Author: Denise Shuk Ting Cheung1, Naomi Takemura1, Tai Chung Lam1,2, James Chung Man Ho1, Wen Deng1, Robert Smith1, Yinxia Yan1, Anne Wing Mui Lee1,2, Chia Chin Lin1,3,4
Affiliation: <sup>1</sup> The University of Hong Kong, Hong Kong, China.
<sup>2</sup> The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
<sup>3</sup> Taipei Medical University, Taipei.
<sup>4</sup> Alice Ho Miu Ling Nethersole Charity Foundation Professorship in Nursing, Hong Kong, China.
Conference/Journal: Integr Cancer Ther
Date published: Jan-Dec 2021
Other:
Volume ID: 20 , Pages: 15347354211033352 , Special Notes: doi: 10.1177/15347354211033352. , Word Count: 343
Background:
A majority of lung cancer patients are diagnosed at advanced stages. Although there is considerable evidence of the benefits of aerobic exercise and tai-chi for lung cancer patients, little is known about the comparative effectiveness of the 2 exercise modes in advanced lung cancer patients.
Objectives:
To explore the feasibility and preliminary effects of aerobic exercise and tai-chi interventions on survival and well-being among advanced lung cancer patients.
Methods:
In an assessor-blinded, exploratory randomized controlled trial, 30 advanced lung cancer patients were randomized to an aerobic exercise group, a tai-chi group (both attending 12-week, twice-weekly supervised sessions), or a self-management control group (receiving written exercise guidelines). The primary outcomes focused on feasibility including intervention completion, exercise adherence, and adverse events, while the secondary outcomes addressed preliminary effects and included 1-year survival, cancer symptoms (Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Score, Brief Fatigue Inventory), quality of life (EORTC QLQ-C30, QLQ-LC13), physical performance (6-minute walk test, up-and-go, sit-to-stand, 1-leg standing), activity levels (actigraph), and circadian rhythms (salivary cortisol).
Results:
Intervention feasibility was established with a satisfactory completion rate at post-intervention for the aerobic exercise group (80%) and the tai-chi group (78%). The tai-chi group attained higher adherence than the exercise group in terms of attendance in supervised sessions (89% vs 75% of scheduled classes) and self-practice (225% vs 87% of the prescribed amount). Higher adherence to self-practice in the tai-chi group remained at the 6-month follow-up (81% vs 38% of the prescribed amount). No adverse event as a result of the intervention was reported. Effect-related outcomes did not show statistically significant changes in any group, except an improvement post-intervention in the up-and-go (-2.26, 95% CI: -4.04, -0.48) and sit-to-stand tests (4.52, 95% CI: 2.19, 6.85) in the aerobic exercise group.
Conclusions:
The findings support the feasibility of aerobic exercise and tai-chi interventions in advanced lung cancer patients. A future study with a larger sample from multiple sites is recommended to confirm the comparative effects of the 2 exercise interventions relative to the self-management group and to enhance the generalizability of the findings.
Keywords: advanced cancer; aerobic exercise; lung cancer; quality of life; survival; tai-chi.
PMID: 34549648 PMCID: PMC8461121 DOI: 10.1177/15347354211033352