Effectiveness of Yoga Interventions in Breast Cancer-Related lymphedema: A systematic review

The Effect of Exercise on Reducing Lymphedema Severity in Breast Cancer Survivors

Exercise has been repeatedly shown to be safe and beneficial for cancer survivors. However, there is no normative guideline for exercise prescription, and it is still under exploration. Therefore, this literature review aims to provide some advice for the formulation of exercise prescriptions for patients with breast cancer-related lymphedema (BCRL) from the perspective of reducing lymphedema severity. A review of relevant studies published before November 2023 was conducted using three scientific databases: PubMed, Embase, and Scopus. A total of 2696 articles were found. Eventually, 13 studies fulfilled the inclusion criteria and were included in this literature review. We concluded that daily, or nearly daily, exercise at home can be recommended. Moreover, reduced lymphedema severity may not be maintained after ceasing the exercise program, so exercise should be a lifelong practice.

Assessment of the Impact of Yoga on the Quality of Life of Breast Cancer Patients: A Systematic Literature Review

Patients with breast cancer (BC) typically undergo multimodal treatment over an extended period and deal with a wide range of symptoms that severely impair their overall quality of life (QoL) and prognosis. Concern about the health-related QoL of persons diagnosed with cancer as well as the calibre of care they receive is increasing every day. This study aims to assess the impact of yoga on the QoL of patients with BC. PRISMA guidelines served as the foundation for the methodologies used to identify the studies. A total of 480 records were found using PubMed/Medline and Google Scholar databases. A final set of 22 studies was assessed for the work based on the exclusion and inclusion criteria and study eligibility. Yoga has a moderate effect on BC patients. Pranayama has been shown to have a positive effect on improving the QoL. The study observed that yoga was more useful during actual treatment for cancer than after completion. The various randomised controlled trials (RCT) and meta-analysis included in this study believe that yoga has a positive effect. However, the outcomes of various studies do not support this point completely. According to the safety information that is currently available, yoga is not associated with severe adverse outcomes. There is no concrete evidence that establishes the role of yoga as one of the alternative medicines in treating BC patients after chemotherapy. More clinical trials are needed to investigate the advantages of yoga in the overall improvement of QoL in BC patients.

Effectiveness of physical exercise programmes in reducing complications associated with secondary lymphoedema to breast cancer: a protocol for an overview of systematic reviews

INTRODUCTION

Breast cancer-related lymphoedema (BCRL) is one of the most underestimated and debilitating complications associated with the treatment that women with breast cancer receive. Several systematic reviews (SRs) of different physical exercise programmes have been published, presenting disperse and contradictory clinical results. Therefore, there is a need for access to the best available and summarised evidence to capture and evaluate all the physical exercise programmes that focus on reducing BCRL.

OBJECTIVE

To evaluate the effectiveness of different physical exercise programmes in reducing the volume of lymphoedema, pain intensity and improving quality of life.

METHOD AND ANALYSIS

The protocol of this overview is reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, and its methodology is based on Cochrane Handbook for Systematic Reviews of Interventions. Only those SRs involving physical exercise by patients with BCRL will be included, whether on its own or combined with other exercises or other physical therapy interventions.The outcomes of interest to be considered will be lymphoedema volume, quality of life, pain intensity, grip strength, range of motion, upper limb function and any adverse event. The MEDLINE/PubMed, Lilacs, Cochrane Library, PEDro and Embase databases will be searched for reports published from database inception to April 2023.Two researchers will perform study selection, data extraction and risk of bias assessment independently. Any discrepancy will be resolved by consensus, or ultimately, by a third-party reviewer. We will use Grading of Recommendations Assessment, Development and Evaluation System to assess the overall quality of the body of evidence.

ETHICS AND DISSEMINATION

The results of this overview will be published in peer-reviewed scholarly journals and the scientific dissemination will take place in national or international conferences. This study does not require approval from an ethics committee, as it does not directly collect information from patients.

PROSPERO REGISTRATION NUMBER

CRD42022334433.

Methodological consideration for a physical activity intervention in breast cancer population: An umbrella review

Objective

Breast cancer patients and survivors are increasing in the last years such as their mean age. A feasible and useful complementary intervention to improve physical and psychological health, and decrease some disease symptoms seems to be physical activity. Consequently, this umbrella review wanted to analyze the protocols of different physical activity interventions and to eventually propose a standard operating procedure for possible exercise training in breast cancer patients.Design, Data sources, Eligibility criteria. The electronic databases PubMed, Scopus, and Web of Science were searched till 25 March 2022 to detect all systematic review and meta-analysis of randomized controlled trials on this topic. The studies were analyzed narratively and evaluated with a scale to assess their quality.

Results

The studies presented heterogeneity in their population included in terms of disease stage and treatments, intervention protocols and outcomes evaluated. This made difficult to synthesize the findings.

Conclusion

It was not possible to propose a standard operating procedure but some indications were proposed to provide feedback for future studies. Ideally, an intervention should be composed of combined training (aerobic and resistance training) with a component of a mindfulness intervention, with an intensity from moderate to high, and 3 times a week. The intervention should be supervised in the first period and then it could be home-based. Exercise training should be personalized to the patients treated.

Managing Lymphedema, Increasing Range of Motion, and Quality of Life through Yoga Therapy among Breast Cancer Survivors: A Systematic Review

Lymphedema is a common complication of breast cancer treatment. Yoga is a nonconventional and noninvasive intervention that is reported to show beneficial effects in patients with breast cancer-related lymphedema (BCRL). This study attempted to systematically review the effect of yoga therapy on managing lymphedema, increasing the range of motion (ROM), and quality of life (QOL) among breast cancer survivors. The review search included studies from electronic bibliographic databases, namely Medline (PubMed), Embase, and Google Scholar till June 2019. Studies which assessed the outcome variables such as QOL and management of lymphedema or related physical symptoms as effect of yoga intervention were considered for review. Two authors individually reviewed, selected according to Cochrane guidelines, and extracted the articles using Covidence software. Screening process of this review resulted in a total of seven studies. The different styles of yoga employed in the studies were Iyengar yoga (n = 2), Satyananda yoga (n = 2), Hatha yoga (n = 2), and Ashtanga yoga (n = 1). The length of intervention and post intervention analysis ranged from 8 weeks to 12 months. Four studies included home practice sessions. QOL, ROM, and musculoskeletal symptoms showed improvement in all the studies. Yoga could be a safe and feasible exercise intervention for BCRL patients. Evidence generated from these studies was of moderate strength. Further long-term clinical trials with large sample size are essential for the development and standardization of yoga intervention guidelines for BCRL patients.

The effects of yoga on breast-cancer-related lymphedema: a systematic review

Purpose

Breast-cancer-related lymphedema (BCRL) is a negative condition that affects biopsychosocial aspects of patients treated with breast cancer. Yoga has been reported as one of the complementary and alternative approaches used by patients diagnosed with BCRL. The aim of this systematic review was to explore the effectiveness of yoga on BCRL.

Design/methodology/approach

A systematic literature was performed by searching existing papers from the electronic scientific databases. Five papers were exclusively examined. Four studies were conducted in women with BCRL, and one study was conducted with women at risk for BCRL.

Findings

Four types of yoga were evaluated in relationship with BCRL, namely: the Satyananda Yoga tradition, the modified Hatha yoga, the aerobic yoga training and the Ashtanga-based yoga practices. Four of five included studies reported that decrease in arm volume was not reported for all yoga-type interventions. One study showed no significant evidence that yoga was associated with limb volume change in women at risk of BCRL. Similarly, three studies reported that the change-of-arm-volume measures were not significantly different between the yoga and the control groups or in the same group before and after the yoga program. One quasi-experimental study reported arm volume significantly decreased after attending the yoga program.

Originality/value

This review reported the importance of being aware that yoga is not shown to be an effective strategy for managing or preventing BCRL. However, quality of research methodology, small sample sizes and the limited number of related studies should be acknowledged. Until more rigorous studies are performed, yoga may continue to be used as a complement to traditional therapy under the supervision of certified trainers.