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Qigong intervention for breast cancer survivors with complaints of decreased cognitive function

Abstract

Purpose

The purpose of this pilot study was to evaluate the feasibility of an 8-week Qigong intervention to improve objectively and subjectively assessed cognitive function in breast cancer survivors who were 2 months to 8 years post completion of chemotherapy and radiation therapy.

Methods

A randomized, single-blind, three-arm intervention pilot was conducted to compare Qigong to gentle exercise and survivorship support. Feasibility was measured by recruitment, group session attendance, and adherence to home practice for the two exercise groups. Changes in self-report and objectively measured cognitive function were compared between the three groups from baseline (T1) to completion of the intervention (T2) and 4 weeks post intervention (T3).

Results

Fifty participants consented (83% of desired sample) with an overall attrition rate of 28%. Attrition was highest for the gentle exercise group (50%). Group attendance adherence ranged from 44 to 67%. The a priori established rate of 75% weekly attendance was not achieved, nor was the goal of 75% adherence to home practice for the two exercise groups (7 to 41%). Self-report of cognitive function improved most for the Qigong group (p = .01). Improvement was demonstrated for the Trail Making A (gentle exercise, p = .007) and F-A-S verbal fluency (support group, p = .02) tests. Qigong participants reported the most reduction of distress (p = .02).

Conclusions

The study results suggest that mindfulness-based exercise may be superior to gentle exercise alone or survivorship support for improving self-report of cognitive function and distress after treatment for breast cancer. The mindfulness component may enhance the positive impact of exercise on cognitive function.

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References

  1. 1.

    Carlson LE, Bultz BD (2003) Cancer, distress screening: needs, models and methods. J Psychosom Res 55:403–409

  2. 2.

    Hampson JP, Zick SM, Khabir T, Wright BD, Harris RE (2015) Altered resting brain connectivity in persistent cancer related fatigue. Neuroimage Clin 8:305–313

  3. 3.

    Myers JS, Wick J, Klemp JR (2015) Potential factors associated with perceived cognitive impairment in breast cancer survivors. Support Care Cancer 23:3219–3228. https://doi.org/10.1007/s00520-015-2708-7

  4. 4.

    Von AD, Jansen C, Allen DH (2014) Evidence-based interventions for cancer- and treatment-related cognitive impairment. Clin J Oncol Nurs 18:17–25

  5. 5.

    Asher A, Myers JS (2015) The effect of cancer treatment on cognitive function. Clin Adv Hematol Oncol 13(7):441–450

  6. 6.

    Myers JS (2015) Complementary and integrative interventions for cancer-related cognitive changes. Asia Pac J Oncol Nurs

  7. 7.

    Myers JS, Erickson KI, Sereika SM, Bender CM (2017) Exercise as an intervention to mitigate decreased cognitive function from cancer and cancer treatment: an integrative review. Cancer Nurs:1. https://doi.org/10.1097/ncc.0000000000000549

  8. 8.

    Baumann FT, Drosselmeyer N, Leskaroski A, Knicker A, Krakowski-Roosen H, Zopf EM, Bloch W (2011) 12-week resistance training with breast cancer patients during chemotherapy: effects on cognitive abilities. Breast Care 6:142–143

  9. 9.

    Crowgey T, Peters KB, Hornsby WE, Lane A, McSherry F, Herndon JE, West MJ, Williams CL, Jones LW (2014) Relationship between exercise behavior, cardiorespiratory fitness, and cognitive function in early breast cancer patients treated with doxorubicin-containing chemotherapy: a pilot study. Appl Physiol Nutr Metab 39:724–729

  10. 10.

    Derry HM, Jaremka LM, Bennett JM, Peng J, Andridge R, Shapiro CL, Malarkey WB, Emery CF, Layman R, Mrozek EE, Glaser R, Kiecolt-Glaser JK (2014) Yoga and self-reported cognitive problems in breast cancer survivors: a randomized controlled trial. Psychooncology 24:958–966. https://doi.org/10.1002/pon.3707

  11. 11.

    Knobf MT, Thompson A, Fennie K, Erdos D (2013) The effect of a community-based exercise intervention on symptoms and quality of life. Cancer Nurs 37:E43–E50

  12. 12.

    Milbury K, Chaol A, Biegler KA, Wangyal T, Spelmen A, Meyers C, Arun B, Palmer JL, Taylor JA, Cohen L (2013) Tibetan sound meditation for cognitive dysfunction: results of a randomized controlled pilot trial. Psychooncology 22:2354–2363

  13. 13.

    Oh B, Butow PN, Mullan BA, Clarke SJ, Beale PJ, Pavlakis N, Lee MS, Rosenthal DS, Larkey L, Vardy J (2012) Effect of medical Qigong on cognitive function, quality of life, and a biomarker of inflammation in cancer patients: a randomized controlled trial. Support Care Cancer 20:1235–1242. https://doi.org/10.1007/s00520-011-1209-6

  14. 14.

    Reid-Arndt AA, Matsuda S, Cox CR (2012) Tai chi effects on neuropsychological, emotional, and physical functioning following cancer treatment: a pilot study. Complement Ther Clin Pract 18:26–30

  15. 15.

    Sprod LK, Mohile SG, Demark-Wahnefried W, Janelsins MC, Peppone LJ, Morrow GR, Lord R, Gross H, Mustian KM (2012) Exercise and cancer treatment symptoms in 408 newly diagnosed older cancer patients. J Geriatr Oncol 3:90–97

  16. 16.

    Larkey LK, Roe DJ, Weihs KL, jahnke R, Lopez AM, Rogers CE, OH B, Guillen-Rodriguez (2015) Randomized controlled trial of qigong/tai chi easy on cancer-related fatigue in breast cancer survivors. Ann Behav Med 49:165–176

  17. 17.

    Lindquist R, Wyman JF, Talley KM, Findorff MJ, Gross CR (2007) Design of control-group conditions in clinical trials of behavioral interventions. J Nurs Scholarsh 39:214–221

  18. 18.

    Kelley GA, Kelley KS (2015) Meditative movement therapies and health-related quality-of-life in adults: a systematic review of meta-analyses. PLoS One 10(6):e0129181. https://doi.org/10.1371/journal.pone.0129181

  19. 19.

    Ahles TA, Saykin A (2002) Breast cancer chemotherapy-related cognitive dysfunction. Clin Breast Cancer 3(Suppl 3):S84–S90

  20. 20.

    Campo RA, Agarwal N, LaStayo PC, O'Connor K, Pappas L, Boucher KM, Gardner J, Smith S, Light KC, Kinney AY (2014) Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong. J Cancer Surviv 8:60–69

  21. 21.

    Liu W, Zahner L, Cornell M, Le T, Ratner J, Wang Y, Pasnoor M, Dimachkie M, Barohn R (2012) Benefit of Qigong exercise in patients with fibromyalgia: a pilot study. Int J Neurosci 122(11):657–664. https://doi.org/10.3109/00207454.2012.707713

  22. 22.

    Oh B, Butow P, Mullan B, Clarke S (2008) Medical Qigong for cancer patients: pilot study of impact on quality of life, side effects of treatment and inflammation. Am J Chin Med 36:459–472

  23. 23.

    Oh B, Butow P, Mullan B, Clarke S, Beale P, Pavlakis N, Kothe E, Lam L, Rosenthal D (2010) Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol 21(3):608–614. https://doi.org/10.1093/annonc/mdp479

  24. 24.

    Liu W, Schaffer L, Herrs N, Choller C, Taylor S (2015) Improved sleep after Qigong exercise in breast cancer survivors, a pilot study. Asia Pac J Oncol Nurs submitted

  25. 25.

    Sanford SD, Beaumont JL, Butt Z, Sweet J, Cella D, Wagner L (2014) Prospective longitudinal evaluation of a symptom cluster in breast cancer. J Pain Symptom Manag 47:721–730

  26. 26.

    Moon S, Schmidt M, Smirnova IV, Colgrove Y, Liu W (2017) Qigong exercise may reduce serum TNF-alpha levels and improve sleep in people with Parkinson’s disease: a pilot study. Medicines (Basel, Switzerland) 4(2). https://doi.org/10.3390/medicines4020023

  27. 27.

    Cleeland CS, Mendoza TR, Wang XS, Chou C, Harle MT, Morrissey M, Engstrom MC (2000) Assessing symptom distress in cancer patients: the M.D. Anderson symptom inventory. Cancer 89:1634–1646

  28. 28.

    Johnson-Kozlow M, Rock CL, Gilpin EA, Hollenbach KA, Pierce JP (2007) Validation of the WHI brief physical activity questionnaire among women diagnosed with breast cancer. Am J Health Behav 31:193–202

  29. 29.

    Lai J, Butt Z, Wagner L, Sweet J, Beaumont JL, Vardy J, Jacobsen PB, Jacobs SR, Shapiro CL, Cella D (2009) Evaluating the dimensionality of perceived cognitive function. J Pain Symptom Manag 37:982–995

  30. 30.

    Lai J, Wagner L, Jacobsen PB, Cella D (2014) Self-reported cognitive concerns and abilities: two sides of one coin? Psychooncology 23:1133–1141. https://doi.org/10.1002/pon.3522

  31. 31.

    Wefel J, Vardy J, Ahles TA, Schagen SB (2011) International cognition and cancer task force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol 12:703–708

  32. 32.

    Luo L, Luk G, Bialystok E (2010) Effect of language proficiency and executive control on verbal fluency performance in bilinguals. Cognition 114:29–41

  33. 33.

    Strauss E, Sherman EM, Spreen O (2006) A compendium of neuropsychological tests: Administration, norms, and commentary, vol 3rd edn. Oxford University Press, New York

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Funding

This research was funded by the Oncology Nursing Society Foundation through an unrestricted grant from the Sigma Theta Tau International Foundation. A portion of Dr. Myers’ time was supported by the National Institution of Nursing Research (NINR) T32: Interdisciplinary Training of Nurse Scientists in Cancer Survivorship while a postdoctoral scholar with the University of Pittsburgh School of Nursing.

Author information

Correspondence to Jamie S. Myers.

Ethics declarations

Approval from the University of Kansas Human Subjects Committee was obtained and all procedures were performed in accordance with institutional ethical standards and the 1964 Helsinki declaration and its later amendments.

Conflict of interest

The authors have no financial relationship with the organization that funded the research (the Oncology Nursing Society Foundation through an unrestricted grant from Sigma Theta Tau International Foundation). The first author and the primary investigator for the study have full control of all primary data. However, data sharing agreement execution would be necessary if the journal requests data review.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Cite this article

Myers, J.S., Mitchell, M., Krigel, S. et al. Qigong intervention for breast cancer survivors with complaints of decreased cognitive function. Support Care Cancer 27, 1395–1403 (2019). https://doi.org/10.1007/s00520-018-4430-8

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Keywords

  • Breast cancer
  • Cognitive function
  • Qigong
  • Mindfulness-based exercise
  • Intervention