Cancer Clinical Trial
Official title:
A Randomized Study of the Effect of Tai Chi Chuan Compared to a Structured Exercise Program on Parameters of Physical Fitness and Stress in Adult Cancer Survivors
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
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.
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