I’ve been hearing from all sides since I took my swipe at Deepak Chopra et al. the other day. The biggest subgroup with a grievance have been the people who weren’t happy with my comments about Qi Gong.
Part of the problem is that “Qi Gong” means different things to different people, ranging from “Chinese-derived low-impact exercise program” to “manipulation of universal healing energies”. That’s a lot of ground to cover, but I obviously have no problem with the first of those. Exercise is clearly beneficial in a number of different ways. I go to a gym myself, and emerge with sore muscles and a glow of self-righteousness.
But it’s hard to get away from that second definition. Different practitioners put different amounts of woo into it (as Orac puts it), but if you just go grab pages off the web or brochures from a local class, odds are very good that you’re going to start hearing about energy fields and such. And that’s where I get off. I have yet to see any convincing evidence for any such “energy lines” or “concentrations of the life force” (whatever that is) that show up in a lot of (semi-)mystical exercise programs.
If the people boosting Qi Gong and the like stick to claiming that exercise is good, and that these are good ways to get people to exercise, then fine. If they want to claim that Qi Gong is more effective than other sorts of exercise programs, then that’s fine, too, because we can subject that to empirical tests: blood pressure, muscle strength, joint flexibility, per cent body fat, resting heart rate, fasting glucose and triglyceride levels. So far, I haven’t seen anything that convinces me that it is – many of the studies that claim this seem to me to be very small and poorly controlled. The ones that address these issues tend to be a wash, or to show the reverse. But post some literature references and we’ll talk.
But claiming greater effectiveness gets tricky, because many of the people who do that aren’t just saying that Qi Gong (or what have you) is more effective for physical reasons. It’s a quick slide into the syrup from here, and in no time we’re aligning our energies and tapping into ancient wisdom. (I’m not that good a customer for ancient wisdom, myself. I don’t think that people were any wiser or more virtuous in the past, however misty and distant, and given the mixed-up course of history, I think that anything really ancient that’s survived has probably done so by accident as much as anything else. But that’s another subject).
And any of these comparisons will have to deal with the placebo effect, which is what I was getting at with my proposal for the Don Ki Kong protocol. There are, no doubt, patients that will show more benefit from an exercise program that they believe comes from the Ancient Orient than they would from a very similar set of moves that just got marketed in Santa Barbara. Some other patients may well show the reverse, depending on their attitudes. If you’re going to claim specific benefits for Qi Gong (or any other such system), you’re going to have to show that it isn’t due to such effects. Is it something that still works whether you believe in it or not? If belief is important, do the details of what you believe matter or not, or is it just a general placebo effect that depends on thinking that something beneficial is underway?
We have enough confusion with placebo effects already with our supposedly mechanistically targeted drugs. It varies, though – for depression, it’s a relatively huge effect in clinical trials. For post-surgical bleeding, not so much. For an exercise and lifestyle program, especially if we’re going to be measuring things like mood and outlook, I’d think that placebo effects would be quite meaningful. Blood pressure will show up there, too, and a number of other things that are tied in to cortisol and other stress responses.
And if you can improve those, fine. Just don’t try to convince me, unless you have good evidence, that it needs to be these particular Chinese gestures, because I’ll ask you what would happen if you did all of them in reverse instead (would your blood pressure go up?) And especially don’t try to convince me that the effects are due to fuzzily defined life energies that Iron Age shamans are tuned in to, but which we somehow can’t detect.