McQuade, J., Prinsloo, S., Chang, D.Z., Spelman, A., Wei, Q., Basen-Engquist, K., . . . Cohen, L. (2016). Qigong/tai chi for sleep and fatigue in prostate cancer patients undergoing radiotherapy: A randomized controlled trial. Psycho-Oncology. Advance online publication. 

DOI Link

Study Purpose

To examine the efficacy of qigong or tai chi to alleviate treatment-related fatigue and disturbed sleep in men who were undergoing radiotherapy for prostate cancer

Intervention Characteristics/Basic Study Process

Participants were randomized to one of three groups: qigong, light exercise, or wait-list control. Participants in the control could select from either of the two interventions. Participants assigned to the qigong group or light exercise group were asked to attend three 40-minute classes each week through their radiotherapy treatment (study follow-up ended at three months). The qigong groups were provided by a qigong master and included six minutes of guided breathing followed by 20 minutes of eight-form tai chi and qigong forms (gentle movement) and nine minutes of tai chi ball form to rebalance the energy, a program developed by Jerry Alan Johnson. The light exercise group was instructed by an exercise physiologist and included resistance training (8–12 repetitions per set) and stretching exercises. Resistance exercises were tailored based on each individual's baseline abilities.

Sample Characteristics

  • N = 90   
  • MEAN AGE = Qigong group: 62.2 years (SD = 7.4 years), light exercise: 65 years (SD = 5.9 years), wait-list control: 66 years (SD = 8.4 years)
  • MALES: 100%  
  • CURRENT TREATMENT: Radiation 
  • KEY DISEASE CHARACTERISTICS: Prostate
  • OTHER KEY SAMPLE CHARACTERISTICS: Thirty-three participants were in stage T2a or less, 19 participants were in T2b–T2c, and 14 were in T3a or greater. The majority of participants were also undergoing androgen deprivation therapy.

Setting

  • SITE: Single site   
  • SETTING TYPE: Outpatient    
  • LOCATION: MD Anderson Cancer Center, Texas

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Study Design

Randomized, controlled trial

Measurement Instruments/Methods

  • Pittsburgh Sleep Quality Index (PSQI)
  • Brief Fatigue Inventory (BFI)
  • Expanded Prostate Cancer Index Composite (EPIC) 

Results

This study did not show improvements in fatigue scores reported in any group either during treatment or after. Improvements in sleep duration was reported by those in the qigong group when compared to the light exercise group and the wait-list control. Sleep disturbance remained higher than clinical cutoff for all groups. Adherence to attendance at intervention in all classes was 64%. Additional practice at home after radiotherapy ended was not assessed.

Conclusions

Men undergoing radiotherapy for prostate cancer are able and willing to participate in physical activity interventions, such as qigong and/or light exercise. Fatigue and sleep disturbance are common symptoms experienced by men undergoing radiotherapy for prostate cancer and may persist after treatment is complete. However, qigong improved sleep duration for participants during radiotherapy treatment. This study did not detect improvements in fatigue or sleep disturbance that were sustained over the three-month period of the study.

Limitations

  • Small sample (< 100)
  • Findings not generalizable
  • Intervention expensive, impractical, or training needs
  • Subject withdrawals ≥ 10%

Nursing Implications

No side effects were reported in either intervention group (qigong or light exercise).