Aerobic and resistance exercise improve patient-reported sleep quality and is associated with cardiometabolic biomarkers in Hispanic and non-Hispanic breast cancer survivors who are overweight or obese: results from a secondary analysis

Efficacy of supervised exercise on sleep of women who survived breast cancer: a systematic review with meta-analysis

PURPOSE

To analyze the efficacy of supervised exercise (SE) compared with control protocols on sleep parameters of women who survived breast cancer.

METHODS

This systematic review with meta-analysis searched studies using the following electronic databases: PubMed, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Library, and EMBASE. The PEDro scale assessed the bias risk, and the study protocol was registered in the PROSPERO (no. CRD42023420894).

RESULTS

Of 3,566 identified studies, 13 randomized clinical trials involving 847 women diagnosed with breast cancer were included. Interventions consisted of SE in an outpatient setting (62%) or combined protocols with supervised and home exercises. Most interventions (85%) used multicomponent protocols with aerobic and resistance exercises. Usual care and health education were the most reported controls. SE decreased the sleep disturbance score (- 31.61 [95% confidence interval =  - 39.40 to - 23.83]) of the European Organisation for Research and Treatment of Cancer quality of life questionnaire and daytime dysfunction score (- 0.41 [95% confidence interval =  - 0.73 to - 0.09]) of the Pittsburgh Sleep Quality Index (PSQI). Also, SE presented a tendency to improve the self-reported sleep quality score of the PSQI (p = 0.06).

CONCLUSION

SE increased the subjective sleep quality and immobility time and decreased sleep disturbance and daytime dysfunction symptoms in women who survived breast cancer. Most SE protocols were multicomponent, with aerobic and resistance exercises ranging from moderate to high intensity.

IMPLICATIONS FOR CANCER SURVIVORS

Supervised exercise may improve sleep quality and reduce symptoms of sleep disorders, contributing to survival outcomes.

Randomized controlled trial investigating the effect of a Baduanjin exercise plus nutrition programme on cancer-related fatigue in elderly lung cancer patients receiving chemotherapy

OBJECTIVE

The purpose of this study was to evaluate the benefits of the Baduanjin exercise and nutrition intervention on Cancer-related fatigue (CRF) in elderly lung cancer patients undergoing chemotherapy.

METHODS

96 elderly patients suffering from lung cancer and undergoing chemotherapy were enlisted and randomly assigned to the control group, the exercise group, and the exercise plus nutrition group. Primary and secondary endpoints were assessed at baseline, week 6, and week 12, including Brief Fatigue Inventory (BFI) scores, Pittsburgh Sleep Quality Index (PSQI) scores, grip strength, and gait speed.

RESULTS

Significant beneficial intervention effects were found for CRF, sleep quality, grip strength, and gait speed in the exercise plus nutrition group at 6 and 12 weeks after the treatment. The exercise group improved CRF, grip strength, and gait speed at 12 weeks. No beneficial effects on the outcomes were noticed in the control group.

CONCLUSIONS

Baduanjin exercise may help alleviate CRF in elderly lung cancer patients undergoing chemotherapy. Moreover, when combined with nutrition intervention, it appears to enhance their sleep quality and physical function more substantially than Baduanjin alone.

The Interplay between nighttime/midday sleep duration and the number of new-onset chronic diseases: A decade-long prospective study in China

OBJECTIVE

To investigate the interplay between individual nighttime and midday sleep duration and the number of new-onset chronic diseases and determine the optimal sleep duration associated with lowest number of new-onset chronic diseases.

METHODS

We used data from the China Health and Retirement Longitudinal Study (CHARLS) covering a decade and involving 10,828 participants. A random intercept cross-lagged model was used to explore the interplay between nighttime/midday sleep durations and new-onset chronic diseases at both the within-individual and between-individual levels, followed by a dose-response analysis at the between-individual level to determine the optimal sleep duration. New-onset chronic diseases include 14 types of self-reported diseases diagnosed by doctors.

RESULTS

Within-individual analysis revealed that increased nighttime/midday sleep duration led to a higher number of new-onset chronic diseases, and an increased number of new-onset chronic diseases resulted in decreased nighttime sleep duration. Between nighttime and midday sleep, one type of sleep duration increase was likely to lead to an increase in another type. Between-individual analysis found a nonlinear relationship between the number of new-onset chronic diseases and nighttime sleep duration, identifying the optimal nighttime sleep duration as 7.46 h.

CONCLUSIONS

These findings elucidate the interplay between sleep duration and number of new-onset chronic diseases and underscore the need for public awareness and comprehensive interventions. Future studies should focus on refining sleep monitoring and exploring the sleep-chronic diseases nexus in greater depth.

Effects of exercise on sleep quality in general population: Meta-analysis and systematic review

PURPOSE

Sleep is the foundation of human physiological health and psychological health, as well as one of the basic needs for human survival. Sleep quality problems are prevalent in the population, and poor sleep quality is often closely related to the occurrence of many diseases, which seriously affects the quality of life and may even result in a shortened lifespan, so that improving sleep health has become a real problem that needs to be solved urgently. Exercise, as an important non-pharmacological tool, has been widely used for sleep quality enhancement, while the efficacy of exercise on subjective and objective sleep with respect to individual sleep quality remains controversial. Therefore, the aim of this meta-analysis was to compare the effects of exercise on subjective sleep quality and objective sleep efficiency in a non-athlete population, and to further rank the effectiveness of exercise types to provide appropriate means of exercise to improve sleep.

METHODS

This study was evaluated by literature search in five databases, PubMed, Embase, Web of Science, Cochrane, and EBSCO, and paired meta-analysis and network meta-analysis were performed using Review Manager 5.3 and stata16.0.

RESULTS

A total of 7494 studies were retrieved, and 81 eligible randomized controlled trials involving 6193 subjects were finally included. The primary outcome metrics included subjective sleep quality (PSQI), and the secondary outcome was objective sleep efficiency (SE), of which 65 reported PSQI and 23 reported SE. The results of paired meta-analysis showed that exercise significantly decreased PSQI [MD = -1.77, (95 % CI = -2.28,-1.25),P < 0.05] and increased SE [MD = 4.81, (95 % CI = 2.89,6.73),P < 0.05]. The results of the network meta-analysis showed that body and mind exercise [MD = -2.28, (95 % CI = -3.19,-1.36),P < 0.05, SUCRA = 85.6] may be the best exercise to improve PSQI, and aerobic exercise [MD = 5.02, (95 % CI = 2.52,7.52),P < 0.05, SUCRA = 75.1] is most likely to be the best type of exercise to improve SE. In regression analyses, there was a moderating effect of exercise cycle (β = -0.25 [0.40, 0.46], SE = 0.10 [P = 0.015, R2 = 0.24]) and age (β = -0.20 [-0.04, -0.01, SE = -2.06 [P = 0.039,R2 = 0.16]) as moderators of objective sleep efficiency.

CONCLUSION

Exercise is effective in improving both subjective and objective sleep quality. Body and mind exercise, aerobic exercise, and aerobic combined with resistance exercise may be the preferred way to improve sleep, and the longer the exercise cycle, the more obvious the improvement in sleep effect, the improvement effect will gradually decrease with age.

Efficacy of Concurrent Training in Breast Cancer Survivors: A Systematic Review and Meta-Analysis of Physical, Psychological, and Biomarker Variables

BACKGROUND

Breast cancer treatments often cause serious side effects, but physical exercise has shown the potential to improve both the physical and psychological health outcomes of survivors. This review and meta-analysis aimed to synthesize and analyze the scientific evidence on the effectiveness of concurrent training on physical, psychological, and biomarkers variables on breast cancer survivors.; Methods: A systematic review and meta-analysis was registered in PROSPERO (CRD42024571851). The ISI Web of Science, PubMed, and Scopus databases were searched. The methodological quality of all the included studies was assessed using the Cochrane risk of bias tool. This review included 14 articles that met the inclusion criteria on the effect of concurrent training on breast cancer survivors.

RESULTS

The results of the meta-analysis on body composition revealed a significant overall effect on body mass (effect size [ES] = -2.23; 95% CI: -4.16, -0.29) and body mass index (ES = -0.66; 95% CI: -1.32, 0.01). In contrast, no significant differences were shown in the % fat mass (ES = -2.63; 95% CI: -5.58, 0.33). Strength significantly improved after simultaneous training (ES = 4.93; 95% CI: 1.94, 7.92). In addition, cardiorespiratory fitness (maximum oxygen consumption) showed significant improvements after simultaneous training (ES = 3.03; 95% CI: 1.88, 4.19).

CONCLUSIONS

The research shows that concurrent training, including strength and aerobic exercises, promotes significant improvements in body mass, body mass index, muscle strength, and cardiorespiratory fitness. However, the effectiveness of the training depends on the intensity, duration and frequency of the exercise, as well as the individualization of the programs.

Creatine Improves Total Sleep Duration Following Resistance Training Days versus Non-Resistance Training Days among Naturally Menstruating Females

Females historically experience sleep disturbances and overall poor sleep compared to males. Creatine has been proposed to impact sleep; however, the effects are not well known. The purpose of this study was to examine the effects of creatine supplementation on sleep among naturally menstruating females. Twenty-one participants completed a double-blind, randomized controlled trial in which they consumed 5 g creatine + 5 g maltodextrin or placebo, 10 g maltodextrin, daily for 6 weeks. Participants completed resistance training 2x/week using the TONAL® (Tonal Systems Inc., San Francisco, CA, USA) at-home gym. Pre- and post-testing assessed body composition, Pittsburgh Sleep Quality Index (PSQI), dietary intake, and muscular strength. Sleep was assessed nightly using an ŌURA® (Oulu, Finland) ring. Compared to the placebo group, those consuming creatine experienced significant increases in total sleep on training days (p = 0.013). No significant changes in chronic sleep and PSQI (pre-post) were observed. There was a significant increase in TONAL® strength score over time (p < 0.001), with no between-group differences. Participants reduced their total calorie (kcal) (p = 0.039), protein (g/kg) (p = 0.009), carbohydrate (g/kg) (p = 0.023), and fat (g) (p = 0.036) intake over time. Creatine supplementation increases sleep duration on resistance training days in naturally menstruating females.

Effect of music therapy combined with aerobic exercise on sleep quality among breast cancer patients undergoing chemotherapy after a radical mastectomy: a randomized controlled trial

PURPOSE

We aimed to study the effect of music therapy combined with aerobic exercise on the sleep quality of patients undergoing chemotherapy after a radical mastectomy.

METHODS

A randomized controlled trial was conducted at the Breast Disease Diagnosis and Treatment Center, Shaanxi Province Tumor Hospital, from July 2017 to June 2019. 110 female breast cancer patients who underwent a radical mastectomy were recruited and randomly allocated into an intervention group or a control group. The intervention group completed music therapy combined with aerobic exercise from the first to the sixth admission to the hospital for chemotherapy, while the control group received only routine nursing care. The sleep quality of these patients was measured using the Pittsburgh Sleep Quality Index (PSQI). A linear mixed model was used to adjust the PSQI of patients after controlling for other confounding factors.

RESULTS

The mean sleep quality score of the breast cancer patients who received chemotherapy after a radical mastectomy (baseline) was 8.86 ± 2.34. The intervention group had a significantly lower mean global PSQI score than the control group from the first test to the third test, with an adjusted mean difference of -1.05 (95%CI: -1.86, -0.24; P = 0.01), -2.89 (95%CI: -3.70, -2.08; P < 0.001) and - 4.84 (95%CI: -5.65, -4.03; P < 0.001), respectively. A change in the global PSQI score from baseline for the intervention group was from 0.55 (95%CI: -0.24, 1.34; P = 0.171) at the first test to 2.75 (95%CI: 1.96, 3.53; P < 0.001) at the last test, and for the control group was from - 0.51 (95%CI: -1.31, 0.29; P = 0.213 at the first test to -2.10 (95%CI: -2.91, -1.30; P < 0.001) at the last test.

CONCLUSIONS

An intervention of music therapy combined with aerobic exercise can significantly improve the sleep quality of female breast cancer patients undergoing chemotherapy after a radical mastectomy, and this intervention continuously improves many aspects of sleep reactivity.

CLINICAL TRIAL REGISTRATION

This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100042975, 02/02/2021).

Lifestyle Behaviors and Health-Related Quality of Life in Cancer Survivors: A Latent Class Analysis

Healthy lifestyle behaviors can improve health-related quality of life (HRQOL) in cancer survivors; but the combination of behaviors most important for HRQOL is not known. This study investigated the patterns of lifestyle behaviors among cancer survivors and differences in HRQOL between behavioral classes. Cancer survivors (n = 2,463) were invited to participate in a cross-sectional survey. Participants (N = 591) were predominately female (63%) and non-Hispanic White (90%). Survey items included self-reported physical activity, diet, smoking, sleep, HRQOL, and demographics. Behavioral classes were estimated by latent class analysis. Differences between classes were assessed by latent class regression. Compared with the "healthy lifestyles" class (higher probabilities of meeting aerobic/strength-based activity guidelines, high fruit/vegetable intake, and no sleep problems; 11% of sample), the "sleep and diet problems with inconsistent physical activity" class (higher probabilities of not meeting strength-based guidelines, low fruit/vegetable intake, some sleep problems; marginally higher probability of meeting aerobic guidelines; 41%) had poorer general and physical HRQOL. The "poor physical activity and diet" class (higher probabilities of not meeting aerobic/strength-based guidelines, low fruit/vegetable intake, and some sleep problems; 48%) had poorer general, physical, and mental HRQOL. Few participants exhibited healthy lifestyle patterns associated with HRQOL. The findings provide opportunities to develop differentiated multiple behavior-change interventions, targeted to two common patterns of behavior. A large subgroup of cancer survivors was susceptible to suboptimal physical activity and diet, warranting interventions exclusively targeting these behaviors. Another subgroup was susceptible to suboptimal physical activity, diet, and sleep, indicating interventions for this group should include strategies targeting these three behaviors.

Role of exercise in reducing the risk of cardiovascular diseases associated with sleep disorders

Cardiovascular diseases are the leading cause of death among urban and rural residents and have become a major global public health problem. The prevention and control of cardiovascular disease risk factors is crucial for preventing, stabilizing, and even reversing cardiovascular disease. Studies have found that certain sleep disorders are directly related to cardiovascular disease and may be induced through pathways such as endothelial dysfunction, dysregulation of autonomic homeostasis, inflammatory response, and metabolic dysfunction. Exercise helps improve sleep disorders and thus reduce the risk of cardiovascular disease, and has irreplaceable advantages over pharmacological treatments for improving sleep. Different types of sleep disorders should be adjusted by factors such as exercise mode, intensity, and duration of exercise. A good sleep state further reduces the risk of cardiovascular disease. Discussing the effect of exercise on the improvement of the risk of cardiovascular disease associated with sleep disorders, and elaborating the mechanism of action of exercise in reducing the risk of cardiovascular disease from the perspective of sleep, can lay a foundation for the treatment of sleep disorders by exercise and propose new directions for reducing cardiovascular disease risk.

Effects of resistance training on sleep quality and disorders among individuals diagnosed with cancer: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological strategies such as exercise interventions may be considered to counteract this phenomenon. The literature supports the beneficial effects of aerobic training (AT), while evidence on resistance training (RT) is scarce. Accordingly, our systematic review aims to investigate the potential novel effect of RT on sleep outcomes in cancer survivors.

METHODS

The literature search was conducted on MEDLINE (Pubmed), Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases, including only randomized controlled trials (RCTs). The screening procedure was conducted using the web-based software COVIDENCE. Sleep outcomes assessed through self-reported questionnaires or objective sleep measurements were extracted from RCTs recruiting cancer survivors of any age and gender, on or off treatment. The risk of bias (RoB) for each study was assessed using the Cochrane RoB 2 tool for RCTs. Meta-analytic syntheses were performed on sleep quality and insomnia.

RESULTS

A total of 21 studies were included in the review. Considering the mean percentage differences of all studies combined, promising positive results were found after combined aerobic and resistance exercise program (COMB) for sleep quality (-19%) and sleep disturbance (-17.3%). The meta-analysis results showed significant improvement for both sleep quality and insomnia (d = 0.28, SE: 0.11, Z = 2.51, p < 0.01, 95% CI: 0.07-0.49 and d = 0.43, SE: 0.20, Z = 2.18, p = 0.029, 95% CI: 0.07-0.49, respectively).

CONCLUSION

RT interventions of 60 minutes per session, performed 2-3 times a week for 12 weeks, with exercise intensity ranging from 60% to 80% of one-repetition maximum can be administered to cancer survivors, aiming to improve sleep outcomes.

Associations between sleep problems and cardiometabolic risk in maintenance hemodialysis patients: A multicenter study

The incidence of cardiovascular disease is increasing around the world, and it is one of the main causes of death in chronic kidney diseases patients. It is urgent to early identify the factors of cardiometabolic risk. Sleep problems have been recognized as a risk factor for cardiometabolic risk in both healthy people and chronic patients. However, the relationship between sleep problems and cardiometabolic risk has not been clearly explored in hemodialysis patients. This study aimed to investigate the relationship between sleep problems and cardiometabolic risk in 3025 hemodialysis patients by a multicenter study. After adjusting for confounders, binary logistic regression models showed that hemodialysis patients reported sleep duration greater than 7 h were more likely to be with hypertension, hyperglycemia, hypertriglyceridemia, and hypercholesterolemia. Patients reported sleep duration less than 7 h were more likely to be with hypertriglyceridemia and hypercholesterolemia, but the risks of hyperglycemia and Low HDL-cholesterol were decreased. Poor sleep quality was negatively correlated to low HDL cholesterol and hypertriglyceridemia. Moreover, gender-based differences were explained.

Metabolic underpinnings of cancer-related fatigue

Cancer-related fatigue (CRF) is one of the most prevalent and detrimental complications of cancer. Emerging evidence suggests that obesity and insulin resistance are associated with CRF occurrence and severity in cancer patients and survivors. In this narrative review, we analyzed recent studies including both preclinical and clinical research on the relationship between obesity and/or insulin resistance and CRF. We also describe potential mechanisms for these relationships, though with the caveat that because the mechanisms underlying CRF are incompletely understood, the mechanisms mediating the association between obesity/insulin resistance and CRF are similarly incompletely delineated. The data suggest that, in addition to their effects to worsen CRF by directly promoting tumor growth and metastasis, obesity and insulin resistance may also contribute to CRF by inducing chronic inflammation, neuroendocrinological disturbance, and metabolic alterations. Furthermore, studies suggest that patients with obesity and insulin resistance experience more cancer-induced pain and are at more risk of emotional and behavioral disruptions correlated with CRF. However, other studies implied a potentially paradoxical impact of obesity and insulin resistance to reduce CRF symptoms. Despite the need for further investigation utilizing interventions to directly elucidate the mechanisms of cancer-related fatigue, current evidence demonstrates a correlation between obesity and/or insulin resistance and CRF, and suggests potential therapeutics for CRF by targeting obesity and/or obesity-related mediators.

Physical Activity, Insulin Resistance and Cancer: A Systematic Review

INTRODUCTION

Insulin resistance (IR), a key aspect of type 2 diabetes and a defining characteristic of obesity and its associated conditions, emerges as a mechanistic pathway potentially implicated in cancer pathophysiology. This presents an appealing intervention target for cancer patients. The objective of this study is to conduct a systematic review, examining the scientific evidence regarding the impact of physical activity on modifying insulin resistance in individuals with cancer.

METHODS

The selection criteria were specific: only randomized controlled clinical trials published in the last 13 years and written in English or Spanish were included. The databases utilized for the search included PubMed, Scopus, Cochrane Library, EBSCO, and WEB OF SCIENCE. The protocol for this review was duly registered in the International Register of Systematic Reviews (CRD42023435002). The final search was conducted on 14 May 2023.

RESULTS

The outcomes were assessed using the tool proposed by the Cochrane Handbook to evaluate the risk of bias in the included studies. Among the 12 studies incorporated, 8 demonstrated a low risk of bias, two had an unclear risk of bias, and the remaining two showed a high risk of bias. The variety of exercise types used across all studies was extensive, making definitive conclusions challenging. Physical activity was linked to enhanced insulin sensitivity in seven studies, while five studies showed no significant changes in insulin resistance between the intervention and control groups. Importantly, none of the interventions employed in the included studies exhibited adverse effects on the study participants.

CONCLUSIONS

The role of exercise as a medicine against insulin resistance has been evidenced in many different studies, mostly related to obesity and cardiovascular diseases. Engaging in physical activity could be a healthy option to combat the effects of insulin resistance in cancer patients, although evidence is weak and limited, according to the results of our systemic review. We further found that literature is lacking at the level of optimal doses, timing, and type of exercise. More studies are needed with more defined PA programs in type and length.

Quality-of-life among women with breast cancer: application of the international classification of functioning, disability and health model

Background

This study aimed to identify the factors that influence Breast Cancer (BC) women's quality of life (QoL) based on the International Classification of Functioning, Disability and Health (ICF) framework.

Method

A cross-sectional study was conducted among 188 women with BC. The dependent variable, QoL, was measured using the Quality of Life Index (QLI-c). The independent variables were measured using the following Arabic-validated questionnaires: Pittsburgh Sleep Quality Index (PSQI), Female Sexual Function Index (FSFI), Modified Fatigue Impact Scale (MFIS), Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ).

Results

There was a significant positive correlation between monthly income (r = 0.17, p = 0.016) and QoL, and significant negative correlation between the stage of disease (r = -0.221, p = 0.002) and duration of first diagnosis (r = -0.280, p = 0.004) with QoL. Poor sleep quality, sexual dysfunction, fatigue, depression, and anxiety had significant negative correlations with QoL (p < 0.01). Multiple regression analysis revealed that among the various factors that might affect QoL, sexual dysfunction, poor sleep quality, depression, and anxiety were significant predictors of QoL (p ≤ 0.05).

Conclusion

The ICF provided an excellent framework to explore the factors influencing QoL among women with BC. This study has given evidence for the relationship of demographic, clinical, and body functional factors with QoL among women with BC. Interestingly, sexual dysfunction, poor sleep quality, depression, and anxiety factors are predictors of QoL. Awareness of these factors that predict QoL will guide healthcare professionals to improve the health and QoL of BC women.

Exercise may not just be good for sleep; It can also help lower cardiovascular event risk

Cardiovascular diseases (CVD) stand at the forefront of global mortality, presenting an immense and urgent public health challenge on a global scale. Effectively addressing the associated risk factors is pivotal in not only preventing but also stabilizing and potentially reversing the progression of these conditions. Emerging research illuminates a compelling correlation between sleep disorders and CVD. Clinically, individuals afflicted with existing CVD or those possessing risk factors frequently grapple with sleep disturbances, exacerbating their conditions, particularly in severe cases where disease progression is accelerated. Even among ostensibly healthy individuals, chronic sleep deprivation exacts a toll on cardiovascular function. The strategic implementation of exercise interventions emerges as a potent tool in enhancing sleep quality, surpassing the efficacy of pharmaceutical treatments. Furthermore, the maintenance of optimal sleep patterns significantly contributes to lowering the risk of cardiovascular diseases. This comprehensive review delves deeply into the intricate relationship between exercise and the amelioration of cardiovascular disease risk associated with sleep. Moreover, it meticulously elucidates the complex mechanisms through which exercise operates, effectively reducing cardiovascular disease risk from the unique perspective of sleep science.

Updated systematic review of the effects of exercise on understudied health outcomes in cancer survivors

INTRODUCTION

The American College of Sports Medicine provided guidelines for exercise prescriptions in cancer survivors for specific cancer- and treatment-related health outcomes. However, there was insufficient evidence to generate exercise prescriptions for 10 health outcomes of cancer treatment. We sought to update the state of evidence.

METHODS

We conducted a systematic review of these 10 understudied health outcomes (bone health, sleep, cardiovascular function, chemotherapy-induced peripheral neuropathy (CIPN), cognitive function, falls and balance, nausea, pain, sexual function, and treatment tolerance) and provided an update of evidence.

RESULTS

While the evidence base for each outcome has increased, there remains insufficient evidence to generate exercise prescriptions. Common limitations observed across outcomes included: variability in type and quality of outcome measurement tools, variability in definitions of the health outcomes, a lack of phase III trials, and a majority of trials investigating breast or prostate cancer survivors only.

CONCLUSION

We identified progress in the field of exercise oncology for several understudied cancer- and treatment-related health outcomes. However, we were not able to generate exercise prescriptions due to continued insufficient evidence base. More work is needed to prescribe exercise as medicine for these understudied health outcomes, and our review highlights several strategies to aid in research acceleration within these areas of exercise oncology.

Aerobic exercise combined with resistance exercise training improves cardiopulmonary function and blood lipid of patients with breast cancer: A systematic review and meta-analysis

BACKGROUND

To compare the therapy effects following the aerobic exercise combined with resistance exercise training (AET + RET) and common care treatment for patients with breast cancer.

METHODS

Articles about the effects of AET + RET on the breast cancer patients in 4 online databases were searched. The differences of cardiopulmonary function, blood pressure, blood lipid, and body mass index between the AET + RET treatment and the usual care treatment were compared.

RESULTS

Totally, 8 articles were involved into the meta-analysis. The qualities of the 8 articles were medium. The combination results showed that AET + RET increased the VO2peak (weighted mean difference (WMD) = 2.93 mL/kg/min; 95% CI: 0.38, 5.49; P = .02) and VO2max (WMD = 6.98 mL/kg/min; 95% CI: 2.04, 15.92; P = .01), demonstrating its improving effects in cardiopulmonary function. Moreover, the AET + RET decreased the TG (WMD = -57.95 mg/dL; 95% CI: -112.25, -3.64; P = .04), demonstrating its improving effects in blood lipid. While or the HRpeak, RERpeak, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, and body mass index, there are no significant differences between the AET + RET and usual care treatment (P < .05).

CONCLUSION

Our results demonstrated that AET + RET can significantly improve the cardiopulmonary function and blood lipid for breast cancer patients.

Comparing the effect of emotional freedom technique on sleep quality and happiness of women undergoing breast cancer surgery in military and nonmilitary families: A quasi-experimental multicenter study

PURPOSE

The aim of this study was to compare the effect of emotional freedom technique (EFT) on sleep quality and happiness of women who underwent breast cancer surgery and lived in military and nonmilitary families.

DESIGN AND METHODS

The patients were randomly divided into four groups of military intervention (n = 34), nonmilitary intervention (n = 33), military control (n = 31), and nonmilitary control (n = 35). Data were collected using demographic information form, Pittsburgh Sleep Quality Index, and Oxford Happiness Questionnaire.

FINDINGS

The mean scores of sleep quality and happiness in military and nonmilitary intervention groups improved significantly immediately and 1 month after the intervention compared to control groups (p < 0.001). However, there was no statistically significant difference between the military and nonmilitary intervention groups regarding the mean scores of sleep quality and happiness before, immediately, and 1 month after the intervention (p > 0.05).

PRACTICE IMPLICATIONS

Given the efficacy of EFT in improving sleep quality and happiness, it is recommended that this technique be taught to nurses to implement in the entire process of providing nursing care to cancer patients.

Reducing Metabolic Dysregulation in Obese Latina and/or Hispanic Breast Cancer Survivors Using Physical Activity (ROSA) Trial: A Study Protocol

Background

Latina and Hispanic breast cancer survivors (LHBCS) are at increased risk for long-term complications and poorer metabolic health, including metabolic dysregulation (MetD) before and following breast cancer diagnosis. MetD can increase risk of cancer recurrence, death, and comorbid conditions by increasing inflammation and cancer cell proliferation. While exercise improves physical fitness and metabolic outcomes in breast cancer survivors, there is a lack of studies including underrepresented and disadvantaged minority groups such as LHBCS.

Methods

Our 12-month randomized (exercise or attention control) controlled trial (the ROSA trial) aims to utilize a progressive combined aerobic and resistance exercise program to improve MetD, insulin resistance, and visceral adiposity among obese LHBCS. We aim to recruit 160 women with Stage I-III breast cancer who are sedentary, centrally obese, and have completed treatment (e.g., surgery, radiation, chemotherapy) prior to enrollment. Participants randomized to the exercise group receive 16-weeks of virtually supervised aerobic and resistance training, followed by 16-weeks of unsupervised home-based aerobic and resistance exercise, and 16-weeks of follow-up. The attention control group receive a 12-month home-based stretching program. Primary and secondary outcomes are measured every 4-weeks during study visits.

Discussion

The ROSA trial is the first exercise oncology trial targeting high-risk sedentary, obese LHBCS to improve MetD-related outcomes. Results of this trial will help illuminate how exercise impacts health-related outcomes, survivorship, and recurrence, and inform future exercise oncology guidelines to reduce health disparities among minority cancer survivors.

Prevalence and Influencing Factors of Irritable Bowel Syndrome in Medical Staff: A Meta-Analysis

BACKGROUND

Irritable bowel syndrome (IBS) is a common functional digestive tract disease worldwide, with a high prevalence among medical staff. The purpose of this study is to systematically evaluate the prevalence and influencing factors of IBS in medical staff.

METHODS

We searched English online databases, including PubMed, The Cochrane Library, Web of Science, Embase, and EBSCOhost. The retrieval time was from database establishment to May of 2021. We screened the literature according to inclusion and exclusion criteria, extracted the relevant information, and evaluated the research quality. A meta-analysis was performed using the Stata 16.0 and Review Manager 5.4.1 software.

RESULTS

A total of 11 English studies from seven countries were included in this study, including 3,360 medical staff. The results of the meta-analysis showed an overall prevalence of IBS among medical staff of 16% [95%CI (0.15 ~ 0.17)] and that shift work (OR 2.27)), poor sleep quality (OR 4.27), and female gender (OR 2.29) are the major influencing factors of medical staff suffering from IBS.

CONCLUSIONS

The prevalence of irritable bowel syndrome among medical staff is relatively high, and hospitals can start by looking for targeted interventions from the highly related factors of IBS among medical staff such as shift work patterns, females, and poor sleep quality.

Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating

Background: Cancer and its therapy is commonly associated with a variety of side effects that impact eating behaviors that reduce nutritional intake. This review will outline potential causes of chemotherapy and radiation damage as well as approaches for the amelioration of the side effects of cancer during therapy. Methods: Information for clinicians, patients, and their caregivers about toxicity mitigation including nausea reduction, damage to epithelial structures such as skin and mucosa, organ toxicity, and education is reviewed. Results: How to anticipate, reduce, and prevent some toxicities encountered during chemotherapy and radiation is detailed with the goal to improve eating behaviors. Strategies for health care professionals, caregivers, and patients to consider include (a) the reduction in nausea and vomiting, (b) decreasing damage to the mucosa, (c) avoiding a catabolic state and muscle wasting (sarcopenia), and (d) developing therapeutic alliances with patients, caregivers, and oncologists. Conclusions: Although the reduction of side effects involves anticipatory guidance and proactive team effort (e.g., forward observation, electronic interactions, patient reported outcomes), toxicity reduction can be satisfying for not only the patient, but everyone involved in cancer care.