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Tan GA, Peiris CL, Dennett AM. Cancer survivors maintain health benefits 6 to 12 months after exercise-based rehabilitation: a systematic review and meta-analysis. J Cancer Surviv 2024; 18:651-672. [PMID: 36547801 DOI: 10.1007/s11764-022-01322-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine if the effects of exercise-based cancer rehabilitation on physical functioning, activity (including physical activity) and participation (including quality of life) are maintained at 6 to 12 months. METHODS Electronic databases CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched from the earliest available time to August 2021. Randomised controlled trials examining the long-term effects (≥ 6 months post-intervention) of exercise-based rehabilitation were eligible for inclusion. Outcome data (e.g. fitness, physical activity, walking capacity, fatigue, depression, quality of life) were extracted and the methodological quality assessed using PEDro. Meta-analyses using standardised mean differences were used to synthesise data and Grades of Recommendation, Assessment, Development and Evaluation criteria were applied. RESULTS Nineteen randomised controlled trials including 2974 participants were included. Participants who underwent exercise-based rehabilitation had improved physical activity (SMD 0.30, 95% CI 0.09 to 0.51, I2 = 0%), cardiorespiratory fitness (SMD 2.00 ml/kg/min, 95% CI 0.56 to 3.45, I2 = 0%), walking capacity (SMD 0.62, 95% CI 0.33 to 0.92, I2 = 0%), depression (SMD 0.71, 95% 0.05 to 1.37, I2 = 90%), quality of life (physical functioning component SMD 0.56, 95% CI 0.11 to 1.01, I2 = 62%) and sleep (MD 0.69 points, 95% 0.46 to 0.92, I2 = 0%) at 6 to 12 months follow-up. There was no data available on cancer-related mortality or recurrence. CONCLUSION Health outcomes of cancer survivors after exercise-based rehabilitation can be maintained after rehabilitation completion. IMPLICATIONS FOR CANCER SURVIVORS Cancer survivors can maintain health benefits achieved through exercise-based rehabilitation.
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Affiliation(s)
- Germaine A Tan
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia.
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia.
| | - Casey L Peiris
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia
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Qi Y, Li H, Chan DNS, Ma X, Wong CL. Effects of yoga interventions on the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients: A systematic review. Eur J Oncol Nurs 2024; 70:102594. [PMID: 38795438 DOI: 10.1016/j.ejon.2024.102594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/07/2024] [Accepted: 04/17/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE This systematic review aimed to evaluate the effectiveness of yoga intervention on the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients. METHODS Ten electronic databases (Medline, Embase, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Scopus, British Nursing Index, China National Knowledge Infrastructure, and Wan Fang database) were searched to identify randomized controlled trials from inception to October 2023. Two independent reviewers evaluated study eligibility, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias tool. The findings were synthesized narratively. This systematic review has been registered (PROSPERO ID: CRD42023391269). RESULTS A total of 1389 studies were identified, and 18 studies were included in this systematic review. Two studies reported significant alleviation of fatigue-pain-sleep disturbance symptoms, and two studies indicated a significant reduction in fatigue-sleep disturbance symptoms compared to the control group. Commonly employed yoga contents included breathing exercise and posture practice. The effective intervention components encompassed the combination of in-person sessions and home-based sessions delivery mode, with intervention sessions lasting 50-120 min each and dosages ranging from once per week to twice daily, spanning 6-16 weeks. CONCLUSIONS Yoga intervention can be beneficial in alleviating the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients. Future research should be tailored to design yoga interventions addressing different treatment stages and preferences of breast cancer patients.
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Affiliation(s)
- Yishu Qi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Huiyuan Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Xing Ma
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Cho Lee Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
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Senger AR, G Ratcliff C, K Semelsberger R, Chaoul A, Cohen L. The Role of Coping and Posttraumatic Stress in Fostering Posttraumatic Growth and Quality of Life Among Women with Breast Cancer. J Clin Psychol Med Settings 2024; 31:368-378. [PMID: 37803095 DOI: 10.1007/s10880-023-09977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/08/2023]
Abstract
Tedeschi & Calhoun's model of posttraumatic growth (PTG) suggests that intrusive thoughts about a traumatic event, in combination with helpful coping strategies, facilitates PTG. This manuscript applies this model to a sample of breast cancer survivors, augments it to conceptualize coping strategies as "active" or "avoidant," and extends it to include health-related quality of life (HRQOL). This is a secondary analysis of a subset of breast cancer patients (N = 123) in a randomized clinical trial of Tibetan yoga, which examines the associations of coping at study entry with PTG, PTSS (i.e., intrusive thoughts and avoidance), and HRQOL (physical (PCS) and mental (MCS) component scales) reported 9 and 15 months later. Mediation analyses revealed that higher baseline active coping predicted higher 9-month PTG, which in turn predicted higher 15-month PCS [effect = .46, 95% CI (.06, 1.07)]. Exploratory moderated mediation analyses revealed that higher baseline intrusive thoughts about cancer predicted lower 9-month PTG, which in turn predicted lower 15-month PCS, but only for those reporting low active coping [effect = - .06, 95% CI (- .16, - .003)]. Active coping may play a critical role of fostering PTG and improving subsequent HRQOL in the presence of rumination about cancer.
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Affiliation(s)
| | - Chelsea G Ratcliff
- Department of Psychology and Philosophy, Sam Houston State University, 1901 Avenue I, Suite 390, Huntsville, TX, 77341, USA.
- Baylor College of Medicine, Houston, TX, USA.
| | - Robin K Semelsberger
- Department of Psychology and Philosophy, Sam Houston State University, 1901 Avenue I, Suite 390, Huntsville, TX, 77341, USA
| | | | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Đorđević D, Garnier J, van Mackelenbergh T, Seitz S, Mundhenke C. The impact of online yoga on sleep and quality of life in women with breast cancer: a randomized trial. Arch Gynecol Obstet 2024:10.1007/s00404-024-07563-6. [PMID: 38814454 DOI: 10.1007/s00404-024-07563-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION There is growing evidence of the benefit of physical activity and mindfulness in breast cancer patients (HC et al. in BMC Complement Altern Med, 2017). Yoga offers a combination of both. The aim of this study was to establish an online yoga program for breast cancer patients and survivors. As the project was launched during the (COVID) pandemic restrictions, we intended to prove effective online yoga as a way to access supportive therapy independently of sanitary issues and geographic locations in rural regions. METHODS The two main outcomes were quality of life and sleep quality, and both were evaluated by standardized questionnaires (EORTC-QLQ 30 BR 23 and PSQI). Participants (n = 173) had breast cancer or a history of breast cancer and were randomized to either 6 weeks online yoga, twice a week for 45 min or a waiting control group. RESULTS Our results show improved sleep quality in the PSQI score and improved subitems (dyspnea and physical activity) in the EORTC quality of life score. DISCUSSION Online yoga seems to be a valid option in supportive therapy for breast cancer patients, as it improves physical fitness, dyspnea and overall sleep quality. It is also safe and cost effective as a remote intervention. TRIAL REGISTRATION Trial registration number and date of registration for prospectively registered trials: DRKS00029548, 07.07.2022.WHO International clinical trials registry platform number: DRKS00029548. The registration number of the ethical committee CAU in Kiel: D 589/20.
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Affiliation(s)
- D Đorđević
- Clinic of Gynecology and Obstetrics, Caritas St. Josef Krankenhaus UKR, Regensburg, Germany.
| | - J Garnier
- Clinic of Gynecology and Obstetrics, Klinikum Amberg, Amberg, Germany.
| | - T van Mackelenbergh
- Clinic of Gynecology and Obstetrics, Universitätsklinik Schleswig-Holstein Kiel, Kiel, Germany
| | - S Seitz
- Clinic of Gynecology and Obstetrics, Caritas St. Josef Krankenhaus UKR, Regensburg, Germany
| | - C Mundhenke
- OB/GYN Breast Unit, Medizincampus Oberfranken/ Klinikum Bayreuth, Bayreuth, Germany
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Bower JE, Lacchetti C, Alici Y, Barton DL, Bruner D, Canin BE, Escalante CP, Ganz PA, Garland SN, Gupta S, Jim H, Ligibel JA, Loh KP, Peppone L, Tripathy D, Yennu S, Zick S, Mustian K. Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update. J Clin Oncol 2024:JCO2400541. [PMID: 38754041 DOI: 10.1200/jco.24.00541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To update the ASCO guideline on the management of cancer-related fatigue (CRF) in adult survivors of cancer. METHODS A multidisciplinary panel of medical oncology, geriatric oncology, internal medicine, psychology, psychiatry, exercise oncology, integrative medicine, behavioral oncology, nursing, and advocacy experts was convened. Guideline development involved a systematic literature review of randomized controlled trials (RCTs) published in 2013-2023. RESULTS The evidence base consisted of 113 RCTs. Exercise, cognitive behavioral therapy (CBT), and mindfulness-based programs led to improvements in CRF both during and after the completion of cancer treatment. Tai chi, qigong, and American ginseng showed benefits during treatment, whereas yoga, acupressure, and moxibustion helped to manage CRF after completion of treatment. Use of other dietary supplements did not improve CRF during or after cancer treatment. In patients at the end of life, CBT and corticosteroids showed benefits. Certainty and quality of evidence were low to moderate for CRF management interventions. RECOMMENDATIONS Clinicians should recommend exercise, CBT, mindfulness-based programs, and tai chi or qigong to reduce the severity of fatigue during cancer treatment. Psychoeducation and American ginseng may be recommended in adults undergoing cancer treatment. For survivors after completion of treatment, clinicians should recommend exercise, CBT, and mindfulness-based programs; in particular, CBT and mindfulness-based programs have shown efficacy for managing moderate to severe fatigue after treatment. Yoga, acupressure, and moxibustion may also be recommended. Patients at the end of life may be offered CBT and corticosteroids. Clinicians should not recommend L-carnitine, antidepressants, wakefulness agents, or routinely recommend psychostimulants to manage symptoms of CRF. There is insufficient evidence to make recommendations for or against other psychosocial, integrative, or pharmacological interventions for the management of fatigue.Additional information is available at www.asco.org/survivorship-guidelines.
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Affiliation(s)
| | | | - Yesne Alici
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debra L Barton
- University of Tennessee, College of Nursing, Knoxville, TN
| | | | | | | | | | | | | | | | | | - Kah Poh Loh
- University of Rochester Medical Center, Rochester, NY
| | - Luke Peppone
- Wilmot Cancer Institute, University of Rochester, Rochester, NY
| | | | | | | | - Karen Mustian
- University of Rochester Medical Center, Rochester, NY
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Giridharan S, Kumar NV. Bibliometric Analysis of Randomized Controlled Trials on Yoga Interventions for Cancer Patients: A Decade in Review. Cureus 2024; 16:e58993. [PMID: 38800314 PMCID: PMC11127709 DOI: 10.7759/cureus.58993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
This literature review presents a bibliometric analysis of the randomized controlled trials conducted between 2014 and 2023 on the potential benefits of yoga as a complementary therapy for cancer patients. To conduct this analysis, we searched medical and scientific databases, such as Scopus, Cochrane, and PubMed, using relevant keywords. Our search yielded 58 clinical trials involving 4,762 patients, which indicates a growing trend in this field of research. The studies we reviewed mainly focused on breast cancer patients and demonstrated the adaptability and versatility of yoga, offering a ray of hope and optimism. Among the various styles of yoga, Hatha yoga was the most frequently practiced style in these clinical trials. The analysis we conducted reveals that yoga interventions have a promising role in cancer care and can be a valuable complementary therapy for cancer patients. However, significant gaps and limitations still need to be addressed in this area of research. For instance, more rigorous and diverse investigations are needed to further establish the potential benefits of yoga interventions for cancer patients. Additionally, the standardization of yoga interventions is crucial to optimize therapeutic benefits. By addressing these gaps and limitations, we can further enhance the potential of yoga as a complementary therapy for cancer patients.
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Gururaj R, Samuel SR, Kumar KV, Nagaraja R, Keogh JW. Effect of exercise based interventions on sleep and circadian rhythm in cancer survivors-a systematic review and meta-analysis. PeerJ 2024; 12:e17053. [PMID: 38468641 PMCID: PMC10926908 DOI: 10.7717/peerj.17053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024] Open
Abstract
Background Disrupted circadian rhythm commonly reported in cancer survivors is closely associated with cancer related fatigue, sleep disturbances and compromised quality of life. As more cancer survivors request non-pharmacological treatment strategies for the management of their chronic sleep-related symptoms, there is a need for meta-analyses of various interventions such as exercise on sleep and circadian rhythm disturbances. Methods A search for RCT's was conducted in April 2020 and updated in July 2023 using relevant keywords for cancer, sleep, circadian rhythm and exercise interventions on PubMed, Scopus, Web of Science, PEDro and CINAHL. Results Thirty-six studies were included for qualitative analysis and 26, for meta-analysis. Thirty-five studies analyzed sleep outcomes, while five analyzed circadian rhythm. RCT's studying the effect of aerobic exercise, resistance exercise, combined aerobic and resistance exercise, physical activity, yoga, or tai chi were included. Meta-analysis results showed significant exercise-related improvements on sleep quality assessed by Pittsburgh Sleep Quality index (PSQI) (SMD = -0.50 [-0.87, -0.13], p = 0.008), wake after sleep onset (WASO) (SMD = -0.29 [-0.53, -0.05], p = 0.02) and circadian rhythm, assessed by salivary cortisol levels (MD = -0.09 (95% CI [-0.13 to -0.06]) mg/dL, p < 0.001). Results of the meta-analysis indicated that exercise had no significant effect on sleep efficiency, sleep onset latency, total sleep time and circadian rhythm assessed by accelerometry values. Conclusion While some sleep and circadian rhythm outcomes (PSQI, WASO and salivary cortisol) exhibited significant improvements, it is still somewhat unclear what exercise prescriptions would optimize different sleep and circadian rhythm outcomes across a variety of groups of cancer survivors. Implication As exercise does not exacerbate cancer-related circadian rhythm and sleep disturbances, and may actually produce some significant benefits, this meta-analysis provides further evidence for cancer survivors to perform regular exercise.
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Affiliation(s)
- Rachita Gururaj
- Ramaiah College of Physiotherapy, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Stephen Rajan Samuel
- Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Cancer Control Division, Department of Surgery University of Rochester Medical Center, University of Rochester, Rochester, NY, United States of America
| | - K Vijaya Kumar
- Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ravishankar Nagaraja
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, New Delhi, India
| | - Justin W.L. Keogh
- Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia, Australia
- Human Potential Centre, AUT University, Auckland, New Zealand
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Niu N, Huang R, Zhao J, Zeng Y. Health benefits of yoga for cancer survivors: An updated systematic review and meta-analysis. Asia Pac J Oncol Nurs 2024; 11:100316. [PMID: 38426042 PMCID: PMC10904170 DOI: 10.1016/j.apjon.2023.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/08/2023] [Indexed: 03/02/2024] Open
Abstract
Objective To evaluate the effects of yoga on health-related outcomes [i.e., physical function, mental health, and overall quality of life (QOL)] of cancer survivors via a systematic review and meta-analysis of randomized controlled trials (RCTs) over the past 5 years across cancer types. Methods An updated systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RCTs published from January 1, 2018, to February 23, 2023, were searched in five English databases (PubMed, The Cochrane Library, ISI, PsycINFO, and CINAHL), three Chinese databases (Wan Fang, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database), and three English clinical trials registry platforms (International Clinical Trials Registry Platform, ClinicalTrials.gov, and EU Clinical Trials Register). Results A total of 34 RCTs were included in this updated review. Yoga benefited the physical function, mental health, and overall QOL of cancer survivors. The effect size of yoga for most physical and mental health-related outcomes was relatively small, but that for the QOL was generally large. The impact of yoga on the QOL of cancer survivors ranged from moderate to high. Conclusions Yoga has health benefits for cancer survivors and could therefore be used as an optional supportive intervention for cancer-related symptom management.
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Affiliation(s)
- Niu Niu
- Department of Colorectal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Ruirui Huang
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Junwen Zhao
- Neonatal Intensive Care Unit, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yingchun Zeng
- School of Medicine, Hangzhou City University, Hangzhou, China
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Li Y, Gao L, Chao Y, Lan T, Zhang J, Li R, Zhang Z, Li S, Lian J, Wang Z, Chen X. Various interventions for cancer-related fatigue in patients with breast cancer: a systematic review and network meta-analysis. Front Oncol 2024; 14:1341927. [PMID: 38406816 PMCID: PMC10885696 DOI: 10.3389/fonc.2024.1341927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/17/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose To investigate the effects of various intervention approaches on cancer-related fatigue (CRF) in patients with breast cancer. Method Computer searches were conducted on PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang databases from their establishment to June 2023. Selection was made using inclusion and exclusion criteria, and 77 articles were included to compare the effects of 12 interventions on patients with breast cancer. Results Seventy-seven studies with 12 various interventions were examined. The network findings indicated that cognitive behavioral therapy (CBT) (SMD, -1.56; 95%CI, -3.08~-0.04), Chinese traditional exercises (CTE) (SMD, -0.85; 95%CI, -1.34~-0.36), aerobic exercise (AE) (SMD, -0.77; 95%CI, -1.09~-0.45), multimodal exercise (ME) (SMD, -0.75; 95%CI, -1.26~-0.25), music interventions (MI) (SMD, -0.74; 95%CI, -1.45~-0.03), and yoga (YG) (SMD, -0.44; 95%CI, -0.83 to -0.06) can reduce CRF more than the control group (CG). For relaxation exercises (RE) (MD, -6.69; 95%CI, -9.81~-3.57), MI (MD, -5.45; 95%CI, -7.98~-2.92), AE (MD, -4.34; 95%CI, -5.90~-2.78), ME (MD, -3.47; 95%CI, -4.95~-1.99), YG (MD, -2.07; 95%CI, -3.56~-0.57), and mindfulness training (MD, -1.68; 95%CI, -2.91~-0.46), PSQI improvement was superior to CG. In addition, for CTE (MD, 11.39; 95%CI, 4.11-18.66), YG (MD, 11.28; 95%CI, 1.63-20.93), and AE (MD, 9.34; 95%CI, 0.26~18.42), Functional Assessment of Cancer Therapy-Breast improvement was superior to CG. Conclusion Cognitive behavioral therapy (CBT) is the most effective measure for alleviating CRF in patients with breast cancer and Relaxation exercises (RE) is the most effective measure for improving sleep quality. In addition, Chinese traditional exercises (CTE) is the best measure for enhancing quality of life. Additional randomized controlled trials (RCTs) are expected to further investigate the efficacy and mechanisms of these interventions. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023471574.
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Affiliation(s)
- Ying Li
- College of Sports Science, Jishou University, Jishou, Hunan, China
| | - Lei Gao
- School of Nursing, Dalian University, Dalian, Liaoning, China
| | - Yaqing Chao
- Ophthalmology Department, Xuzhou First People’s Hospital, Xuzhou, Jiangsu, China
| | - Tianhao Lan
- School of Stomatology, Dalian University, Dalian, Liaoning, China
| | - Jie Zhang
- College of Sports Science, Jishou University, Jishou, Hunan, China
| | - Ruoqi Li
- The Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zerui Zhang
- Medical School, Weifang University of Science and Technology, Weifang, Shandong, China
| | - Shuming Li
- College of Sports Science, Jishou University, Jishou, Hunan, China
| | - Jing Lian
- Department of Pathology, Cancer Hospital Affiliated to Shanxi Province Cancer Hospital, Taiyuan, Shanxi, China
| | - Zhaofeng Wang
- College of Physical Education, Beibu Gulf University, Qinzhou, Guangxi, China
| | - Xiaoan Chen
- College of Sports Science, Jishou University, Jishou, Hunan, China
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Bailey LE, Morris MA. Mind-body therapies adjuvant to chemotherapy improve quality of life and fatigue in top cancers: A systematic review and meta-analysis. Complement Ther Clin Pract 2024; 54:101811. [PMID: 38029633 DOI: 10.1016/j.ctcp.2023.101811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Breast, lung and colorectal cancers are 3 of the top 4 most common cancers worldwide. Their treatment with chemotherapy often results in adverse effects on quality of life, fatigue and functional exercise capacity amongst patients. Mind-body therapies, including yoga, Tai chi and Qigong, are commonly used as complementary and alternative therapies in cancer. This meta-analysis evaluates the effects of yoga, Tai chi and Qigong in alleviating the adverse effects of chemotherapy. METHODS Various databases were systematically interrogated using specific search terms, returning 1901 manuscripts. Removal of duplicates, irrelevant studies, those lacking available data and applying inclusion/exclusion criteria reduced this number to 9 manuscripts for inclusion in the final meta-analyses. Mean differences were calculated to determine pooled effect sizes using RStudio. RESULTS This is the first systematic review and meta-analysis to demonstrate significant improvements in fatigue for colorectal cancer patients undergoing chemotherapy with a reduction of -1.40 (95 % CI: -2.24 to -0.56; p = 0.001) observed in mind-body therapy intervention groups. CONCLUSION Yoga, Tai chi and Qigong could all be implemented alongside adjuvant therapies to alleviate the adverse effects on colorectal cancer patient fatigue during chemotherapy treatment. REVIEW REGISTRATION This systematic review and meta-analysis is registered on InPlasy: registration number INPLASY202390035; doi: https://doi.org/10.37766/inplasy2023.9.0035.
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Affiliation(s)
- Lucy Ella Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Mhairi Anne Morris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
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Hou L, Wang J, Mao M, Zhang Z, Liu D, Gao S, Liang K, Lu L. Effect of yoga on cancer-related fatigue in patients with breast cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e36468. [PMID: 38181269 PMCID: PMC10766251 DOI: 10.1097/md.0000000000036468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/14/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Breast cancer is a common malignant tumor in women and most patients with breast cancer experience fatigue. Numerous studies have investigated the relationship between yoga and cancer-related fatigue (CRF) in patients with breast cancer. However, these studies drew their conclusions from small sample sizes and lacked sufficient evidence to demonstrate that yoga can effectively alleviate CRF. Therefore, this meta-analysis aims to systematically examine the effects of yoga on cancer fatigue in patients with breast cancer and establish a scientific basis for enhancing their quality of life. OBJECTIVE To assess the effect of yoga on CRF in patients with breast cancer. METHODS Computer searches were conducted on PubMed, Embase, Web of Science, CKNI, and Wanfang databases to retrieve articles related to yoga and CRF in patients with breast cancer from the hospital establishment date to July 2023. The literature was independently screened, and the information was extracted by the researchers. A meta-analysis was conducted using Review Manager Software (version 5.3). RESULTS The findings from the meta-analysis of 18 studies indicate that yoga can effectively enhance CFR (standardized mean difference (SMD) = -0.51, 95% confidence interval [CI] = -0.92 to -0.10), improve sleep quality (MD = -3.86, 95%CI = -4.03 to -3.70) in patients with breast cancer, alleviate anxiety and depression (SMD = -0.93, 95%CI = -1.68, -0.18, SMD = -1.23, 95%CI = -2.02 to -0.44), and enhance quality of life (MD = -11.20, 95%CI = -14.16 to -8.24). CONCLUSION Our study offers evidence for the subsequent reduction of CFR in patients with breast cancer. Yoga can alleviate fatigue, improve sleep quality and negative emotions, and improve the quality of life of patients with breast cancer.
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Affiliation(s)
- Lingyu Hou
- Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China
| | - Jianhua Wang
- Medical School, Weifang University of Science and Technology, Shandong, Weifang, People’s Republic of China
| | - Meina Mao
- Medical School, Weifang University of Science and Technology, Shandong, Weifang, People’s Republic of China
| | - Zerui Zhang
- Medical School, Weifang University of Science and Technology, Shandong, Weifang, People’s Republic of China
| | - Dandan Liu
- Medical School, Weifang University of Science and Technology, Shandong, Weifang, People’s Republic of China
| | - Shun Gao
- Medical School, Weifang University of Science and Technology, Shandong, Weifang, People’s Republic of China
| | - Kaixue Liang
- Medical School, Weifang University of Science and Technology, Shandong, Weifang, People’s Republic of China
| | - Linlin Lu
- Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China
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Wu T, Yan F, Wei Y, Yuan C, Jiao Y, Pan Y, Zhang Y, Zhang H, Ma Y, Han L. Effect of Exercise Therapy on Cancer-Related Fatigue in Patients With Breast Cancer: A Systematic Review and Network Meta-analysis. Am J Phys Med Rehabil 2023; 102:1055-1062. [PMID: 37204936 DOI: 10.1097/phm.0000000000002277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
OBJECTIVE This study aimed to explore the efficacy of different exercise therapies in reducing fatigue in patients with breast cancer. DESIGN PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, China Biology Medicine, China National Knowledge Infrastructure, Database of Chinese Sci-tech Periodicals, and Wanfang databases were searched from their inception to March 2022. The authors independently screened all randomized controlled trials of exercise therapy in patients with breast cancer. A network meta-analysis was performed using Stata 16.0 software. RESULTS Seventy-eight studies were analyzed, with 167 comparisons and 6235 patients. The network results showed that stretching (standardized mean difference = -0.74, confidence interval = -1.43 to -0.06), yoga (standardized mean difference = -0.49, confidence interval = -0.75 to -0.22), combined exercise (standardized mean difference = -0.47, confidence interval = -0.70 to -0.24), aerobic exercise (standardized mean difference = -0.46, confidence interval = -0.66 to -0.26), and resistance exercise (standardized mean difference = -0.42, confidence interval = -0.77 to -0.08) significantly reduced fatigue. Pairwise comparisons confirmed that yoga, combined exercise, aerobic exercise, and resistance exercise were positively associated with fatigue relief. However, no significant association was identified between reduced fatigue and traditional Chinese exercises or stretching. CONCLUSIONS The most effective exercise therapy to relieve cancer-related fatigue in patients with breast cancer was yoga, followed by combined aerobic and resistance exercises. It is expected that more randomized controlled trials will be conducted to further explore the efficacy and mechanisms of exercise.
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Affiliation(s)
- Tong Wu
- From the School of Nursing, Evidence-Based Nursing Center, Lanzhou University, Lanzhou, China (TW, FY, YW, CY, YJ, YP, YM, LH); School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China (YZ); Department of Nursing, Gansu Provincial Hospital, Lanzhou, China (HZ); and Office of the Dean, Gansu Provincial Hospital, Lanzhou, China (LH)
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13
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Ma X, Li SN, Chan DNS. Effects of Yoga on Cancer-Related Fatigue, Psychological Distress, and Quality of Life Among Patients With Cancer Undergoing Chemotherapy and/or Radiotherapy: A Systematic Review and Meta-analysis. Cancer Nurs 2023:00002820-990000000-00196. [PMID: 38011074 DOI: 10.1097/ncc.0000000000001293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Yoga can be considered supportive therapy for patients with cancer to alleviate cancer-related symptoms. However, there has been no meta-analysis examining yoga's effects among patients with cancer undergoing chemotherapy and/or radiotherapy. OBJECTIVE To synthesize the evidence regarding the effects of yoga on improving cancer-related fatigue, psychological distress, and quality of life among patients with cancer undergoing chemotherapy and/or radiotherapy. METHODS Ten English databases and 2 Chinese databases were searched from inception to December 2022. Two independent reviewers screened studies and extracted the data. Randomized controlled trials examining the effects of yoga on cancer-related fatigue, psychological distress, and quality of life were included. Meta-analysis was conducted, and narrative synthesis was performed when meta-analysis was not applicable. RESULTS Fourteen studies from 16 articles were included. The results showed that yoga reduced cancer-related fatigue (standardized mean difference [SMD], -0.75; 95% confidence interval [CI], -1.12 to -0.38; P < .001), anxiety (SMD, -0.91; 95% CI, -1.68 to -0.14; P = .02), but not depression (SMD, -0.82; 95% CI, -1.67 to 0.04; P = .06). The effects of yoga on distress and quality of life were inconclusive. CONCLUSIONS Yoga significantly helped reduce cancer-related fatigue and anxiety but did not reduce depression among patients with cancer undergoing chemotherapy and/or radiotherapy. Further rigorous studies are needed to identify the optimal characteristics of yoga for these patients. IMPLICATIONS FOR PRACTICE It is possible to recommend yoga to patients with cancer undergoing chemotherapy and/or radiotherapy for managing cancer-related fatigue and anxiety after duly considering patients' physical conditions and ensuring appropriate instructions are given.
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Affiliation(s)
- Xing Ma
- Author Affiliation: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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14
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Han J, Shi M, Bi LN, Wang LL, Cai YX. Efficacy of mind-body therapies for sleep disturbance in patients with early-stage cancer: A systematic review and network meta-analysis. Psychooncology 2023; 32:1315-1338. [PMID: 37395137 DOI: 10.1002/pon.6187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/30/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To evaluate and compare the efficacy of different mind-body therapies (MBTs) for sleep disturbance in patients with early-stage cancer. METHODS Randomised controlled trials that included patients (aged ≥18 years) with early stage cancer who underwent MBTs (mindfulness, hypnosis, relaxation, yoga, and qigong) were searched in the CINAHL via the EBSCO Host, Cochrane Library, Embase, MEDLINE, PsycINFO, PubMed, and Scopus databases, from the date of database inception to October 2022. The outcomes were subjective sleep disturbance and objective sleep efficiency. Network meta-analysis (NMA) and comparative effects ranking were performed using STATA (v14.0; STATACorp, College Station, TX, USA). RESULTS Forty-seven studies investigating five MBTs were included in the NMA. For cancer patients receiving active treatment, mindfulness demonstrated the largest effect size in reducing subjective sleep disturbance (standardised mean difference [SMD]: 0.85; 95% confidence intervals [CI]: 0.20-1.50; Grading of Recommendations Assessment, Development, and Evaluation assessment: moderate), and had the highest cumulative probability compared to usual care or waitlist. For cancer patients who had completed active treatment, qigong demonstrated the largest effect size in reducing subjective sleep disturbance (SMD: 0.99; 95% CI: 0.35-1.63; GRADE: low), followed by hypnosis (SMD: 0.87; 95% CI: 0.32-1.42; GRADE: moderate), and mindfulness (SMD: 0.42; 95% CI: 0.24-0.59; GRADE: moderate). Qigong also demonstrated the largest effect size in improving objective sleep efficiency (weighted mean differences: 10.76; 95% CI: 2.01-19.50; GRADE: low); however, the effect of qigong was tested in only one study in this NMA. Among the eight different treatment conditions, cognitive behavioral therapy (CBT) showed the highest cumulative probability (surface under the cumulative ranking curve: 96.3%) in reducing subjective sleep disturbance and the second highest cumulative probability (SUCRA: 83.3%) in improving objective sleep efficiency. CONCLUSION There is no evidence supporting the use of MBTs to replace or be comparable to CBT. Mindfulness can be recommended as an optional treatment for reducing sleep disturbance in patients with early-stage cancer. Some support was observed for qigong and hypnosis in reducing sleep disturbances in patients with early-stage cancer who had completed active treatment. More rigorous trials are warranted to confirm whether different forms of MBTs have different effects on sleep in patients with cancer.
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Affiliation(s)
- Jing Han
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Ming Shi
- National and Local Joint Engineering Laboratory of Tumor Biotherapy, The First Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Liu-Na Bi
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Lin-Lin Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Yan-Xiu Cai
- School of Nursing, Xuzhou Medical University, Xuzhou, China
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Brownson-Smith R, Orange ST, Cresti N, Hunt K, Saxton J, Temesi J. Effect of exercise before and/or during taxane-containing chemotherapy treatment on chemotherapy-induced peripheral neuropathy symptoms in women with breast cancer: systematic review and meta-analysis. J Cancer Surviv 2023:10.1007/s11764-023-01450-w. [PMID: 37615928 DOI: 10.1007/s11764-023-01450-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/13/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE To systematically review and meta-analyse the efficacy of exercise interventions delivered before and/or during taxane-containing chemotherapy regimens on chemotherapy-induced peripheral neuropathy (CIPN), fatigue, and health-related quality of life (HR-QoL), in women with breast cancer. METHODS Seven electronic databases were systematically searched for randomised controlled trials (RCTs) reporting on the effects of exercise interventions in women with breast cancer receiving taxane-containing chemotherapeutic treatment. Meta-analyses evaluated the effects of exercise on CIPN symptoms, fatigue, and HR-QoL. RESULTS Ten trials involving exercise interventions ranging between 2 and 12 months were included. The combined results of four RCTs consisting of 171 participants showed a reduction in CIPN symptoms following exercise compared with usual care (standardised mean difference - 0.71, 95% CI - 1.24 to - 0.17, p = 0.012; moderate-quality evidence, I2 = 76.9%). Pooled results from six RCTs with 609 participants showed that exercise interventions before and/or during taxane-containing chemotherapy regimens improved HR-QoL (SMD 0.42, 95% CI 0.07 to 0.76, p = 0.03; moderate-quality evidence, I2 = 49.6%). There was no evidence of an effect of exercise on fatigue (- 0.39, 95% CI - 0.95 to 0.18, p = 0.15; very low-quality evidence, I2 = 90.1%). CONCLUSIONS This systematic review found reduced levels of CIPN symptoms and an improvement in HR-QoL in women with breast cancer who exercised before and/or during taxane-based chemotherapy versus usual care controls. IMPLICATIONS FOR CANCER SURVIVORS This evidence supports the role of exercise as an adjunctive treatment for attenuating the adverse effects of taxane-containing chemotherapy on CIPN symptoms and HR-QoL.
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Affiliation(s)
- Rosiered Brownson-Smith
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.
| | - Samuel T Orange
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle uponTyne, UK
- Newcastle University Centre for Cancer, Newcastle University, Newcastle-Upon-Tyne, UK
| | - Nicola Cresti
- Northern Centre for Cancer Care, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Katherine Hunt
- Northern Centre for Cancer Care, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - John Saxton
- School of Sport, Exercise & Rehabilitation Sciences, University of Hull, Hull, UK
| | - John Temesi
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
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Herranz-Gómez A, Cuenca-Martínez F, Suso-Martí L, Varangot-Reille C, Prades-Monfort M, Calatayud J, Casaña J. Effectiveness of Therapeutic Exercise Models on Cancer-Related Fatigue in Patients With Cancer Undergoing Chemotherapy: A Systematic Review and Network Meta-analysis. Arch Phys Med Rehabil 2023; 104:1331-1342. [PMID: 36736602 DOI: 10.1016/j.apmr.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess and compare the effectiveness of different exercise modalities in reducing cancer-related fatigue (CRF) in patients with cancer undergoing chemotherapy. Exercise intensities for selected exercise types were also compared. DATA SOURCES We conducted a search in MEDLINE, Embase, CINAHL, Scopus, SPORTDiscus, and Web of Science from inception to October 15, 2021. STUDY SELECTION Randomized controlled trials concerning the effectiveness of exercise modalities on CRF in patients with cancer undergoing chemotherapy were included. DATA EXTRACTION Study characteristics were extracted using a structured protocol. Methodological quality was assessed employing the PEDro scale and risk of bias was assessed using the Revised Cochrane Risk of Bias Tool for Randomized Trials. The certainty of evidence was assessed based on Grading of Recommendations, Assessment, Development and Evaluation. The measure of effect used was the adjusted standardized mean difference (SMD) or Hedge's g, together with the corresponding 95% confidence intervals (CI). DATA SYNTHESIS Forty-seven studies were included. Data were pooled employing a random-effects model. There was a trend that adding low-intensity aerobic and resistance exercise (SMD=1.28, 95% CI -0.18; 2.75, P=.086), or moderate-intensity aerobic and resistance exercise (SMD=0.85; 95% CI -0.12; 1.82, P=.087), was more effective than adding flexibility training to usual care (UC). There was also a trend that UC alone was less effective than adding moderate-intensity aerobic and resistance exercise (SMD=-0.47, 95% CI -0.96, 0.02, P=.060) to UC. CONCLUSIONS The addition of low- to moderate-intensity aerobic and/or resistance exercise demonstrated a positive trend for improvement in CRF in patients with cancer undergoing chemotherapy, when compared with UC alone or UC with flexibility training.
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Affiliation(s)
- Aida Herranz-Gómez
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, Valencia, Spain; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | | | - Miriam Prades-Monfort
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Jose Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
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Zhu J, Chen X, Zhen X, Zheng H, Chen H, Chen H, Liao H, Zhu J, Wang C, Zheng Z, Chen R, Wang Y. Meta-analysis of effects of yoga exercise intervention on sleep quality in breast cancer patients. Front Oncol 2023; 13:1146433. [PMID: 37456259 PMCID: PMC10348890 DOI: 10.3389/fonc.2023.1146433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/23/2023] [Indexed: 07/18/2023] Open
Abstract
Objective This study seeks to systematically evaluate and test the effects of yoga exercise intervention programs on sleep quality in breast cancer patients in order to suggest more optimized exercise programs. Method Computer searches of the PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases are conducted from the date of their inception to June 8th, 2022 to collect randomized controlled trials on the effects of yoga exercise intervention on sleep quality in breast cancer patients. Two investigators independently carry out the inclusion and exclusion criteria literature screening, data extraction and methodological quality assessment of the included literature by applying the Cochrane risk of bias tool. Subgroup analysis is performed using RevMan 5.4.1 software, and the six moderating variables of intervention format, intervention type, weekly intervention frequency, total intervention duration, single intervention duration and intervention evaluation at different time points are set for the 782 subjects of the 12 included publications. Results Twelve randomized controlled trials with a total sample size of 782 subjects are included, including 393 subjects in the experimental group and 389 subjects in the control group. The meta-analysis shows that yoga exercise intervention is effective in improving sleep quality in breast cancer patients [SMD = -0.40, 95% CI: (-0.71, -0.09), P = 0.01]; yoga exercise intervention focusing on positive meditation [SMD = -0.55, 95% CI: (-1.08, -0.03), P = 0.04] is effective in improving sleep; yoga exercise intervention two or three times a week is effective in improving sleep quality [SMD = -0.69, 95% CI: (-1.19, -0.19), P = 0.007]; yoga exercise intervention for 6-8 weeks significantly improves sleep quality [SMD = -0.86, 95% CI: (-1.65, -0.08), P =0.03]; and evaluation immediately after the end of intervention improves sleep outcomes [SMD = -0.17, 95% CI: (-0.33, 0.00), P = 0.05], while differences in sleep quality improvement are not statistically significant for the remaining subgroup outcomes (P > 0.05). Conclusion The available evidence suggests that yoga exercise intervention has good effects on improving sleep quality in breast cancer patients. Positive meditation intervention type, intervention frequency of two or three times per week, total intervention duration of 6-8 weeks and evaluation immediately after the end of intervention are shown to be effective in improving sleep quality.
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Affiliation(s)
- Jingzhi Zhu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaojuan Chen
- Medical College, Jiaying University, Meizhou, Guangdong, China
| | - Xinxian Zhen
- Department of Respiratory and Critical Care Medicine, Taishan People's Hospital, Jiangmen, Guangdong, China
| | - Huan Zheng
- Department of Endocrinology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Hong Chen
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Yubei, District of Chongqing City, Chongqing, China
| | - Huimin Chen
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Huizhao Liao
- Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jinru Zhu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Chaoyu Wang
- Department of Respiratory and Critical Care Medicine, Taishan Hospital of Traditional Chinese Medicine, Jiangmen, Guangdong, China
| | - Zhenzhen Zheng
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Riken Chen
- Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yang Wang
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Chongqing Liang Jiang New Area, Chongqing, China
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Jin Q, Liu L, Chen Y, Yin P. Non-pharmaceutical interventions in complementary and alternative medicine for insomnia in breast cancer survivors: a protocol for a systematic review and network meta-analysis. BMJ Open 2023; 13:e071784. [PMID: 37142314 PMCID: PMC10163449 DOI: 10.1136/bmjopen-2023-071784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Insomnia has a high incidence in patients with breast cancer, which not only affects the quality of life of patients, but also affects the efficiency of later treatment and rehabilitation. Although the sedative and hypnotic drugs commonly used in clinical practice have a rapid onset of action, they are also accompanied by different degrees of sequelae, withdrawal effects and dependence and addiction. Complementary and alternative medicine (CAM) or complementary and integrative medicine, complementary integrative therapies, including natural nutritional supplement therapy, psychotherapy, physical and mental exercise, physiotherapy, have been reported to be used to treat cancer-related insomnia. Its clinical results are increasingly recognised and accepted by patients. However, the effectiveness and safety of these CAM are uneven, and there is no standard clinical application method. Therefore, in order to objectively evaluate the effects of different non-pharmaceutical interventions in CAM on insomnia, we will conduct a network meta-analysis (NMA) to explore the effects of different CAM interventions on improving sleep quality in patients with breast cancer. METHODS AND ANALYSIS We will search all Chinese and English databases from the inception of the database to 31 December 2022. The databases include PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials and the Chinese literature databases include CBM, CNKI, VIP, WANFANG. The Insomnia Severity Index and the Pittsburgh Sleep Quality Index will be considered as the primary outcomes in the study. STATA V.15.0 software will be used to conduct pairwise meta-analysis and NMA. Finally, we will use the recommended risk assessment tool RoB2 for risk and bias assessment, and use the Grading of Recommendations Assessment, Development and Evaluation evaluation method to evaluate the quality of evidence. ETHICS AND DISSEMINATION Ethical approval will not be required because the study will not include the original information of participants. The results will be published in a peer-reviewed journal or disseminated in relevant conferences. PROSPERO REGISTRATION NUMBER CRD42022382602.
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Affiliation(s)
- Qi Jin
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Acupuncture Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Lumin Liu
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuelai Chen
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Yin
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Wong WM, Chan DNS, He X, So WKW. Effectiveness of Pharmacological and Nonpharmacological Interventions for Managing the Fatigue-Sleep Disturbance-Depression Symptom Cluster in Breast Cancer Patients Undergoing Chemotherapy: A Systematic Review. Cancer Nurs 2023; 46:E70-E80. [PMID: 35025770 DOI: 10.1097/ncc.0000000000001048] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The symptom cluster of cancer-related fatigue-sleep disturbance-depression (F-S-D) is common among breast cancer (BC) patients undergoing chemotherapy. Given the coexisting nature and synergistic effect of this symptom cluster, interventions for managing it are expected to benefit patient outcomes. OBJECTIVES The aims of this study were to examine the effectiveness and identify the essential components of interventions used to manage the F-S-D and quality of life (QOL) in BC patients undergoing chemotherapy. METHODS A systematic review was performed in March 2020 through 7 electronic databases. Relevant studies were assessed using the inclusion criteria. The level of evidence was assessed using the Cochrane risk-of-bias tool. The results were summarized and synthesized in narrative forms. RESULTS Sixteen randomized controlled trials were included. Results showed that bright light therapy, acupressure, and psychological nursing interventions were useful in managing F-S-D in BC patients. Exercise and diet counseling alleviated F-D, whereas stress management and a health promotion program alleviated S-D. Bright light therapy, exercise, diet counseling, and psychological nursing interventions enhanced the QOL of these patients. CONCLUSION Interventions that could alleviate F-S, F-D, S-D, and F-S-D in BC patients and enhance their QOL were identified. Future studies should investigate the effects of evidence-based multimodal interventions that integrate psychological support, education on the management of chemotherapy side effects, and diet counseling and exercise on F-S-D in and reduced QOL of BC patients undergoing chemotherapy. IMPLICATIONS FOR PRACTICE Nurses act as patient advocates, and the development of evidence-based interventions for managing F-S-D and QOL is significant to nursing practice.
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Affiliation(s)
- Wai Man Wong
- Author Affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, China
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20
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Bò MC, Merlo A, Ligabue MB, Bassi MC, Lusuardi M, Campanini I. Self-managed physical activity in breast cancer survivors: A scoping review. PLoS One 2023; 18:e0284807. [PMID: 37093839 PMCID: PMC10124851 DOI: 10.1371/journal.pone.0284807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/01/2023] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVE Breast cancer survivors (BCS) experience many issues of rehabilitative concern due to the treatments they have undergone. Given the chronicity of these outcomes, the increasing number of survivors, and the positive results obtained by supervised exercise, professionals should consider offering self-managed physical activity (PA) programs to this population. Our aim was to map the currently available evidence about self-care rehabilitation for BCS. METHODS Medline, CINAHL, and Cochrane databases were searched for primary literature. Scoping review methodological frameworks were used to tackle the heterogeneity of the topic. Studies investigating self-managed PA interventions prescribed to adult BCS were included. RESULTS One hundred-eight studies were included, with sample sizes ranging from 6 to 692 patients. Information was systematically collected in tables displaying study design, type of PA, duration and recommended frequency, professional leading the study, type of supervision, initial training, strategies used to help patients integrate self-care into their daily lives, and self-managed PA efficacy. Tables were produced for every oncological side effect that BCS might experience: lymphedema, arthralgia, cancer-related fatigue, a decline in physical parameters, treatment-related cardiotoxicity, peripheral neurotoxicity, and a possible decline in the quality of life. CONCLUSIONS Self-managed PA has the potential to improve BCS oncological issues. Professionals can adopt many strategies to support patients and empower them with long-lasting self-care competencies. This scoping review provided a comprehensive and easy-to-consult overview of self-managed PA interventions for BCS. We also provided recommendations for future primary studies and secondary synthesis.
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Affiliation(s)
- Maria Chiara Bò
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
- Merlo Bioengineering, Parma, Italy
| | - Andrea Merlo
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
- Merlo Bioengineering, Parma, Italy
| | - Maria Bernadette Ligabue
- Motor Rehabilitation Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
| | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Correggio (Reggio Emilia), Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Correggio (Reggio Emilia), Italy
| | - Isabella Campanini
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
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Liu YC, Hung TT, Konara Mudiyanselage SP, Wang CJ, Lin MF. Beneficial Exercises for Cancer-Related Fatigue among Women with Breast Cancer: A Systematic Review and Network Meta-Analysis. Cancers (Basel) 2022; 15:cancers15010151. [PMID: 36612147 PMCID: PMC9817866 DOI: 10.3390/cancers15010151] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022] Open
Abstract
CONTEXT Cancer-related fatigue (CRF) is the most common cause of physical powerlessness in women with breast cancer (BC). The practice of continuous effective exercise is beneficial with respect to reducing CRF. OBJECTIVE To explore exercise efficacy and respective ranks with respect to reducing CRF in women with BC within the inter-treatment and post-treatment periods. METHODS Throughout this systematic review and network meta-analysis, articles published from 2000 to March 2022 were included. Article searches were conducted on the MEDLINE, Embase, CINAHL, and CENTRAL databases. Adult women with BC and different exercise programs were compared with those involved in regular care as a control during or after treatment. In addition, randomized controlled trials (RCT) were also included. A risk-of-bias assessment, with the revised Cochrane risk-of-bias tool regarding RCT and probability-based ranking, was established based on the surface under the cumulative rank (SUCRA) method via network meta-analysis. RESULTS a total of 5747 women with BC followed seven exercise interventions. Yoga (SMD = -0.54, 95% CI [-0.86, -0.22]) was ranked first (94.5%), with significant effects in respect of mitigating CRF, followed by resistance exercise (66.2%), and aerobic resistance (63.3%), while Qigong ranked last (22.2%) among the 36 RCT in inter-treatment. Aerobic resistance exercise (SMD = -0.52, 95% CI [-0.98, -0.07]) induced significant effects in respect of mitigating CRF in the 38 RCTs in the post-treatment period. Yoga, aerobic yoga, and aerobic resistance exercise ranked as the top three (75.5%, 75.0%, and 72.4%, respectively), whereas relaxation ranked last (38.8%) in the post-treatment period. CONCLUSION Yoga, aerobic resistance, and aerobic yoga are recommended for the purposes of inter- and post-treatment exercise to reduce CRF in women with BC by enhancing their physical resilience and long-term quality of life.
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Affiliation(s)
- Yu-Chen Liu
- School of Nursing, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Tsai-Tzu Hung
- Nursing Department, National Cheng Kung University Hospital, Tainan 70101, Taiwan
| | | | - Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: ; Tel.: +886-6-2353535 (ext. 5035); Fax: +886-6-237-7550
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22
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Campanini I, Ligabue MB, Bò MC, Bassi MC, Lusuardi M, Merlo A. Self-managed physical activity in cancer survivors for the management of cancer-related fatigue: A scoping review. PLoS One 2022; 17:e0279375. [PMID: 36542639 PMCID: PMC9770433 DOI: 10.1371/journal.pone.0279375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) is a disabling chronic condition that cancer survivors could experience during and after recovery and that might benefit from self-managed physical activity (PA) programs. This scoping review aimed to map self-managed PA interventions found in literature for the management of CRF. METHODS Given the heterogeneity of the topic, scoping review methodological frameworks were used. Pubmed, Cinahl and Cochrane databases were searched for primary literature. Inclusion criteria: self-managed PA meant as any exercise program prescribed by a professional either with or without initial supervision and training which then continued independently for a given time frame; patient-reported fatigue assessment included in the outcome measures. Articles dealing with entirely supervised interventions, dietary or psychological-only therapies, and with palliative care were excluded. RESULTS Of the 543 experimental or observational studies screened, 63 were included. Of these forty-three studies were randomized controlled trials. Data were summarized in tables describing self-managed interventions according to: type of self-managed activity, frequency and duration, strategies to promote adherence, professionals supervising the treatment, outcome measures, and efficacy. A narrative synthesis was also added to further explain findings. CONCLUSIONS We collected the available evidence on PA when this was self-managed by patients after prescription by a healthcare provider. Clinicians and researchers should consider incorporating self-care programs in CRF patients' recovery journey gradually, identifying the best strategies to integrate them into daily life. Researchers should specify the characteristics of PA programs when designing new studies. This review highlighted the areas to be investigated for future studies pertaining to self-managed PA.
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Affiliation(s)
- Isabella Campanini
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | - Maria Bernadette Ligabue
- Motor Rehabilitation Unit, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | | | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Merlo
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
- Merlo Bioengineering, Parma, Italy
- * E-mail:
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23
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Silveira JD, Fausto DY, Saraiva PSDS, Boing L, Lyra VB, Bergmann A, Guimarães ACDA. How do Body Practices Affect the Psychological Aspects of Survivors Women Undergoing Treatment for Breast Cancer? Systematic Literature Review. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2023v69n1.2981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction: Body practices can bring physical, psychological benefits and social rehabilitation and may be an alternative treatment for breast cancer. Objective: To analyze the evidence of the results of body practices over the psychological aspects of survivors women undergoing treatment for breast cancer. Method: Systematic blind and independent review from September to December 2021 following the PRISMA guidelines, carried out in the databases: Embase Elsevier; PubMed Central; ScienceDirect; Scopus Elsevier and Web of Science – Core Collection. Results: Of 1,372 studies identified, 22 were included in this systematic review. Among the practices that stood out are meditation and Yoga, with anxiety being the most investigated variable by the studies. It is clear that body practices are options for non-pharmacological clinical treatments utilized in clinical practice by different health professionals in women who have survived breast cancer. Conclusion: Body practices proved to be beneficial in the treatment and psychological health of women who survived breast cancer. This evidence may help to implement body practices as a therapeutic resource to be used in the clinical practice of health professionals. However, more randomized clinical trials that follow study protocols more rigorously are suggested, so that the effectiveness of this approach can be evaluated in different clinical outcomes.
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24
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Pathania M. Effect of 4-day Online Breath Meditation Workshop on Ballistocardiography-based Sleep and Cardiac Health Assessments among Medical Professionals of a Tertiary Care Hospital in North India during COVID-19. JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2022; 70:11-12. [DOI: 10.5005/japi-11001-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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25
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Saraiva PSDS, Silveira JD, Moratelli JA, Alexandre KH, Dias M, Guimarães ACDA. An Overview on the Evidence of Physical Activity Interventions in the Health of Individuals with Head and Neck Cancer: Literature Systematic Review. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2023v69n1.2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Head and neck cancer is considered a global public health problem, which arises in aesthetically and functionally critical areas. The practice of physical exercise has been considered one of the significant and effective non-pharmacological strategies to minimize the physical and psychological consequences. Objective: To analyze the evidence of physical activity interventions in the physical and psychological health of individuals with head and neck cancer. Method: A systematic review was conducted blindly and independently, from March to May 2021, according to the PRISMA guidelines. The search was performed in the following databases: PubMed Central®; Cochrane Library; Web of Science, Scopus, ScienceDirect. Results: Of the 515 selected studies, 15 were included in this systematic review with a total of 670 participants aged between 18 and 76 years old. The studies included aerobic exercises, endurance, mobility, stretching, strengthening, and yoga. Conclusion: Evidence proves that physical activity interventions performed with individuals with head and neck cancer may be beneficial in the treatment and physical/psychological health of this population. This study may help new researches considering the detailed information described previously regarding the interventions applied, in addition to discussing the most used instruments with this public and indicating the modalities that are being safely performed. It is suggested that more randomized trials be conducted to obtain more concise results.
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Adaptive Auricular Point Acupressure for Sleep Disturbance in Women with Breast Cancer: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8637386. [PMID: 36353150 PMCID: PMC9640241 DOI: 10.1155/2022/8637386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Abstract
Objectives The study aimed to evaluate the preliminary effect and efficacy of auricular point acupressure (APA) on the quality of sleep in women with breast cancer who were undergoing chemotherapy. Sample & Setting. We conducted a randomized controlled trial on 68 patients with breast cancer who reported poor sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) scores (>7). Methods & Variables. Participants were randomly assigned to an APA treatment group or a control group. Patients in the APA group had magnetic pellets attached to selected auricular points and were instructed to apply pressure to these points 4×/day for three consecutive weeks. We objectively measured sleep quality using the Actiwatch Spectrum and the PSQI at the baseline and postintervention. Statistical analyses of changes in sleep data were performed using the t-test, a rank-sum test, and analyses of covariance. Results In patients treated with APA, the PSQI total score and sleep onset latency had significantly decreased, while the total sleep time and sleep efficiency had significantly increased. Although the total PSQI score differed between groups at the baseline, ANCOVA results showed that the APA group had a significantly lower total PSQI score. Conclusion APA could be an inexpensive and effective approach to improving sleep quality and reducing sleep disturbance in patients with breast cancer. Further research needs a larger sample size to verify our findings.
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Şahin MF, Özkaraman APA, Irmak Kaya MDZ. The effect of a combined treatment of foot soak and lavender oil inhalation therapy on the severity of insomnia of patients with cancer: Randomized interventional study. Explore (NY) 2022; 19:426-433. [PMID: 36270928 DOI: 10.1016/j.explore.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/24/2022] [Accepted: 09/25/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This three-arm randomized intervention study was carried out with the aim to evaluate the effects of a combined foot soak and lavender oil inhalation therapy on the severity of insomnia of patients with cancer. METHOD This research was carried out in oncology and palliative services. Forty-five patients were randomly assigned to three groups. Throughout a 14-day period, 20 min of foot soak treatment was applied to the patients in the F group, patients in the L group were applied lavender oil inhalation therapy for 5 min and a combined treatment of foot soak and lavender oil inhalation therapy were applied to the patients in the FL group. Insomnia severity of the patients in all groups were evaluated twice using the Insomnia Severity Index at the baseline and on the fifteenth day. RESULTS The severity of the insomnia of the patients in all groups was found to be moderate. The severity of the insomnia in the second evaluation was found to be statistically significantly lower in the L and FL groups (p<0.05) compared to the baseline evaluation within the group, however no significant difference was found in the F group (p>0.05). The effect size of a combined treatment of foot soak and lavender oil inhalation therapy on the severity of insomnia of patients in the FL group was higher and moderate (d = 0.684) compared to merely foot soak and merely lavender oil inhalation therapy. CONCLUSION A combined treatment of foot soak and lavender oil inhalation therapy shall mitigate the severity of a moderate level of insomnia of patients with cancer.
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28
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Sleight A, Gerber LH, Marshall TF, Livinski A, Alfano CM, Harrington S, Flores AM, Virani A, Hu X, Mitchell SA, Varedi M, Eden M, Hayek S, Reigle B, Kerkman A, Neves R, Jablonoski K, Hacker ED, Sun V, Newman R, McDonnell KK, L'Hotta A, Schoenhals A, Dpt NLS. Systematic Review of Functional Outcomes in Cancer Rehabilitation. Arch Phys Med Rehabil 2022; 103:1807-1826. [PMID: 35104445 PMCID: PMC9339032 DOI: 10.1016/j.apmr.2022.01.142] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer and describe the breadth of evidence as well as strengths and limitations across a range of functional domains. DATA SOURCES PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019. STUDY SELECTION Prospective, controlled trials including single- and multiarm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. DATA EXTRACTION Extraction was performed by coauthor teams and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme (class I-IV). DATA SYNTHESIS Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: (1) quality of life (109 studies), (2) activities of daily living (61 studies), (3) fatigue (59 studies), (4) functional mobility (55 studies), (5) exercise behavior (37 studies), (6) cognition (20 studies), (7) communication (10 studies), (8) sexual function (6 studies), and (9) return to work (5 studies). Most studies were categorized as class III in quality/bias. Averaging results found within each of the functional domains, 71% of studies reported statistically significant results after cancer rehabilitation intervention(s) for at least 1 functional outcome. CONCLUSIONS These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types.
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Affiliation(s)
- Alix Sleight
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, United States; Center for Integrated Research in Cancer and Lifestyle (CIRCL), Cedars-Sinai Medical Center, Los Angeles, California, United States; Cedars Sinai Cancer, Los Angeles, California, United States; Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States.
| | - Lynn H Gerber
- College of Health and Human Services, George Mason University, Fairfax County, Virginia, United States; Inova Health System, Inova Medicine Services, Falls Church, Virginia, United States
| | | | - Alicia Livinski
- National Institutes of Health Library, Office of Research Services, National Institutes of Health, Bethesda, Maryland, United States
| | - Catherine M Alfano
- Northwell Health Cancer Institute, New Hyde Park, New York, United States; Center for Personalized Health, Feinstein Institutes for Medical Research, Manhasset, New York, United States; Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States
| | - Shana Harrington
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Ann Marie Flores
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States; Robert H. Lurie Comprehensive Cancer Center, Cancer Survivorship Institute, Chicago, Illinois, United States
| | - Aneesha Virani
- Rehabilitation Department, Northside Hospital, Atlanta, Georgia, United States
| | - Xiaorong Hu
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Boston, Massachusetts, United States; Rehabilitation Medicine School, Nanjing Medical University, Nanjing, China
| | - Sandra A Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States
| | - Mitra Varedi
- Epidemiology and Cancer Control Department, St Jude Children's Research Hospital, Memphis, Tennessee, United States
| | - Melissa Eden
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, Arizona, United States
| | - Samah Hayek
- Clalit Health Services, Clalit Research Institute, Ramat-Gan, Israel
| | - Beverly Reigle
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, United States
| | - Anya Kerkman
- Lincoln Cancer Rehabilitation, Lincoln, Nebraska, United States; CHI Health St Elizabeth, Lincoln, Nebraska, United States
| | - Raquel Neves
- Czech Rehabilitation Hospital, Al Ain, United Arab Emirates
| | - Kathleen Jablonoski
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; Department of Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Eileen Danaher Hacker
- Department of Science of Nursing Care, Indiana University School of Nursing, Indianapolis, Indiana, United States
| | - Virginia Sun
- Department of Population Sciences, City of Hope, Duarte, California, United States; Department of Surgery, City of Hope, Duarte, California, United States
| | - Robin Newman
- Department of Occupational Therapy, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, Massachusetts, United States
| | - Karen Kane McDonnell
- College of Nursing, University of South Carolina, Columbia, South Carolina, United States
| | - Allison L'Hotta
- Department of Occupational Therapy, Washington University in St Louis, St Louis, Missouri, United States
| | - Alana Schoenhals
- Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, United States
| | - Nicole L Stout Dpt
- West Virginia University Cancer Institute, West Virginia University School of Public Health, Morgantown, West Virginia, United States; Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States
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Andersen HH, Vinther A, Lund CM, Paludan C, Jørgensen CT, Nielsen D, Juhl CB. Effectiveness of different types, delivery modes and extensiveness of exercise in patients with breast cancer receiving systemic treatment - A systematic review and meta-analysis. Crit Rev Oncol Hematol 2022; 178:103802. [PMID: 36031174 DOI: 10.1016/j.critrevonc.2022.103802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Effects of exercise in patients with breast cancer have been thoroughly investigated. The aim was to explore differences in effects regarding type, delivery mode and extensiveness (e.g. intensity; volume) of the interventions. METHODS We searched for randomised controlled trials including patients with breast cancer receiving systemic treatment, exercise-based interventions, and measures on patient reported- and objectively measured outcomes. RESULTS Exercise showed significant and moderate effects on the primary outcomes quality of life and physical function, Standardised Mean Difference: 0.52 (95 % CI 0.38-0.65) and 0.52 (95 % CI 0.38-0.66), respectively. Type of exercise had little influence on the effects, however combined aerobic- and resistance exercise seemed superior for increasing physical function, compared to aerobic or resistance exercise. Supervised interventions were superior to partly and unsupervised. Extensiveness of the intervention only influenced physical function. CONCLUSIONS Supervised interventions, more than type or extensiveness of interventions, seem to increase effects.
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Affiliation(s)
- Høgni Hammershaimb Andersen
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 29, Level 8, 3. Floor, O1, 2730 Herlev, Denmark.
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 29, Level 8, 3. Floor, O1, 2730 Herlev, Denmark; Hospital Secretariat and Communication, Research, Copenhagen University Hospital, Herlev and Gentofte, 2730 Herlev, Denmark.
| | - Cecilia Margareta Lund
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, 2730 Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark.
| | - Camilla Paludan
- Department of Sports Science and Biomechanics, University of Southern Denmark, 5230 Odense, Denmark.
| | - Claus Thomas Jørgensen
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 29, Level 8, 3. Floor, O1, 2730 Herlev, Denmark.
| | - Dorte Nielsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark; Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, 2730 Herlev, Denmark.
| | - Carsten Bogh Juhl
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 29, Level 8, 3. Floor, O1, 2730 Herlev, Denmark; Department of Sports Science and Biomechanics, University of Southern Denmark, 5230 Odense, Denmark.
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Application of Nursing Intervention Plan Based on Symptom Management Theory among Breast Cancer Patients. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:3816768. [PMID: 36051927 PMCID: PMC9410828 DOI: 10.1155/2022/3816768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
In order to explore the application effect of nursing intervention based on symptom management theory in breast cancer patients, a total of 120 breast cancer patients who were hospitalized in the Thyroid and Breast Surgery Department of Zhejiang Xiaoshan Hospital from July 2018 to July 2021 were selected as the research subjects. Patients from the control group received routine nursing, while patients from the intervention group underwent nursing interventions based on symptom management theory. Before and after the intervention, symptom distress, Herth Hope Index, quality of life, self-rating anxiety scale (SAS), self-rating depression scale (SDS), visual analogue score (VAS), and Pittsburgh sleep quality index (PSQI) were evaluated in two groups. The results showed that the symptom severity score and the symptom distress score, SAS scores, SDS scores, VAS scores, and PSQI scores in the intervention group were significantly lower than those in the control group, while the Herth Hope Index scores and FACT-B scores in the intervention group were obviously higher than those in the control group (all P < 0.05) after intervention. In conclusion, nursing interventions based on symptom management theory could decrease symptom distress among breast cancer patients, increase their hope levels, improve their life quality, relieve the negative emotions, enhance the sleep quality, and reduce their pain. It is worthy of clinical application.
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Yang J, Du Y, Shen H, Ren S, Liu Z, Zheng D, Shi Q, Li Y, Wei GX. Mindfulness-Based Movement Intervention to Improve Sleep Quality: A Meta-Analysis and Moderator Analysis of Randomized Clinical Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10284. [PMID: 36011918 PMCID: PMC9408303 DOI: 10.3390/ijerph191610284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: Given that the most effective dose, optimal type, and most beneficial population for improving sleep with mindfulness-based movement (MBM) remains unknown, we conducted a systematic review and meta-analysis with moderator analysis of randomized controlled trials (RCTs) to assess these effects. (2) Methods: Three electronic databases (PubMed, Web of Science, and EBSCO) were systematically searched for RCTs published through August 2021 for analysis. The risk of bias of the included studies was assessed with Review Manager 5.3, and the meta-analysis was performed in Stata 16.0. (3) Results: A meta-analysis of 61 RCTs with 2697 participants showed that MBM significantly improved sleep quality compared to controls (SMD = −0.794; 95% CI: −0.794 to −0.994, p < 0.001, I2 = 90.7%). Moderator analysis showed that a long-term MBM (SMD = −0.829; 95% CI: 0.945 to 0.712; p < 0.001) had a larger effect size on sleep than a short-term MBM (SMD = −0.714; 95% CI: 0.784 to 0.644; p < 0.001). Practicing at least twice per week (SMD = −0.793; 95% CI: −0.868 to −0.718; p < 0.001) was more effective compared to practicing once per week (SMD = −0.687; 95% CI: −0.804 to −0.570; p < 0.001). Studies with a total intervention time of more than 24 h also revealed better sleep quality improvement (SMD = −0.759; 95% CI: −0.865 to −0.653; p < 0.001). In addition, the healthy population and older adults gained more from MBM than the patients and younger adults. (4) Conclusions: MBM can effectively improve subjective sleep quality, and the optimal intervention dose of MBM can be utilized in future intervention studies to treat or improve sleep disturbance (MBM more than twice a week for more than three months, with a total intervention time of more than 24 h).
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Affiliation(s)
- Jiayi Yang
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing 100875, China
| | - Yan Du
- School of Nursing, Health Science San Antonio, University of Texas, Austin, TX 78712, USA
| | - Haoran Shen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 101408, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 101408, China
| | - Shujie Ren
- School of Education, Beijing Sport University, Beijing 100084, China
| | - Zhiyuan Liu
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Danni Zheng
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Qingqing Shi
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Youfa Li
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing 100875, China
| | - Gao-Xia Wei
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 101408, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 101408, China
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Systematic review of yoga for symptom management during conventional treatment of breast cancer patients. Complement Ther Clin Pract 2022; 48:101581. [DOI: 10.1016/j.ctcp.2022.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/20/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022]
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Dean R. Can improving quality of sleep reduce the symptoms of cancer-related fatigue in adults?: A systematic review. Eur J Cancer Care (Engl) 2022; 31:e13597. [PMID: 35474359 PMCID: PMC9541520 DOI: 10.1111/ecc.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/03/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022]
Abstract
Purpose Cancer‐related fatigue (CRF) results in reduced quality of life for cancer patients. The relationship between tiredness and fatigue has been established in cancer patients and has been shown to be reciprocal, meaning the relationship is somewhat ‘chicken or the egg’ with tiredness influencing fatigue and vice versa. The aim of this study is to determine whether an improvement in sleep quality can ease the symptoms of CRF and whether this can support the theory that CRF symptoms stem from the effect of tiredness. Method Three databases were searched producing 259 papers. The papers were filtered using several inclusion criteria, resulting in a final list of 20 papers for analysis. The remaining papers (20) were critically appraised using the Critical Appraisals Skills Programme (CASP) randomised control trial checklist and assessed for bias using the Cochrane Collaboration's tool for assessing risk of bias in randomised trials. Results Fourteen papers showed an increase in sleep quality that also resulted in an improvement in fatigue symptoms. Cognitive behavioural therapy was shown to be the most effective intervention with a statistically significant decrease in fatigue alongside significant improvement in sleep quality shown in six of the papers (p < 0.05). Sleep education also had a positive impact on both sleep and fatigue scores with three papers showing significant improvements. Three papers focusing on exercise interventions produced a significant improvement in fatigue symptoms and quality of sleep. Conclusion Improving quality of sleep does ease the symptoms of CRF; however, the ‘chicken or the egg’ question regarding CRF and tiredness cannot be answered at this stage.
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Affiliation(s)
- Rogan Dean
- Warwick Medical School, University of Warwick, Coventry, UK
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Haussmann A, Schmidt ME, Illmann ML, Schröter M, Hielscher T, Cramer H, Maatouk I, Horneber M, Steindorf K. Meta-Analysis of Randomized Controlled Trials on Yoga, Psychosocial, and Mindfulness-Based Interventions for Cancer-Related Fatigue: What Intervention Characteristics Are Related to Higher Efficacy? Cancers (Basel) 2022; 14:cancers14082016. [PMID: 35454922 PMCID: PMC9032769 DOI: 10.3390/cancers14082016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Many individuals with cancer suffer from persistent exhaustion due to cancer therapy, known as cancer-related fatigue (CRF). Yoga, psychosocial, and mindfulness-based interventions are recommended to reduce CRF. However, it is not clear yet how interventions need to be designed to maximize their efficacy. This meta-analysis aimed to identify intervention characteristics associated with greater reductions in CRF. A total of 70 interventions with 6387 participants were included in the analysis. Our results found a positive effect of yoga, psychosocial, and mindfulness-based interventions, while all invention types revealed large differences in intervention effects. In psychosocial interventions, using a group setting and working on cognition was related to higher efficacy. Regarding yoga and mindfulness-based interventions, no specific intervention characteristics emerged as more favorable than others. Overall, this meta-analysis suggests opportunities to optimize psychosocial interventions for CRF, whereas the design of yoga and mindfulness-based interventions seems to allow for variation. Abstract Cancer-related fatigue (CRF) is a burdensome sequela of cancer treatments. Besides exercise, recommended therapies for CRF include yoga, psychosocial, and mindfulness-based interventions. However, interventions conducted vary widely, and not all show a significant effect. This meta-analysis aimed to explore intervention characteristics related to greater reductions in CRF. We included randomized controlled trials published before October 2021. Standardized mean differences were used to assess intervention efficacy for CRF and multimodel inference to explore intervention characteristics associated with higher efficacy. For the meta-analysis, we included 70 interventions (24 yoga interventions, 31 psychosocial interventions, and 15 mindfulness-based interventions) with 6387 participants. The results showed a significant effect of yoga, psychosocial, and mindfulness-based interventions on CRF but with high heterogeneity between studies. For yoga and mindfulness-based interventions, no particular intervention characteristic was identified to be advantageous for reducing CRF. Regarding psychosocial interventions, a group setting and work on cognition were related to higher intervention effects on CRF. The results of this meta-analysis suggest options to maximize the intervention effects of psychosocial interventions for CRF. The effects of yoga and mindfulness-based interventions for CRF appear to be independent of their design, although the limited number of studies points to the need for further research.
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Affiliation(s)
- Alexander Haussmann
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Martina E. Schmidt
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Mona L. Illmann
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Marleen Schröter
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte and Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany; (M.S.); (H.C.)
| | - Thomas Hielscher
- Division of Biostatistics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany;
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte and Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany; (M.S.); (H.C.)
| | - Imad Maatouk
- Division of Medical Psychosomatics, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany;
| | - Markus Horneber
- Division of Pneumology, Klinikum Nürnberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Str. 1, 90340 Nürnberg, Germany;
| | - Karen Steindorf
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
- Correspondence: ; Tel.: +49-6221-422351
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Turmel D, Carlier S, Bruyneel AV, Bruyneel M. Tailored individual Yoga practice improves sleep quality, fatigue, anxiety, and depression in chronic insomnia disorder. BMC Psychiatry 2022; 22:267. [PMID: 35421962 PMCID: PMC9012014 DOI: 10.1186/s12888-022-03936-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 04/12/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Chronic insomnia disorder (CI) is a prevalent sleep disorder that can lead to disturbed daytime functioning and is closely associated with anxiety and depression. First-choice treatment is cognitive behavioral therapy (CBT-I). Other mind-body interventions, such as Tai-chi and Yoga, have demonstrated subjective improvements in sleep quality. The purpose of this study was to assess the efficacy of Yoga for improvement of subjective and objective sleep quality as well as measures of anxiety, depression, sleepiness, and fatigue in patients with CI. METHODS Adults with CI were prospectively included in this single group pre-post study. Baseline assessments included home polysomnography (PSG), 7-day actigraphy, and questionnaires (Pittsburgh Sleep Quality Index questionnaire (PSQI), Hospital Anxiety Depression scale (HADS), Epworth Sleepiness Scale (ESS), Pichot fatigue scale (PS)). Patients practiced Viniyoga, an individualised Yoga practice with daily self-administered exercises, for 14 weeks. Assessments were repeated at the end of Yoga practice. RESULTS Twenty-one patients completed the study. Objective sleep measurements revealed no change in PSG parameters after Yoga practice, but a decrease in arousals on actigraphy (p < 0.001). Subjective symptoms improved for all questionnaires (PSQI, p < 0.001; HAD-A, p = 0.020, HAD-D, p = 0.001, ESS, p = 0.041, PS, p = 0.010). In univariate correlations, decrease in PSQI was associated with increase in sleep stage N3 (p < 0.001) on PSG. CONCLUSIONS We have demonstrated a positive impact of individualized Yoga practice on subjective parameters related to sleep and daytime symptoms in CI, resulting in fewer arousals on actigraphy. Yoga could be proposed as a potentially useful alternative to CBT-I in CI, as it is easy to practice autonomously over the long-term. However, given the design of the present study, future prospective controlled studies should first confirm our results. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03314441 , date of registration: 19/10/2017.
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Affiliation(s)
| | - Sarah Carlier
- grid.50545.310000000406089296Department of Pulmonary Medicine, CHU Saint-Pierre, Brussels, Belgium and Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Anne Violette Bruyneel
- grid.5681.a0000 0001 0943 1999Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Marie Bruyneel
- Department of Pulmonary Medicine, CHU Saint-Pierre, Brussels, Belgium and Université Libre de Bruxelles (ULB), Brussels, Belgium.
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Sleep moderates the effects of Tibetan yoga for women with breast cancer undergoing chemotherapy. Support Care Cancer 2022; 30:4477-4484. [PMID: 35107599 DOI: 10.1007/s00520-022-06861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/21/2022] [Indexed: 10/19/2022]
Abstract
This study examined self-reported and actigraphy-assessed sleep and depression as moderators of the effect of a Tibetan yoga intervention on sleep and depression among women undergoing chemotherapy for breast cancer. This is a secondary analysis of an RCT examining a 4-session Tibetan yoga program (TYP; n = 74) versus stretching program (STP; n = 68) or usual care (UC; n = 85) on self-reported sleep (Pittsburgh Sleep Quality Index (PSQI), actigraphy-assessed sleep efficiency (SE)) and depression (Centers for Epidemiological Studies Depression Scale; CES-D) for women undergoing chemotherapy for breast cancer. Data were collected at baseline and 1-week and 3-month post-intervention. Baseline PSQI, actigraphy-SE, and CES-D were examined as moderators of the effect of group on PSQI, actigraphy-SE, and CES-D 1 week and 3 months after treatment. There was a significant baseline actigraphy-SE × group effect on PSQI at 1 week (p < .001) and 3 months (p = .002) and on CES-D at 3 months (p = .049). Specifically, the negative association of baseline actigraphy-SE with subsequent PSQI and CES-D was buffered for women in the TYP and, to a lesser extent in STP, compared to those in the UC. Baseline PSQI and CES-D were not significant moderators of the effect of group on any outcome. Behaviorally assessed sleep may be a more robust indicator of which patients are most appropriate for a yoga intervention than self-reported sleep quality. Women with poor sleep efficiency may derive the greatest benefit in terms of sleep quality and mood from a yoga intervention.
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Greaney SK, Amin N, Prudner BC, Compernolle M, Sandell LJ, Tebb SC, Weilbaecher KN, Abeln P, Luo J, Tao Y, Hirbe AC, Peterson LL. Yoga Therapy During Chemotherapy for Early-Stage and Locally Advanced Breast Cancer. Integr Cancer Ther 2022; 21:15347354221137285. [PMID: 36412916 PMCID: PMC9706042 DOI: 10.1177/15347354221137285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Chemotherapy is associated with decreased quality of life (QOL), fatigue, depression, and weight gain in patients with breast cancer. Weight gain is associated with poorer prognosis. Yoga improves QOL, fatigue, and mood in women with breast cancer but its effect on treatment-related weight gain has not been studied. The aim of this trial was to determine the feasibility of personalized yoga therapy in women receiving treatment for early-stage or locally advanced breast cancer and assess its impact on weight gain. Methods: Thirty women were randomized 1:1 to receive yoga therapy by a certified yoga therapist during treatment or a control group. Participants in the yoga arm were asked to complete three 30 minute yoga sessions weekly (which included movement, breath work, mindfulness, and relaxation) throughout adjuvant or neoadjuvant chemotherapy (N = 29) or endocrine (N = 1); the control arm received breast cancer treatment without yoga. For comparability between participants randomized to yoga therapy, the single patient treated with endocrine therapy was excluded from the analysis. Primary outcomes were feasibility and weight change. Additional outcomes were mood, fatigue, QOL, serum tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP) as immune mediator biomarkers. Results: Mean age was 51.6 years, 75.9% were white and 24.1% were people of color, reflecting the cancer center population. 80% had stage II-III disease. Enrollment was completed in 9 months. Compliance was lower than predicted; however, participants participated in on average 1.7 yoga sessions/week for a mean 15.6 weeks duration. There were no adverse events. Control arm participants gained on average 2.63% body weight during treatment while yoga participants lost 0.14% body weight (weight change = −0.36 in yoga arm vs. 2.89 in standard of care arm, Wilcoxon rank sum test P = .024). Control participants reported increased fatigue and decreased QOL, while yoga participants reported no change in QOL. No significant change in TNF-alpha or CRP was noted in either arm. Conclusion: This feasibility study suggests that personalized yoga therapy is beneficial for QOL and weight maintenance among women undergoing chemotherapy for early-stage or locally advanced breast cancer. Weight maintenance associated with yoga therapy may be of clinical significance in this population given the poorer prognosis associated with weight gain in breast cancer survivors. Trial Registration: NIH Clinicaltrials.gov #NCT03262831; August 25, 2017. https://clinicaltrials.gov/ct2/show/NCT03262831
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Affiliation(s)
| | - Neha Amin
- Washington University School of Medicine, Saint Louis, MO, USA
| | | | | | | | | | | | - Peri Abeln
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Jingqin Luo
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Yu Tao
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Angela C. Hirbe
- Washington University School of Medicine, Saint Louis, MO, USA
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Sohl SJ, Tooze JA, Johnson EN, Ridner SH, Rothman RL, Lima CR, Ansley KC, Wheeler A, Nicklas B, Avis NE, Wagner LI. A Randomized Controlled Pilot Study of Yoga Skills Training Versus an Attention Control Delivered During Chemotherapy Administration. J Pain Symptom Manage 2022; 63:23-32. [PMID: 34343620 PMCID: PMC8766874 DOI: 10.1016/j.jpainsymman.2021.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 01/03/2023]
Abstract
CONTEXT It is important to address fatigue and co-occurring symptoms during chemotherapy to preserve quality of life in patients with gastrointestinal (GI) cancer. OBJECTIVE To conduct a randomized controlled pilot study of a Yoga Skills Training (YST) intervention compared to an attention control (AC) among adults diagnosed with GI cancer. METHODS YST consisted of four 30-minute sessions delivered individually during chemotherapy plus home practice. AC provided empathic attention plus home diaries. Patient-reported (PROMIS T-score) assessments of fatigue, depressive symptoms, sleep disturbances, and psychological stress (Perceived Stress Scale) were collected at chemotherapy visits: baseline, Week 8, Week 10 and Week 14, and analyzed using a mixed effects model. Inflammatory cytokines were assessed at baseline and Week 10. RESULTS Forty-four of 77 adults approached agreed to participate (57%; YST n = 23; AC n = 21). Participants' mean age was 58 years and 48% were men. Participants randomized to YST reported a larger decline in fatigue (-2.4 difference, d = 0.30) and depressive symptoms (-2.5 difference, d = 0.30) than AC participants from baseline to Week 10 and sleep disturbances at Week 8 (-3.9 difference, d = 0.50). Differences in magnitude of change in symptoms were consistent with or exceeded a minimally important difference. Psychological stress decreased more in the AC at Week 10 (d = 0.30). Reductions in inflammatory cytokines (IL-6, sTNF R1) were larger in the YST group than AC. CONCLUSION YST showed promise for improving fatigue, depressive symptoms, sleep disturbances, and inflammation. YST is also feasible and reaches patients underrepresented in yoga research (i.e., GI cancer, men), thus warranting further examination.
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Affiliation(s)
- Stephanie J Sohl
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA.
| | - Janet A Tooze
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Emily Nance Johnson
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Sheila H Ridner
- Vanderbilt University School of Nursing (S.H.R.), Nashville, Tennessee, USA
| | - Russell L Rothman
- Vanderbilt University School of Medicine (R.L.R.), Nashville, Tennessee, USA
| | - Caio Rocha Lima
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Katherine C Ansley
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Amy Wheeler
- California State University (A.W.), San Bernardino, California, USA
| | - Barbara Nicklas
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Nancy E Avis
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Lynne I Wagner
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
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3-Doors Compassion Project: Examining the longitudinal effects of a nine-month Tibetan mind-body meditation program. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractAbundant research supports the benefits of participating in mindfulness meditation training programs including Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy. However, these well researched programs include a narrow range of meditation practices and research to date has minimally examined how home practice associates with favorable outcomes. The present study evaluated the 3 Doors Compassion Project (3DCP), a structured 9-months meditation program that teaches Tibetan Mind-Body practices and examined how frequency and duration of home practice associated with favorable outcomes. Twenty-seven medical and mental healthcare professionals completed assessments prior to, during, and following participation in the 3DCP program and recorded daily meditation practices. Study aims were to test general effectiveness of the 3DCP program and to test the hypotheses that frequency and duration of meditation home-practice would associate with improvements on mindfulness, stress, and depression. General linear mixed modeling demonstrated significant improvements throughout the duration of the 3DCP program for mindfulness, depression (p < .001) and stress (p < .05), with each variable evidencing incremental monthly improvements. Frequency of meditation (i.e., days practiced per month), but not time (i.e., minutes per month) was significantly associated with improvements throughout the 3DCP program. Results provide support for the benefits of the 3DCP while offering clinically useful information that can inform current guidelines for meditation home practice. As predicted, the 3DCP was associated with significant improvements on all outcomes. Favorable outcomes were linked to frequency, but not total time of meditation practice, which suggests that consistent meditation may be more helpful than extended meditation.
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A Meta-Analysis: Intervention Effect of Mind-Body Exercise on Relieving Cancer-Related Fatigue in Breast Cancer Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9980940. [PMID: 34285706 PMCID: PMC8275388 DOI: 10.1155/2021/9980940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/12/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022]
Abstract
Objective This paper aims to systematically evaluate the intervention effect of mind-body exercise on cancer-related fatigue in breast cancer patients. Methods Databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and SINOMED were retrieved to collect randomized controlled trials on the effects of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. The retrieval period started from the founding date of each database to January 6, 2021. Cochrane bias risk assessment tools were used to evaluate the methodological quality assessment of the included literature, and RevMan 5.3 software was used for meta-analyses. Results 17 pieces of researches in 16 papers were included with a total of 1133 patients. Compared with the control group, mind-body exercise can improve cancer-related fatigue in breast cancer patients. The combined effect size SMD = 0.59, 95% CI was [0.27, 0.92], p < 0.00001. Doing Tai Chi for over 40 minutes each time with an exercise cycle of ≤6 weeks can improve cancer-related fatigue in breast cancer patients more significantly. Sensitivity analysis shows that the combined effect results of the meta-analysis were relatively stable. Conclusion Mind-body exercise can effectively improve cancer-related fatigue in breast cancer patients.
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Yang B, Nie Q, Yang Y. The effects of mindfulness-based intervention on sleep disturbance and benzodiazepine hypnotics use in patients hospitalized with cancer: A systematic review and meta-analysis. J Psychosom Res 2021; 146:110483. [PMID: 33895429 DOI: 10.1016/j.jpsychores.2021.110483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/28/2022]
Abstract
Previous studies have reported discrepant outcomes for mindfulness-based intervention (MBI) to improve sleep quality or reduce the benzodiazepines (BZDs) use in cancer patients; therefore, a meta-analysis was required to examine the relationships. The MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials et al. were searched by independent reviewers from date of inception to January 2020 to examine the associations between MBI and sleep disturbance or BZDs use among cancer patients. Randomized controlled studies that reported the effect of MBI on sleep disturbance or BZDs use in cancer patients aged over 18 years were included. Standardized mean differences with 95% CIs were calculated to estimate effect size. If P ≥ 0.1, I2 < 50%, the fixed effect model was used for meta-analysis, while if P < 0.1, I2 ≥ 50%, the random effects model was used. Fourteen studies of 1659 participant were identified in the meta-analysis. Overall, sleep disturbance was significantly relieved in MBI group (SMD = 0.37, 95% CI 0.19 to 0.55, P < 0.001), and the effect could sustain to follow up duration (SMD = 0.35, 95% CI 0.02 to 0.69, P < 0.001). Only three studies reported that MBI could decrease the BZDs use in hospitalized cancer patients. Our findings indicate that MBI were effective in alleviating sleep disturbance in a short time, and may be associated with therapeutic benefits for BZDs use. Further randomized controlled studies are needed to examine the effectiveness of MBI for BZDs use in cancer patients.
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Affiliation(s)
- Bei Yang
- Department of obstetrics and gynecology intensive care unit Nursing, West China Second Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Qiao Nie
- Department of obstetrics and gynecology intensive care unit Nursing, West China Second Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Yi Yang
- Department of obstetrics and gynecology intensive care unit Nursing, West China Second Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
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Song J, Wang T, Wang Y, Li R, Niu S, Zhuo L, Guo Q, Li X. The Effectiveness of Yoga on Cancer-Related Fatigue: A Systematic Review and Meta-Analysis. Oncol Nurs Forum 2021; 48:207-228. [PMID: 33600394 DOI: 10.1188/21.onf.207-228] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION The aim of this article is to evaluate the effectiveness of yoga on cancer-related fatigue (CRF) in patients undergoing chemotherapy and/or radiation therapy. LITERATURE SEARCH Relevant English and Chinese articles were retrieved from medical databases and included in this analysis. Standardized critical appraisal instruments from the Joanna Briggs Institute were adopted for the quality assessment. DATA EVALUATION 16 randomized controlled trials met the inclusion criteria. SYNTHESIS Yoga interventions had a positive effect in reducing CRF among patients undergoing chemotherapy and/or radiation therapy, but the adherence to yoga was low. Mixed types of yoga, in addition to supervised and self-practicing strategies, were associated with increased patient adherence and improved CRF. IMPLICATIONS FOR PRACTICE Yoga appears to be a safe and effective exercise for the management of CRF during chemotherapy and/or radiation therapy; however, additional high-quality studies are needed to define an optimal yoga intervention strategy.
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Affiliation(s)
- Jihong Song
- Xi'an Jiaotong University Health Science Center
| | | | | | - Rong Li
- Qilu Hospital of Shandong University
| | | | | | - Qian Guo
- Xi'an Jiaotong University Health Science Center
| | - Xiaomei Li
- Xi'an Jiaotong University Health Science Center
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Hsueh EJ, Loh EW, Lin JJA, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer 2021; 28:264-276. [PMID: 33452652 DOI: 10.1007/s12282-020-01209-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Complications of breast cancer treatment can cause physical and psychosocial distress in patients. Yoga demonstrates substantial potential as a supportive therapy for patients with breast cancer. Our aim is to conduct a meta-analysis of randomized controlled trials to evaluate the effectiveness of yoga in enhancing the quality of life (QoL) of patients with breast cancer. METHODS We searched for studies published before March 2020 in the PubMed, Embase, and Cochrane Library databases. Individual effect sizes were standardized, and the pooled effect size was calculated using a random effect model. Measured outcomes included QoL, anxiety and depression, stress, fatigue, pain severity, and sleep quality. RESULTS In total, 26 trials involving 2069 patients were reviewed. Significant enhancement in QoL was observed immediately after the yoga intervention. The pooled mean differences in social (weighted mean difference [WMD]: 1.36, 95% confidence interval [CI] 0.12-2.61), emotional (WMD: 1.46, 95% CI 0.26-2.66), and functional well-being (WMD: 2.04, 95% CI 0.21-3.87) were significantly higher in the yoga group than in the control group. Patients practicing yoga exhibited significant improvements in physical well-being, mental well-being, and sleep quality as well as reductions in anxiety, depression, stress, fatigue, and pain severity after the intervention. CONCLUSIONS Yoga may enhance QoL in patients with breast cancer experiencing post-treatment complications. Therefore, we recommend yoga as a supportive therapy for patients with breast cancer to relieve post-treatment distress.
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Affiliation(s)
- Er-Jung Hsueh
- Cancer Center, Yuan's General Hospital, Kaohsiung, Taiwan
| | - El-Wui Loh
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Joyce Jui-An Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Ka-Wai Tam
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. .,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. .,Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan.
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Anand A, Ghani A, Sharma K, Kaur G, Khosla R, Devi C, Podder V, Sivapuram MS, Maity K, Kaur H. War-Related Mental Health Issues and Need for Yoga Intervention Studies: A Scoping Review. Int J Yoga 2021; 14:175-187. [PMID: 35017859 PMCID: PMC8691442 DOI: 10.4103/ijoy.ijoy_60_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/04/2022] Open
Abstract
Conflicts and humanitarian crises lead to serious mental health disorders, including depression, anxiety, stress, and cognitive decline. Exposure to these circumstances in early life can lead to the development of disorders such as mild cognitive impairment, dementia, and Alzheimer's disease (AD), for which no treatments are available. In this review, various research papers have been compiled to develop an understanding about mental health of population affected due to wars and conflicts and how stress and depression can accelerate the development of dementia and AD. Due to failure of drugs in the treatment of dementia and AD, yoga and mindfulness-based approach has been proposed for future investigations. Although studies have shown that yoga and mindfulness can be helpful in the management of stress, anxiety, depression, and posttraumatic stress disorder in the war-afflicted areas, limited mechanistic studies in yoga and mindfulness remain the chief cause precluding its clinical application in such warzones. The molecular studies in the field of yoga can be undertaken by targeting these warzones. This review provides a scientific evaluation of mind-body techniques as a justification for mental health rehabilitation in the war-afflicted zones in face of failed clinical trials for various drugs. This may help reduce the risk of developing dementia and AD in this susceptible population.
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Affiliation(s)
- Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Panjab University, Chandigarh, India,CCRYN Center for Mind Body Interventions through Yoga PGIMER, Chandigarh, India,Centre for Cognitive Sciences and Phenomenology, Panjab University, Chandigarh, India,Address for correspondence: Prof. Akshay Anand, Department of Neurology, Neuroscience Research Lab, Post Graduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
| | - Abdul Ghani
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kanupriya Sharma
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Panjab University, Chandigarh, India
| | - Gurkeerat Kaur
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Panjab University, Chandigarh, India
| | - Radhika Khosla
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Panjab University, Chandigarh, India
| | - Chandra Devi
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Panjab University, Chandigarh, India
| | - Vivek Podder
- Department of Internal Medicine, Kamineni Institute of Medical Sciences, Nalgonda, Telangana, India
| | - Madhava S. Sivapuram
- Department of Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, Andhra Pradesh, India
| | - Kalyan Maity
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Harmandeep Kaur
- Department of Physical Education, Panjab University, Chandigarh, India
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Takemura N, Cheung DST, Smith R, Deng W, Ho KY, Lin J, Kwok JYY, Lam TC, Lin CC. Effectiveness of aerobic exercise and mind-body exercise in cancer patients with poor sleep quality: A systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev 2020; 53:101334. [PMID: 32505970 DOI: 10.1016/j.smrv.2020.101334] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 02/02/2023]
Abstract
Exercise has promising effects on sleep disturbances and quality of life among cancer patients. Aerobic exercises (AE) and mind-body exercises (MBE) have different mechanisms for improving sleep, but whether they are effective remains unclear. This systematic review and meta-analysis is the first to examine the effectiveness of AE and MBE on sleep outcomes, specifically among cancer patients with sleep disturbances. A systematic search of several databases, from inception to January 2018, was conducted. The pooled effect sizes suggested that both AE (standardized mean difference (SMD) = 0.33, 95% confidence intervals (CI): 0.11, 0.54) and MBE (SMD = 0.18, 95% CI: 0.06, 0.30), improved sleep outcomes in cancer patients with poor sleep quality post-intervention. The effects remained significant after 3-6 months for AE, but not MBE. Due to the heterogeneity in AE, future studies should establish the optimal AE prescription. For MBE, future research should study essential components that make the intervention effect sustainable.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Robert Smith
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Wen Deng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Ka Yan Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jingxia Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong; School of Nursing, College of Nursing, Taipei Medical University, Taiwan.
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Ratcliff CG, Zepeda SG, Hall MH, Tullos EA, Fowler S, Chaoul A, Spelman A, Arun B, Cohen L. Patient characteristics associated with sleep disturbance in breast cancer survivors. Support Care Cancer 2020; 29:2601-2611. [PMID: 32964261 DOI: 10.1007/s00520-020-05777-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Disturbed sleep is common among breast cancer survivors. Identifying patients at risk for disturbed sleep and its sequelae will aid in improving screening and intervention strategies to improve sleep and cancer-related quality of life (QOL). METHODS Women with stages I-III breast cancer undergoing neoadjuvant or adjuvant chemotherapy (N = 415) reported subjectively assessed sleep quality (PSQI) and actigraphy-assessed wake after sleep onset (AAS-WASO), total sleep time (AAS-TST), and sleep efficiency (AAS-SE), sociodemographic, and clinical characteristics and completed questionnaires assessing physical and mental health QOL at study entry and 3, 6, 12, and 15 months later. RESULTS Being from a racially/ethnically underserved population was associated with poorer sleep in all indices (p's < .04). Lower income was associated with poorer subjective sleep and greater AAS-WASO (p's < .02). BMI was associated with lower AAS-SE (p < .001). Baseline subjective sleep complaints were positively associated with depression, fatigue, and health-related QOL and cancer-related symptoms across follow-up (p's < 0.05). Baseline AAS-WASO was positively associated with anxiety and negatively associated with physical health-related QOL at the 3-month follow-up (p's < .001). Baseline AAS-WASO and AAS-SE were associated with mental health-related QOL at the 6-month follow-up (p's < .05). CONCLUSIONS In keeping with previous health disparity research, racially/ethnically underserved populations, lower household income, and higher BMI were associated with increased risk for disturbed sleep. Sleep disturbance may have long-term effects on multiple aspects of QOL for women undergoing treatment for breast cancer. Results may inform strategies to identify patients at greatest risk for disturbed sleep and its sequelae.
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Affiliation(s)
- Chelsea G Ratcliff
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA. .,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Stephanie G Zepeda
- Departmnet of Psychology, Our Lady of the Lake University, The Woodlands, TX, USA
| | - Martica H Hall
- Department of Psychology, The University of Pittsburgh, Pittsburgh, PA, USA
| | - Emily A Tullos
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
| | - Shaelyn Fowler
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
| | | | - Amy Spelman
- Office of Protocol Research, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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Effects of Mind-Body Exercise in Cancer Survivors: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7607161. [PMID: 32952591 PMCID: PMC7487122 DOI: 10.1155/2020/7607161] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 08/11/2020] [Accepted: 08/26/2020] [Indexed: 12/11/2022]
Abstract
Objective Mind-body exercise may have potential benefits for cancer survivors according to previous studies. We performed a systematic review and meta-analysis to summarize the published evidence and evaluate the safety and efficacy of mind-body exercise on general quality of life (QOL) and symptom management in cancer survivors. Methods Four English language databases were systematically searched for existing randomized controlled trials (RCTs) of mind-body exercise in cancer survivors from database inception through October 23, 2019. Methodological quality was appraised with the Cochrane Risk of Bias tool. A meta-analysis of comparative effects was performed using the Review Manager v.5.3 software. Results Fifteen studies encompassing 1461 patients were included. Analysis results showed that mind-body exercise could have a statistically significant effect on the outcomes of physical fitness, fatigue, sleep quality, depression, anxiety, and BMI, while effects on general QOL and stress were not statistically significant (all p > 0.05). No serious adverse events were reported. Conclusions The current evidence demonstrates that mind-body exercise is relatively safe and modestly effective for symptom management in cancer survivors. Furthermore, randomized trials with larger sample sizes and of higher methodological quality are needed to confirm these results.
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Effects of a wearable technology-based physical activity intervention on sleep quality in breast cancer survivors: the ACTIVATE Trial. J Cancer Surviv 2020; 15:273-280. [PMID: 32875536 DOI: 10.1007/s11764-020-00930-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Physical activity interventions can improve sleep quality in breast cancer survivors. This paper examines the effects of the ACTIVATE Trial, a wearable-based physical activity intervention (Garmin Vivofit2® coupled with behavioral feedback, goal setting, and health coaching) on sleep outcomes. METHODS Post-primary treatment, inactive, postmenopausal breast cancer survivors were recruited and randomized to primary intervention or waitlist. Wrist-worn actigraphy (sleep onset latency, SOL; total sleep time, TST; sleep efficiency, SE; wake after sleep onset, WASO; and number of awakenings, NWAKE) and questionnaire-derived sleep measures (Pittsburgh Sleep Quality Index) were assessed at baseline (T1), 12 weeks (end of primary intervention and start of waitlist intervention, T2), and at 24 weeks (T3). RESULTS Eighty-three women (mean age = 62 years) were randomized; trial retention was 94% at T2 and 87% at T3. At T2, primary intervention participants had greater improvements in WASO (- 5.7 min, 95% CI - 11.7 to - 0.2) and NWAKE compared with the waitlist arm (- 2.0, 95% CI - 3.6 to - 0.4). At T3, within-group improvements were observed for SE (both groups), WASO (both groups), NWAKE (primary intervention group only), total PSQI score (primary intervention group), and sleep efficacy (primary intervention group). CONCLUSIONS The intervention reduced actigraphy-measured sleep disturbances. Within-group analyses suggest that improvements in sleep quality are sustained over a longer duration, and there may be similar benefits from an abridged intervention (wearable device only). Actigraphy-measured effects appeared stronger in participants who were poor sleepers at study entry. IMPLICATIONS FOR CANCER SURVIVORS Wearable technology can increase physical activity and improve sleep for breast cancer survivors.
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Ahn SJ, Kim JH, Chun M, Yoon WS, Rim CH, Yang DS, Lee JH, Kim K, Kong M, Kim S, Kim J, Park KR, Shin YJ, Ma SY, Jeong BK, Kim SS, Kim YB, Lee DS. Physical activity status in relation to quality of life and dietary habits in breast cancer survivors: subset analyses of KROG 14-09 nationwide questionnaire study. Qual Life Res 2020; 29:3353-3361. [PMID: 32705458 DOI: 10.1007/s11136-020-02585-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE We investigated the relationship of physical activity with dietary habits and quality of life (QoL) in breast cancer survivors in accordance with the recommendations of the American Cancer Society. METHODS Data of 928 breast cancer survivors were obtained from the KROG 14-09 study to measure QoL in early phase after adjuvant radiotherapy. According to the extent of physical activity, survivors were divided into four groups: inactivity (0-149 min/week, N = 144), regular activity (150-450 min/week, N = 309), moderate activity (451-900 min/week, N = 229), and marked activity (901-1800 min/week, N = 164) excluding hyperactivity (> 1800 min/week, N = 82) as it is a difficult condition to recommend to survivors. Global physical activity questionnaire, 5-dimensional questionnaire by EuroQoL (EQ-5D-3L), QoL Questionnaire-breast cancer (QLQ-BR23) from EORTC, and dietary habits were surveyed. A linear-to-linear association test for EQ-5D-3L and Kruskal-Wallis analysis for QLQ-BR23 and dietary habit were conducted. RESULTS Overall, 15.5% respondents (144/928) were classified as physically inactive. The trends of frequent intake of fruits (p = 0.001) and vegetable (p = 0.005) and reluctance toward fatty food (p < 0.001) were observed in physically active groups. Mobility (p = 0.021) and anxiety (p = 0.030) of EQ-5D-3L, and systemic therapy side effect (p = 0.027) and future perspective (p = 0.008) of QLQ-BR23 were better in physically active groups besides body image (p = 0.003) for the survivors with breast-conserving surgery. However, moderate and marked activities did not further improve QoL than regular activity. CONCLUSION Physicians and care-givers have to pay attention to inactive survivors to boost their physical activity, thereby facilitating a better QoL and dietary habit.
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Affiliation(s)
- Sung-Ja Ahn
- Radiation Oncology, Chonnam National Univiersity Hwasun Hospital, Hwasun, Jeollanam-do, Republic of Korea
| | - Jin Hee Kim
- Radiation Oncology, Dongsan Medical Center, Keimyung University, Daegu, Republic of Korea
| | - Mison Chun
- Radiation Oncology, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Won Sup Yoon
- Department of Radiation Oncology, Ansan Hospital, Korea University, 123 Jeokgeum-ro, Danwon-gu, Ansan, 15355, Gyeonggi-do, Republic of Korea.
| | - Chai Hong Rim
- Department of Radiation Oncology, Ansan Hospital, Korea University, 123 Jeokgeum-ro, Danwon-gu, Ansan, 15355, Gyeonggi-do, Republic of Korea
| | - Dae Sik Yang
- Radiation Oncology, Guro Hospital, Korea University, Seoul, Republic of Korea
| | - Jong-Hoon Lee
- Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyubo Kim
- Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea
- Radiation Oncology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Moonkyoo Kong
- Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Suzy Kim
- Radiation Oncology, Boramae Medical Center, Seoul National University, Seoul, Republic of Korea
| | - Juree Kim
- Radiation Oncology, Ilsancha Hospital, Cha Medical Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Kyung Ran Park
- Radiation Oncology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Young-Joo Shin
- Radiation Oncology, Sanggye Paik Hospital, Inje University, Seoul, Republic of Korea
| | - Sun Young Ma
- Radiation Oncology, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Bae-Kwon Jeong
- Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National Univeristy Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Su Ssan Kim
- Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Bae Kim
- Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Soo Lee
- Radiation Oncology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Gyeonggi-do, Republic of Korea
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Yang M, Chen S, Wan Y, Hu X. Psychometric properties of the Multidimensional Fatigue Inventory-10 in breast cancer patients. Contemp Nurse 2020; 56:90-100. [PMID: 32567976 DOI: 10.1080/10376178.2020.1742178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives: Fatigue is very common in patients with breast cancer. Developing appropriate measurement tools to assess fatigue is critical. The aim of this study is to evaluate the psychometric properties of the Chinese version of Multidimensional Fatigue Inventory-10 (MFI-10) in patients with breast cancer. Design: A cross-sectional validation study. Methods: The MFI-10 was translated in Chinese using a combination of expert assessment and cross-cultural adaptations. The Chinese version of MFI-10 was then administered to 402 patients with breast cancer from three affiliated hospitals. Results: Principal component analysis extracted three factors that explained 78.197% of the total variance. The internal consistency reliability coefficient of MFI-10 scale was 0.864. The results of the confirmatory factor analysis showed a good fit to data (χ 2 = 51.638, df = 35, NFI = 0.943, CFI = 0.981, AGFI = 0.924, TLI = 0.975 and RMSEA = 0.049), which represents good construct validity. Conclusions: The MFI-10 is a reliable and valid tool to measure fatigue in Chinese patients with breast cancer.
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Affiliation(s)
- Manli Yang
- School of Nursing, University of South China, Hengyang, Hunan 421001, People's Republic of China
| | - Shi Chen
- Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang School of Medicine, University of South China, Hengyang, Hunan 421001, People's Republic of China
| | - Yanping Wan
- School of Nursing, University of South China, Hengyang, Hunan 421001, People's Republic of China
| | - Xiaoping Hu
- Department of Nursing, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421002, People's Republic of China
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