Aerobic Exercise, Tai Chi Clinically Benefit Patients With Advanced Lung Cancer

Aerobic exercise (AE) and tai chi (TC) are associated with significant improvement in sleep disturbances, anxiety, depression, and physical function in patients with advanced lung cancer, according to study findings published in JAMA Oncology.

Investigators conducted a randomized clinical trial that compared sleep quality and other outcomes in patients with advanced lung cancer who did AE and TC vs those in a self-managed control group (CG).

The multicenter trial enrolled participants from December 19, 2018, to September 7, 2021, from the oncology and medical outpatient clinics of 3 hospitals in Hong Kong, China. Eligible patients were diagnosed with stage IIIB or IV non-small cell lung cancer, were aged 18 years or older, and did not exercise regularly.

The trial included 226 participants (mean age, 61.41 years [range, 35-78 years]; 54.0% female) who were randomly assigned 1:1:1 to AE (n=75), TC (n=76), or the CG (n=75). The AE intervention was 16 weeks with 8 supervised group exercise sessions (2 sessions per month) and home-based exercises. The TC intervention involved 60-minute group classes twice weekly for 16 weeks. The CG group received written information on the World Health Organization’s recommended level of physical activity and usual care from the hospital.

Data were obtained at baseline, week 16 (T1), and 8 months (T2) postintervention from self-report questionnaires, physical function tests, actigraphy, and saliva samples. The primary endpoint was subjective sleep quality per the Pittsburgh Sleep Quality Index (PSQI).

A statistically significant greater decrease in PSQI occurred in the AE and TC groups vs the CG at T1 (AE: between-group difference, −2.72; 95% CI, −3.97 to −1.46; P <.001; TC: between-group difference, −4.21; 95% CI, −5.48 to −2.94; P <.001) and T2 (AE: between-group difference, −1.75; 95% CI, −3.24 to −0.26; P =.02; TC: between group difference, −3.95; 95% CI, −5.41 to −2.49; P <.001).

TC participants had a statistically significant greater decrease in PSQI vs the AE group at T1 (between group difference, −1.49; 95% CI, −2.77 to −0.22; P = .02) and

T2 (between-group difference, −2.20; 95% CI, −3.57 to −0.83; P < .001).

Statistically significant between-group differences were observed in anxiety and depression with the 2 interventions vs the CG at T1 and T2. In addition, statistically significant improvements occurred in the 6-minute walk test and sit-to-stand test in the AE and TC groups at T1 and T2 vs the control group.

Median survival was 47.76 weeks for the AE group (95% CI, 45.24-50.28 weeks), 49.18 weeks in the TC group (95% CI, 47.32-51.05 weeks), and 44.20 weeks in the control group (95% CI, 41.04- 47.36). A statistically significant difference in overall survival was observed among the 3 groups (P =.005).

No adverse events were reported with the interventions.

Limitations include potential expectation bias because the participants were aware of the group assignment, and the potential for social desirability bias in the self-reported self-practice records, leading to overestimated physical activity.

“In this randomized clinical trial, AE and TC improved sleep, psychological distress, physical function, and circadian rhythm, with TC demonstrating greater benefits on sleep and survival,” the study authors concluded. “Given the safe nature of the exercises, both, but particularly TC, could be considered as a complementary therapeutic option to enhance the holistic well-being of patients with advanced lung cancer,” the study authors added.

This article originally appeared on Pulmonology Advisor