Researchers have found that patients with cancer-related fatigue who practiced qigong may have demonstrated clinically significant improvements in their fatigue burden after 10 weeks, according to a new study published by Zimmerman et al in Integrative Cancer Therapies. The findings revealed that qigong might be as effective at reducing fatigue as more energy-intensive exercises and nutrition programs.
Background
Fatigue is a common, debilitating, and often long-term side effect of cancer as well as its treatment. As many as 45% of cancer survivors report moderate to severe fatigue, even years after stopping treatment. Often, fatigue can be more burdensome and disruptive to daily life than ongoing pain, nausea, and depression. While previous studies have shown that exercise can help improve fatigue, there is not yet enough evidence to recommend a particular type of exercise or regimen. In addition, a moderate-to-vigorous exercise program may be too intense or overwhelming for some patients with fatigue.
Qigong is a Chinese mind-body practice involving sequences of coordinated, gentle, rhythmic, and repetitive movements as well as meditation. Mind-body approaches such as qigong, yoga, mindfulness techniques, and tai-chi are receiving increasing attention for their potential to affect physical, emotional and cognitive health—all of which may be helpful for those with cancer-related fatigue.
“Our study is important because it is the first randomized clinical trial to directly compare qigong practice to the best standards of care for fatigue—namely, exercise,” explained co–study author Stephanie R. Jones, PhD, Associate Professor of Neuroscience at the Robert J. and Nancy D. Carney Institute for Brain Science at Brown University. “It would have been hard to predict that [patients] who perform gentle nonaerobic intentional movements would show the same level of improvement as those who go through moderate strength training and aerobic exercise. It is exciting that our findings establish that this is indeed the case,” she highlighted.
Study Methods and Results
In the new study, researchers randomly assigned 24 female patients who had completed cancer treatments such as surgery, radiation, and/or chemotherapy at least 8 weeks prior to baseline to either take classes in qigong or classes focused on health living that incorporated both physical exercises—including Pilates-like core movements, resistance training, and aerobics—as well as general health and nutrition education. All of the classes were held twice weekly for 2 hours per session. The researchers sought to analyze changes in the patients’ fatigue, emotional health, and stress before and after the interventions and to compare the effects of a regular qigong practice with that of standard exercise and nutrition regimens on cancer-related fatigue.
The researchers also noted that the new study was built on the research of the Catherine Kerr, PhD, Assistant Professor of Family Medicine at Brown University, who died in 2016. Diagnosed with multiple myeloma in 1995, Dr. Kerr benefited from qigong practice and worked to better understand the factors contributing to the treatment’s success.
After 10 weeks of follow-up, the researchers found that both qigong and the standard exercise and nutrition regimens significantly improved cancer-related fatigue. The improvement levels were more than double the established minimal clinically important difference. Further, the outcomes from the qigong group were comparable to those from the standard exercise and nutrition group. Patients who took qigong also reported significant improvements in mood, emotion regulation, and stress, whereas those who had completed the standard exercise and nutrition regimens reported significant improvements in sleep and fatigue.
The researchers noted that a gentle, low-intensity practice like qigong may offer some of the same physical benefits as exercise without requiring the same level of physical effort, which can be difficult for patients who have recently been through an experience like cancer.
Conclusions
Dr. Jones and her colleagues are currently examining how qigong might affect patients’ perceptions of fatigue.
“We are … also examining changes in electrophysiological measures of brain and muscle activity that occur with practice in each group. We’re testing the hypothesis that the treatment efficacy is related to modulation of brain-muscle communication that may be distinct in each group due to the different techniques,” Dr. Jones stated. “We hope that this study … sets a foundation for further scientific inquiry on the healing trajectories promoted by qigong,” she added.
The researchers hope to further analyze the effects of mind-body interventions on cancer-related fatigue in larger, more diverse study populations in the future.
“I think we still have a lot to learn about which mind-body practices are best for which patient. Being a part of this clinical trial with qigong has shown me how much healing potential there is from practices that have been historically dismissed by the biomedical clinical and research communities. I think we have a responsibility to keep investigating how they may exert their healing effects in rigorously designed studies,” concluded Chloe S. Zimmerman, and MD/PhD student in the Department of Neuroscience at Brown University.
Disclosure: The research in this study was supported by funding from the Berkman-Landis Family Fund. For full disclosures of the study authors, visit journals.sagepub.com.
