Effects of Tai Chi Exercise on Cancer-Related Fatigue in Patients With Nasopharyngeal Carcinoma Undergoing Chemoradiotherapy: A Randomized Controlled Trial

Abstract

Context. Tai Chi exercise has been shown to improve cancer-related fatigue (CRF) and autonomic nervous system (ANS) balance in some cancer patients or survivors; however, such effects are yet to be verified in nasopharyngeal carcinoma (NPC) patients undergoing chemoradiotherapy. Objectives. To explore the effects of Tai Chi exercise on CRF in NPC patients undergoing chemoradiotherapy and then to evaluate ANS information indicated by heart rate variability parameters and their association with CRF. Methods. A randomized controlled trial of Tai Chi exercise was conducted from January 2014 to August 2015. Participants in the Tai Chi group practiced Tai Chi a one-hour session, five sessions/week during chemoradiotherapy. Participants in the control group received usual care. The primary end points were scores of the multidimensional fatigue symptom inventoryeshort form (MFSI-SF). Secondary end points were heart rate variability parameters, including normalized lowfrequency (nLF) power, normalized high-frequency (nHF) power, and the nLF/nHF ratio, and their association with CRF. Results. One hundred fourteen patients were recruited in this study, and 83 patients completed the trial. The Tai Chi group and the control group had comparable baseline characteristics. After chemoradiotherapy, the Tai Chi group exhibited lower MFSI-SF total score and three negative subscale (general, physical, and emotional fatigue) scores and higher vigor score compared with the control group (P < 0.01 for all). The nLF/nHF ratio was significantly lower in the Tai Chi group compared to the control group after chemoradiotherapy. The MFSI-SF total score was markedly correlated with the nLF/nHF ratio. Conclusion. Tai Chi exercise is conducive to alleviate CRF in NPC patients undergoing chemoradiotherapy. The improvement in ANS balance might fit into the process of Tai Chi for CRF management in this population.

Effects of Mind–Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

“…Of 44 full-text articles, 27 were excluded because researchers investigated the acute effects of mind–body exercise ( n = 5), no Tai Chi/Yoga was implemented as the primary intervention ( n = 2), Yoga training took place at a heated environment ( n = 1), non-randomized controlled trials were used ( n = 11), outcome of interest was not reported ( n = 3), children or youth were included as study participants ( n = 2), and resting measure of HRV was not performed ( n = 3). Therefore, we included 17 RCTs in this review [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. The process of study selection is presented in Figure 1 .…”

“…The remaining studies were published between 2012 and 2018. While 12 RCT involved healthy individuals, five other studies reported people with disease (low back pain, chronic heart failure, nasopharyngeal carcinoma, or fibromyalgia) [ 41 , 50 , 51 , 52 , 53 ]. Sample size (attrition rate from zero to 46.8%) varied greatly across studies, ranging from 26 to 355 (mean age ranged from 25.85 to 71.4).…”

“…Overall, the intervention effect was statistically significant but of small magnitude, as denoted by the Hedge’s value. Of the 11 studies included in the final meta-analysis, five demonstrated significant reductions of nLF [ 42 , 44 , 46 , 50 , 51 ]. Participants for these studies were older adults [ 42 ], middle-aged women [ 44 ], menopausal women [ 46 ], patients with nasopharyngeal cancer [ 50 ], and sedentary young women [ 51 ].…”

“…Of the 11 studies included in the final meta-analysis, five demonstrated significant reductions of nLF [ 42 , 44 , 46 , 50 , 51 ]. Participants for these studies were older adults [ 42 ], middle-aged women [ 44 ], menopausal women [ 46 ], patients with nasopharyngeal cancer [ 50 ], and sedentary young women [ 51 ]. Four of the studies reporting significant results used Yoga as the intervention activity [ 42 , 44 , 46 , 51 ], with the total weekly training volume ranging from 60 to 200 min/week, training frequency of 1 to 2 times/week, and total intervention duration of 8 to 16 weeks.…”

Effect of Tai Chi Chuan in Breast Cancer Patients: A Systematic Review and Meta-Analysis

“…TCC improves vigor in patients with lung cancer undergoing chemotherapy (88). In addition, TCC can alleviate fatigue, enhance neck and shoulder joints mobility, and improves sleep in nasopharyngeal carcinoma patients (89,90). For cancer survivors undergoing chemotherapy, TCC improves cancerrelated fatigue, self-efficacy, and QOL (91).…”