Reference
Oh B, Butow P, Mullan B, et al. Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol. 2010;21:608-614.
Design
Randomized controlled trial of 162 patients with various cancers. Average age was 60 years old (range 31–86) All patients had a prognosis >12 months and had never done QiGong before participating in the study. Outcome measures, including quality of life (QOL), fatigue, mood, and an inflammatory biomarker were measured before intervention and at 10 weeks post-intervention. Intervention consisted of two 90-minute, supervised medical QiGong (MQ) sessions per week and assigned 30-minute sessions to be done at home daily. Assessment was made using Functional Assessment of Cancer Therapy—General; QOL, quality of life (FACT-G); Functional Assessment of Cancer Therapy—Fatigue (FACT-F); Profile of Mood State (POMS). Inflammation was assessed using C-reactive protein serum measurements.
Key Findings
QOL and all subdomain measures (physical, social, emotional, and functional well being) as measured by the FACT-G were significantly improved in the intervention vs. non-treatment group at 10 weeks (P=0.001). The intervention group also had significant improvement in cancer-related fatigue as measured by FACT-F (P=0.001). Improvements in total mood status as measured by POMS was also significantly improved in the intervention group (P=0,021) versus the control group. C-reactive protein was significantly improved in the intervnention group as well (P=0.044).
Practice Implications
QiGong is an ancient healing practice from China that uses what in Western terms is a mind-body approach to improve physical and mental well being. Of course, from an Eastern perspective this improvement is centered around the improved flow of energy or “qi” throughout the body. The program used in this study was a customized medical Qigong developed by the lead author “to specifically target the needs of cancer patients to control emotions and stress, as well as to improve physical function.” It consisted of “15-min discussion of health issues, 30-min gentle stretching and body movement in standing postures to stimulate the body along the energy channels, 15-min movement in seated posture … and 30-min meditation including breathing exercises.”
The program used was customized to specifically target the needs of cancer patients to control emotions and stress, as well as to improve physical function.
It should be noted that these varied techniques may have improved the effectiveness of the overall treatment. Each segment of the 90-minute supervised routine may have its own independent therapeutic value; therefore pooling these therapies is more likely to be beneficial for a substantial number of patients. However, this should not diminish the significance of the results. There has been previous evidence of Qigong’s ability to improve the quality of life in those with chronic illness.1 In addition, the systemic calming effects of Qigong have been demonstrated in studies on heart rate and blood pressure.2,3
The authors of the current study had demonstrated a similar trend in a pilot study published in 2008.4 Thirty participants received a similar MQ program for 8 weeks. Trends for improved QOL were observed, but statistical significance was not reached in the small number of patients. The importance of the current publication is that it is first one with enough power to demonstrate statistically significant improvement in QOL with MQ in patients with a diagnosis of cancer. It should also be noted that there have been no studies published to the contrary.
Chinese medical practitioners may consider this study proof of the obvious in that Qigong is expected to provide the improvements in physical and emotional well-being observed in this study. As with so many studies, what this publication provides is “evidence-based” substantiation of ancient wisdom and/or practices. In our day-to-day practices, many practitioners are already guiding patients to mind/body/spirit techniques. This study, along with corroborating publications, can aid our discussions with colleagues as well as help patients comply with our recommendations for Qigong specifically and mind/body techniques in general.
Limitations
The customized and unique program developed by the lead author means replicating this study by other researchers will be difficult. There may have been some level of selection bias in the study as participants volunteered for the study. The duration of the study was limited to only 10 weeks, and longer-term effects cannot be extrapolated from the data. Lastly, this study was not blinded to participants or investigators.
