Breast Cancer Research and Treatment

, Volume 120, Issue 2, pp 309–316 | Cite as

Tai chi for breast cancer patients: a systematic review

Review

Abstract

The objective of this review was to assess the effectiveness of tai chi for supportive breast cancer care. Eleven databases were searched from inception through December 2009. Controlled trials testing tai chi in patients with breast cancer that assessed clinical outcome measures were considered. The selection of studies, data extraction, and validations were performed independently by two reviewers. Risk of bias was assessed using Cochrane criteria. Three randomized clinical trials (RCTs) and four non-randomized controlled clinical trials (CCTs) met our inclusion criteria. The three RCTs tested the effects of tai chi on breast cancer care compared with walking exercise, psychological support therapy, or spiritual growth or standard health care and showed no significant differences between tai chi and these control procedures in quality of life and psychological and physical outcome measures. The meta-analysis also failed to demonstrate significant effects of tai chi compared with control interventions (n = 38, SMD, 0.45, 95% CI −0.25 to 1.14, P = 0.21; heterogeneity: χ2 = 0.23, P = 0.63; I2 = 0%). All of the four CCTs showed favorable effects of tai chi. Three trials suggested effectiveness in psychological and physical outcome measures, whereas one study was too poorly reported to be evaluated in detail. All of the CCTs had a high risk of bias. Collectively, the existing trial evidence does not show convincingly that tai chi is effective for supportive breast cancer care. Future studies should be of high methodological quality, with a particular emphasis on including an adequate control intervention.

Keywords

Tai chi Breast cancer Complementary therapies Systematic review 

Notes

Acknowledgment

M.S. Lee and T.-Y. Choi were supported by KIOM.

References

  1. 1.
    Markes M, Brockow T, Resch KL (2006) Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev CD005001Google Scholar
  2. 2.
    Wyatt G, Sikorskii A, Wills CE, Su H (2010) Complementary and alternative medicine use, spending, and quality of life in early stage breast cancer. Nurs Res 59:58–66CrossRefPubMedGoogle Scholar
  3. 3.
    Owens B, Jackson M, Berndt A (2009) Complementary therapy used by Hispanic women during treatment for breast cancer. J Holist Nurs 27:167–176CrossRefPubMedGoogle Scholar
  4. 4.
    Matthews AK, Sellergren SA, Huo D, List M, Fleming G (2007) Complementary and alternative medicine use among breast cancer survivors. J Altern Complement Med 13:555–562CrossRefPubMedGoogle Scholar
  5. 5.
    Greenlee H, Kwan ML, Ergas IJ et al (2009) Complementary and alternative therapy use before and after breast cancer diagnosis: the pathways study. Breast Cancer Res Treat 117:653–665CrossRefPubMedGoogle Scholar
  6. 6.
    Gerber B, Scholz C, Reimer T, Briese V, Janni W (2006) Complementary and alternative therapeutic approaches in patients with early breast cancer: a systematic review. Breast Cancer Res Treat 95:199–209CrossRefPubMedGoogle Scholar
  7. 7.
    Chen Z, Gu K, Zheng Y, Zheng W, Lu W, Shu XO (2008) The use of complementary and alternative medicine among Chinese women with breast cancer. J Altern Complement Med 14:1049–1055CrossRefPubMedGoogle Scholar
  8. 8.
    Carpenter CL, Ganz PA, Bernstein L (2009) Complementary and alternative therapies among very long-term breast cancer survivors. Breast Cancer Res Treat 116:387–396CrossRefPubMedGoogle Scholar
  9. 9.
    Boon H, Olatunde F, Zick S (2007) Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Womens Health 7:4CrossRefPubMedGoogle Scholar
  10. 10.
    Mansky P, Sannes T, Wallerstedt D et al (2006) Tai chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors. Integr Cancer Ther 5:192–201CrossRefPubMedGoogle Scholar
  11. 11.
    Lee MS, Pittler MH, Ernst E (2007) Is tai chi an effective adjunct in cancer care? A systematic review of controlled clinical trials. Support Care Cancer 15:597–601CrossRefPubMedGoogle Scholar
  12. 12.
    Higgins JPT, Altman DG (2008) Assessing risk of bias in included studies. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, West Sussex, UK, pp 187–241CrossRefGoogle Scholar
  13. 13.
    Follmann D, Elliott P, Suh I, Cutler J (1992) Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol 45:769–773CrossRefPubMedGoogle Scholar
  14. 14.
    Galantino ML, Capito L, Kane RJ, Ottey N, Switzer S, Packel L (2003) The effects of tai chi and walking on fatigue and body mass index in women living with breast cancer: a pilot study. Rehabil Oncol 21:17–22Google Scholar
  15. 15.
    Mustian KM, Roscoe JA, Katula JA, Gill DL, Lang D, Murphy K (2004) Tai chi chuan, health-related quality of life and self-esteem: a randomized trial with breast cancer survivors. Support Care Cancer 12:871–876CrossRefPubMedGoogle Scholar
  16. 16.
    Rausch SM (2007) Evaluating psychosocial effects of two intervention, tai chi and spiritual growth groups, in women with breast cancer. College of Humanities and Sciences, MS thesis. Virginia Commonwealth University, VirginiaGoogle Scholar
  17. 17.
    Eom A (2007) Effects of a tai chi program for early mastectomy patients. Korean J Women Health Nurs 13:43–50Google Scholar
  18. 18.
    Seoung MY (2008) Effect of tai chi exercise program on physical functioning and psychological problems of breast cancer patients after surgery. MS thesis, Department of Nursing, Chungnam National University, DaejeonGoogle Scholar
  19. 19.
    Kim CW (2009) The effect of tai-chi exercise on the function of shoulder joint, cardiovascular systems and immune system in breast cancer patients. PhD dissertation, Dong Eui University, BusanGoogle Scholar
  20. 20.
    Hwang IS, Kwak YS (2009) Tai chi exercise on MDA, SOD and physical fitness in breast cancer patients. J Life Sci 19:543–548Google Scholar
  21. 21.
    Higgins JPT, Green S (2008) Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, West Sussex, UKCrossRefGoogle Scholar
  22. 22.
    Lee MS, Chen KW, Sancier KM, Ernst E (2007) Qigong for cancer treatment: a systematic review of controlled clinical trials. Acta Oncol 46:717–722CrossRefPubMedGoogle Scholar
  23. 23.
    Sannes TS, Mansky PJ, Chesney MA (2008) The need for attention to dose in mind-body interventions: lessons from tai chi clinical trials. J Altern Complement Med 14:645–653CrossRefPubMedGoogle Scholar
  24. 24.
    Egger M, Smith GD (1998) Bias in location and selection of studies. BMJ 316:61–66PubMedGoogle Scholar
  25. 25.
    Ernst E, Pittler MH (1997) Alternative therapy bias. Nature 385:480CrossRefPubMedGoogle Scholar
  26. 26.
    Rothstein HR, Sutton AJ, Borenstein M (eds) (2005) Publication bias in meta-analysis. Wiley, Chichester, West SussexGoogle Scholar
  27. 27.
    Vickers A, Goyal N, Harland R, Rees R (1998) Do certain countries produce only positive results? A systematic review of controlled trials. Control Clin Trials 19:159–166CrossRefPubMedGoogle Scholar
  28. 28.
    Wayne PM, Kaptchuk TJ (2008) Challenges inherent to tai chi research. Part II. Defining the intervention and optimal study design. J Altern Complement Med 14:191–197CrossRefPubMedGoogle Scholar
  29. 29.
    Wayne PM, Kaptchuk TJ (2008) Challenges inherent to tai chi research. Part I. Tai chi as a complex multicomponent intervention. J Altern Complement Med 14:95–102CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Myeong Soo Lee
    • 1
    • 2
  • Tae-Young Choi
    • 1
  • Edzard Ernst
    • 2
  1. 1.Division of Standard ResearchKorea Institute of Oriental MedicineDaejeonSouth Korea
  2. 2.Complementary Medicine, Peninsula Medical SchoolUniversities of Exeter & PlymouthExeterUK

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