Comparative Study on the Effect of Aerobic Exercise and Tai Chi on Emotional Symptom Cluster for Patients with Late-stage Lung Cancer: A Three-arm Randomized Clinical Trial

Abstract

<p><strong>Background/aims</strong>: An emotional symptom cluster comprising sleep disturbance, depression, anxiety, and fatigue is prevalent in late-stage lung cancer patients, negatively affecting their quality of life. Yet, no effective treatment is available for this symptom cluster. This study aimed to investigate and compare the effects of aerobic exercise (AE) and tai chi (TC) on the emotional symptom cluster, and its individual symptoms in late-stage lung cancer patients.</p><p><strong>Methods</strong>: This study was a three-arm randomized controlled trial. Participants were randomized into<br>1) AE group,<br>2) TC group, or<br>3) self-management control group.<br>For 16 weeks, the AE group received two 60-minute supervised exercise sessions and home-based exercises per month; TC group received 60-minute classes twice a week; whereas the control group received information on the physical activity guideline. Assessments were done at baseline, post-intervention (T1), and eight-month post-intervention (T2). A linear mixed-effects model was used to study the between-group differences in outcomes.</p><p><strong>Results</strong>: A total of 226 patients with late-stage lung cancer were recruited and randomized into AE group (n=75), TC group (n=76), and self-management control group (n=75). The analysis indicated significant group x time interaction effects in AE and TC compared to control for the emotional symptom cluster at T1 (AE: d, -1.347, P<0.001; TC: d, -1.803, P<0.001) and T2 (AE: d, -0.827, P=0.033; TC: d, -1.060, P=0.004), as well as sleep disturbance, anxiety, and depression.</p><p><strong>Conclusions</strong>: This is the first study examining the comparative effect of AE and TC on the emotional symptom cluster, and its individual symptoms in patients with late-stage lung cancer. The results indicated that AE and TC were superior to control for alleviating the emotional symptom cluster, with statistically significant results, while the effects of AE and TC were comparable.</p>