Qigong Massage
Evidence reviewed as of before 01-01-2021
Author(s): Ogourtsova, T. (PhD OT); Steven, E. (MSc App OT); Iliopoulos, G. (MSc App OT); & Majnemer, A. (PhD, OT, FCAHS)
Introduction
Qigong massage is a non-invasive therapeutic massage that originates in China and is based on Chinese medical theory. There are a variety of approaches to qigong (active and passive) and uses, such as pain management, stress management, improving sleep, flexibility and posture as well as improving sensory conditions (qigong sensory training).
Qigong sensory training (QST) is a specific type of qigong massage that was first developed for improving sensory and self-regulation issues for children with autism. It has been adapted for pediatric populations with sensory, motor and/or orthopaedic issues (e.g. cerebral palsy, Down syndrome).
Qigong massage aims to improve sensory and motor conditions by stimulating capillary circulation and awareness to the skin by means of normalization of the sympathetic and parasympathetic nervous system function. Based on Chinese medical theory, it is believed that children with high or low muscle tone (e.g. children with cerebral palsy, Down syndrome) will have decreased circulation to the affected muscles. Qigong massage aims to improve circulation to these areas, thereby improving sensory and motor function.
Qigong massage is suitable for any age. A qigong massage practitioner (often an occupational therapist trained in QST) can administer qigong massage for children with CP and other neurological conditions (autism, Down syndrome) and provide training to parents. Many QST pediatric protocols involve parent training so that treatments can be given at home daily.
Parent & Family Information
Qigong massage is a massage therapy method that was first developed for children with autism (qigong sensory training, QST) to help improve sensory and self-regulation issues. In this population, qigong massage has also shown improvement in sleep, communication as well as social skills. QST has been adapted for pediatric populations with sensory, motor and/or orthopaedic issues (e.g. cerebral palsy, Down syndrome).
Children with motor delays often have abnormal responses to sensations (for example, they can be over or under reactive to certain sensations). It is believed that these responses negatively affect the process of learning motor skills. Based on Chinese medical theory, children with abnormal muscle tone (high or low) likely have decreased circulation in the affected muscles.
Through repetitive movements, tapping and massage, intended to increase awareness and blood flow to the skin and muscles, qigong massage aims to restore normal sensory and motor functions.
A qigong massage practitioner often provides weekly sessions over 5 months directly to the child, but parents are often implicated in the protocol and received training to administer the massage daily for 15 minutes.
Qigong sensory training (QST) adapted for use with children with cerebral palsy (high or low muscle tone) aims to improve motor development, for example: balance, walking/crawling, and use of the limbs (throwing or kicking a ball). It is also used to normalize sensory functions (e.g. hyper/hyposensitivity to different sensations) as well as self-regulatory functions (sleep, digestion, attention and emotions).
There are different types of qigong massage that are used with a variety of clientele and ages. QST is a qigong massage technique specifically designed for children with sensory-motor issues (e.g. autism). It has been adapted for use with children with CP.
There is very limited research to indicate if qigong massage works for CP. One small study that compared qigong massage vs. standard care (state funded follow-up program) for improving motor skills or sensory symptoms in children with CP did not find any difference in effectiveness between the two interventions.
You and your child will meet a qigong massage practitioner for initial evaluation so that the therapist can understand your child’s areas of difficulty and needs (sensory, motor and self-regulatory). Evaluations (determined by the therapist) will be conducted before beginning the protocol in order to measure the effect of the intervention.
You may be asked to plan sessions to learn qigong massage techniques for your child at home. A qigong massage practitioner will then schedule regular sessions with your child (usually 30 minutes weekly for 5 months) to administer more focused treatment and monitor progress.
A registered QST practitioner/trainer (you can consult https://www.qsti.org/ for a list of practitioners/trainers in your area) can provide QST or QST adapted massage for CP.
If recommended, the parent will receive training in qigong massage techniques so that they can provide treatment at home.
Typical qigong massage protocols involve 5 months of 30 minute weekly sessions with a practitioner and 15 minute daily massage sessions provided by the parent at home. It may be recommended to continue providing the 15 minute massage treatments at home for up to 2 years.
Not much is known about the long term effects of qigong massage.
For children with autism, a hypersensitivity phase has been reported after several months of the massage. If this is observed, massage techniques should be adapted and guidance from a licensed practitioner is recommended.
More research is required to determine if qigong massage is an effective treatment approach for children with CP. One recent study showed no improvements in motor skills or sensory responses in children under 4 after 5 months of treatment.
There are some contraindications for QST (for children with autism) which may apply to the adapted version of qigong massage for CP. Seek the advice of a licensed QST professional if any of these conditions apply to your child:
1. Uncontrolled seizures
2. Other neurological conditions
3. Other intensive treatments planned at the same time
4. Drugs that may delay progress (e.g. sedatives)
Information on this website is provided for informational purposes only and is not a substitute for professional medical advice.
Clinician Information
One fair quality cross-over RCT (Silva et al., 2012) investigated the effects of Qigong massage on sensory and self-regulatory difficulties among children with CP. In this fair quality cross-over RCT, children were randomized to receive Qigong massage or no treatment (waitlist); both groups received standard care (early childhood education services). At 5 months, the control group crossed over to receive Qigong massage. Sensory symptoms were assessed using the Sense and Self-Regulation Checklist at post-treatment (5 months) and follow-up (10 months). No significant between-group differences were found.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that Qigong massage is as effective as the comparison intervention (no treatment) in improving sensory symptoms in children with CP.
One fair quality cross-over RCT (Silva et al., 2012) investigated the effects of Qigong massage on motor skills among children with CP. In this fair quality cross-over RCT, children were randomized to receive Qigong massage or no treatment (waitlist); both groups received standard care (early childhood education services). At 5 months, the control group crossed over to receive Qigong massage. Motor skills were assessed using the Peabody Gross Motor Scale (PGMS: Stationary body control, Locomotion, Object manipulation) at post-treatment (5 months) and follow-up (10 months). No significant between-group differences were found.
Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that Qigong massage is as effective as the comparison intervention (no treatment) in improving motor skills in children with CP.
References
Silva, L. M., Schalock, M., Garberg, J., & Smith, C. L. (2012). Qigong massage for motor skills in young children with cerebral palsy and Down syndrome. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 66(3), 348–355. https://doi.org/10.5014/ajot.2012.003541
Definitions
A group of lifelong disorders affecting a person’s movement, coordination, and muscle tone and which are the result of damage to the brain before, during, or shortly after birth.
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