Effectiveness of Aerobic Exercise and Tai Chi Interventions on Sleep Quality in Patients With Advanced Lung Cancer A Randomized Clinical Trial

Naomi Takemura, Denise Shuk Ting Cheung, Daniel Yee Tak Fong, Anne Wing Mui Lee, Tai Chung Lam, James Chung Man Ho, Tsz Yeung Kam, Jeannie Yin Kwan Chik, Chia Chin Lin

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

IMPORTANCE Sleep disturbances prevalent among patients with advanced lung cancer can aggravate physical and psychological symptoms, contributing to decreased quality of life and survival. OBJECTIVE To compare the effectiveness of 2 physical activities of different modalities and intensities, namely aerobic exercise (AE) and tai chi (TC), on subjective sleep quality, physical and psychological outcomes, and survival in patients with advanced lung cancer. DESIGN, SETTING, AND PARTICIPANTS This assessor-blinded, randomized clinical trial was conducted in 3 public hospitals in Hong Kong between December 19, 2018, and September 7, 2022. A total of 226 patients with advanced lung cancer were recruited and randomized 1:1:1 to AE, TC, or the control group. INTERVENTIONS For 16 weeks, the AE group received two 60-minute supervised group exercise sessions and home-based exercises per month, and the TC group received 60-minute group sessions twice weekly. The control group received physical activity guidelines. MAIN OUTCOMES AND MEASURES The primary outcome was subjective sleep quality. Secondary outcomes included objective sleep measures, anxiety, depression, fatigue, quality of life, physical function, circadian rhythm, and 1-year survival. Assessments were conducted at baseline, 16 weeks (T1), and 1 year (T2). RESULTS The 226 participants had a mean (SD) age of 61.41 (8.73) years, and 122 (54.0%) were female. Compared with the control group, participants in the AE and TC groups showed statistically significant improvements in subjective sleep quality from baseline to 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), psychological distress, physical function, step count, and circadian rhythm. The TC group had a statistically significant greater improvement in sleep than 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). Participants in the TC group showed statistically significant improvement in survival compared with the control group. CONCLUSIONS AND RELEVANCE 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. Both exercises, but particularly TC, can be incorporated into lung cancer survivorship care. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04119778.

Original languageEnglish
Pages (from-to)176-184
Number of pages9
JournalJAMA oncology
Volume10
Issue number2
DOIs
Publication statusPublished - Feb 15 2024

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Effectiveness of Aerobic Exercise and Tai Chi Interventions on Sleep Quality in Patients With Advanced Lung Cancer A Randomized Clinical Trial'. Together they form a unique fingerprint.

Cite this