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Tanay MAL, Armes J, Moss-Morris R, Rafferty AM, Robert G. A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms. J Cancer Surviv 2023; 17:254-277. [PMID: 33710510 PMCID: PMC9971149 DOI: 10.1007/s11764-021-00997-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/19/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) can result in functional difficulties. Pharmacological interventions used to prevent CIPN either show low efficacy or lack evidence to support their use and to date, duloxetine remains the only recommended treatment for painful CIPN. Non-pharmacological interventions such as exercise and behavioural interventions for CIPN exist. PURPOSE The aims were to (1) identify and appraise evidence on existing behavioural and exercise interventions focussed on preventing or managing CIPN symptoms, (2) describe psychological mechanisms of action by which interventions influenced CIPN symptoms, (3) determine the underpinning conceptual models that describe how an intervention may create behaviour change, (4) identify treatment components of each intervention and contextual factors, (5) determine the nature and extent of patient and clinician involvement in developing existing interventions and (6) summarise the relative efficacy or effectiveness of interventions to lessen CIPN symptoms and to improve quality of life, balance and muscle strength. METHODS A systematic search of Ovid Medline, Cochrane Library, EMBASE, PsycINFO, Health Management Information Consortium, Global Health and CINAHL was performed to identify articles published between January 2000 to May 2020, followed by OpenGrey search and hand-searching of relevant journals. Studies that explored behavioural and/or exercise interventions designed to prevent or improve symptoms of CIPN in adults who had received or were receiving neurotoxic chemotherapy for any type of cancer, irrespective of when delivered within the cancer pathway were included. RESULTS Nineteen randomised controlled trials and quasi-experimental studies which explored behavioural (n=6) and exercise (n=13) interventions were included. Four studies were rated as methodologically strong, ten were moderate and five were weak. Ten exercise and two behavioural interventions, including those that improved CIPN knowledge and self-management resources and facilitated symptom self-reporting, led to reduced CIPN symptoms during and/or after chemotherapy treatment. CONCLUSIONS The extent of potential benefits from the interventions was difficult to judge, due to study limitations. Future interventions should incorporate a clear theoretical framework and involve patients and clinicians in the development process. IMPLICATIONS FOR CANCER SURVIVORS Our findings show exercise interventions have beneficial effects on CIPN symptoms although higher quality research is warranted. Behavioural interventions that increase patient's CIPN knowledge, improve self-management capacity and enable timely access to symptom management led to reduced CIPN symptoms.
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Affiliation(s)
- Mary Anne Lagmay Tanay
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Rona Moss-Morris
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Salwana Kamsan S, Kaur Ajit Singh D, Pin Tan M, Kumar S. Systematic review on the contents and parameters of self-management education programs in older adults with knee osteoarthritis. Australas J Ageing 2021; 40:e1-e12. [PMID: 32881241 DOI: 10.1111/ajag.12844] [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] [Received: 03/12/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of this review was to determine the contents and parameters of self-management education programs (SMEPs) for older adults with knee osteoarthritis (KOA). METHODS A systematic electronic literature search (Scopus, MEDLINE, ProQuest, CINAHL, Cochrane and a grey literature specific site through Google Scholar) was undertaken between March and May 2018 (search updated in June 2019). Studies were selected based on predetermined criteria. Data relating to the contents and parameters of the SMEP were extracted and collated. RESULTS A total of 11 experimental studies met the inclusion criteria. Overall quality of the selected studies was good. The contents used for SMEP in older adults with KOA were information and management of KOA, healthy lifestyle and additional management strategies for KOA. The parameters used were face-to-face sessions led by health professionals and were chiefly group-based. CONCLUSION This review comprehensively summarises the structure of multifaceted SMEP for people with KOA, which could be used to inform clinical practice and future research.
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Affiliation(s)
- Siti Salwana Kamsan
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Physical Rehabilitation Sciences, Faculty of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia
| | - Saravana Kumar
- School of Health Sciences, City East Campus, University of South Australia, Adelaide, South Australia, Australia
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Ormel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME. Predictors of adherence to exercise interventions during and after cancer treatment: A systematic review. Psychooncology 2018; 27:713-724. [PMID: 29247584 PMCID: PMC5887924 DOI: 10.1002/pon.4612] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/25/2017] [Accepted: 12/05/2017] [Indexed: 11/18/2022]
Abstract
Objective Exercise interventions benefit cancer patients. However, only low numbers of patients adhere to these interventions. This review aimed to identify predictors of exercise intervention adherence in patients with cancer, during and after multimodality cancer treatment. Methods A literature search was performed using electronic databases (PubMed, Embase, and Cochrane) to identify relevant papers published before February 1, 2017. Papers reporting randomized controlled trials, conducted in adult cancer patients who participated in an exercise intervention during and/or after multimodality cancer treatment, and providing outcome of factors predicting exercise adherence were included. Papers were assessed for methodological quality by using the Physiotherapy Evidence Database scale. Results The search identified 720 potentially relevant papers, of which 15 fulfilled the eligibility criteria. In these 15 studies, 2279 patients were included and 1383 of these patients were randomized to an exercise intervention. During cancer treatment, the factors predicting exercise adherence were as follows: location of the rehabilitation center, extensive exercise history, high motivation for exercise, and fewer exercise limitations. After cancer treatment, factors that predicted adherence were as follows: less extensive surgery, low alcohol consumption, high previous exercise adherence, family support, feedback by trainers, and knowledge and skills of exercise. Methodological quality of the included papers was rated “high”. Conclusions The most prominent predictors of adherence to exercise interventions were location of the rehabilitation center, extensive exercise history, high motivation for exercise, and fewer exercise limitations. To increase the number of cancer patients who will benefit, these results should be considered into the development and implementation of future exercise interventions.
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Affiliation(s)
- H L Ormel
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G G F van der Schoot
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - W J Sluiter
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M Jalving
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J A Gietema
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A M E Walenkamp
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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D’Souza V, Daudt H, Kazanjian A. Survivorship care plans for breast cancer patients: understanding the quality of the available evidence. Curr Oncol 2017; 24:e446-e465. [PMID: 29270054 PMCID: PMC5736484 DOI: 10.3747/co.24.3632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
AIM The overall goal of the present study was to contribute to consistency in the provincial approach to survivorship care planning through knowledge synthesis and exchange. Our review focused on the research concerning the physical and emotional challenges of breast cancer (bca) patients and survivors and the effects of the interventions that have been used for lessening those challenges. METHODS The psychosocial topics identified in bca survivorship care plans created by two different initiatives in our province provided the platform for our search criteria: quality of life (qol), sexual function, fatigue, and lifestyle behaviours. We conducted an umbrella review to retrieve the best possible evidence, and only reviews investigating the intended outcomes in bca survivors and having moderate-to-high methodologic quality scores were included. RESULTS Of 486 reports retrieved, 51 reviews met the inclusion criteria and form part of the synthesis. Our results indicate that bca patients and survivors experience numerous physical and emotional challenges and that interventions such as physical activity, psychoeducation, yoga, and mindfulness-based stress reduction are beneficial in alleviating those challenges. CONCLUSIONS Our study findings support the existing survivorship care plans in our province with respect to the physical and emotional challenges that bca survivors often face. However, the literature concerning cancer risks specific to bca survivors is scant. Although systematic reviews are considered to be the "gold standard" in knowledge synthesis, our findings suggest that much remains to be done in the area of synthesis research to better guide practice in cancer survivorship.
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Affiliation(s)
- V. D’Souza
- BC Cancer Agency–Vancouver Island Centre, Victoria, BC
| | - H. Daudt
- BC Cancer Agency–Vancouver Island Centre, Victoria, BC
| | - A. Kazanjian
- BC Cancer Agency–Vancouver Island Centre, Victoria, BC
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC
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Segal R, Zwaal C, Green E, Tomasone JR, Loblaw A, Petrella T. Exercise for people with cancer: a systematic review. ACTA ACUST UNITED AC 2017; 24:e290-e315. [PMID: 28874900 DOI: 10.3747/co.24.3619] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND This systematic review was completed by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario's Program in Evidence-Based Care (pebc). It provides background and guidance for clinicians with respect to exercise for people living with cancer in active and post treatment. It focuses on the benefits of specific types of exercise, pre-screening requirements for new referrals, safety concerns, and delivery models. METHODS Using the pebc's standardized approach, medline and embase were systematically searched for existing guidelines, systematic reviews, and primary literature. RESULTS The search identified two guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present review provides conclusions about the duration, frequency, and intensity of exercise appropriate for people living with cancer. CONCLUSIONS The evidence shows that exercise is safe and provides benefit in quality of life and in muscular and aerobic fitness for people with cancer both during and after treatment. The evidence is sufficient to support the promotion of exercise for adults with cancer, and some evidence supports the promotion of exercise in group or supervised settings and for a long period of time to improve quality of life and muscular and aerobic fitness. Exercise at moderate intensities could also be sustainable for longer periods and could encourage exercise to be continued over an individual's lifetime. It is important that a pre-screening assessment be conducted to evaluate the effects of disease, treatments, and comorbidities.
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Affiliation(s)
- R Segal
- Medical Oncology, The Ottawa Hospital, Ottawa
| | - C Zwaal
- McMaster University, Hamilton
| | - E Green
- Canadian Partnership Against Cancer, Toronto
| | | | - A Loblaw
- Odette Cancer Research Program, Sunnybrook Hospital, Toronto; and
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Pudkasam S, Tangalakis K, Chinlumprasert N, Apostolopoulos V, Stojanovska L. Breast cancer and exercise: The role of adiposity and immune markers. Maturitas 2017; 105:16-22. [PMID: 28515012 DOI: 10.1016/j.maturitas.2017.04.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 04/25/2017] [Indexed: 02/06/2023]
Abstract
Currently, breast cancer accounts for a quarter of all cancers and 15% of cancer-specific deaths amongst females. The global occurrence of breast cancer has increased in the last decade whilst the mortality rate has decreased. Exercise can be beneficial to breast cancer patients through changes in adiposity and immune responses. Even though there is some evidence supporting the improvement of fat metabolism and immune function after an exercise program in breast cancer, randomized controlled studies are limited and require further comprehensive analysis in this population group. Herein, we identify the known effects of exercise programs on adiposity and immunological markers which can improve breast cancer outcomes.
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Affiliation(s)
- Supa Pudkasam
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14426, Melbourne VIC 8001 Australia; Faculty of Nursing Science, Assumption University, Bangkok, Thailand
| | - Kathy Tangalakis
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14426, Melbourne VIC 8001 Australia
| | | | - Vasso Apostolopoulos
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14426, Melbourne VIC 8001 Australia.
| | - Lily Stojanovska
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14426, Melbourne VIC 8001 Australia.
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Segal R, Zwaal C, Green E, Tomasone JR, Loblaw A, Petrella T. Exercise for people with cancer: a clinical practice guideline. ACTA ACUST UNITED AC 2017; 24:40-46. [PMID: 28270724 DOI: 10.3747/co.24.3376] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario's Program in Evidence-Based Care (pebc). The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer, focusing on the benefits of specific types of exercise, recommendations about screening requirements for new referrals, and safety concerns. METHODS Consistent with the pebc's standardized approach, a systematic search was conducted for existing guidelines, and systematic literature searches were performed in medline and embase for both systematic reviews and primary literature. Content and methodology experts performed an internal review, which was followed by an external review by targeted experts and intended users. RESULTS The search identified three guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present guideline provides recommendations for the duration, frequency, and intensity of exercise appropriate for people living with cancer. It also provides recommendations for pre-exercise assessment, safety concerns, and delivery models. CONCLUSIONS There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment, and that it does not cause harm. The present guideline is intended to support the Canadian Society for Exercise Physiology's Canadian physical activity guidelines. The recommendations are intended for clinicians and institutions treating cancer patients in Ontario, and for policymakers and program planners involved in the delivery of exercise programs for cancer patients.
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Affiliation(s)
- R Segal
- Medical Oncology, The Ottawa Hospital, Ottawa
| | - C Zwaal
- McMaster University, Hamilton
| | - E Green
- Canadian Partnership Against Cancer, Toronto
| | | | - A Loblaw
- Evaluative Clinical Sciences, Odette Cancer Research Program, Sunnybrook Hospital, Toronto; and
| | - T Petrella
- ncic Melanoma Clinical Trials Group, Sunnybrook Hospital, Toronto, ON
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Smith-Turchyn J, Richardson J, Tozer R, McNeely M, Thabane L. Physical Activity and Breast Cancer: A Qualitative Study on the Barriers to and Facilitators of Exercise Promotion from the Perspective of Health Care Professionals. Physiother Can 2016; 68:383-390. [PMID: 27904238 DOI: 10.3138/ptc.2015-84] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: We determined the barriers to and facilitators of exercise promotion by health care professionals (HCPs) for women with breast cancer (BC). Methods: The study was a qualitative descriptive study. Semi-structured interviews were conducted with HCPs who treat individuals with BC in Ontario. The interviews were recorded and transcribed. Two reviewers independently used content analysis to determine codes and themes developed in the interviews. NVivo 10 was used during the coding process. Results: A total of 24 HCPs participated in this study. The data from the interviews were grouped into five main categories: (1) institutional barriers, (2) HCP barriers, (3) perceived patient barriers, (4) facilitators (resource and service needs), and (5) patient characteristics. A graphic depiction of the interaction was created for these categories and how they affect the promotion of exercise for women with BC. Conclusions: Participants in this study identified several barriers to exercise promotion at the institutional, professional, and patient levels and suggested several strategies to facilitate exercise promotion. These findings can inform future exercise interventions to increase exercise adherence and engagement in this population.
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Affiliation(s)
| | | | | | - Margaret McNeely
- School of Rehabilitation Medicine, University of Alberta, Edmonton, Alta
| | - Lehana Thabane
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ont
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Perraton L, Machotka Z, Gibbs C, Mahar C, Kennedy K, Grimmer K. Evidence-based Practice Intentions and Long-term Behaviours of Physiotherapy Graduates Following an Intensive Education Programme. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2016; 22. [PMID: 26916106 DOI: 10.1002/pri.1666] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 07/21/2015] [Accepted: 08/28/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Assisting physiotherapists to implement research evidence into clinical practice is essential to ensure the quality of practice and encourage lifelong learning and professional progression. However, many physiotherapists report barriers to implementing research, and there is little evidence regarding the sustainability of intended evidence-based practice (EBP) behaviours following EBP education programmes. This paper reports on intended and actual long-term EBP behaviours of physiotherapy students who completed an intensive EBP training programme embedded within a post-graduate coursework programme. METHODS An intensive 3-week course in quantitative health research methods and EBP was delivered annually from 2007 to 2014 as part of the programme to national and international students. Following the course, students were asked about their intention of using evidence to inform their future clinical practice. An online survey was used to evaluate EBP behaviours of graduates. RESULTS Of a possible total of 202 students, contact details for 193 students were sourced, and 65 students responded to the survey (34% response rate). At course completion, 174 students (86%) indicated that they intended to use research to guide their clinical decisions at least once a week. At follow-up, most graduates reported frequently using research to inform their clinical practice; indicated by a mean score of 6.5 (±1.9) from a possible range of 0 (not at all) to 10 (all the time). On average, students reported spending 2.2 (±2.2) hours accessing and reading research evidence per week. The most common barriers to implementing evidence were lack of time, limited access to evidence sources and a perceived lack of generalizability of research findings to specific patient groups. CONCLUSION Graduates of an intensive EBP training programme embedded within an existing post-graduate physiotherapy programme regularly implemented EBP in clinical practice. Barriers to evidence implementation were time, access to research and perceived lack of generalizability of research findings. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- L Perraton
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia.,School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Z Machotka
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia
| | - C Gibbs
- Library, University of South Australia, Adelaide, Australia
| | - C Mahar
- Library, University of South Australia, Adelaide, Australia
| | - K Kennedy
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia
| | - K Grimmer
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia
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"We're All in the Same Boat": A Review of the Benefits of Dragon Boat Racing for Women Living with Breast Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:167651. [PMID: 22811743 PMCID: PMC3395246 DOI: 10.1155/2012/167651] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 05/05/2012] [Accepted: 05/06/2012] [Indexed: 11/23/2022]
Abstract
This narrative review summarizes findings from quantitative and qualitative research literature that has been published over the past 15 years since an initial, community-based pilot study first challenged the long-held medical belief that vigorous, upper-body exercise would lead to lymphedema in women who were at risk due to treatments for breast cancer. Dragon boat racing originated in China more than 2000 years ago and has become a popular recreational and competitive support around the world. From the advent of the world's first breast cancer survivor dragon boat team, Abreast in a Boat launched in Vancouver, British Columbia, in 1996, there are now more than 140 breast cancer survivor dragon boat teams paddling and competing in 12 different countries. The wealth of quantitative and qualitative research that has ensued since that pilot study further supports the initial hypothesis that resistance exercise, for example, dragon boat paddling, is not only safe for women recovering from conventional breast cancer therapies but also shows that dragon boating has been embraced as a complementary exercise therapy by the cancer survivors participating in this magical sport.
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