Effects of qigong training on physical and psychological health in breast cancer survivors : a randomized controlled trial

Abstract

Cancer is the second leading death cause globally in 2018. The disease brings influences to patients and their families on physical, emotional aspects as well as financial burdens to the communities and health systems. Among all different types of cancer, breast cancer is the most common among women worldwide. The primary treatments of breast cancer include surgery, chemotherapy, radiotherapy and hormonal therapy. With advanced technology and improved treatments, the survival rate of the breast cancer patients raised. Thus, survivor populations expanded in the past few decades. However, patients usually receive a combination of these treatments come up with the complications and side effects by the disease and treatments. The negative impacts on the survivors lead to compromised quality of life (QOL) at the end. Qigong training, as a mind-and-body exercise, also known as one of the Tradition Chinese Medicine, is widely used to improve health and QOL on general health population and sick people since the late 90s. This intervention has been practiced on various populations included the cancer patients and survivors. Several studies revealed the beneficial influences by Qigong training on both physiological and psychosocial scopes during the rehabilitation period for them. With limited and insufficient study, the effects of Qigong training on survivors of breast cancer had not yet been proofed. Therefore, the aim of this thesis was to investigate the effects of Qigong training on physical and psychological impacts on survivors of breast cancer. The findings would help to consider Qigong as supportive care strategy to the population and figure out efficient training protocols to them. The study was a single-blinded randomized controlled trial. Due to the nature of intervention and group assignment, this study would not be a double-blinded study. The 18-Form Tai Chi Internal Qigong was taught to the intervention group while regular medical care was offered to the control group. A 12-week and biweekly supervised Qigong training and home self-practice (total 5 hours per week) program was provided to the intervention group. There were fifty-six female participants recruited from local community self-help groups. With two participants excluded from the initial screening procedure for their eligibility, the rest fifty-four women were allocated into two groups evenly. Assessments were carried out at the pre-test, post-test, and three months thereafter (follow-up test). Applying the intention-to-treat principle, data analysis was conducted. Significant group and time interaction effects (p<0.05) showed increased palmar skin temperature, improved range of motion (ROM) in flexion, external rotation and horizontal flexion, and increased in muscular strength in internal rotation of the affected side shoulder flexion and horizontal flexion, and improved index finger sensitivity of the affected upper limb. In summary, the twelve weeks of Qigong training implied that the improvements in peripheral circulation, ROM and increased of maximum force exerted, shortened the time to exert force, and improved finger sensitivity of the affected side upper limb in the participants in the intervention group. Therefore, Qigong training could be potential adjunct to be incorporated into the rehabilitation exercise program for the survivors of breast cancer.