Tai Chi Exercise for Cancer-Related Fatigue in Patients With Lung Cancer Undergoing Chemotherapy: A Randomized Controlled Trial

Context. Tai Chi is a traditional Chinese health-promoting exercise. It has been shown to enhance mental health and improve psychological condition. Objectives. We aimed to assess the effectiveness of Tai Chi exercise for cancer-related fatigue in patients with lung cancer undergoing chemotherapy. Methods. We conducted a randomized trial of Tai Chi exercise as compared with low-impact exercise as a control intervention. Exercises were practiced every other day, a one-hour session for 12 weeks for each of the study groups. The primary end point was a change in total score of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Secondary end points were changes in five subscale scores of the MFSI-SF. All assessments were repeated at three time points, T0: before first course of chemotherapy; T1: before third course of chemotherapy; and T2: at the end of the fourth course of chemotherapy. Results. Between January 2012 and December 2014, 96 patients were enrolled in this trial. At six and 12 weeks, the Tai Chi group had a lower MFSI-SF total score compared with the control group (59.5 +/- 11.3 vs. 66.8 +/- 11.9, P < 0.05; 53.3 +/- 11.8 vs. 59.3 +/- 12.2, P < 0.05). At six weeks, the Tai Chi group had lower MFSI-SF general subscale scores (18.1 +/- 4.6 vs. 20.4 +/- 4.5, P < 0.05) and physical subscale scores (17.5 +/- 4.4 vs. 19.1 +/- 4.5, P < 0.05), and higher MFSI-SF vigor subscale scores (14.5 +/- 3.3 vs. 11.6 +/- 3.4, P < 0.05), compared with the control group. But no significant differences were found in emotional subscale (20.2 +/- 3.6 vs. 20.0 +/- 3.5, P > 0.05) and mental subscale (18.2 +/- 4.0 vs. 18.9 +/- 3.9, P > 0.05) scores between the Tai Chi group and the control group. At 12 weeks, the MFSI-SF subscale scores showed the same trends as at six weeks. Conclusion. Tai Chi is an effective intervention for managing cancer-related fatigue in patients with lung cancer undergoing chemotherapy, especially for decreasing general fatigue and physical fatigue, and increasing vigor. (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.