title: The effects of a 6-month Tai Chi Qigong training program on temporomandibular, cervical, and shoulder joint mobility and sleep problems in nasopharyngeal cancer survivors.
abstract: BACKGROUND
  Nasopharyngeal cancer (NPC) survivors often sustain head-neck-shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors.
  
  
  METHODS
  Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up.
  
  
  RESULTS
  Intention-to-treat analysis revealed improvement in cervical side flexion ROM only (P < .008) and unchanged shoulder and TMJ mobility (P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time (P < .008). Sleep problems also decreased in the TC Qigong group (P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training (P < .05).
  
  
  CONCLUSIONS
  The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors.
authors.affiliation: Institute of Human Performance, The University of Hong Kong, Hong Kong smfong@hku.hk.
authors.forename: Shirley S M
authors.initials: SS
authors.lastname: Fong
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Shamay S M
authors.initials: SS
authors.lastname: Ng
authors.affiliation: Institute of Human Performance, The University of Hong Kong, Hong Kong.
authors.forename: H W
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Marco Y C
authors.initials: MY
authors.lastname: Pang
authors.affiliation: The Association of Licentiates of the Medical Council of Hong Kong, Hong Kong.
authors.forename: W S
authors.initials: WS
authors.lastname: Luk
authors.affiliation: Department of Health and Physical Education, Hong Kong Institute of Education, Hong Kong.
authors.forename: Joanne W Y
authors.initials: JW
authors.lastname: Chung
authors.affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: Janet Y H
authors.initials: JY
authors.lastname: Wong
authors.affiliation: Institute of Human Performance, The University of Hong Kong, Hong Kong Department of Sport and Leisure Studies, University of Waikato, Hamilton, New Zealand.
authors.forename: Rich S W
authors.initials: RS
authors.lastname: Masters
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000503:physiopathology*; D019547:Neck Pain / Q000503:physiopathology / Q000628:therapy*; D064906:Qigong / Q000379:methods*; D016059:Range of Motion, Articular; D020069:Shoulder Pain / Q000503:physiopathology / Q000628:therapy*; D012893:Sleep Wake Disorders / Q000503:physiopathology / Q000628:therapy*; D026302:Tai Ji / Q000379:methods*; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000628:therapy*
keywords: head and neck cancer; mind–body exercise; sleep; upper-body joint mobility