Difficult Diseases

Qigong Exercise Alleviates Fatigue, Anxiety, and Depressive Symptoms, Improves Sleep Quality, and Shortens Sleep Latency in Persons with Chronic Fatigue Syndrome-Like Illness

The University of Hong Kong, Hong Kong, China and Harvard School of Public Health, Cambridge, MA, USA


Outcomes: In conclusion, we found that 16 sessions of Baduanjin Qigong exercise were an efficacious and acceptable treatment for sleep disturbance, fatigue, anxiety, and depressive symptoms in people with chronic fatigue syndrome-(CFS-) like illness. Future studies should examine the effectiveness of Qigong exercise in a mixed group of insomnia and insomnia in other comorbid conditions. Strategies to enhance participation in Qigong lesson and regular practice are needed.

Tai Chi Chih Compared with Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial

University of California Los Angeles, Los Angeles, CA, USA


Outcomes: Purpose -Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer.

Conclusion – CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

Exploratory outcome assessment of Qigong/Tai Chi Easy on Breast cancer survivors

Arizona State University, Phoenix, AZ, USA and Women’s Health Internal Medicine and Integrative Medicine, Mayo Clinic, Scottsdale, AZ, USA


Outcomes: Objective -Breast cancer survivors (BCSs) experience symptoms affecting overall quality of life (QOL), often for a prolonged period post-treatment. Meditative Movement (MM), including Qigong and Tai Chi Easy (QG/TCE), has demonstrated benefit for improving QOL issues such as fatigue and sleep, but there is limited evidence of its impact on cognitive function, overall physical activity, and body weight for BCSs. Interventions – Twelve weekly sessions of QG/TCE were compared to sham Qigong (SQG), a gentle movement control intervention similar to QG/TCE but without the focus on breathing and meditative state.

Conclusions – Practices that include gentle movement (such as QG/TCE or our sham protocol) among women with a history of breast cancer may improve many facets of the cancer experience, including QOL, cognitive function, and PA patterns. Practicing QG/TCE may show some advantage for BMI reduction compared to non-meditative gentle exercise.

Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial

UCLA Semel Institute for Neuroscience, UCLA David Geffen School of Medicine, LA, USA and University of Arizona, AZ, USA


Outcomes: Background – Sleep disturbance is associated with activation of systemic and cellular inflammation, as well as pro-inflammatory transcriptional profiles in circulating leukocytes. Whether treatments that target insomnia-related complaints might reverse these markers of inflammation in older adults with insomnia is not known.

Methods – In this randomized trial, 123 older adults with insomnia were randomly assigned to cognitive behavioral therapy for insomnia (CBT-I), tai chi chih (TCC), or sleep seminar education active control condition (SS) for two hour sessions weekly over 4 months with follow-up at 7- and 16-months. We measured C-reactive protein (CRP) at baseline, month 4 and 16, Toll-like receptor-4 (TLR-4)-activated monocyte production of proinflammatory cytokines at baseline, month 2, 4, 7, and 16, and genome-wide transcriptional profiling at baseline and month 4.

Conclusions – Among older adults with insomnia, CBT-I reduced systemic inflammation, TCC reduced cellular inflammatory responses, and both treatments reduced expression of genes encoding proinflammatory mediators. The findings provide an evidence-based molecular framework to understand the potential salutary effects of insomnia treatment on inflammation, with implications for inflammatory disease risk.

Effect of Tai Chi on mononuclear cell functions in patients with non-small cell lung cancer

Shanghai University of Sport, Shanghai, China and University of Michigan, Ann Arbor, MI, USA and

Wayne State University School of Medicine, Detroit, Michigan, USA


Outcomes: Background – Tai Chi is the Chinese traditional medicine exercise for mind-body health. The objective of this study is to investigate the effect of Tai Chi Chuan (TCC) exercise on the proliferative and cytolytic/tumoricidal activities of peripheral blood mononuclear cells (PBMCs) in postsurgical non-small cell lung cancer (NSCLC) patients.

Conclusion – Regular Tai Chi exercise has the promise of enhancing PBMC proliferative and cytolytic activities in NSCLC patients. Our results affirm the value of a future trial with a larger scale and longer duration for cancer survivors.

Feasibility, utility and symptom impact of modified mindfulness training in sarcoidosis

New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, University Medical Center Comprehensive Pulmonary Hypertension Center and Tulane University School of Medicine, New Orleans, LA, USA, plus others


Outcomes:  In conclusion, this study is the first to show that a modified 45-min mindfulness training workshop (mindfulness-based exercise interventions informed by t’ai chi) had immediately measurable benefit and was perceived as a feasible, acceptable and beneficial introduction to routine daily life by people living with sarcoidosis and their caregivers. This model is cost-effective and sustainable as a one-off intervention. However, further studies with a robust patient-centred end-point model are needed. Longitudinal assessment of adherence to mindfulness practices, its impacts, perceived benefit and utility will need to be demonstrated before mindfulness practices are endorsed by health service commissioners and providers.

Children and Adults Tai Chi Study (CF-CATS2): a randomised controlled feasibility study comparing internet-delivered with face-to-face Tai Chi lessons in cystic fibrosis

Department of Paediatric Respiratory Medicine, The Royal Brompton and Harefield NHS Foundation Trust, London, UK, plus others.


Outcomes: Tai Chi was safe and well tolerated; it was feasible to deliver individual lessons via the internet, reducing concerns regarding cross-infection, and appeared to improve self-reported symptoms.

Effect of Baduanjin Qigong Exercise on Cancer-Related Fatigue in Patients with Colorectal Cancer Undergoing Chemotherapy: A Randomized Controlled Trial

Department of Oncological Surgery, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China, plus others


Outcomes: Baduanjin qigong exercise can relieve CRF in patients with colorectal cancer undergoing chemotherapy and can improve their physical activity level and their quality of sleep.

Qigong Improves Quality of Life in Women Undergoing Radiotherapy for Breast Cancer: Results of a Randomized Controlled Trial

Fudan University Shanghai Cancer Center, Shanghai, China and MD Anderson Cancer Center, Houston, Texas, USA


Outcomes: Qigong may have therapeutic effects in the management of Quality of Life (QOL) in women receiving radiotherapy for breast cancer. Benefits were particularly evident for patients with pre-intervention elevated levels of depressive symptoms.

Feasibility and Acceptability of a Tai Chi Chih Randomized Controlled Trial in Senior Female Cancer Survivors

Huntsman Cancer Institute, University of Utah, Salt Lake City, UT


Outcomes: A TCC intervention was found to be a feasible and acceptable modality for senior female cancer survivors. Future, larger definitive trials are needed to clarify TCC dosage effects on QOL in this vulnerable population.

Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong

Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA


Outcomes: This 12-week Qigong intervention was feasible and potentially efficacious in improving senior prostate cancer survivors’ levels of fatigue and distress levels. Future, larger definitive randomized controlled trials are needed to confirm these benefits in older prostate cancer survivors and in racially and ethnically diverse populations. Qigong may be an effective nonpharmacological intervention for the management of senior prostate cancer survivors’ fatigue and distress.

Blood Pressure, Salivary Cortisol, and Inflammatory Cytokine Outcomes in Senior Female Cancer Survivors Enrolled in a Tai Chi Chih Randomized Controlled Trial

University of North Carolina at Chapel Hill, Chapel Hill, NC and University of Utah, Salt Lake City, Utah and University of California, Los Angeles, California and University of New Mexico Cancer Center, Albuquerque, NM, USA


Outcomes: This Tai Chi Chih (TCC) feasibility trial was associated with significant reductions in systolic blood pressure (SBP) and cortisol area-under-curve (AUC) in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings.

Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial

Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA and Department of Psychiatry and Biobehavioral Sciences and Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA and Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA and Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA and Department of Psychology, UCLA, Los Angeles, CA, USA


Outcomes: Among breast cancer survivors with insomnia, 3 months of TCC reduced cellular inflammatory responses, and reduced expression of genes encoding proinflammatory mediators. Given the link between inflammation and cancer, these findings provide an evidence-based molecular framework to understand the potential salutary effects of Tai Chi Chih (TCC) on cancer survivorship.

The effect of group aerobic exercise and t’ai chi on functional outcomes and quality of life for persons living with acquired immunodeficiency syndrome

Richard Stockton College of New Jersey, Pomona, NJ, USA.


Outcomes: This study shows that Tai Chi (TC) and aerobic exercise (EX) improve physiologic parameters, functional outcomes, and quality of life (QOL). Group intervention provides a socialization context for management of chronic HIV disease. This study supports the need for more research investigating the effect of other types of group exercise for this population. This study sets the stage for a larger randomized controlled trial to examine the potential short- and long-term effects of group exercise that may prove beneficial in the management of advanced HIV disease. Further research is warranted to evaluate additional exercise interventions that are accessible, safe, and cost-effective for the HIV population.

Mitigating cellular inflammation in older adults: a randomized controlled trial of Tai Chi Chih

University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience


Outcomes:  Tai Chi Chih (TCC) can be considered a useful behavioral intervention to reduce circulating levels of IL-6 in older adults who show elevated levels of this inflammatory marker and are at risk for inflammation-related morbidity.