I would like to do a follow-up report on our discussion of designing
the best control group in qigong meditation study.
I have received many interesting and encouraging suggestions from
this group. Thank you very much! I am attaching some of the
comments at the end of this email for your information.
At this moment, I decide to follow mostly Dr. Mayer's suggestion to
do a three-arm design -- qigong group, best existent exercise group
(comparison), and the waiting list (or education) control
group. Hopefully, the results will be convincing enough for those
skeptical scientists to take the study outcomes seriously -- if we
find something significant.
However, I have not yet finalized which qigong form to use in this
study of osteoarthritis at knee(s) or hip(s). I am open to the
suggestions based on existent studies or cumulative clinical
experience. (Not just what you think which qigong is better for OA patients).
Thank you all for your support and help! we should continue thinking
of more creative designs in this field.
Selected comments and feedback follow:
At 12:42 PM 8/29/2006, Michael Mayer wrote:
Congratulations on putting together this type of study and for asking
the good question you are addressing about a control. What about
calling an arthritis foundation. Ask them where some of their members
go for physical exercise. One of the best controls is "other forms of
exercise." There may be hospital programs at Kaiser etc. You could
also survey gyms and find out who that comes to their gym has
arthritis. Obviously the type of person who would go to a gym might
have less severe arthritis than a medical center; so that would need
to be equated in terms of severity with your group. RA versus
Other types of great controls to compare would be to find a yoga
center and see if they'd participate, or various meditation paths.
It would be fascinating to see how Qigong compares to Mindfullness
Meditation---you'd contact John Kabat-Zinns' U of Mass group for this.
I think that a non-exercise control group, as you mentioned would be
a good third control. I wonder whether the National Arthritis
Foundation could give you a good lead.
At 11:28 AM 8/30/2006, Chang-Qing Xun wrote:
>Truth is that healing is not a single factor. It is a combination of
>many factors. Even more challenge, it is an individulized
>regimen/practice, not one treatment/technique fits all because we
>all have different Karma.
>If you try to compare different factors and want to say one is
>better than others, it is like you ask a traditional chinese
>medicine herbalist: "In your magic herbal soup, which one herb is
>the best and most effect?" You know the answer is they are all
>needed to be there to achieve the best result.
>So tell reviewers, I am trying to achieve the best result here.
>People can not read 60 mins, can not being a particular posture for
>60 mins, can not.....
>But they can sit down for 60 mins to practice Qigong because Qigong
>is a combination of breathing, visulation, energy......
>So we combine Qigong with reading, posture.... to achieve the best
>result, (better than historical data from pain meds; better than
>drugs because it has no side effect or addiction; better than drugs
>because it has less cost...
>So, please educate the reviewers, help them to change their view of
>healing. You will then have enthusiam to support your study.
At 11:53 AM 8/30/2006, Andreas wrote:
I think the choice of the control group is a delicate problem and it
is not always enough to use standard procedures as in blinded
As you obviously cannot do a blinded trial, you would need to compare
to a similar training which does not include movement of qi.
Additionally it would be required that the trainer of that
intervention belives in his training, so that differences are not
attributable to differences in trainer motivation.
I assume that all subjects are optimally treated from a standard
medical point of view. So I would install a 3 armed trial with a only
standard treatment group, standard+ qigong treatment and standard +
The choice of intervention x depends on what you want to show. I would
try a mixture of aerobic gymnastics with low calory expenditure
similar to that of your planned intervention, combined with some form
of relaxation technique, e.g. jacobson or listening to relaxing music.
If you consider this to be too far from qigong, you could think of
sham qigong only without movement of qi. However, then you would have
the implicit qi manipulation that may be directly triggerd by the
This design may still be insufficient to eliminate the placebo
argument, but I don't see how this should be possible. But this problem
is shared by any behavioural intervention, e.g. all psychotherapy
studies. I belive that, in the end, it is pointless to try to disprove
the placebo argument. Rather the usefulness and validity of the
placebo concept itself should be (and is) challenged.
Hope this helps a bit (or is at least good for a little inspiration :))
At 11:16 AM 8/30/2006, Martin Eisen wrote:
>The control group should be sedentary people who do nothing.
>If you have a group that does mild exercise or stretching, they will
>improve from my experience in teaching students. In fact, if you
>just use the processes in the 5-element medical qigong, the exercise
>group might even do better in increased mobility. The meditative
>group might learn to ignore pain.
>You should use another type of Qigong. I think Zhineng Qigong is
>better in that every joint in the body is gently stretched.
**** Please note my new affiliation and email ****
Kevin W Chen, Ph.D. MPH
Center for Integrative Medicine,
University of Maryland School of Medicine,
2200 Kernan Drive, Kernan Hospital Mansion,
Baltimore, MD 21207-6697
Tel: 410-448-6876; Fax: 410-448-6875;