{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:52:06Z","timestamp":1793119926432,"version":"4.5.0"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"Importance<\/jats:title>Sleep disturbances prevalent among patients with advanced lung cancer can aggravate physical and psychological symptoms, contributing to decreased quality of life and survival.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the effectiveness of 2 physical activities of different modalities and intensities, namely aerobic exercise (AE) and tai chi (TC), on subjective sleep quality, physical and psychological outcomes, and survival in patients with advanced lung cancer.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This assessor-blinded, randomized clinical trial was conducted in 3 public hospitals in Hong Kong between December 19, 2018, and September 7, 2022. A total of 226 patients with advanced lung cancer were recruited and randomized 1:1:1 to AE, TC, or the control group.<\/jats:p><\/jats:sec>Interventions<\/jats:title>For 16 weeks, the AE group received two 60-minute supervised group exercise sessions and home-based exercises per month, and the TC group received 60-minute group sessions twice weekly. The control group received physical activity guidelines.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was subjective sleep quality. Secondary outcomes included objective sleep measures, anxiety, depression, fatigue, quality of life, physical function, circadian rhythm, and 1-year survival. Assessments were conducted at baseline, 16 weeks (T1), and 1 year (T2).<\/jats:p><\/jats:sec>Results<\/jats:title>The 226 participants had a mean (SD) age of 61.41 (8.73) years, and 122 (54.0%) were female. Compared with the control group, participants in the AE and TC groups showed statistically significant improvements in subjective sleep quality from baseline to T1 (AE: between-group difference, \u22122.72; 95% CI, \u22123.97 to \u22121.46; P<\/jats:italic>\u2009&amp;lt;\u2009.001; TC: between-group difference, \u22124.21; 95% CI, \u22125.48 to \u22122.94; P<\/jats:italic>\u2009&amp;lt;\u2009.001) and T2 (AE: between-group difference, \u22121.75; 95% CI, \u22123.24 to \u22120.26; P<\/jats:italic>\u2009=\u2009.02; TC: between-group difference, \u22123.95; 95% CI, \u22125.41 to \u22122.49; P<\/jats:italic>\u2009&amp;lt;\u2009.001), psychological distress, physical function, step count, and circadian rhythm. The TC group had a statistically significant greater improvement in sleep than the AE group at T1 (between-group difference, \u22121.49; 95% CI, \u22122.77 to \u22120.22; P<\/jats:italic>\u2009=\u2009.02) and T2 (between-group difference, \u22122.20; 95% CI, \u22123.57 to \u22120.83; P<\/jats:italic>\u2009&amp;lt;\u2009.001). Participants in the TC group showed statistically significant improvement in survival compared with the control group.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial, AE and TC improved sleep, psychological distress, physical function, and circadian rhythm, with TC demonstrating greater benefits on sleep and survival. Both exercises, but particularly TC, can be incorporated into lung cancer survivorship care.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT04119778<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoncol.2023.5248","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T16:31:55Z","timestamp":1701966715000},"page":"176","source":"Crossref","is-referenced-by-count":91,"title":["Effectiveness of Aerobic Exercise and Tai Chi Interventions on Sleep Quality in Patients With Advanced Lung Cancer"],"prefix":"10.1001","volume":"10","author":[{"given":"Naomi","family":"Takemura","sequence":"first","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise Shuk Ting","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, 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Hong Kong"},{"name":"Rosemere Cancer Center, Royal Preston Hospital, Lancashire, England, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Chung-Man","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsz Yeung","family":"Kam","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie Yin Kwan","family":"Chik","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Chin","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, 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