“Walk for life”: a feasibility randomised controlled trial of Guolin Qigong for fatigue, sleep disturbance and depression symptom cluster in cancer survivors

Purpose: To evaluate the feasibility and the preliminary estimate of effect of a 12-week Guolin Qigong (GQ) intervention, a mind-body exercise, on the fatigue-sleep disturbance-depression symptoms among breast, lung and colon cancer survivors. Methods: Forty-one breast, lung, and colon cancer survivors with moderate to severe fatigue as measured by the Brief Fatigue Index were randomised to a GQ intervention (n = 21) or a waitlist control (n = 20). Outcome measures were assessed at baseline, 6, 12 weeks (post-intervention), and 16 weeks (4 weeks post-intervention). The primary feasibility was assessed using recruitment, retention, class attendance, home practice, safety and quantum of missing data. Secondary outcomes of symptom differences across timepoints in fatigue, sleep, and depression were assessed using a Generalised Estimating Equations (GEE) model with a Gaussian family, independent link, exchangeable correlation structure, and robust variance estimation. Results: Forty-one cancer survivors were successfully recruited with a recruitment rate of 72%. Retention was 95% (GQ) and 80% (control) at Week-12 and Week-16. GQ intervention class attendance was 86% for the 12-weeks duration with home practice averaging 5 day/week and 394 minutes/week. Missing data were less than 10%. There were no intervention-related serious adverse events. From baseline to Week 12 or Week 16, the average decreases in fatigue, sleep quality, and depression were 0.66, 0.11, and 1.79 respectively, after adjusting for gender and cancer-type imbalances. Conclusion: GQ was feasible and safe for cancer survivors with fatigue-sleep disturbance-depression symptoms, within the defined small sample size. A larger randomised trial is needed for statistical validation.