Table 1.
Descriptive summary of secondary studies included in the umbrella review (n 19).
| Authors | Study Design | Number of Studies | Population | Qigong Styles in Exposure Group | Control Group | Outcome | Results |
|---|---|---|---|---|---|---|---|
| Klein 2016 [13] | Systematic review | 11 RCTs | 831 cancer patients (50% breast) | Guolin Qigong, Kuala Lumpur Qigong, Medical Qigong | Any type of control | Non-biological outcomes (fatigue, QOL, depression, mood, anxiety, distress, sleep quality, cognition, systolic blood pressure, and survival rate). Biological marker outcomes of inflammation and immune function |
Significant effect of Qigong on: Fatigue: (p < 0.03) in 4/5 studies; Mood: (p = 0.021) in 1/1 study; Cognition: (p = 0.014) in 1/1 study; Social/family well-being: (p = 0.022) in 1/1 study; QoL: (p < 0.05) in 4/5 studies. Cardiovascular (systolic BP): (p = 0.002); Inflammatory response/immune support: (p < 0.05) in 6/10 studies No significant effect of Qigong on: Survival rate, sleep, anxiety, depression (except for 1/5 studies), and distress. |
| Henshall 2019 [14] | Systematic review | 3 RCTs; 7 pre–post test |
516 cancer patients (58% lung) | Medical Qigong (style n.r.) | n.r. | Dyspnea, fatigue, depression | Significant effect of Qigong at 10 weeks post-intervention on: Fatigue: (MD = 5.70 [95% CI, 3.32–8.09]) Depression: (MD = 2.56 [95% CI = 5.14–0.01]; p = 0.029) No effect of Qigong on: Dyspnea. |
| Lee 2007 [15] | Systematic review | 4 RCTs; 5 CCTs | 871 cancer patients | Internal Qigong (style n.r.) | Any type of control | Treatment effects | Significant effect of Qigong on: Fatigue (p < 0.05); Nausea, vomiting, and stomatitis (p < 0.05); Distress (p < 0.01). |
| Matthews 2018 [16] | Systematic review | 12 RCTs; 3 quasi-experimental designs | 1691 breast cancer women | Qigong (style n.r.) | Exercise, usual care | Sleep quality | Significant effect of Qigong on: Fatigue: decrease at post-intervention (p = 0.005) and 3-month follow-up (p = 0.024); decrease in people with fewer depressive symptoms at the RXT onset; Depression: decrease over time in both Qigong + Tai Chi and Qigong Shame (p < 0.05) compared to the control group; QoL: better QoL in people with fewer depressive symptoms at the RXT onset. No effect of Qigong on: Sleep quality |
| Van Vu 2017 [17] | Systematic review | 14 RCTs; 7 CCTs; 1 quasi-CCT | 1751 cancer patients | Guolin New Qigong, Tai Chi Qigong, 18 forms of Tai Chi Qigong, Yudong Kong exercise, Zhi Neng Qigong, Chan-Chuang Qigong, Medical/exercise Qigong (style n.r.), Sporting Qigong (style n.r.), |
Any type of control | Physical symptoms, psychological symptoms, quality of life, adverse events | Significant effect of Qigong on: Fatigue: lower in 7/10 studies; QoL: improved in 6/10 studies; Neuropathy symptoms; Muscular strength; Cervical spine range of motion and shoulder complex range of motion; Frailty; Cognitive function; 6 min walking. No effect of Qigong on: Pain; Dyspnea; Cortisol rhythm; Temporomandibular joint mobility: Tumor size; Survival rate. Conflicting results on: Psychological symptoms; Sleep quality; Gastrointestinal symptoms. |
| Chan 2012 [18] | Systematic review | 8 RCTs; 15 CCTs | Studies on physical and psychosocial outcomes covered 572 cancer patients in Qigong groups and 595 cancer patients in control groups; the studies on biomedical outcomes covered 656 cancer patients in Qigong groups and 601 cancer patients in control groups |
Medical/exercise Qigong (style n.r.), Guolin Qigong, Chan-Chuan Qigong, YoudoKong, a series of Qigong exercises (Jing Yang Gong, Fong Song Gong, Zhen Qu Yun Sing Gong, Zi Ti Sun Taiji Gong), multi-style Qigong |
Any type of control and treatment | Self-perceived symptoms, quality of life, psychological distress, survival rate, response rate, fatigue, physical functioning, body weight, tumor size, “inflammatory markers” (C-reactive protein), parameters of immunity such as immunoglobulin and complement, the numbers or proportions of blood cells or their antioxidant capacity, and hepatic function |
Significant effect of Qigong on: Symptoms (strength, appetite, diarrhea, or irregular defecation); Inflammation; Overall QOL (FACT-G); Mood disturbance; Increase in the number or levels of components in peripheral blood; Increase in the 5-year survival rate. Significant effect of Qigong on: Fatigue; Physical functioning (SF-36); Treatment side effects; Nausea and vomiting after 4 weeks (not significant after 8 weeks). No significant effect on: Psychological distress; Anxiety; Depression; Symptoms after 2.5 months. |
| Farahani 2022 [19] | Systematic review | 9 RCTs; 1 pilot study; 1 feasibility study | 1032 cancer survivors (85.8% breast cancer women) | Medical Qigong (style n.r.), Six Healing Sounds |
Waitlist control, active control, usual care | Cognitive function | Significant effect of Qigong on: Subjective self-reported cognitive functions (in 6 out of 11 studies): for significant studies p < 0.05; Objective cognitive performance (in 1 out of 2 studies): processing speed (p = 0.007); executive function (p = n.r., Cohen’s d = −0.43 in favor of Qigong group); improvement in cognitive function (p = 0.014). |
| Tao 2016 [20] | Meta-analysis | 67 RCTs | 5465 adults with cancer | Qigong (style n.r.) | Usual care and active control conditions | HRQOL at post-treatment, cancer-related symptoms, and therapy-related adverse events | Significant effect of Qigong on: Sleep disturbance: positive effect of Qigong on Z = 3.02 (p = 0.003). No effect of Qigong on: QoL: Z = 0.98 (p = 0.33). |
| Wayne 2018 [21] | Systematic review and meta-analysis | 15 RCTs; 7 studies with non-randomized design or no control group | 1571 cancer patients | Qigong (style n.r.) | Active control; no treatment control | Cancer symptoms | Significant effect of Tai Chi Qigong on: Sleep difficulty: reduction in difficulties (Hedges’ g = −0.49, 95% CI −0.89 to −0.09, p = 0.018); Fatigue: reduction in fatigue (Hedges’ g = −0.53, 95% CI −0.97 to −0.28, p < 0.001); Depression: reduction in depression (Hedges’ g = −0.27, 95% CI −0.44 to −0.11, p = 0.001); QoL: (Hedges’ g = 0.33, 95% CI 0.10 to 0.56, p = 0.004). No effect of Tai Chi Qigong on: Cancer-related pain (Hedges’ g = −0.38, 95% CI −0.89 to 0.12, p = 0.136). |
| Wu 2019 [22] | Systematic review and Bayesian network meta-analysis | 182 RCTs | 18,491 cancer patients (45.05% studies on women with breast cancer, 25.27% studies on patients with multiple forms of cancer) |
Qigong (style n.r.) | Placebo, usual care control, no intervention, waitlist control, or other non-pharmacological intervention | Cancer-related fatigue | Significant effect of Qigong on: Fatigue: lower level of fatigue compared to the control group (MD [95% CI], −2.03 [−3.36, −0.68]) |
| Kuo 2021 [23] | Systematic review and meta-analysis | 10 RCTs | 811 cancer patients | Baduanjin Qigong | Routine care; active exercise | Cancer-related fatigue, sleep quality, QoL | Significant effect of Qigong on: Cancer-related fatigue: significantly less in the Baduanjin Qigong group compared with the control group (odds ratio = 0.27; 95% CI [0.17, 0.42]; test for overall effect: Z = 5.81, p < 0.00001; Heterogeneity I2 = 0%); QoL: Baduanjin Qigong exercise has a positive effect on breast cancer patients’ QoL: From EORTC-C30: MD = 13.13 (95% CI [1.87, 24.40]; Z = 2.29, p = 0.02; Heterogeneity I2 = 92%); From FACT-B: MD = 11.04 (95% CI [9.56, 12.53] Z = 14.57, p < 0.00001; Heterogeneity I2= 88%); Sleep Quality: Baduanjin Qigong exercise has a positive effect on breast cancer patients’ sleep quality: MD = −2.89 (95% CI [−3.48, −2.30] Z = 9.55, p < 0.001; Heterogeneity I2 = 0%). |
| Meng 2021 [24] | Systematic review and meta-analysis | 14 RCTs; 3 CCTs | 1236 breast cancer women | Chan-Chuang Qigong, Guolin New Qigong, Tai Chi Qigong, Kuala Lumpur Qigong, Sporting Qigong, Baduanjin | Any type of control | QoL, fatigue, sleep disturbance, cancer-related emotional disturbance | Significant effect of Qigong on: QoL: positive effect of Qigong compared to control procedures (n = 950, SMD = 0.65, 95% CI 0.23–1.08, p = 0.002); Depression: (n = 540, SMD = −0.32, 95% CI −0.59 to −0.04, p = 0.02, I2 = 59%); Anxiety-related serum protein (1 study): positive rate was significantly lower in the Qigong group than in the control group (p < 0.01); Immune responses (2 studies): significant reduction in IL-2, IFN-γ, IL-6, IL-1β, and TNF-α levels in Qigong group. No effect of Qigong on: Sleep disturbance: (n = 298, SMD = −0.11, 95% CI −0.74 to −0.52, p = 0.73, I2 = 86%); Cancer-related fatigue: (n = 206; SMD = −0.32, 95 % CI −0.71 to 0.07, p = 0.11, I2 = 73%); Anxiety: (n = 439, SMD = −0.71, 95% CI −1.32 to −0.10, p = 0.02, I2 = 89%). |
| Zeng 2014 [25] | Systematic review and meta-analysis | 13 RCTs | 592 cancer patients | Guolin Qigong, Medical Qigong | Any type of control | Body fat mass (BFM) and body mass index (BMI); anxiety and depression, biomarkers (cortisol levels, C-reactive protein (CRP)), and QOL |
Significant effect of Qigong/Tai Chi on: Cancer-specific QOL (Z = 4.00 (p < 0.0001), I2 = 95%); Fatigue (Z = 2.09, p = 0.04, I2 = 90%); Immune function; Cortisol level: (Z = 1.97 (p = 0.05), I2 = 0%). |
| Cheung 2021 [26] | Systematic review and meta-analysis | 11 RCTs | 907 cancer patients | Guolin Qigong, Chan-Chuang Qigong, Xianggong, Baduanjin, General Qigong (style n.r.) |
Placebo or usual care | Sleep quality and fatigue/depressive symptoms | Significant effect of Qigong on: Improving post-intervention: Sleep quality: (SMD = −1.28, 95% CI: −2.01, −0.55; p = n.r.; I2 = 95%); Fatigue: (SMD = −0.89, 95% CI: −1.59, −0.19; p = n.r.; I2 = 94%) in cancer patients post-intervention. Qigong’s effect on sleep was significantly mediated by its effect on fatigue (b = 1.27, SE = 0.24, p = 0.002), but not depressive symptoms (b = 0.53, SE = 0.26, p = 0.106). No effect of Qigong: Beneficial effects on sleep and fatigue became non-significant after 3 months. No effect of Qigong post-intervention on: Depressive symptoms: (SMD = −0.69, 95% CI: −1.81, 0.42; p = n.r.; I2 = 95%). |
| Lin 2019 [27] | Systematic review and meta-analysis | 34 RCTs | 3010 cancer patients (92% female) | Qigong (style n.r.) | No intervention | HRQoL | Significant improvement over usual care on: HRQOL - CH (MD = 6.03 [0.15–11.92]); - Qigong + MM (MD = 12.66 [8.75–16.57]) |
| Ye 2022 [28] | Systematic review and meta-analysis | 7 RCTs | 450 postoperative breast cancer patients | Baduanjin Qigong | Any type of control | QoL, anxiety, depression | Significant effect of Qigong on: General QoL (FACT-B): (WMD = 5.70, 95% CI [3.11–8.29], Z = 4.32, p < 0.0001, I2 = 35%); Physical well-being (FACT-B): (WMD = 1.83, 95% CI [1.13, 2.53], Z = 5.15, p < 0.00001, I2 = 0%); Functional well-being (FACT-B): (WMD = 1.58, 95% CI [0.77–2.39], Z = 3.83 p = 0.0001, I2 = 0%); Role-physical QoL (SF-36): (WMD = 11.49, 95% CI [8.86, 14.13], Z = 8.55, p < 0.00001, I2 = 0%); Vitality (fatigue) (SF-36): (WMD = 8.58, 95% CI [5.60–11.56], Z = 5.65, p < 0.00001, I2 = 0%); Anxiety: (WMD = −8.02, 95% CI [−9.27- −6.78], Z = 12.62, p < 0.00001, I2 = 10%); Depression: (WMD = −4.45, 95%CI [−5.62–−3.28], Z = 7.45, p < 0.00001, I2 = 32%). No significant difference in: Social and emotional well-being (FACT-B); Physical functioning (SF-36); Bodily pain (SF-36); Social functioning (SF-36); General health (SF-36); Mental health (SF-36). |
| Liu 2022 [29] | Systematic review and network meta-analysis | 12 RCTs | 818 female breast cancer patients | Internal Qigong (style n.r.) | Routine nursing or treatments (e.g., placebo, usual care, no intervention, waitlist control, supportive therapy or other nonpharmacologic intervention) |
Chemotherapy-related cognitive impairment (CRCI) | Significant effect of Qigong on: CRCI: improvement in the objective outcome of CRCI compared to psychotherapy (SMD = 1.27; 95% CI, 0.13–2.41) and to music therapy (SMD = 1.69; 95% CI, 0.10–3.28). No significant effect of Qigong compared with the non-pharmacological and control interventions on: CRCI: subjective outcomes. |
| Wang 2021 [30] | Systematic review and meta-analysis | 16 RCTs | 1313 patients (339 cancer patients) | Baduanjin, Six Healing Sounds Qigong, Wu Xing Ping Heng Gong, Shaolin Qigong Exercises, Self-improving exercise (style n.r.), Wuqinxi, Yijinjing |
Any type of control | Fatigue | Significant effect of Qigong on: Cancer-related fatigue (total, physical, and mental): SMD−0.75 (−1.37 to−0.13) p = 0.02 I2 = 86%. |
| Zeng 2019 [31] | Systematic review and meta-analysis | 12 RCTs | 915 cancer patients | Qigong (style n.r.), Medical Qigong (style n.r.) |
Usual care, support groups, waitlist control, or sham Qigong control | Treatment effects | Significant effect of Qigong on: Fatigue: (MD = 2.05, 95% CI [0.63, 3.47]; Z = 2.83 p = 0.005, I2 = 96%); Sleep difficulties (MD = 344.17, 95% CI [316.95, 371.39]; Z = 24.78, p = 0.00001, I2 0%). No effect of Qigong on: Stress (MD = −8.56, 95% CI [−17.56, 0.44]; Z = 1.86, p = 0.06, I2 = 74%); Anxiety: (MD = −1.26, 95% CI [−3.73, 1.20]; Z = 1.00, p = 0.32, I2 = 43%); Depression: (MD = −2.58, 95% CI [−7.33, 2.17]; Z = 1.06, p = 0.29, I2 = 88%). |
Notes: n.r. = not reported.