Effect of Dance Movement Therapy on Cancer-Related Fatigue in Breast Cancer Patients Undergoing Radiation Therapy: A Pre-post Intervention Study

Free Dance Proves to be Effective in Depressive Symptoms, Anxiety and Stress in Women Undergoing Breast Cancer Surgery: A Randomized Clinical Trial

Objective: To analyze the effects of 12 weeks of free dancing compared to the control group and the reference group without breast cancer, on depressive symptoms, anxiety and stress in women after breast cancer surgery and to verify the association between the variables. Methods: Randomized clinical trial, comprising women after breast cancer surgery (57.7 ± 9.0 years) and women without breast cancer (51.5 ± 10.8 years), divided into 3 groups; (a) received the free dance intervention (n = 11); (b) control group with breast cancer (n = 11) maintained their routine activities, and (c) control group without breast cancer (n = 12) who were matched by age and could not perform physical exercise during the study period. The dance intervention lasted 12 weeks, with 60-minute sessions, held twice a week. The evaluated outcomes were: depressive symptoms (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), and stress (Perceived Stress Scale). Results: There was statistically significant improvement in the intragroup for free dance in depressive symptoms (P = .025), anxiety (P = .009) and stress (P = .050). No significant intragroup differences were found in the control group I and control group II, as well as intergroup differences. In the association of variables, the healthy reference group worsened in the simple analysis, for anxiety (P ≤ .001) and stress (P = .040), and worsened in the adjusted analysis, also for anxiety (P ≤ .001) and stress (P = .025). Conclusion: Free dancing had positive effects on depressive symptoms, anxiety and stress in women after breast cancer surgery. After verifying the association of the variables, it was noticed a worsening of the variables in the CGII. Clinical registry: Brazilian Registry of Clinical Trials (ReBEC) (no. 0RBR-772ktp).

Effectiveness of dance movement therapy and dance movement interventions on cancer patients' health-related outcomes: a systematic review and meta-analysis

OBJECTIVES

This review examined the effectiveness of using dance movement therapy (DMT) and dance movement interventions (DMIs) with cancer and palliative care patients.

METHODS

A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched from inception to July 9, 2022, without limits on year or age. Searching was updated on July 10, 2023. The risk of bias was assessed by the Cochrane (RoB 2) and ROBINS-I tools. Meta-analyses were conducted to pool estimates of the effects of DMT and DMI on patients' health-related outcomes. A narrative synthesis of outcomes was performed where meta-analysis was not appropriate.

RESULTS

Among a total of 16 studies included in this review, nine were randomized controlled trials and seven were non-randomized trials, with a total of 893 participants. Only six of these studies were fully or partially described as true DMTs (some with less clarity than others), whereas the majority (n = 10) were DMIs with unclear therapeutic alignment. Most studies focused on female patients with breast cancer. Cancer patients undergoing palliative care received little attention. The overall risk of bias from the evaluated studies was high. Meta-analysis of two trials revealed that DMTs had no effect on QOL in cancer patients (SMD - 0.09, 95% CI - 0.21-0.40, P = 0.54), while narrative analysis and non-randomized trials showed no overall effect of DMTs on anxiety, depression, body image, self-esteem, or sleep disturbance but significant positive effects on perceived stress, pain severity, and pain interference. DMIs had significant positive effects on cancer patients' depression (SMD - 0.53, 95% CI - 0.93 to - 0.14, P = 0.008) and fatigue (SMD - 0.42, 95% CI - 0.70 to - 0.14, P = 0.003). DMI trials synthesized narratively showed an effect on patients' body image, self-esteem, physical function, right and left handgrip strength, life satisfaction, and the mental component of QOL.

CONCLUSION

Both DMT and DMIs had promising effects on several health outcomes, but results were inconsistent, and the evidence was weak. The reviewed studies' low evidence quality and small sample sizes affected the findings' robustness and reliability. Large-scale, high-quality randomized controlled trials with sufficient sample sizes, and clear and veracious DMT and DMI protocols and data are required to provide more credible research evidence and influence practice.