Takemura Naomi, Cheung Denise Shuk Ting, Fong Daniel Yee Tak, Lee Anne Wing Mui, Lam Tai-Chung, Ho James Chung-Man, Kam Tsz Yeung, Chik Jeannie Yin Kwan, Lin Chia-Chin
School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China.
J Cancer Surviv. 2024 May 1. doi: 10.1007/s11764-024-01607-1.
Cancer-related cognitive impairment is prevalent in metastatic lung cancer survivors. This study aimed to compare the effectiveness of aerobic exercise and Tai Chi on perceived cognitive function and the mediating role of psychoneurological symptoms with perceived cognitive impairment.
In a subgroup of a parent randomized clinical trial, participants who reported cognitive impairment underwent a 16-week aerobic exercise (n = 49), Tai Chi (n = 48), and control (n = 54) groups. Measures included perceived cognitive function and psychoneurological symptoms (sleep disturbance, fatigue, anxiety, and depression) assessed at baseline (T0), 16-week (T1), and 1 year (T2).
Participants in Tai Chi showed significant improvements compared to aerobic exercise and control groups in perceived cognitive function at T1 (AE: between-group difference, 6.52; P < 0.001; CG: 8.34; P < 0.001) and T2 (AE: between-group difference, 3.55; P = 0.05; CG: 5.94; P < 0.001). Sleep disturbance, fatigue, anxiety, and depression at month 12 explained 24%, 31%, 32%, and 24% of the effect of the intervention on cognitive function at month 12, respectively. Only anxiety at month 4 explained 23% of the intervention effect at month 12.
Tai Chi demonstrated beneficial effects on cognitive function in advanced lung cancer survivors with perceived cognitive impairment. Improvement in cognitive function was mediated by reducing sleep disturbance, fatigue, anxiety, and depression, highlighting the importance of addressing these symptoms in future interventions to improve cognitive function, with anxiety playing a significant role at an earlier stage.
Tai Chi is a potentially safe complementary therapeutic option for managing cognitive impairment in this vulnerable population.
ClinicalTrials.gov identifier: NCT04119778; retrospectively registered on 8 October 2019.
癌症相关认知障碍在转移性肺癌幸存者中很普遍。本研究旨在比较有氧运动和太极拳对认知功能感知的有效性，以及心理神经症状在认知障碍感知中的中介作用。
在一项母随机临床试验的子组中，报告有认知障碍的参与者被分为16周有氧运动组（n = 49）、太极拳组（n = 48）和对照组（n = 54）。测量指标包括在基线（T0）、16周（T1）和1年（T2）时评估的认知功能感知和心理神经症状（睡眠障碍、疲劳、焦虑和抑郁）。
与有氧运动组和对照组相比，太极拳组在T1（有氧运动组：组间差异，6.52；P < 0.001；对照组：8.34；P < 0.001）和T2（有氧运动组：组间差异，3.55；P = 0.05；对照组：5.94；P < 0.001）时的认知功能感知有显著改善。第12个月时的睡眠障碍、疲劳、焦虑和抑郁分别解释了干预对第12个月认知功能影响的24%、31%、32%和24%。只有第4个月时的焦虑解释了第12个月干预效果的23%。
太极拳对有认知障碍感知的晚期肺癌幸存者的认知功能有有益影响。认知功能的改善是通过减少睡眠障碍、疲劳、焦虑和抑郁来介导的，这突出了在未来干预中解决这些症状以改善认知功能的重要性，其中焦虑在早期阶段起着重要作用。
太极拳是管理这一脆弱人群认知障碍的一种潜在安全的辅助治疗选择。
ClinicalTrials.gov标识符：NCT04119778；于2019年10月8日追溯注册。
