A Randomized Controlled Pilot Trial Comparing Effects of Qigong and Exercise/Nutrition Training on Fatigue and Other Outcomes in Female Cancer Survivors

Author: Chloe S Zimmerman1,2, Simona Temereanca3,4, Dylan Daniels1, Cooper Penner1, Tariq Cannonier1, Stephanie R Jones1,3,5, Catherine Kerr1,2
1 Brown University, Department of Neuroscience, Providence, RI, USA.
2 Miriam Hospital, Women's Medicine Collaborative Lifestyle Medicine, Providence, RI, USA.
3 Brown University, Robert J. and Nancy D. Carney Institute for Brain Science, Providence, RI, USA.
4 Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA.
5 VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence, Providence, RI, USA.
Conference/Journal: Integr Cancer Ther
Date published: 2023 Jan-Dec
Other: Volume ID: 22 , Pages: 15347354231162584 , Special Notes: doi: 10.1177/15347354231162584. , Word Count: 300

Cancer-related fatigue (CRF) is a common and burdensome, often long-term side effect of cancer and its treatment. Many non-pharmacological treatments have been investigated as possible CRF therapies, including exercise, nutrition, health/psycho-education, and mind-body therapies. However, studies directly comparing the efficacy of these treatments in randomized controlled trials are lacking. To fill this gap, we conducted a parallel single blind randomized controlled pilot efficacy trial with women with CRF to directly compare the effects of Qigong (a form of mind-body intervention) (n = 11) to an intervention that combined strength and aerobic exercise, plant-based nutrition and health/psycho-education (n = 13) in a per protocol analysis. This design was chosen to determine the comparative efficacy of 2 non-pharmacologic interventions, with different physical demand intensities, in reducing the primary outcome measure of self-reported fatigue (FACIT "Additional Concerns" subscale). Both interventions showed a mean fatigue improvement of more than double the pre-established minimal clinically important difference of 3 (qigong: 7.068 ± 10.30, exercise/nutrition: 8.846 ± 12.001). Mixed effects ANOVA analysis of group × time interactions revealed a significant main effect of time, such that both groups significantly improved fatigue from pre- to post-treatment (F(1,22) = 11.898, P = .002, generalized eta squared effect size = 0.116) There was no significant difference between fatigue improvement between groups (independent samples t-test: P = .70 ), suggesting a potential equivalence or non-inferiority of interventions, which we could not definitively establish due to our small sample size. This study provides evidence from a small sample of n = 24 women with CRF that qigong improves fatigue similarly to exercise-nutrition courses. Qigong additionally significantly improved secondary measures of mood, emotion regulation, and stress, while exercise/nutrition significantly improved secondary measures of sleep/fatigue. These findings provide preliminary evidence for divergent mechanisms of fatigue improvement across interventions, with qigong providing a gentler and lower-intensity alternative to exercise/nutrition.

Keywords: Qigong; cancer survivorship; cancer-related fatigue; exercise; nutrition; vital energy; vitality.

PMID: 37204076 DOI: 10.1177/15347354231162584