Can Guolin Qigong (mind-body exercise) intervention improve fatigue in cancer survivors? A randomized controlled feasibility trial

This will be a randomized controlled trial to evaluate the feasibility and effects of a 12-week Guolin Qigong (GQ) intervention (compared to usual care) on fatigue, depression, sleep quality and diurnal cortisol slope of 60 breast, lung and colorectal cancer survivors who meet the inclusion and exclusion criteria and provide written consent. All outcomes will be assessed at Week-1 (baseline), Week-6 (mid-intervention), Week-12 (post-intervention) and Week-16 (4 weeks post- intervention). At baseline (Week-1), participants will undergo a baseline assessment of questionnaires, and provide urinary samples (for 24-hour urinary cortisol test) a day prior to enrolment date to assess urinary cortisol and complete Brief Fatigue Inventory (BFI), Pittsburgh Sleep Quality Index (PSQI) and Centre for Epidemiologic Studies Depression (CES-D). At mid-intervention (week-6) and 4 weeks after completion of intervention (Week-16) BFI, PSQI and CES-D will be collected. Post-intervention (week-12) data collection will include both the three patient reported outcomes and urinary cortisol outcome. Adherence, attendance, and any adverse event will be recorded throughout the intervention period from Week-1 to Week-12 in the practice diary by the participants randomised to GQ group. The GQ intervention will include 12 weeks of face-to-face (F2F) training class in the hospital with home practice on non-class days. There will be two F2F training classes/ week of two hours each for the first two weeks to intensify the opportunity to learn the practice well and once a week for the remaining period. The frequency of home practice will be three to four times a week over the 12-week intervention period with one and a half hours to 2 hours a day of training recommended to have efficacy. As GQ is an adaptive exercise and the main goal is for patients not to feel exhausted after practice, the home practice can be broken down into shorter sessions of 5 to 40 minutes to achieve cumulative effect. The F2F GQ class will be taught by qualified GQ instructors with more than 5 years of experience in GQ training to ensure the full potential of the GQ intervention. The co-investigator who is a registered Chinese Medicine practitioner in Malaysia and Australia with more than 15 years in Qigong will be in attendance during the F2F GQ classes. The GQ protocol includes one-on-one first F2F session and group class for subsequent F2F sessions. The GQ training is a “walking qigong,” consisted of several breathing and moving exercises.