The effect of qigong on frailty in older cancer survivors: A randomised controlled trial

Abstract

Background Frailty predicts increased cancer recurrence and mortality among older cancer survivors. Qigong has been shown to improve physical and mental well-being, as well as inflammation, which are closely linked with frailty in the cancer population. Objective This study aims to evaluate the effect of qigong on frailty among older cancer survivors. Design An assessor-blind multi-centre randomised controlled trial. Methods Post-treatment cancer survivors aged 65+ screened as pre-frail or frail based on the Fried frailty phenotype were recruited and randomised to an intervention (16-week qigong Baduanjin) or an active control group (16-week light flexibility exercise). The primary outcome was the reversal of frailty status. The secondary outcomes included physical frailty severity, multidimensional frailty severity, physical performance, psychological well-being and quality of life. Analysis was based on the intention-to-treat principle. Results Two hundred twenty-six older cancer survivors were randomised, 113 to the qigong group and 113 to the light flexibility exercise group. At 16 weeks, the difference in the rates of frailty reversal in the qigong group (28.7%) and the light flexibility exercise group (22.5%) was insignificant (adjusted odds ratio = 1.39, 95% CI, 0.65 to 2.95). While both groups had significant improvement in physical frailty severity, physical performance, psychological well-being and quality of life, only the qigong group had significant improvement in multidimensional frailty severity. The group × time interaction was not significant. Conclusion Qigong was not superior to an active control in its effect on improving frailty in older cancer survivors. Researchers should include routine care as control and examine the underlying mechanisms driving the change in frailty.