Qigong and tai chi

What it is

Two related Chinese practices combining slow deliberate movement, breath regulation and sustained attention.

Qìgōng (氣功) covers a very wide range of exercises — standing postures, gentle repeated movements, breathing sequences, static meditation — traditionally understood as cultivating and circulating qi.

Tàijíquán (太極拳), tai chi, is a martial art performed as a slow continuous sequence of weight-shifting movements. Its combat origins are real, and the slowness is a training method rather than the point of the art.

Where it came from

Movement-and-breath practices are old in China, appearing under names such as dǎoyǐn (guiding and pulling) — illustrated on a silk chart recovered from the Mǎwángduī tomb, sealed in 168 BCE.

The word qìgōng itself is modern. It was adopted in the 1950s as an umbrella term during the same state standardisation that produced "Traditional Chinese Medicine", gathering diverse regional practices under one heading.

Tai chi as a named art traces to the Chen family village in the seventeenth century, spreading through the Yang, Wu, Sun and other lineages. Its transformation from a fighting art into a mass health practice happened largely in the twentieth century, with state promotion after 1949 — simplified forms were devised specifically for public health use.

One episode belongs here rather than in a footnote. From the late 1970s China experienced qìgōng rè, "qigong fever": an extraordinary mass enthusiasm in which tens of millions practised, charismatic masters claimed to emit healing qi and to perform paranormal feats, and state institutions funded research into "external qi". Official attitudes swung between promotion and alarm. Falun Gong emerged from this milieu in 1992 and grew enormous before being banned in 1999 and subjected to a severe and well-documented campaign of suppression. The episode connects directly to the material on high-demand groups — and it is also a case where a state's response to a movement became a far larger human rights problem than anything the movement itself was doing.

How it is done

Standing or moving slowly with attention to alignment, weight transfer and breath, typically for twenty minutes to an hour. Tai chi forms are learned as sequences and take months to acquire.

What we can and cannot say

We can say tai chi has genuinely good evidence for preventing falls in older adults, and that is a substantial claim. Multiple randomised trials and meta-analyses find meaningful reductions in fall rates and improvements in balance among older people who practise regularly, and tai chi appears in fall-prevention recommendations from major clinical bodies. Falls are a leading cause of injury, hospitalisation and loss of independence in old age, so this is not a marginal benefit.

We can say the evidence extends further with decreasing confidence: reasonable support for knee osteoarthritis pain and function, and for fibromyalgia — a 2018 trial in the BMJ found tai chi performed as well as or better than supervised aerobic exercise for fibromyalgia symptoms. Some support in COPD, Parkinson's disease and balance after stroke. Weaker and mixed evidence for cardiovascular outcomes, and little for the broader claims made about qigong for specific diseases.

And we can say the mechanism does not require qi. Tai chi is weight-bearing exercise emphasising slow controlled weight transfer, single-leg support, ankle and hip strategy, proprioception, and sustained attention to body position. That is, almost exactly, a well-designed balance-training programme. It is also gentle enough to be sustainable for people who will not take up resistance training, and social, which improves adherence — and adherence is usually the limiting factor in exercise interventions.

So this section's recurring verdict applies again, and this time the practice comes out well: the thing works, the explanation is not why, and the correct response is to keep doing it.

We can say claims of external qi — practitioners emitting energy to affect others or objects at a distance — have been tested and have not been supported. The research programme that flourished during the qigong fever produced no replicable result.

We cannot say every qigong style delivers what tai chi does; the category is far too broad to carry a single verdict, and most of the trial evidence is on tai chi specifically.

Further reading

• Cochrane and clinical guideline summaries on exercise for falls prevention, which include tai chi.
• Wang et al., "Effect of tai chi versus aerobic exercise for fibromyalgia" (BMJ, 2018).
• David Palmer, Qigong Fever (2007) — the standard account of the mass movement and its aftermath.