Randomized controlled trial testing Tai Chi Easy/Qigong and Sham Qigong on breast cancer survivors' fatigue and associated symptoms

Authors: LARKEY, LINDA - Arizona State University; JAMES, DARA - Arizona State University; HAN, SEUNG - Arizona State University; WEIHS, KAREN - University Of Arizona; JAHNKE, ROGER - Non ARS Employee; OH, BYEONGSANG - University Of Sydney; KIM, SUNNY - Arizona State University; HUBERTY, JENNIFER - University Of Texas At San Antonio; PETROV, MEGAN - Arizona State University; MARTIN, DANIELLE - Arizona State University; HOWE, NANCY - Arizona State University; HOOK, JANE - Arizona State University; SOLTERO, ERICA - Children'S Nutrition Research Center (CNRC); RAO, SANTOSH - Case Western Reserve University (CWRU); NORTHFELT, DONALD - Mayo Clinic

Submitted to: Complementary Therapies in Clinical Practice
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/7/2025
Publication Date: 7/8/2025
Citation: Larkey, L.K., James, D.L., Han, S.Y., Weihs, K., Jahnke, R., Oh, B., Kim, S.W., Huberty, J., Petrov, M.E., Martin, D., Howe, N., Hook, J., Soltero, E., Rao, S., Northfelt, D. 2025. Randomized controlled trial testing Tai Chi Easy/Qigong and Sham Qigong on breast cancer survivors' fatigue and associated symptoms. Complementary Therapies in Clinical Practice. 61:Article 102014. https://doi.org/10.1016/j.ctcp.2025.102014.
DOI: https://doi.org/10.1016/j.ctcp.2025.102014

Interpretive Summary: Breast cancer survivors often struggle with post-treatment symptoms, one of which includes 'brain fog' or reduced cognition and fatigue. It is important for survivors to remain active to reduce other cancer-related symptoms and factors associated with cancer recurrence like weight gain. However, light activity movements are needed to effectively engage breast cancer survivors who may be struggling with fatigue and need a gentle movement activity to begin their journey towards active living. In this study, 167 women who had finished treatment for early-stage breast cancer and still felt fatigued. Participants joined one of three groups for eight weeks: Tai Chi Easy/Qigong, which combines slow movement with breathing and meditation; Sham Qigong, where they did similar movements but without mindful breathing; and a health education group that attended weekly talks without exercise. Compared to the education group, women in the Tai Chi and Sham groups reported improved cognitive functioning. Women with moderate fatigue in the Tai Chi group also reported better sleep and less anxiety than those who only attended education sessions. Women across all three groups showed within-group improvements in sleep, anxiety and cognition for those moderately fatigued, and improvements in fatigue for severely fatigued participants. These improvements may be related to the group support and encouragement provided across all three groups. Findings from the Tai Chi and Sham groups show that a gentle, light movement exercise like meditative movement is a great starting place for engaging breast cancer survivors in physical activity. These findings also demonstrate that light movements like those associated with Tai Chi improve physical as well as cognitive symptoms, further emphasizing the need for activities suited for the needs of survivors. Practices like Tai Chi are low-cost, accessible, and safe for most people, making them a promising option for long-term recovery and better quality of life.

Technical Abstract: Fatigue is the most frequently reported symptom among breast cancer survivors (BCSs). Interventions using Tai Chi and Qigong improve fatigue and related symptoms for BCSs when compared to controls; less is known about sham Qigong (i.e., gentle exercise without meditative state or breath focus). Fatigued BCSs <10 years post-treatment, aged 45-75, stages 0-III, were randomized to 8 weeks of once-weekly, 60-min sessions of Tai Chi Easy/Qigong (TCQ) (n=57), Sham Qigong (SQG) (n=53), or an education support (ES) control (n=57). Self-reported fatigue (Fatigue Symptom Inventory), sleep (Pittsburgh Sleep Quality Index), anxiety/depression (Profile of Mood States) and cognitive function (FACT-COG) were assessed at pre-, post-, and 24-weeks post intervention. Participants (N=167, Mean age=59.87; 93.41% White; 20.96% Hispanic) reported improvements in cognitive function in TCQ (and SQG) compared to ES. TCQ participants with moderate fatigue significantly improved compared with ES on sleep, anxiety, and cognition (p<0.05). SQG showed significant improvement over ES for sleep and cognitive function (p<0.05). All intervention/control groups (p<0.05) showed within-group improvements in sleep, anxiety and cognition for those moderately fatigued, and improvements in fatigue for severely fatigued participants. While significant improvements found for TCQ compared to ES were limited to cognitive factors, within-group improvements over time for fatigue, sleep, anxiety, and cognitive factors were found for TCQ, SQG and ES. Gentle exercise, including TCQ, may be an appropriate intervention to address sleep, anxiety and cognition, especially for moderately fatigued BCSs, and for fatigue for severely fatigued BCSs.