Effect of Tai Chi Vs. Structured Exercise on Physical Fitness and Stress in Cancer Survivors
Condition: Cancer; Cancer Survivor
Study type: Interventional
Phase: Phase 2

Summary: 
      This study will compare the effectiveness of Tai Chi (a sequence of slow, graceful body
      movements) and a cardiovascular exercise fitness program in improving physical fitness and
      endurance, reducing stress and improving well-being in adult survivors of cancer. Tai Chi,
      described by some as a moving form of yoga and meditation combined, evolved from martial arts
      and breathing exercises in China hundreds of years ago. This study uses the 24-posture
      standardized Tai Chi. The movements are continuous, smooth, and natural, with the upper and
      lower parts of the body following each other. The entire body is always in motion, with the
      movements performed gently and at a uniform speed. The exercise training program uses an
      exercise machine. The training regimen is adjusted to maintain the individual's average
      training heart rate at 70 to 80 percent heart rate reserve; i.e., 220 minus the person's age.

      Cancer survivors of solid tumor cancers who are between 18 and 65 years of age, whose
      treatment included chemotherapy, biologic agents or vaccines, who have had no cancer
      treatment for at least 24 months, and who have had no evaluable disease within 3 months of
      screening for this study may be eligible to participate.

      Participants are randomly assigned to one of three study groups: Tai Chi, exercise training,
      or a waiting list. Individuals in the Tai Chi and exercise training groups participate in a
      supervised program for 1 hour 3 times a week for 12 weeks in the NIH Clinical Center's
      Rehabilitation Medicine department. Individuals assigned to the waiting list are followed for
      12 weeks during the waiting period and are then assigned to either the Tai Chi or exercise
      program for another 12 weeks as described above.

      At three time points during the study-before starting the program and after 6 weeks and 12
      weeks of practicing the study intervention or being on the waiting list-participants undergo
      the following procedures:

      Complete questionnaires regarding their quality of life and stress

      Rehabilitation medicine evaluation, including the following:

        -  Questions about managing their daily activities, whether their skills have changed over
           time, what they may or may not have been able to do, or what they may have had to
           overcome as a result of their previous illness and the study program they have been
           practicing

        -  Measurements of strength and mobility

        -  Evaluation of overall physical fitness and endurance

        -  Blood tests to measure blood cell counts and cholesterol, lipid, hormone and mineral
           levels
    

Detailed description: 
      Diagnosis and treatment for cancer represent a major life-time stressor for any patient.
      While the diagnosis of a life-threatening illness is stressful, undergoing treatment for
      cancer including surgery, radiotherapy and chemotherapy result in stress to the patient. In
      addition, cancer treatment frequently is associated with fatigue, physical de-conditioning
      and metabolic abnormalities characteristic of the metabolic syndrome, leading to speculations
      that cancer therapy may render survivors more prone to developing metabolic syndrome and its
      sequelae, cardiovascular disease. In a recently conducted study we detected a high incidence
      of hyperlipidemia and increased body fat content, decreased aerobic performance and
      musculoskeletal functioning and a high frequency of parameters of psychological distress in
      long-term survivors of pediatric sarcoma. Based on these data and findings, it appears
      desirable to devise a program that would help cancer survivors not only to improve
      musculoskeletal functioning and aerobic performance, as a physical exercise program would
      offer, but in addition relieve psychological stress and enhance the well-being of cancer
      survivors after completion of treatment with multimodality therapy. Tai Chi Chuan (TCC) has
      been used in Asian culture for centuries to improve wellness, reduce stress, and to promote
      healing by improving the flow of Qi. While a number of studies have provided scientific
      support for these claims in different populations, a beneficial role for TCC in the
      management of cancer survivors has not been established.

      This study aims to compare in a randomized, wait-list controlled design, the efficacy of TCC
      to an exercise program in improving aerobic exercise capacity and endurance, reducing stress
      and improving Quality of Life in adult survivors of malignant solid tumors.
    

Intervention name(s): Tai Chi Chuan
Intervention type(s): Procedure
Primary purpose: Treatment
Keywords: Mind-Body; Stress Reduction; Complementary Medicine; Quality of Life; Well-being; Psychoneuroimmunology; Tai Chi; Aerobic Exercise; Cancer Survivor