Can Qigong (body mind exercise) improve symptoms of insomnia in cancer survivors? : a feasibility study

Background: Many cancer survivors experience insomnia that significantly affects their quality of life (QOL). Due to the limitations of the current conventional cancer care and inadequate and inconclusive studies of Qigong on insomnia-related outcomes in this population, this pilot study aims to investigate the feasibility and effect of a 3-week Qigong intervention in cancer survivors experiencing insomnia. Methods: Seven cancer survivors aged 40-65, with an Insomnia Severity Index (ISI) score of ≥ 11, who had completed radiotherapy or chemotherapy treatment and/or at least eight weeks post cancer-related surgery participated in the study. Participants attended face to face sessions two times per week and supervised online home practice three sessions per week for a 3-week period. Feasibility outcomes included recruitment source, compliance to data collection, adherence to Qigong intervention, serious adverse events and experience of trial. Clinical outcome measures of insomnia included subjective ISI score and Pittsburgh Sleep Quality Index (PSQI) global scores collected at Week 0 (baseline), Week 2 (mid-intervention), Week 3 (post-intervention) and Week 4 (one-week follow-up). Results: Retention rate was 71% while adherence rate was 90 % for face to face sessions and 80% for online sessions. Participants reported increased relaxation, improved sleep and reduced stress. Repeated measures ANOVA reported statistically significantly difference in mean ISI values (F(1.963, 7.852) = 5.606, P = 0.031) and PSQI values (F(1.229, 4.915) = 16.508, P = 0.009) over the four time points. Contrasts tests revealed statistically significant reduction in group ISI means between Week 0 (baseline) compared to Week 2 (mean=5.6, ᶯp2 = 0.694, p=0.040), Week3 (mean=7.8, ᶯp2 = 0.838, p=0.010) and Week 4 (mean=6, ᶯp2 = 0.709, p=0.036). The contrast tests also reported statistically significant reduction in group PSQI means between Week 0 (baseline) compared to Week 2 (mean=5.1, ᶯp2 =0.841, p=0.018), Week3 (mean=5.4, ᶯp2 =0.833, p=0.011) and Week 4 (mean=4.7, ᶯp2 =0.835, p=0.011). Non parametric tests reported significant difference in ISI (p=0.006) and PSQI (p=0.007). Conclusion: In summary, this study demonstrated that it is feasible to prescribe the current Qigong intervention with the potential to improve insomnia in cancer survivors. Potential benefits identified indicated the need for larger future trials to further evaluate the effect of Qigong on cancer survivors experiencing insomnia

The feasibility and effects of Qigong intervention (mind-body exercise) in cancer patients with insomnia : a pilot qualitative study

Background: Up to 80% of cancer patients experience insomnia that significantly affects their quality of life. This pilot qualitative study investigated the feasibility and effects of a 3-week Qigong (mind-body exercise) intervention with a 1-week follow-up in cancer patients experiencing insomnia. Methods: Cancer patients with insomnia who had completed radiotherapy or chemotherapy treatment and/or were at least 8weeks post-cancer-related surgery were recruited. Primary outcomes were feasibility outcomes, which included recruitment, retention, attendance, completion of assessment, adverse events and participant feedback via a questionnaire and focus group/individual interview. Secondary outcomes on insomnia severity and sleep quality were measured using the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI) at baseline, mid, post-intervention and follow-up. Results: Seven participants were recruited and two withdrew from the study. The participant retention rate was 71.4% with an overall attendance rate of more than 84% and participants were able to complete all required assessments. An adverse event relating to the worsening of existing musculoskeletal condition was reported. Qualitative analysis of participant feedback identified 4 emerging themes: (1) experience from Qigong intervention; (2) class preferences; (3) barriers to participation; and (4) recommendation for improvement. Participants reported increased relaxation, improved sleep and energy level, better upper body flexibility and reduced stress. Both ISI and PSQI scores improved significantly (P<.05). Conclusion: This study demonstrated that it is feasible to employ the current clinical trial design using Qigong intervention on insomnia in cancer patients. Preliminary data suggest that the intervention may improve sleep outcomes, however, these findings need to be confirmed by future robust randomized controlled trials