Effectiveness Not Established

Tai Chi

for Anxiety

Tai Chi is a Chinese martial arts activity that involves deep breathing, exercise, and slow movement with a meditative aspect, connecting the individuals physical, mental, and emotional states. Tai Chi has been examined for its effect on symptoms such as anxiety, depression, and fatigue.

Research Evidence Summaries

Galantino, M.L., Callens, M.L., Cardena, G.J., Piela, N.L., & Mao, J.J. (2013). Tai chi for well-being of breast cancer survivors with aromatase inhibitor-associated arthralgias: A feasibility study. Alternative Therapies in Health and Medicine, 19(6), 38-44.

Study Purpose

To evaluate the feasibility of tai chi to improve well-being for women with breast cancer treatment-associated arthralgia

Intervention Characteristics/Basic Study Process

Women met twice weekly for eight weeks for group tai chi under supervision. The program was a gentle, low-impact form of tai chi focusing on body awareness, deep breathing, and weight bearing. Women were provided written information for home practice. Participants were asked to complete journal entries after each tai chi session and home exercise, encouraged to maintain usual activities, and asked to refrain from other exercise during the study. Study measures were obtained at baseline and at the end of 8 weeks.

Sample Characteristics

  • N = 12  
  • MEAN AGE = 59 years (range = 49-76 years)
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: All had completed initial breast cancer treatment and were post-menopausal, currently free of disease, and on aromatase inhibitors.  
  • OTHER KEY SAMPLE CHARACTERISTICS: 91.6% were white, one-third were employed full-time, and 58% had some college education.

Setting

  • SITE: Single site
  • SETTING TYPE: Outpatient   
  • LOCATION: New Jersey

Phase of Care and Clinical Applications

PHASE OF CARE: Late effects and survivorship

Study Design

Single-group observational, mixed-method, feasibility

Measurement Instruments/Methods

  • Functional Assessment of Cancer Therapy–Breast (FACT-B)
  • Brief Pain Inventory
  • Hospital Anxiety and Depression Scale (HADS)
  • Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue)
  • Qualitative analysis of journal entries

Results

There was a reduction in anxiety from 8.0 to 5.7 (p = .003) and in depression from 5.17 to 2.42 (p = .02). A positive, but non significant, reduction in fatigue and pain occurred. Themes from analysis of qualitative results were improved relaxation and reduced stress, an increase in undisturbed sleep, and perceived value from the group and instructor support. There were no adverse events.

Conclusions

Tai chi participation appears to be feasible for breast cancer survivors and may have positive effects on anxiety and other symptoms.

Limitations

  • Small sample (< 30)
  • Risk of bias (no control group)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)
  • Risk of bias (no appropriate attentional control condition) 
  • Risk of bias (sample characteristics)
  • Other limitations/explanation: Adherence to sessions is not reported. Sample was limited to women on aromatase inhibitors experiencing pain from arthralgia.

Nursing Implications

Tai chi sessions are feasible for cancer survivors and may be of benefit. This combination of relaxation and exercise disciplines may be helpful and acceptable to some patients. Study findings here suggest that the supportive nature of instructor-led group sessions contributed to the positive results.

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