial. Integrative Cancer Therapies. 2021 Jan-Dec;20:15347354211008253.

Range of motion: preliminary evidence of better shoulder range of motion among people with breast cancer practicing qigong

• Better shoulder range of motion among people with breast cancer practicing Baduanjin qigong exercise 3 days a week at hospital and another 4 days a week at home for 6 months compared to controls in a small RCT¹⁰⁵Ying W, Min QW et al. The health effects of Baduanjin exercise (a type of Qigong exercise) in breast cancer survivors: a randomized, controlled, single-blinded trial. European Journal of Oncology Nursing. 2019 Apr;39:90-97.

Frailty: insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on frailty among people with cancer practicing qigong in small studies

• No evidence of an effect on frailty among older people with cancer screened as pre-frail or frail participating in a 16-week Baduanjin qigong intervention compared to light flexibility exercise in a small RCT¹⁰⁶Cheung DST, Chau PH et al. A pilot randomized controlled trial using Baduanjin qigong to reverse frailty status among post-treatment older cancer survivors. Journal of Geriatric Oncology. 2022 Jun;13(5):682-690.
• Lower frailty scores during chemotherapy among people with breast cancer practicing sporting qigong (at 1 and 3 months) or non-sporting qigong (at 3 months) at least 30 minutes 3 times a week compared to controls in a small controlled trial¹⁰⁷Huang SM, Tseng LM et al. Effects of non-sporting and sporting qigong on frailty and quality of life among breast cancer patients receiving chemotherapy. European Journal of Oncology Nursing. 2016 Apr;21:257-65.

Tai chi

Preliminary evidence of better physical function among people with cancer practicing tai chi

• Better physical function and step count among people with advanced lung cancer participating in 60-minute group tai chi sessions twice a week or 2 60-minute supervised group aerobic exercise sessions and home-based exercises per month compared to controls in a mid-sized RCT¹⁰⁸Takemura N, Cheung DST et al. Effectiveness of aerobic exercise and tai chi interventions on sleep quality in patients with advanced lung cancer: a randomized clinical trial. JAMA Oncology. 2024 Feb 1;10(2):176-184.
• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward better 6-minute walking distance among people with breast cancer practicing tai chi compared to controls in a meta-analysis of 2 RCTs¹⁰⁹Chen YW, Hunt MA, Campbell KL, Peill K, Reid WD. The effect of tai chi on four chronic conditions-cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses. British Journal of Sports Medicine. 2016 Apr;50(7):397-407.

Good evidence of better limb function and strength among people with cancer practicing tai chi

• Greater muscle strength during chemotherapy or radiotherapy among middle-aged and elderly people with cancer practicing tai chi compared to controls in a mid-sized RCT¹¹⁰Cheng D, Wang X et al. Effect of tai chi and resistance training on cancer-related fatigue and quality of life in middle-aged and elderly cancer patients. Chinese Journal of Integrative Medicine. 2021 Apr;27(4):265-272.
• Substantially better shoulder function and arm strength among people with breast cancer practicing tai chi chuan compared to non-exercise therapy in a meta-analysis of 15 RCTs¹¹¹Luo XC, Liu J et al. Effect of tai chi chuan in breast cancer patients: a systematic review and meta-analysis. Frontiers in Oncology. 2020 Apr 23;10:607.
• Better limb/muscular function among people with breast cancer practicing tai chi compared to controls in a meta-analysis of 22 RCTs with moderate-level evidence¹¹²Ni X, Chan RJ et al. The effects of tai chi on quality of life of cancer survivors: a systematic review and meta-analysis. Supportive Care in Cancer. 2019 Oct;27(10):3701-3716.
• Better handgrip strength and elbow flexion among people with breast cancer practicing tai chi chuan compared to controls in a meta-analysis of 9 RCTs¹¹³Pan Y, Yang K et al. Tai Chi Chuan exercise for patients with breast cancer: a systematic review and meta-analysis. Evidence-based Complementary and Alternative Medicine. 2015;2015:1–15.

Without regard to treatment phase

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of better quality of life among people with cancer practicing mind-body exercises including tai chi or qigong without regard to treatment phase

• Better overall quality of life among people with lung cancer participating in mind-body exercises compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 4 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹¹⁴Sun J, Chen D, Qin C, Liu R. The effect of mind-body exercise in lung cancer patients: a meta-analysis of RCTs. Supportive Care in Cancer. 2023 Oct 23;31(12):650.
• Slightly better psychosocial outcomes among males with cancer participating in yoga, tai chi, or qigong compared to usual care (10 studies), but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. when compared to other active interventions (6 studies) in meta-analyses of RCTs¹¹⁵Ford CG, Vowles KE, Smith BW, Kinney AY. Mindfulness and meditative movement interventions for men living with cancer: a meta-analysis. Annals of Behavioral Medicine. 2020 Apr 20;54(5):360-373.
• Better quality of life among people with cancer practicing tai chi or qigong compared to all controls, and a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward better quality compared to active controls (participating in other movement activities) in a meta-analysis of 13 RCTs and controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹¹⁶Wayne PM, Lee MS et al. Tai chi and qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. Journal of Cancer Survivorship. 2018 Apr;12(2):256-267.
• Better quality of life among people with cancer practicing qigong or tai chi compared to controls in a meta-analysis of 9 RCTs¹¹⁷Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complementary Therapies in Medicine. 2014 Feb;22(1):173-86.

Qigong: good evidence of better quality of life among people with cancer practicing qigong without regard to treatment phase

• Better global health status/quality of life among people with stage 1–4 lung cancer practicing Guolin qigong for an hour at least twice a week for 3 months compared to usual care in a small controlled trial¹¹⁸Xing R, Wang R et al. Effects of qigong exercise on physical fitness and patient-reported health outcomes in lung cancer survivors. Supportive Care in Cancer. 2024 Jan 12;32(2):99.
• No evidence of an effect on overall quality of life among people with cancer practicing qigong compared to controls in a meta-analysis of 5 RCTs¹¹⁹Zeng Y, Xie X, Cheng ASK. Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Current Oncology Reports. 2019 Apr 6;21(6):48.
• Better quality of life and cancer-specific quality of life among people with cancer practicing qigong compared to controls (typically usual care) in a very large overview of 12 systematic reviews covering 101 studies¹²⁰Amatya B, Khan F, Lew TE, Dickinson M. Rehabilitation in patients with lymphoma: an overview of systematic reviews. Journal of Rehabilitation Medicine. 2021 Mar 17;53(3):jrm00163.
• Better quality of life scores (FACT-B, 3 studies, and EORTC QLQ-C30, 2 studies) among people with cancer practicing qigong compared to controls in meta-analyses of RCTs¹²¹Kuo CC, Wang CC et al. Clinical effects of Baduanjin qigong exercise on cancer patients: a systematic review and meta-analysis on randomized controlled trials. Evidence-Based Complementary and Alternative Medicine. 2021 Apr 8;2021:6651238.
• Moderately better quality of life among women with breast cancer practicing qigong compared to controls in a meta-analysis of 13 clinical trials¹²²Meng T, Hu SF et al. Qigong for women with breast cancer: an updated systematic review and meta-analysis. Complementary Therapies in Medicine. 2021 Aug;60:102743.
• Better global health status among people with lung cancer practicing qigong compared to controls in a mid-sized RCT¹²³Molassiotis A, Vu DV, Ching SSY. The effectiveness of qigong in managing a cluster of symptoms (breathlessness-fatigue-anxiety) in patients with lung cancer: a randomized controlled trial. Integrative Cancer Therapies. 2021 Jan-Dec;20:15347354211008253.

Tai chi: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better quality of life among people with cancer practicing tai chi without regard to treatment phase

• Better quality of life among people with breast cancer practicing tai chi chuan compared to non-exercise therapy in a meta-analysis of 15 RCTs¹²⁴Luo XC, Liu J et al. Effect of tai chi chuan in breast cancer patients: a systematic review and meta-analysis. Frontiers in Oncology. 2020 Apr 23;10:607.
• Better quality of life among people with breast cancer practicing tai chi compared to conventional supportive care interventions in a meta-analysis of 16 RCTs¹²⁵Liu L, Tan H, Yu S, Yin H, Baxter GD. The effectiveness of tai chi in breast cancer patients: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2020 Feb;38:101078.
• Better physical and mental health domains of quality of life scores among people with cancer practicing tai chi compared to controls in a meta-analysis of 22 RCTs with low-level evidence¹²⁶Ni X, Chan RJ et al. The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis. Supportive Care in Cancer. 2019 Oct;27(10):3701-3716.
• No evidence of an effect on quality of life among people with breast cancer practicing tai chi compared to controls in a meta-analysis of 2 RCTs¹²⁷Chen YW, Hunt MA, Campbell KL, Peill K, Reid WD. The effect of tai chi on four chronic conditions-cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses. British Journal of Sports Medicine. 2016 Apr;50(7):397-407.
• No evidence of an effect on quality of life among people with breast cancer practicing tai chi compared to controls in a meta-analysis of 5 RCTs¹²⁸Yan JH, Pan L, Zhang XM, Sun CX, Cui GH. Lack of efficacy of tai chi in improving quality of life in breast cancer survivors: a systematic review and meta-analysis. Asian Pacific Journal of Cancer Prevention. 2014;15(8):3715-20.

During treatment

No evidence of an effect on quality of life during chemotherapy among people with colorectal cancer practicing tai chi or qigong

• No evidence of an effect on quality of life during chemotherapy among people with colorectal cancer practicing tai chi or qigong compared to controls in a meta-analysis of 2 RCTs¹²⁹Bailey LE, Morris MA. Mind-body therapies adjuvant to chemotherapy improve quality of life and fatigue in top cancers: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2024 Feb;54:101811.

Qigong: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better quality of life during cancer treatment among people with gastrointestinal or breast cancer practicing qigong

• Better global health status and role, emotional, and social functions during chemotherapy among people with gastrointestinal cancer participating in 5 sessions of qigong in addition to conventional treatment each week compared to conventional treatment alone in a small RCT¹³⁰Yang LH, Duan PB, Hou QM, Wang XQ. Qigong exercise for patients with gastrointestinal cancer undergoing chemotherapy and at high risk for depression: a randomized clinical trial. Journal of Alternative and Complementary Medicine. 2021 Sep;27(9):750-759.
• Better quality of life among people with breast cancer practicing Baduanjin qigong exercise 3 days a week at hospital and another 4 days a week at home for 6 months compared to controls in a small RCT¹³¹Ying W, Min QW et al. The health effects of Baduanjin exercise (a type of Qigong exercise) in breast cancer survivors: a randomized, controlled, single-blinded trial. European Journal of Oncology Nursing. 2019 Apr;39:90-97.
• Better quality of life, mediated by lower frailty scores, during chemotherapy among people with breast cancer practicing sporting qigong at least 30 minutes 3 times a week compared to controls in a small controlled trial¹³²Huang SM, Tseng LM et al. Effects of non-sporting and sporting qigong on frailty and quality of life among breast cancer patients receiving chemotherapy. European Journal of Oncology Nursing. 2016 Apr;21:257-65.

Tai chi: preliminary evidence of better quality of life during chemotherapy among people with cancer with a peripherally inserted central catheter practicing tai chi

• Better quality of life during the intermission of long-term chemotherapy among people with cancer with a peripherally inserted central catheter (PICC) practicing 24 simplified tai chi exercises for 3 months compared to grip strength exercise in a small RCT¹³³Ding Y, Ji L, Hu Y. Effects of tai chi on catheter management and quality of life in tumor patients with PICC at the intermission of chemotherapy: a non-inferiority randomized controlled trial. Annals of Palliative Medicine. 2020 Sep;9(5):3293-3303.

After treatment

Preliminary evidence of better quality of life after completing treatment among people with nasopharyngeal or breast cancer cancer practicing qigong

• Better quality of life (FACT-H&N) after chemoradiotherapy among people with nasopharyngeal carcinoma practicing Baduanjin qigong exercise for 12 weeks compared to usual care in a small RTC¹³⁴Wen L, Chen X, Cui Y, Zhang M, Bai X. Effects of Baduanjin exercise in nasopharyngeal carcinoma patients after chemoradiotherapy: a randomized controlled trial. Supportive Care in Cancer. 2022 Dec 23;31(1):79.
• Marginal improvement in quality of life scores among people with cancer participating in an 8-week qigong intervention compared to usual care in a small RCT¹³⁵Loh SY, Lee SY. The Qigong and Quality of life Trial: implications for women in cancer survivorship phase. Journal of Women’s Health, Issues & Care. 2014;4:3.

Preliminary evidence of better quality of life after completing treatment among people with breast cancer practicing tai chi

• Better self-esteem and a weak trend toward better health-related quality of life within 30 months after completing treatment among women with breast cancer practicing 12 weeks of tai chi chuan compared to psychosocial support in a small RCT¹³⁶Mustian KM, Katula JA et al. Tai Chi Chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors. Supportive Care in Cancer. 2004 Dec;12(12):871-6.

With advanced or terminal cancer: no evidence of an effect on quality of life among people with terminal cancer practicing tai chi or qigong in a combined analysis of studies

• No evidence of an effect on quality of life among people with terminal cancer practicing tai chi or qigong compared to controls in a meta-analysis of 3 RCTs¹³⁷Tao WW, Jiang H et al. Effects of acupuncture, tuina, tai chi, qigong, and traditional Chinese medicine Five-Element Music Therapy on symptom management and quality of life for cancer patients: a meta-analysis. Journal of Pain and Symptom Management. 2016 Apr;51(4):728-747.

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on sexual satisfaction, activities, or relationships among women with metastatic breast cancer practicing medical qigong

• No evidence of an effect on sexual satisfaction, activities, or relationships among women with metastatic breast cancer practicing medical qigong (integration of gentle exercise and meditation) compared to meditation alone in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹³⁸Oh B, Butow PN et al. Effects of qigong on quality of life, fatigue, stress, neuropathy, and sexual function in women with metastatic breast cancer: a feasibility study. 2014 ASCO Annual Meeting I.

Without regard to treatment phase: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less sleep disturbance among people with cancer practicing tai chi or qigong

• Less reported sleep difficulty among people with cancer practicing tai chi or qigong compared to all controls or to active controls (participating in other movement activities) in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 7 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects and controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹³⁹Wayne PM, Lee MS et al. Tai chi and qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. Journal of Cancer Survivorship. 2018 Apr;12(2):256-267.
• Moderately better sleep quality among people with cancer practicing tai chi or qigong immediately following the practice (2 studies) or 3 months later (3 studies) compared to controls in meta-analyses of RCTs¹⁴⁰Zeng Y, Xie X, Cheng ASK. Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Current Oncology Reports. 2019 Apr 6;21(6):48.

Qigong: modestsignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) and somewhat conflicting evidence of better sleep among people with cancer practicing qigong

• Better sleep quality among people with stage 1–4 lung cancer practicing Guolin qigong for an hour at least twice a week for 3 months compared to usual care in a small controlled trial¹⁴¹Xing R, Wang R et al. Effects of qigong exercise on physical fitness and patient-reported health outcomes in lung cancer survivors. Supportive Care in Cancer. 2024 Jan 12;32(2):99.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on sleep disturbance among people with breast cancer practicing qigong compared to controls in a meta-analysis of 4 clinical trials¹⁴²Meng T, Hu SF et al. Qigong for women with breast cancer: an updated systematic review and meta-analysis. Complementary Therapies in Medicine. 2021 Aug;60:102743.
• Better sleep among people with cancer practicing qigong compared to controls immediately after the intervention (10 studies), although no evidence of an effect 3 months after stopping qigong (4 studies), in meta-analyses of RCTs¹⁴³Cheung DST, Takemura N et al. Effect of qigong for sleep disturbance-related symptom clusters in cancer: a systematic review and meta-analysis. Sleep Medicine. 2021 Sep;85:108-122.
• Better sleep quality scores among people with cancer practicing Baduanjin qigong exercise compared to controls in a meta-analysis of 2 RCTs of low quality¹⁴⁴Kuo CC, Wang CC et al. Clinical effects of Baduanjin qigong exercise on cancer patients: a systematic review and meta-analysis on randomized controlled trials. Evidence-Based Complementary and Alternative Medicine. 2021 Apr 8;2021:6651238.

Tai chi: modest evidence of better sleep quality among people practicing tai chi

• Better subjective sleep quality at 16 weeks and 1 year among people with advanced lung cancer participating in 60-minute group tai chi sessions twice a week compared to aerobic exercise sessions or controls receiving physical activity guidelines in a mid-sized RCT¹⁴⁵Takemura N, Cheung DST et al. Effectiveness of aerobic exercise and tai chi interventions on sleep quality in patients with advanced lung cancer: a randomized clinical trial. JAMA Oncology. 2024 Feb 1;10(2):176-184.
• Less sleep disturbance among people with breast cancer participating in 8 weeks of tai chi compared to routine care in a small RCT¹⁴⁶Yao LQ, Kwok SWH et al. The effect of an evidence-based tai chi intervention on the fatigue-sleep disturbance-depression symptom cluster in breast cancer patients: a preliminary randomised controlled trial. European Journal of Oncology Nursing. 2022 Dec;61:102202.
• Comparable improvements in sleep quality among people with breast cancer either practicing tai chi or receiving conventional supportive care interventions in a meta-analysis of 16 RCTs¹⁴⁷Liu L, Tan H, Yu S, Yin H, Baxter GD. The effectiveness of tai chi in breast cancer patients: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2020 Feb;38:101078.

During or after cancer treatment

Good evidence of better sleep quality after cancer treatment among people with cancer practicing tai chi or qigong, but insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect during cancer treatment

• No evidence of an effect on sleep disturbance during cancer treatment among people practicing qigong compared to controls in a network meta-analysis of 3 RCTs¹⁴⁸Han J, Shi M, Bi LN, Wang LL, Cai YX. Efficacy of mind-body therapies for sleep disturbance in patients with early-stage cancer: a systematic review and network meta-analysis. Psycho-oncology. 2023 Sep;32(9):1315-1338.
• Less sleep disturbance after completing cancer treatment among people practicing qigong compared to active support or controls in a network meta-analysis of 2 RCTs¹⁴⁹Han J, Shi M, Bi LN, Wang LL, Cai YX. Efficacy of mind-body therapies for sleep disturbance in patients with early-stage cancer: a systematic review and network meta-analysis. Psycho-oncology. 2023 Sep;32(9):1315-1338.
• Better sleep scores during or after cancer treatment among people with breast cancer practicing tai chi or qigong compared to controls in a meta-analysis of 22 RCTs¹⁵⁰Kreutz C, Schmidt ME, Steindorf K. Effects of physical and mind-body exercise on sleep problems during and after breast cancer treatment: a systematic review and meta-analysis. Breast Cancer Research and Treatment. 2019 Jul;176(1):1-15.
• Lower sleep disturbance scores but no evidence of an effect on sleep problems index scores after cancer treatment among people with nasopharyngeal cancer receiving tai chi qigong training for 1.5 hours per session, 4 sessions per week including self-practice for 6 months compared to controls in a small controlled trial¹⁵¹Fong SS, Ng SS et al. The effects of a 6-month tai chi qigong training program on temporomandibular, cervical, and shoulder joint mobility and sleep problems in nasopharyngeal cancer survivors. Integrative Cancer Therapies. 2015 Jan;14(1):16-25.

Tai chi: good evidence of better sleep quality during or after cancer treatment among people with cancer practicing supervised tai chi

• Better sleep quality during or after cancer treatment among people with cancer practicing 40–60 minutes of supervised tai chi 3 times a week for 8–12 weeks compared to controls in a systematic review of 13 RCTs and 1 controlled trial¹⁵²Yang L, Winters-Stone K et al. Tai chi for cancer survivors: a systematic review toward consensus-based guidelines. Cancer Medicine. 2021 Sep 17.
• Less sleep disruption (lower scores) during chemotherapy or radiotherapy among middle-aged and elderly people with cancer practicing tai chi compared to controls in a mid-sized RCT¹⁵³Cheng D, Wang X et al. Effect of tai chi and resistance training on cancer-related fatigue and quality of life in middle-aged and elderly cancer patients. Chinese Journal of Integrative Medicine. 2021 Apr;27(4):265-272.

One study found that the nervous system response that calms the body is greater when both paced breathing and rhythmic muscle contraction are done together (similar to what you do during tai chi or qigong) than either alternating contractions or breathing alone.¹⁵⁴Chin MS, Kales SN. Understanding mind-body disciplines: a pilot study of paced breathing and dynamic muscle contraction on autonomic nervous system reactivity. Stress and Health. 2019 Oct;35(4):542-548.

Qigong: insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on distress or stress among people with cancer practicing qigong

• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on distress among people with breast cancer practicing qigong compared to no qigong in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 2 clinical trials¹⁵⁵Meng T, Hu SF et al. Qigong for women with breast cancer: an updated systematic review and meta-analysis. Complementary Therapies in Medicine. 2021 Aug;60:102743.
• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less stress among people with cancer practicing qigong compared to controls in a meta-analysis of 3 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁵⁶Zeng Y, Xie X, Cheng ASK. Qigong or tai chi in cancer care: an updated systematic review and meta-analysis. Current Oncology Reports. 2019 Apr 6;21(6):48.

Tai chi: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less distress or stress and greater posttraumatic growth among people with cancer practicing tai chi

• Less psychological distress among people with advanced lung cancer participating in 60-minute group tai chi sessions twice a week or 2 60-minute supervised group aerobic exercise sessions and home-based exercises per month compared to controls in a mid-sized RCT¹⁵⁷Takemura N, Cheung DST et al. Effectiveness of aerobic exercise and tai chi interventions on sleep quality in patients with advanced lung cancer: a randomized clinical trial. JAMA Oncology. 2024 Feb 1;10(2):176-184.
• Greater posttraumatic growth and lower perceived stress scores persisting a year after the intervention among people with breast cancer participating in a 1-hour nurse-led mindfulness-based tai chi chuan (MTCC) program twice a week for 8 weeks compared to wait-list controls in a small RTC¹⁵⁸Zhang JY, Li SS, Meng LN, Zhou YQ. Effectiveness of a nurse-led mindfulness-based tai chi chuan (MTCC) program on posttraumatic growth and perceived stress and anxiety of breast cancer survivors. European Journal of Psychotraumatology. 2022 Feb 3;13(1):2023314.

Bone-related side effects: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher bone mineral density among people practicing qigong

• Higher bone mineral density and T-score of the lumbar spine after a standard physiotherapy regimen among people with deep second and third-degree thermal burns affecting the trunk and lower extremities practicing qigong 4 times a week for 8 weeks compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁵⁹Othman EM, Toson RA. Response of bone mineral density and balance performance in post-burn patients with selected qigong training: a single-blind randomized controlled trial. Burns. 2024 Mar;50(2):495-506.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on bone strength among middle-aged women practicing Muscle/Tendon Change Classic (MTCC) qigong for 8 weeks compared to controls in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁶⁰Tsai YK, Chen HH, Lin IH, Yeh ML. Qigong improving physical status in middle-aged women. Western Journal of Nursing Research. 2008 Dec;30(8):915-27.
• Higher bone mineral density among middle-aged women participating in a Baduanjin qigong training program for 12 weeks compared to controls in a small RCT¹⁶¹Chen HH, Yeh ML, Lee FY. The effects of Baduanjin qigong in the prevention of bone loss for middle-aged women. American Journal of Chinese Medicine. 2006;34(5):741-7.

Breathlessness and other lung symptoms

No evidence of an effect on breathlessness among people with advanced chronic obstructive pulmonary disease (COPD) participating in meditative movement, including tai chi or qigong

• No evidence of an effect on breathlessness among people with advanced chronic obstructive pulmonary disease (COPD) participating in meditative movement (yoga, tai chi, or qigong) compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 11 RCTs¹⁶²Nolan CM, Brighton LJ et al. Meditative movement for breathlessness in advanced COPD or cancer: a systematic review and meta-analysis. European Respiratory Review. 2023 Jun 21;32(168):220243.

Preliminary evidence of better respiratory function among people with chronic obstructive pulmonary disease participating tai chi qigong

• Better respiratory function (forced vital capacity, forced expiratory volume in 1 second, walking distance, and exacerbation rate) among people with chronic obstructive pulmonary disease participating in 60-minute tai chi qigong sessions twice a week for 3 months compared to controls in a mid–sized RCT¹⁶³Chan AW, Lee A, Suen LK, Tam WW. Tai chi qigong improves lung functions and activity tolerance in COPD clients: a single blind, randomized controlled trial. Complementary Therapies in Medicine. 2011 Feb;19(1):3-11.

Cardiovascular side effects

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better cardiopulmonary function among healthy people practicing qigong

• Better cardiopulmonary function among healthy people practicing 30 minutes of Liuzijue qigong exercise with 0.25 kg sandbag on each wrist, 5 times a week for 4 weeks compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design¹⁶⁴Li D, Shen M et al. Effect of weight-bearing Liuzijue qigong on cardiopulmonary function. Medicine (Baltimore). 2023 Feb 22;102(8):e33097.

Qigong

A marker of better heart function after a heart attack among people participating in a qigong exercise cardiac rehabilitation program

• A marker of better heart function (lower change in echocardiographic left ventricular end-diastolic volume index) after revascularization of infarcted coronary arteries among people with with ST-elevation myocardial infarction participating in Baduanjin qigong exercise cardiac rehabilitation program compared to usual physical exercise in a mid-sized RCT¹⁶⁵Mao S, Zhang X et al. Beneficial effects of Baduanjin exercise on left ventricular remodelling in patients after acute myocardial infarction: an exploratory clinical trial and proteomic analysis. Cardiovascular Drugs and Therapy. 2021 Feb;35(1):21-32.

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower blood pressure among people with high blood pressure (hypertension) practicing qigong

• Lower diastolic and systolic blood pressure among people with essential hypertension practicing Mawangdui Daoyinshu qigong 5 times a week for 6 months compared to controls in a small RCT¹⁶⁶Chen D. Effect of Health Qigong Mawangdui Daoyinshu on blood pressure of individuals with essential hypertension. Journal of the American Geriatrics Society. 2016 Jul;64(7):1513-5.
• Lower diastolic and systolic blood pressure among people with essential hypertension practicing Ba duan jin qigong 5 times a week for 6 months compared to controls in a small RCT¹⁶⁷Xiao C, Yang Y, Zhuang Y. Effect of Health Qigong Ba Duan Jin on blood pressure of individuals with essential hypertension. Journal of the American Geriatrics Society. 2016 Jan;64(1):211-3.
• Lower diastolic and systolic blood pressure among people with prehypertension or mild hypertension attending qigong classes 3 times a week and performing qigong at home at least 2 times a week compared to controls in a small RCT¹⁶⁸Park JE, Hong S et al. Randomized, controlled trial of qigong for treatment of prehypertension and mild essential hypertension. Alternative Therapies in Health and Medicine. 2014 Jul-Aug;20(4):21-30.
• Comparable improvements in blood pressure and heart rate among people with mild essential hypertension practicing either Goulin qigong for 16 weeks or conventional exercise in a small RCT¹⁶⁹Cheung BM, Lo JL et al. Randomised controlled trial of qigong in the treatment of mild essential hypertension. Journal of Human Hypertension. 2005 Sep;19(9):697-704.
• Lower systolic diastolic blood pressure among people with mild essential hypertension practicing qigong compared to controls in a small RCT¹⁷⁰Lee MS, Lee MS, Choi ES, Chung HT. Effects of qigong on blood pressure, blood pressure determinants and ventilatory function in middle-aged patients with essential hypertension. American Journal of Chinese Medicine. 2003;31(3):489-97.

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower blood pressure among people with metabolic syndromea cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels practicing fitness qigong

• Lower diastolic and systolic blood pressure among people with metabolic syndrome practicing fitness qigong (Baduanjin or Wuqinxi) compared to controls in a meta-analysis of 8 RCTs¹⁷¹Li S, Wang P, Wang J, Zhao J, Wang X, Liu T. Effect of mind-body exercise on risk factors for metabolic syndrome including insulin resistance: a meta-analysis. Frontiers in Endocrinology (Lausanne). 2024 Jan 26;15:1289254.

Preliminary evidence of lower blood pressure among healthy adults practicing fitness qigong

• Lower diastolic and systolic blood pressure among female college freshmen practicing qigong Baduanjin exercise 1 hour a day 3 days a week for 12 weeks compared to controls in a small RCT¹⁷²Zhang Y, Jiang X. The effect of Baduanjin exercise on the physical and mental health of college students: a randomized controlled trial. Medicine (Baltimore). 2023 Aug 25;102(34):e34897.

External qigong: preliminary evidence of lower heart rate and higher heart rate variability among people receiving external qi therapy

• Lower heart rate and higher heart rate variability among people receiving external qi therapy (external qigong) compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest therapy in 2 small RCTs¹⁷³Lee MS, Rim YH et al. Nonlinear analysis of heart rate variability during qi therapy (external qigong). American Journal of Chinese Medicine. 2005;33(4):579-88; Lee MS, Kim MK, Lee YH. Effects of qi-therapy (external qigong) on cardiac autonomic tone: a randomized placebo controlled study. International Journal of Neuroscience. 2005 Sep;115(9):1345-50.

Laughing qigong: no evidence of an effect on blood pressure, heart rate, or heart rate variability among adolescents participating in a laughing qigong program in a small study

• No evidence of an effect on blood pressure, heart rate, or heart rate variability among adolescents participating in a laughing qigong program for 45 minutes once a week for 8 weeks in a small RCT¹⁷⁴Chang C, Tsai G, Hsieh CJ. Psychological, immunological and physiological effects of a laughing qigong program (LQP) on adolescents. Complementary Therapies in Medicine. 2013 Dec;21(6):660-8.

Tai chi: no evidence of an effect on blood pressure among older adults with mild or moderate hypertension practicing a single session of Tai Chi Easy

• No evidence of an effect on systolic or diastolic blood pressure among older adults with mild or moderate hypertension practicing a single 50-minute session of Tai Chi Easy compared to baseline in a small uncontrolled trial¹⁷⁵Larkey LK, James T, Han S, James DL. Pilot study of Qigong/Tai Chi Easy acute effects of meditative movement, breath focus and “flow” on blood pressure, mood and oxytocin in older adults. Complementary Therapies in Medicine. 2023 Mar;72:102918.

Sexual difficulties: preliminary evidence of better female genital self-image and Female Sexual Function Index total scores among postmenopausal women participating in training based on qigong exercises

• Better female genital self-image and Female Sexual Function Index total score and scores in domains of desire, arousal, lubrication, satisfaction, and pain but not orgasm among postmenopausal women participating in training based on qigong exercises for 12 weeks compared to controls in a small RCT¹⁷⁶Carcelén-Fraile MDC, Aibar-Almazán A et al. Changes in satisfaction with female genital self-image and sexual function after a qigong exercise intervention in Spanish postmenopausal women: a randomized-controlled trial. Menopause. 2022 Jun 1;29(6):693-699.

Stress: preliminary evidence of less stress among people participating in a qigong-based stress reduction program

• Larger decreases in Perceived Stress Scale score among people participating in a 4-week intervention of a brief qigong-based stress reduction program compared to controls in a small RCT¹⁷⁷Hwang EY, Chung SY et al. Effects of a brief qigong-based stress reduction program (BQSRP) in a distressed Korean population: a randomized trial. BMC Complementary and Alternative Medicine. 2013 May 25;13:113.

Urinary side effects: preliminary evidence of better urinary control among females with stress urinary incontinence taught to practice Mawangdui Guidance qigong

• Less urine leakage, greater muscle strength of type I and II muscle fibers of the pelvic floor, and higher incontinence quality of life questionnaire scores after basic rehabilitation therapy among females with stress urinary incontinence taught to practice Mawangdui Guidance qigong 6 times per week for 6 consecutive weeks compared to Kegel exercise with a procedure of 20 minutes, 6 times per week for 6 weeks in a small RCT¹⁷⁸Xu M, Zhang X. Health qigong Mawangdui Guidance can improve pelvic floor muscle function and quality of life in females with stress urinary incontinence: a randomized controlled trial pilot study. Medicine (Baltimore). 2024 Apr 12;103(15):e37671.

Qigong and mindfulness: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately better health-related quality of life among people with cancer practicing qigong and mindfulness practice

• Moderately better health-related quality of life among people with cancer practicing qigong and mindfulness practice, but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. with qigong alone compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 34 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low quality¹⁷⁹Lin WF, Zhong MF et al. Efficacy of complementary and integrative medicine on health-related quality of life in cancer patients: a systematic review and meta-analysis. Cancer Management and Research. 2019;11:6663-6680.

Qigong with breathing meditation: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better emotional function but decreased role function during chemotherapy among people with breast cancer practicing qigong with breathing meditation

• Better emotional function but decreased role function during chemotherapy among people with breast cancer practicing Chan-Chuang qigong with breathing meditation for 15 weeks compared to usual care in a small RCT¹⁸⁰Chang CI, Yeh ML, Liao J. Chan-Chuang qigong with breathing meditation improves quality of life and interoceptive awareness in patients with breast cancer: a randomised controlled trial. Supportive Care in Cancer. 2023 Jan 28;31(2):140.

Video intervention: no evidence of an effect on anxiety, fear of progression, fatigue, or depression among people with cancer participating in a video intervention comprising psychoeducation on distress and psychological symptoms, acceptance and commitment therapy elements, and yoga and qigong exercises

• No evidence of an effect on anxiety, fear of progression, fatigue, or depression among people with cancer participating in a video intervention comprising 8 video sequences over 4 weeks; the videos included psychoeducation on distress and psychological symptoms, Acceptance and Commitment Therapy elements, and yoga and qigong exercises compared to controls in a mid-sized RCT¹⁸¹Neubert S, Schlecht S, Meng K, Rabe A, Jentschke E. Effects of a video sequence based intervention on anxiety, fatigue and depression in cancer patients: results of a randomized controlled trial. Integrative Cancer Therapies. 2023 Jan-Dec;22:15347354231153172.

Supportive-expressive group, cognitive-behavioral therapy, and Guolin qigong: preliminary evidence of better total quality of life scores but no evidence of an effect on individual scores among people with cancer participating in a multi-focused psychosocial residence rehabilitation intervention combining supportive-expressive group, cognitive-behavioral therapy, and Guolin qigong

• Better total quality of life scores but no evidence of an effect on individual scores among people with cancer participating in a multi-focused psychosocial residence rehabilitation intervention combining supportive-expressive group, cognitive-behavioral therapy, and Guolin qigong compared to controls in a mid-sized RCT¹⁸²Chen X, Gong X et al. Multi-focused psychosocial residential rehabilitation interventions improve quality of life among cancer survivors: a community-based controlled trial. Journal of Translational Medicine. 2018 Sep 6;16(1):250.