Article
of the Month
Reviewed by Dr Carla Ripamonti (Italy), an IAHPC Board Member
Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial.
B. Oh, P. Butow, B. Mullan, S. Clarke, P. Beale, N. Pavlakis et al.
Annals of Oncology 2010; 21: 608-614
Complementary medicine (CM) therapies are increasingly used in clinical practice, particularly in countries such as Australia and USA where 52% and 83% of cancer patients respectively have been reported to use them. However, the efficacy and tolerability of CM therapies in the cancer population is not supported by evidence from RCTs.
Medical Qigong (MQ) uses physical activity and meditation to harmonize the body, mind and spirit. MQ is part of Chinese medicine and is based on the theory that pain, discomfort and fatigue are due to a blockage, or stagnation, of energy flow in the energy channels of the body. This energetic block causes the onset of disease and the worsening of a patient’s health.
In uncontrolled studies, MQ produced a decrease of heart rate, blood pressure, and circulating stress hormones whereas it increases immune function and impacts survival. In the present study, the authors randomized 162 Qigong naïve cancer patients (mean age 60 years, range 31-86 years; 34% breast cancer and 12% colorectal cancer) who had an expected survival length of greater than 12 months and had no brain metastasis, epilepsy, psychiatric disorders or pathologic conditions where exercise is contraindicated.
The patients gave blood at entry, completed the QOL measure and were randomly assigned into the intervention and control groups. Nine MQ programs were considered and the patients were divided in groups with 7 to 20 patients. At baseline and at 10 weeks postintervention the patients were assessed for QOL (by means of FACT-G), cancer related fatigue (by means of the FACT-F subscale), mood (by Profile of Mood State), and inflammation (by the C-reactive protein).
The MQ program lasted 10 weeks and included two supervised 90-min sessions per week. The patients were invited to practice the exercises at home every day for at least half an hour. Each supervised session consisted of a 15-min discussion of health issues, 30-min of gentle stretching and body movement in a standing posture to stimulate the body along the energy channels, 15-min of movement in the seated position, 30-min of meditation including various breathing exercises based on the energy channel theory in Chinese medicine, relaxation, feeling the Qi (nature’s/cosmic energy) and visualization.
The patients in the control group received usual care and were assessed on a regular basis using the same assessment tools.
At the 10-week follow-up, regression analysis showed that the MQ group significantly improved in overall QOL and fatigue (p<0.001), mood disturbance (p= 0.021) on four subscales: tension, anxiety, depression, lack of vigour and fatigue. The patients in MQ group had significant differences in the level of inflammation biomarker (p<0.044) compared to the control group at week 10. No adverse effects were reported.
Why I chose this article
This is the first randomized controlled trial with adequate statistical power that assessed the impact of MQ on QOL, fatigue, mood and inflammation in cancer patients.
Although the study presents some limitations, I consider the results interesting. This is something we could test on patients in our clinical practice at the beginning of the illness when there is a need to control physical symptoms as well as anxiety and fatigue by a non –pharmacological means.
This review was written by Dr. Carla Ripamonti, Italy
Dr. Ripamonti is a member of the IAHPC Board of Directors; her bio may be viewed at: http://www.hospicecare.com/Bio/c_ripamonti.htm |