Does Qigong or Tai Chi bring benefits in improving quality of life, immunity and psychological health among cancer patients?
Date of publication of the systematic review: February 2014
Design
Systematic review of 13 randomized controlled trials (RCTs).
Participants
592 adult patients aged 18 or above diagnosed with any types of cancer who were undergoing cancer treatment, cancer survivors who had completed primary cancer treatment, and cancer patients who were at the end of their life. The reviewers did not report mean age and gender proportion of the participants.
Intervention
Among 13 included RCTs, qigong or Tai Chi was used as intervention. The qigong or Tai Chi exercise lasted for 40 to 120 min per session at a frequency of 1 to 5 sessions per week. The duration of interventions ranged from 5 to 12 weeks. In one of the included RCTs, home-based exercise was included as part of the intervention.
Comparator
Comparison: Qigong or Tai Chi versus intervention without qigong or Tai Chi.
Major Outcomes
Outcome 1: Changes in Quality of life (QOL) as measured by cancer-specific QOL scores from baseline to 12-week follow-up;
Outcome 2: Changes in fatigue scores from baseline to 12-week follow-up;
Outcome 3: Changes in cortisol levels from baseline to 12-week follow-up.
Settings
The reviewers did not state where the trials were conducted and whether the trials were conducted in inpatient or outpatient settings.
Comparison    Qigong or Tai Chi versus intervention without qigong or Tai Chi among cancer patients
Main Results
Compared to intervention without qigong or Tai Chi, either qigong or Tai Chi showed significant effects on improving cancer-specific QOL (pooled weighted mean difference (WMD): 7.99, 95% CI: 4.07 to 11.91) and fatigue (pooled standardized mean difference (SMD): -0.93, 95%CI: -1.80 to -0.06) from baseline to 12-week follow-up. Significant reduction in cortisol level (pooled SMD: -0.37, 95%CI: -0.74 to -0.00) was observed from baseline to 12-week follow-up among patients in qigong or Tai Chi group.
Comparison: Qigong or Tai Chi versus intervention without qigong or Tai Chi among cancer patients
Outcomes No. of studies (Total number of participants) Mean value/ No. of participants Heterogeneity test (I2) Pooled WMD/ SMD (95% CI) Overall quality of evidence*
Intervention Comparator
1 5 (405) Not reported/200 Not reported/205 95% WMD: 7.99 (4.07 to 11.91) Moderate
2 5 (257) Not reported/328 Not reported/129 99% SMD: -0.93 (−1.80 to −0.06) Low
3 2 (114) Not reported/58 Not reported/58 5% SMD: -0.93 (−1.80 to −0.06) Low
Keys: WMD: weighted mean difference; SMD: standardized mean difference; CI: confidence interval.
Comparison    Qigong or Tai Chi versus intervention without qigong or Tai Chi among cancer patients
Main Results
Compared to intervention without qigong or Tai Chi, either qigong or Tai Chi showed significant effects on improving cancer-specific QOL (pooled weighted mean difference (WMD): 7.99, 95% CI: 4.07 to 11.91) and fatigue (pooled standardized mean difference (SMD): -0.93, 95%CI: -1.80 to -0.06) from baseline to 12-week follow-up. Significant reduction in cortisol level (pooled SMD: -0.37, 95%CI: -0.74 to -0.00) was observed from baseline to 12-week follow-up among patients in qigong or Tai Chi group.
Comparison: Qigong or Tai Chi versus intervention without qigong or Tai Chi among cancer patients
Outcomes 1 2 3
No. of studies (Total number of participants) 5 (405) 5 (257) 2 (114)
Mean value/ No. of participants Intervention Not reported/200 Not reported/328 Not reported/58
Comparator Not reported/205 Not reported/129 Not reported/58
Pooled WMD/ SMD (95% CI) WMD: 7.99 (4.07 to 11.91) SMD: -0.93 (−1.80 to −0.06) SMD: -0.93 (−1.80 to −0.06)
Overall quality of evidence* Moderate Low Low
Keys: WMD: weighted mean difference; SMD: standardized mean difference; CI: confidence interval.
Conclusion
Benefits
Either qigong or Tai Chi showed significant positive effects on improving cancer-specific QOL and fatigue from baseline to 12-week follow-up. Qigong or Tai Chi also significantly lowers the cortisol level in cancer patients within the 12-week follow-up. For outcome 1, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect. For outcomes 2 and 3, 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
Safety issues related to study interventions were reported in one included study, but details were not mentioned. None of the serious adverse events related to qigong or Tai Chi practice was found in this study.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/24559833
The synopsis is based on the following article:
Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complementary Therapies in Medicine. 2014 Feb 28;22(1):173-86.


* 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.