Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis
This study aims to summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind–body exercises on symptoms and quality of life (QOL) in cancer survivors.
A systematic search in four electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and QOL in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges’ g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed.
Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n = 7), prostate (n = 2), lymphoma (n = 1), lung (n = 1), or combined (n = 4) cancers. RCT comparison groups included active intervention (n = 7), usual care (n = 5), or both (n = 3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue (ES = − 0.53, p < 0.001), sleep difficulty (ES = − 0.49, p = 0.018), depression (ES = − 0.27, p = 0.001), and overall QOL (ES = 0.33, p = 0.004); a statistically non-significant trend was observed for pain (ES = − 0.38, p = 0.136). Random effects models were used for meta-analysis based on Q test and I 2 criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results.
Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made.
Implications for Cancer Survivors
TCQ shows promise in addressing cancer-related symptoms and QOL in cancer survivors.
KeywordsTai Chi Qigong Meta-analysis Cancer Fatigue Quality of life
This study was supported by grants to PMW from the National Center for Complementary and Integrative Health/National Institutes of Health (K24AT009282) and the Osher Center for Integrative Medicine. MSL was supported by a grant from Korea Institute of Oriental Medicine (K17111). LEC holds the Enbridge Research Chair in Psychosocial Oncology, co-funded by the Canadian Cancer Society Alberta/NWT Division and the Alberta Cancer Foundation. RS was supported by a grant from the National Research Foundation of Korea’s Ministry of Education (2013R-1A-1A-2065536).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
For this type of study formal consent is not required. This article does not contain any studies with human participants or animals performed by any of the authors.
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