Is Qigong/Tai Chi Easy effective in improving persistent fatigue, depression and sleep dysfunction among breast cancer survivors, as compared to sham Qigong?
Date of publication of the randomized controlled trial: April 2015
Design
Randomized controlled trial (RCT).
Participants
87 women aged 40 to 75 who diagnosed with stages 0-III breast cancer reporting clinical significant fatigue, scoring <50 on the 4-item Vitality scale of the Medical Outcomes Scale short-form (SF-36) (mean age: 58.8 years).
Intervention
A 12-week Qigong /Tai Chi Easy practice was provided twice a week for the first two weeks, then once a week for the remaining ten weeks. Each session was 60 min long. Participants were asked to practice at home at least 30 min a day, 5 days per week. The practices were taught by a nurse experienced in leading exercise with cancer patients.
Comparator
Comparison: Qigong /Tai Chi Easy practice versus sham Qigong.
Major Outcomes
Outcome 1: Fatigue as measured by 16-item self-reported Fatigue Symptom Inventory (FSI) ranging from 0 to 10 with higher scores indicating greater fatigue at the end of 12-week intervention;
Outcome 2: Sleep quality as measured by 19-item The Pittsburgh Sleep Quality Index (PSQI) with a global PSQI score >5 indicating poor sleep quality;
Outcome 3: Depression as measured by 20-item Beck Depression Inventory (BDI) at the end of 12-week intervention. Higher scores indicated higher level of depression.
Settings
This trial was performed in an outpatient setting.
Comparison    Qigong /Tai Chi Easy practice versus sham Qigong
Main Results
Compared to sham Qigong, Qigong /Tai Chi Easy practice showed significant decrease in FSI score at post-intervention (z: -1.08, 95% CI: not reported); but it did not show significant effect on PSQI score (z: -1.14, 95% CI: not reported) and BDI score (z: 0.42, 95% CI: not reported).
Comparison: Qigong /Tai Chi Easy practice versus sham Qigong amongst breast cancer survivors at the end of 12-week intervention
Outcomes No. of studies (Total no. of participants) Mean score (SD)/ No. of participants Heterogeneity test (I2) Coefficient from hierarchical linear model (z statistics) (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 1 (87) 2.1(1.34)/40 2.6(1.65)/44 Not applicable as there is only 1 study. -1.08 (not reported) 0.005 Low
2 1 (87) 6.6(3.27)/31 7.3(4.06)/37 Not applicable as there is only 1 study. -1.14 (not reported) 0.136 Low
3 1 (87) 7.9(5.97)/38 6.3(5.06)/43 Not applicable as there is only 1 study. 0.42 (not reported) 0.725 Low
Keys: SD = standard deviation; CI = confidence interval.
Comparison    Qigong /Tai Chi Easy practice versus sham Qigong
Main Results
Compared to sham Qigong, Qigong /Tai Chi Easy practice showed significant decrease in FSI score at post-intervention (z: -1.08, 95% CI: not reported); but it did not show significant effect on PSQI score (z: -1.14, 95% CI: not reported) and BDI score (z: 0.42, 95% CI: not reported).
Comparison: Qigong /Tai Chi Easy practice versus sham Qigong amongst breast cancer survivors at the end of 12-week intervention
Outcomes 1 2 3
No. of studies (Total no. of participants) 1 (87) 1 (87) 1 (87)
Mean score (SD)/ No. of participants Intervention 2.1(1.34)/40 6.6(3.27)/31 7.9(5.97)/38
Comparator 2.6(1.65)/44 7.3(4.06)/37 6.3(5.06)/43
Coefficient from hierarchical linear model (z statistics) (95% CI) -1.08 (not reported) -1.14 (not reported) 0.42 (not reported)
p value 0.005 0.136 0.725
Overall quality of evidence* Low Low Low
Keys: SD = standard deviation; CI = confidence interval.
Conclusion
Benefits
Compared to sham Qigong, Qigong /Tai Chi Easy practice can significantly benefit breast cancer survivors by reducing scores in the FSI. Besides, Qigong /Tai Chi Easy practice also showed beneficial effects for reducing depression and sleep dysfunction symptoms. However, these beneficial effects between Qigong /Tai Chi Easy group versus sham Qigong were statistically insignificant. For all outcomes, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported in this trial.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/25124456
The synopsis is based on the following article:
Larkey LK, Roe DJ, Weihs KL, Jahnke R, Lopez AM, Rogers CE, et al. Randomized controlled trial of Qigong/Tai Chi Easy on cancer-related fatigue in breast cancer survivors. Annals of Behavioral Medicine. 2015 Apr; 49(2):165-76.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.