Accepted for/Published in: JMIR Formative Research
Date Submitted: Nov 15, 2021
Open Peer Review Period: Nov 15, 2021 - Nov 22, 2021
Date Accepted: May 16, 2022
(closed for review but you can still tweet)
Telehealth delivered Tai Chi intervention for managing aromatase inhibitor-induced arthralgia in breast cancer patients: TaiChi4Joint during COVID-19, a pilot study
ABSTRACT
Background:
Estrogen receptor positive breast cancer (BC) is the most common type of breast cancer in postmenopausal women and aromatase inhibitors (AI) are the endocrine therapy of choice recommended for these patients. Arthralgia is common side effects of AI occurring in up to 50% of those treated with an AI often resulting in poor adherence and decreased quality of life for breast cancer patients
Objective:
This is a single arm longitudinal pilot study aiming to evaluate the safety, feasibility, acceptability and potential efficacy of TaiChi4Joint, a remotely-delivered 12-week Tai Chi intervention program designed for the relief of AI-induced joint pain
Methods:
Women diagnosed with stage 0-III BC who have been receiving an AI for at least 2 months and reporting arthralgia with a ≥ 4 score on a 0-10 scale for worst joint pain were eligible for study enrollment. Study participants were encouraged to participate in Tai Chi classes delivered over ZOOM three times a week for 12 weeks. Program engagement strategies include the use of a private Facebook study group and box cloud for archiving live class recordings and text messaging and email with periodic positive quotes and evidence information of Tai Chi for facilitating community bonding and class attendance. Participants were invited to complete the following assessment at baseline, 1 month, 2 months and 3 months from study enrollment: Brief Pain Inventory (BPI), Western Ontario and McMaster University Osteoarthritis index (WOMAC), The Australian Canadian Osteoarthritis Hand Index (AUSCAN), Fatigue Symptom Inventory (FSI), Hot Flash Related Daily Interference Scale (HFRDIS), Pittsburg Sleep Quality Index (PSQI) and Center for Epidemiological Studies Depression (CES-D).
Results:
Fifty-five eligible patients were invited to participate and 39 consented and completed the baseline assessments. Participants attended 61% (median) of the classes, with no Tai Chi related adverse events reported. Twenty two of the 39 participants completed the 3-month follow up assessments with a 56% retention rate. Study participants reported improvement from baseline to 3 month as follows: For BPI (P<0.001), AUSCAN (P<0.001), WOMAC (P<0.001)), FSI (P<0.001), HFRDIS (P<0.005), PSQI (P=0.023 for 38 patients) and CES-D (P= 0.010).
Conclusions:
The COVID-19 global pandemic has resulted in an unprecedented need to rethink how mind-body therapies can be delivered. This study demonstrated the feasibility, acceptability, and potential efficacy of a Tai Chi intervention remotely delivered over telehealth for reducing AI-induced arthralgia during COVID-19. The intervention decreased patient reported pain, stiffness, functioning, hot flash, sleep quality and depressive symptoms. With our promising findings, future larger telehealth trials of Tai Chi for AI-associated arthralgia are critically needed Clinical Trial: NCT04716920
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