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Ibañez GE, Ahmed S, Hu N, Larkey L, Fennie KP, Lembo M, Huertas L. Acceptability and Feasibility of a Tai Chi/Qigong Intervention for Older People Living With HIV. AIDS Behav 2024; 28:1291-1300. [PMID: 37597056 DOI: 10.1007/s10461-023-04158-1] [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: 08/10/2023] [Indexed: 08/21/2023]
Abstract
Tai chi/qigong (TCQ) is a low impact, meditative movement with breathwork that may benefit people with HIV (PWH) over 50 years old. This study is a feasibility clinical trial of a remote TCQ intervention for older PWH. Participants (n = 48) were recruited via clinic sites and social media and randomized to a TCQ, sham qigong, or wait-list control group. The 12-week intervention included fourteen 45-60-minute sessions. Acceptability (satisfaction, attitudes, practice, attendance) and feasibility (retention rate, adverse events, remote delivery) data were surveyed. Overall retention rate was 72.9%, but 81.2% for the TCQ group. Most TCQ participants attended at least 10 sessions (62.5%) and were practicing TCQ after 2 weeks (72.7%). Over 92% of TCQ participants reported satisfaction and positive attitudes and preferred remote versus in person delivery (63.6%). Two mild intervention related adverse events occurred. Findings suggest that a remote TCQ intervention is acceptable, feasible, and safe among older PWH.
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Affiliation(s)
- Gladys E Ibañez
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA.
- Natural Sciences Division, New College of Florida, Sarasota, Fl, 34243, USA.
| | - Shyfuddin Ahmed
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Nan Hu
- Department of Biostatistics, Florida International University, Miami, Fl, 33199, USA
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA
| | - Kristopher P Fennie
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Micaela Lembo
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
| | - Laura Huertas
- Department of Epidemiology, Florida International University, Miami, Fl, 33199, USA
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Wang F, Syed Ali SKB. Health benefits of short Taichi Qigong exercise (STQE) to University Students' core strength, lower limb explosive force, cardiopulmonary endurance, and anxiety: A Quasi experiment research. Medicine (Baltimore) 2024; 103:e37566. [PMID: 38552100 PMCID: PMC10977524 DOI: 10.1097/md.0000000000037566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/20/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND College students' physical fitness has declined over the past decades. Taichi Qigong exercise offers numerous health benefits and could serve as a suitable option for them. Traditional programs, however, are time-consuming and necessitate long-term commitments. Therefore, a more cost-effective intervention is needed. METHODS The study enrolled a total of 31 students who actively participated in a 5-week STQE program, consisting of three 60-minute sessions per week. Physical and mental health assessments included the Plank test, vital capacity measurement, 1000/800 m run test, standing jump, and the Zung Self-Rating Scale. Data analysis was performed using SPSS. RESULTS Following the STQE intervention, participants showed improvement in core strength (28.1 seconds in the Plank test, P = .025) and lower limb explosive force (6.52 cm in the standing jump test, P = .011), accompanied by a decrease in anxiety levels (a reduction of 3.41 in the Zung Self-Rating Scale, P = .039). However, no significant improvements were observed in cardiopulmonary endurance, as evidenced by a non-significant increase of 237.84 mL in vital capacity (P = .134) and a non-significant reduction of 1.6 seconds in the 1000/800 m run test (P = .764). CONCLUSION The study suggests that the STQE program effectively improves core strength, lower limb explosive force, and reduces anxiety levels among university students.
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Affiliation(s)
- Feng Wang
- Department of Education Foundations and Humanities, Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
| | - Syed Kamaruzaman Bin Syed Ali
- Department of Education Foundations and Humanities, Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
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Low SLK, Ho GF, Liu B, Koh ES, Fei Y, Teo CS, Zhu X. Exploring Guolin Qigong (Mind-Body Exercise) for Improving Cancer Related Fatigue in Cancer Survivors: A Mixed Method Randomized Controlled Trial Protocol. Integr Cancer Ther 2024; 23:15347354241252698. [PMID: 38757745 PMCID: PMC11102686 DOI: 10.1177/15347354241252698] [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] [Received: 08/05/2023] [Revised: 04/05/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Cancer-related fatigue and its associated symptoms of sleep disorder and depression are prevalent in cancer survivors especially among breast, lung, and colorectal cancer survivors. While there is no gold standard for treating cancer-related fatigue currently, studies of mind-body exercises such as Qigong have reported promise in reducing symptoms. This study was designed to evaluate the feasibility and effect of Guolin Qigong on cancer-related fatigue and other symptoms in breast, lung and colorectal cancer survivors while exploring their perceptions and experiences of Guolin Qigong intervention. METHODS This is an open-label randomized controlled trial with 60 participants divided into 2 study groups in a 1:1 ratio. The intervention group will receive 12 weeks of Guolin Qigong intervention with a 4-week follow-up while control will receive usual care under waitlist. The primary outcome will be feasibility measured based on recruitment and retention rates, class attendance, home practice adherence, nature, and quantum of missing data as well as safety. The secondary subjective outcomes of fatigue, sleep quality and depression will be measured at Week-1 (baseline), Week-6 (mid-intervention), Week-12 (post-intervention), and Week-16 (4 weeks post-intervention) while an objective 24-hour urine cortisol will be measured at Week-1 (baseline) and Week-12 (post-intervention). We will conduct a semi-structured interview individually with participants within 3 months after Week-16 (4 weeks post-intervention) to obtain a more comprehensive view of practice adherence. DISCUSSION This is the first mixed-method study to investigate the feasibility and effect of Guolin Qigong on breast, lung, and colorectal cancer survivors to provide a comprehensive understanding of Guolin Qigong's intervention impact and participants' perspectives. The interdisciplinary collaboration between Western Medicine and Chinese Medicine expertise of this study ensures robust study design, enhanced participant care, rigorous data analysis, and meaningful interpretation of results. This innovative research contributes to the field of oncology and may guide future evidence-based mind-body interventions to improve cancer survivorship. TRIAL REGISTRATION This study has been registered with ANZCTR (ACTRN12622000688785p), was approved by Medical Research Ethic Committee of University Malaya Medical Centre (MREC ID NO: 2022323-11092) and recognized by Western Sydney University Human Research Ethics Committee (RH15124).
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Affiliation(s)
- Sara L. K. Low
- Western Sydney University, Penrith South, NSW, Australia
| | - Gwo Fuang Ho
- University Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Eng-Siew Koh
- University of New South Wales, Liverpool, NSW, Australia
| | - Yutong Fei
- Beijing University of Chinese Medicine, Beijing, China
| | | | - Xiaoshu Zhu
- Western Sydney University, Penrith South, NSW, Australia
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James DL, Larkey LK, Evans B, Sebren A, Goldsmith K, Ahlich E, Hawley NA, Kechter A, Sears DD. Mechanisms of improved body composition among perimenopausal women practicing Meditative Movement: a proposed biobehavioral model. Menopause 2023; 30:1114-1123. [PMID: 37788427 DOI: 10.1097/gme.0000000000002262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES Weight gain and unfavorable body composition are prevalent among midlife/older women throughout menopause. These shifts may negatively impact health, well-being, and longevity. Efforts to attenuate weight and body composition changes are traditionally driven by manipulation of diet and/or exercise; however, sustained results are limited, possibly because the full spectrum of biobehavioral systems is not addressed by diet and exercise alone. We propose a biobehavioral model detailing mechanisms of body composition decline among perimenopausal women and the associated components of Meditative Movement (ie, tai chi, qigong, yoga) that address each of these factors. METHODS Based on our previous work and extensive review of the literature, we developed a multifactorial and multidimensional biobehavioral model including factors that most directly relate to body composition among perimenopausal women: 1) psychological (ie, stress and mood, mindfulness and self-compassion, body awareness), 2) behavioral (ie, sleep, physical activity, eating behaviors), and 3) physiological (ie, cortisol, estrogen). Relationships between each factor, Meditative Movement practice components, and predicted effects on body composition were explored in detail. RESULTS Our model describes select psychological, behavioral, and physiological factors, and potential mechanistic pathways of Meditative Movement practice driving improved changes in body composition and weight outcomes for perimenopausal women. CONCLUSIONS The proposed model details a novel, evidence-supported means to reduce the risk of deleterious shifts in body composition throughout perimenopause and menopause thereafter. We suggest that these changes may occur directly and/or indirectly through psychological, behavioral, and physiological mechanisms that facilitate the desired changes in body composition.
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Affiliation(s)
| | - Linda K Larkey
- From the Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Bronwynne Evans
- From the Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Ann Sebren
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Kimberley Goldsmith
- Department of Biostatistics & Informatics, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Erica Ahlich
- Department of Psychology, University of South Alabama, Mobile, AL
| | - Nanako A Hawley
- Department of Psychology, University of South Alabama, Mobile, AL
| | | | - Dorothy D Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ
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Liu Y, Liu JE, Chen S, Zhao F, Chen L, Li R. Effectiveness of Nonpharmacologic Interventions for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients: A Systematic Review and Network Meta-analysis. Cancer Nurs 2023; 46:E305-E319. [PMID: 37607381 DOI: 10.1097/ncc.0000000000001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neurotoxicity is a major adverse effect of chemotherapy in breast cancer (BC) patients. A number of nonpharmacologic interventions are used to alleviate chemotherapy-related cognitive impairment (CRCI), but no studies have compared their effectiveness. OBJECTIVES The aim of this study was to identify and compare the effectiveness of different nonpharmacologic interventions for CRCI in BC patients. METHODS A systematic review and network meta-analysis was conducted following the Cochrane guidelines. All randomized controlled trials were searched in the Cochrane Library, PubMed, MEDLINE (via OVID), Web of Science, EMBASE, and CINAHL databases from inception to September 2021. Studies using nonpharmacologic interventions to manage CRCI symptoms were included. A network meta-analysis and a comparative effects ranking were completed by STATA v14.0. RESULTS Twelve studies with 8 nonpharmacologic interventions were included. For subjective outcomes on CRCI, there was no significant difference between nonpharmacologic interventions. For objective outcomes, qigong and exercise were more effective than the psychotherapy. Qigong and exercise were also more effective than music therapy. The top 3 interventions were psychotherapy (83.4%), music therapy (60.8%), and electroacupuncture (52.5%) for subjective outcomes and qigong (87.7%), exercise (82.1%), and electroacupuncture (70.3%) for objective outcomes. CONCLUSION In the subjective evaluation, it was difficult to judge which interventions are best, but psychotherapy had the greatest probability. For objective evaluation, qigong and exercise may be the best nonpharmacologic interventions. IMPLICATIONS FOR PRACTICE This study provides evidence for the effectiveness of nonpharmacologic interventions for CRCI in BC patients and facilitates support for future clinical trials and work.
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Affiliation(s)
- Yu Liu
- Author Affiliation: School of Nursing, Capital Medical University, People's Republic of China
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Brunet J, Sharma S. A scoping review of studies exploring physical activity and cognition among persons with cancer. J Cancer Surviv 2023:10.1007/s11764-023-01441-x. [PMID: 37561316 DOI: 10.1007/s11764-023-01441-x] [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: 05/08/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE This scoping review aimed to identify and synthesize published studies on physical activity (PA) and cognition among persons with cancer and elucidate knowledge gaps. METHODS Articles were identified through electronic and manual searches (02/21 and 03/22) using the following inclusion criteria: (1) empirical, peer-reviewed publication in English, (2) sample comprised persons with cancer, and (3) reported at least one statistical association between PA and cognition. Multiple reviewers independently performed study selection and data extraction, and results were mapped in tabular and narrative form. RESULTS Ninety-seven articles were eligible; these were largely published from 2017 to 2022 (54.6%), conducted in high-income countries (96.9%), and presented (quasi-)experimental studies (73.2%). Samples predominantly comprised women with breast cancer (48.5%), and recruitment often occurred post-treatment (63.9%). PA interventions included: aerobic (32.3%), resistance (4.8%), combined aerobic/resistance (38.7%), mind-body (19.4%), or other PA (4.8%). Most (66%) articles reported inconclusive findings; 32% were positive (in support of PA promoting cognition or vice versa), and 2.1% were negative. Diverse samples and studies with long-term follow-up were scarce. CONCLUSIONS The state of knowledge is insufficient and more rigorous, large-scale studies are required to provide definitive conclusions about the cognitive benefits of PA among persons with cancer. IMPLICATIONS FOR CANCER SURVIVORS Cancer-related cognitive impairment (CRCI) thwarts quality of life. This review summarizes what is known about the association between PA and cognition among persons with cancer and concludes that the evidence is currently equivocal. Hence, it remains uncertain if PA interventions can reduce CRCI, and large-scale PA intervention trials explicitly designed to promote cognition are greatly needed.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University (MNT 339), Ottawa, ON, K1N 6N5, Canada.
- Institut du savoir Montfort, l'Hôpital Montfort, Ottawa, ON, Canada.
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| | - Sitara Sharma
- School of Human Kinetics, University of Ottawa, 125 University (MNT 339), Ottawa, ON, K1N 6N5, Canada
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Soltero EG, James DL, Han S, Larkey LK. The impact of a meditative movement practice intervention on short- and long-term changes in physical activity among breast cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01430-0. [PMID: 37507530 DOI: 10.1007/s11764-023-01430-0] [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: 03/02/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Tai Chi Easy (TCE) is a low-impact, meditative movement practice that is feasible for breast cancer survivors, even in the face of post-treatment symptoms, and may even serve as a gateway into developing an active lifestyle and improving overall physical activity (PA). In the context of a randomized controlled trial testing effects of an 8-week TCE intervention on breast cancer survivors' symptoms, we examined the short- (8-week) and long-term (9-month) impact on total PA compared to an educational control group. METHODS Participants were recruited from two hospital systems, local community organizations, and different media platforms. Eligible participants were predominant non-Hispanic White (82%), college educated (92%), and middle- to high-income (65%), and most commonly reported stage 1 (40%) or 2 breast cancer (38%). After baseline assessments, participants were randomized to the 8-week TCE intervention (N=51) or education control (N=53). Weekly intervention TCE classes were led by a trained instructor. Weekly educational control classes focused on a series of readings and group discussions. Total PA and steps were objectively measured via accelerometry, and the international physical activity questionnaire was used to measure self-reported total PA. RESULTS Multilevel mixed-effects linear regression models revealed no significant short- or long-term changes in objectively measured total PA or steps in either group; however, participants in the intervention reported short- and long-term changes in self-reported total PA. CONCLUSIONS TCE is an appropriate PA strategy for survivors that may lead to modest improvements in PA; however, more research is needed to examine the long-term impact on PA as well as other physical and psychological outcomes (i.e., flexibility, mobility, stress). IMPLICATIONS FOR CANCER SURVIVORS Low-impact, low-intensity activities like meditative movement practices are needed to assist survivors in overcoming post-treatment physical and psychological limitations to initiate a more active lifestyle.
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Affiliation(s)
- Erica G Soltero
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St, Houston, TX, 77030, USA.
| | - Dara L James
- College of Nursing, University of South Alabama, 5721 USA Drive North, Mobile, AL, 36688, USA
| | - SeungYong Han
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Linda K Larkey
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500N 3rd St, Phoenix, AZ, 85004, USA
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Sharma S, Brunet J. Young Adults' Lived Experiences with Cancer-Related Cognitive Impairment: An Exploratory Qualitative Study. Curr Oncol 2023; 30:5593-5614. [PMID: 37366905 DOI: 10.3390/curroncol30060422] [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: 05/08/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI; e.g., disrupted memory, executive functioning, and information processing) affects many young adults, causing significant distress, reducing quality of life (QoL), and thwarting their ability to engage in professional, recreational, and social experiences. The purpose of this exploratory qualitative study was to investigate young adults' lived experiences with CRCI, and any strategies (including physical activity) they use to self-manage this burdensome side effect. Sixteen young adults (Mage = 30.8 ± 6.0 years; 87.5% female; Myears since diagnosis = 3.2 ± 3) who reported clinically meaningful CRCI whilst completing an online survey were interviewed virtually. Four themes comprising 13 sub-themes were identified through an inductive thematic analysis: (1) descriptions and interpretations of the CRCI phenomenon, (2) effects of CRCI on day-to-day and QoL, (3) cognitive-behavioural self-management strategies, and (4) recommendations for improving care. Findings suggest CRCI is detrimental to young adults' QoL and must be addressed more systematically in practice. Results also illuminate the promise of PA in coping with CRCI, but research is needed to confirm this association, test how and why this may occur, and determine optimal PA prescriptions for young adults to self-manage their CRCI.
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Affiliation(s)
- Sitara Sharma
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON K1N 6N5, Canada
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Li C, Dong X, Yu L, Yuan K, Yi X, Shen Y, Niu H. The effects of qigong intervention based on the Internet on quality of life and physical fitness in Chinese postoperative breast cancer patients: a protocol of randomized controlled trial. Trials 2023; 24:186. [PMID: 36915187 PMCID: PMC10010003 DOI: 10.1186/s13063-023-07187-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The purpose of this study is to verify the improvement of remote qigong intervention on the quality of life and physical fitness of breast cancer patients after surgery by means of a randomized controlled trial and to compare it with the conventional exercise combination of aerobic exercise and resistance training. METHODS/DESIGN The research approach applied in this study is a randomized controlled trial. After completing the baseline questionnaire and physical fitness test, participants were randomly assigned to either the qigong group or the combined exercise rehabilitation group. Patients in the qigong group performed Qigong-Baduanjin twice a week for 30 min each time under remote guidance and practiced Baduanjin by themselves at other times. Patients in the combined exercise rehabilitation group were given resistance training twice a week for 30 min under remote guidance, and walking the rest of the time. At the end of the 12-week intervention, outcomes testing and data collection were carried out. The primary outcomes are quality of life, measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Functional Assessment of Cancer Therapy-Breast (FATC-B). The secondary outcomes include cardiopulmonary endurance, upper limb strength, lower limb strength, and skinfold thickness. DISCUSSION The importance of postoperative exercise rehabilitation for breast cancer has been gradually accepted by more and more doctors and patients, but further research and development of simple and practical means of exercise rehabilitation are necessary. Remote qigong intervention for breast cancer patients via the Internet will be a great alternative. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900027989. Registered on December 7, 2019.
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Affiliation(s)
- Chengxiang Li
- College of Physical Education, Shandong Normal University, Jinan, 250014, China
| | - Xiaosheng Dong
- College of Physical Education, Shandong University, Jinan, 250011, China
| | - Lina Yu
- College of Physical Education, Shandong Normal University, Jinan, 250014, China
| | - Kai Yuan
- The First Affiliated Hospital of Shandong First Medical University, Jinan, 250011, China
| | - Xiangren Yi
- College of Physical Education, Shandong University, Jinan, 250011, China
| | - Yuanlong Shen
- College of Physical Education, Shandong Normal University, Jinan, 250014, China
| | - Hu Niu
- Department of Breast and Thyroid Surgery, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, China.
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Chang CI, Yeh ML, Liao J. Chan-Chuang qigong with breathing meditation improves quality of life and interoceptive awareness in patients with breast cancer: a randomised controlled trial. Support Care Cancer 2023; 31:140. [PMID: 36707489 DOI: 10.1007/s00520-023-07578-w] [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: 06/28/2022] [Accepted: 01/05/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the effect of Chan-Chuang qigong with breathing meditation on quality of life (QoL) and interoceptive awareness in patients with breast cancer during chemotherapy. METHODS This was a randomised controlled trial. Participants were randomly assigned to a qigong group (n = 30), which practised Chan-Chuang qigong with breathing meditation for 15 weeks, and a control group (n = 30), which received routine care. Outcomes were measured by using the European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ-C30) and Multidimensional Assessment of Interoceptive Awareness (MAIA-C). RESULTS The qigong group, when compared with the control group and baseline, exhibited significantly improved emotional function (p = 0.01) and decreased role function (p = 0.04) at week 15. The MAIA-C indicated a significant difference between groups in self-regulation at week 15 (p = 0.04). Within the qigong group, changes were found in attention regulation (p = 0.03), emotional awareness (p = 0.04), self-regulation (p = 0.01), and body listening (p = 0.002). CONCLUSIONS A 15-week programme of Chan-Chuang qigong with breathing meditation is a simple and safe intervention for patients with breast cancer to improve their emotional function and adjust to their role identity. Participants who practised qigong achieved increased awareness of their own bodies and were able to better regulate their emotion and attention. TRIAL REGISTER ClinicalTrials.gov Identifier: NCT05385146.
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Affiliation(s)
- Ching-I Chang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan.,Chang Gung University of Science and Technology, No.261, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 333324, Taiwan
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan.
| | - Justin Liao
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan
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Li W, You F, Wang Q, Shen Y, Wang J, Guo J. Effects of Tai Chi Chuan training on the QoL and psychological well-being in female patients with breast cancer: a systematic review of randomized controlled trials. Front Oncol 2023; 13:1143674. [PMID: 37197428 PMCID: PMC10183581 DOI: 10.3389/fonc.2023.1143674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Background Tai Chi Chuan (TCC) may have a positive impact on physical and psychological well-being in breast cancer patients, but the evidence remains limited and inconclusive. This systematic review aims to evaluate the effects of TCC on the quality of life (QoL) and psychological symptoms in women patients with breast cancer. Methods This review has been registered on PROSPERO (ID: CRD42019141977). Randomized controlled trials (RCTs) of TCC for breast cancer were searched from eight major English and Chinese databases. All trials included were analyzed in accordance with the Cochrane Handbook. The primary outcomes were QoL, anxiety, and depression in patients with breast cancer. Fatigue, sleep quality, cognitive function, and inflammatory cytokine were the secondary outcomes. Results Fifteen RCTs involving a total of 1,156 breast cancer participants were included in this review. The methodological quality of included trials was generally poor. The pooled results suggested that TCC-based exercise could significantly improve QoL [standardized mean difference (SMD)=0.35, 95%CI: 0.15-0.55, I 2 = 0, model: fixed, IV], anxiety [weighted mean difference (WMD)=-4.25, 95%CI: -5.88 to -2.63, I 2 = 0, model: fixed, IV], and fatigue (SMD=-0.87, 95%CI: -1.50 to -0.24, I 2 = 80.9%, model: random, DL) compared other controls, with moderate to low certainty of evidence. The improvement of QoL and fatigue by TCC was also clinically meaningful. However, TCC-based exercise failed to show any between-group differences in depression, sleep quality, cognitive function, and inflammatory cytokine. Post-hoc analysis revealed that TCC-based exercise outperformed the other exercise in improving shoulder function with very low certainty of evidence. Conclusion Our findings manifested that TCC-based exercise is helpful for improving the QoL, anxiety, and fatigue in patients with breast cancer within the range of comparisons covered in this study. However, the results must be treated with great caution because of the methodological flaws of included trials. Larger, well-designed, and conducted randomized controlled trials with longer follow-up is warranted in the future to evaluate the important outcomes of TCC for breast cancer. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141977, identifier, CRD42019141977.
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Affiliation(s)
- Wenyuan Li
- Evidence Based Traditional Chinese Medicine Center of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fengming You
- Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Teaching and Research Office of Oncology in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Departmental Office of Scientific Research, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiaoling Wang
- Departmental Office of Scientific Research, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yifeng Shen
- Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jundong Wang
- Evidence Based Traditional Chinese Medicine Center of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Traditional Chinese Medicine Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Guo
- Teaching and Research Office of Oncology in Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Jing Guo,
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Mackenzie L, Marshall K. Effective non-pharmacological interventions for cancer related cognitive impairment in adults (excluding central nervous system or head and neck cancer): systematic review and meta-analysis. Eur J Phys Rehabil Med 2022; 58:258-270. [PMID: 34498828 PMCID: PMC9980504 DOI: 10.23736/s1973-9087.21.06898-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Cancer-related cognitive impairment (CRCI) is prevalent in cancer survivors, and impairments affect daily living tasks and overall wellbeing. This review aimed to identify and evaluate published randomized controlled trials (RCTs) of interventions to manage CRCI in adult populations, to analyze their effectiveness and to investigate the quality of the studies. EVIDENCE ACQUISITION Seven databases were searched (Medline, Scopus, CINAHL, AMED, PsychINFO, OTseeker, and the Cochrane Database of Systematic Reviews), including years 2005-2020, for randomized controlled trials (RCTs) investigating interventions to address cognition for adults with cancer. The final search was conducted in February 2021. The quality of studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for RCTs. Meta-analysis used comprehensive meta-analysis software. The study protocol was registered with PROSPERO (registration N. CRD42017076868). EVIDENCE SYNTHESIS A total of 45 studies involving 4727 participants examined interventions for CRCI and met selection criteria. Categories of interventions included cognitive training-based intervention (N.=15), cognitive behavior therapy (CBT) (N.=4), physical activity (N.=16) and other supportive therapies (N.=10). Meta-analysis indicated beneficial overall effects for all categories of interventions: cognitive training (standardized mean difference [SMD]=0.41, 95% CI: 0.28-0.53, I2=88.87%); CBT (SMD=0.30, 95% CI: 0.14-0.46, I2=44.86%); physical activity (SMD=0.27, 95% CI: 0.20-0.35, I2=37.67%); and supportive therapies (SMD=0.27, 95% CI: 0.16-0.39, I2=64.94%). Studies used self-report cognitive outcome measures and neurocognitive testing, or a mixture. CONCLUSIONS Findings suggest that effective intervention for CRCI exist, and cognitive training is consistently supported as an effective intervention; however, a high level of heterogeneity was found. CRCI research is currently dominated by breast cancer survivors, and quality research is also needed to address the broader population of cancer survivors who experience CRCI.
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Affiliation(s)
- Lynette Mackenzie
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia -
| | - Kelsey Marshall
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Ren T, Rong S, Wang H, Dai Y, Gu E, Tan N, Qi Y. Effect of Chinese Traditional Wushu on Cancer-Related Fatigue, Sleep Quality and Upper Limb Dysfunction of Breast Cancer Survivors: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6879566. [PMID: 35342756 PMCID: PMC8942623 DOI: 10.1155/2022/6879566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/12/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022]
Abstract
Objective This study is aimed at evaluating the effect of Chinese traditional Wushu (CTW) on cancer-related fatigue (CRF), sleep quality, and upper limb dysfunction. Data Sources. We searched studies containing randomized controlled trials up to July 2021 in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database, and China Biological Medicine on this topic. Methods A randomized controlled trial of CTW on major outcome indicators such as CRF, sleep quality, and upper limb dysfunction of breast cancer survivors. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Stata 16.0 software. The quality of the evidence was assessed by the Cochrane Collaboration Risk of Bias (ROB2.0). Results Eighteen studies met the requirements for meta-analysis (n = 1331). We found that CTW has no obvious effect on improving breast cancer survivors' CRF (SMD = -0.733; P = 0.059; I 2 = 89.3%), but it can effectively improve their sleep quality (WMD = -2.266; P = 0.022; I 2 = 99.2%) and upper limb dysfunction (SMD = 1.262; P ≤ 0.001; I 2 = 88.5%). Conclusion Although more studies on this topic are needed to prove the effectiveness of this method, the results of our review show that CTW is significantly helpful for better sleep and upper limb dysfunction. But the effects on CRF will need to be confirmed further. Implications for Cancer Survivors. In the future intervention process, to verify the effectiveness of CTW on improving CRF for breast cancer survivors, it would be suggested to pay close attention to breast cancer survivors' response to exercise, achieve regular follow-up, strictly conduct the intervention scheme on the premise of ensuring absolute security, and reduce the loss of intervention objects.
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Affiliation(s)
- Tuo Ren
- Sports and Art Institute, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Siyu Rong
- Sports and Art Institute, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Haonan Wang
- Department of Physical Education and Research, Central South University, 932 Lushan South Rd., Changsha 410083, China
| | - Yinghong Dai
- Xiangya School of Medicine, Central South University, No. 172 Tongzipo Road, Changsha Hunan 410013, China
| | - Erya Gu
- School of Foreign Languages, Central South University, 932 Lushan South Rd., Changsha 410083, China
| | - Na Tan
- Department of Physical Education and Research, Central South University, 932 Lushan South Rd., Changsha 410083, China
| | - Yufei Qi
- Department of Physical Education and Research, Central South University, 932 Lushan South Rd., Changsha 410083, China
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14
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Latin dance and Qigong/Tai Chi effects on physical activity and body composition in breast cancer survivors: A pilot study. Complement Ther Clin Pract 2022; 47:101554. [DOI: 10.1016/j.ctcp.2022.101554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 12/26/2022]
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15
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Matourypour P, Ghorbani A, Mahmoudi M, Binaei N, Manesh HJ, Nayeri ND, Bagheri I. Blinding and Its Quality in Clinical Trials Conducted on Patients with Breast Cancer: A Systematic Review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:1-7. [PMID: 35280192 PMCID: PMC8865247 DOI: 10.4103/ijnmr.ijnmr_49_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/07/2020] [Accepted: 05/16/2021] [Indexed: 11/14/2022]
Abstract
Background Blinding is one of the critical criteria of clinical trials that prevents probable bias. Judgment regarding results of an intervention significantly depends on the quality of such studies, one of which is blinding. This study aimed to investigate blinding and its quality in clinical trials in patients with breast cancer. Materials and Methods A systematic review was conducted on the online databases of PubMed, ScienceDirect and ProQuest using keywords, MeSH terms and grey literature. Articles were screened by predefined inclusion and exclusion criteria. They were evaluated based on the checklists introduced by Cochrane database. Results From 22519 articles obtained at the initial stage, 20 articles remained after screening for the inclusion and exclusion criteria. Fifteen articles had used single, five: double and none had used triple or quadruple blinding. Seventeen studies had described the details of blinding. Of the 15 single blind articles, the blinded subjects were patients in five, patients and research assistants in three, research assistants in five studies, and two had not given any details. Conclusions The majority of researchers had used the single blind method, though using double, triple or quadruple blinding increases the trustworthiness of results and increases the quality of clinical trials. The details of blinding should be explained to other researchers and for a better understanding of the method if it is to be repeated. Thereafter, nurses can apply new interventions and earn their patients' trust and help those with breast cancer by relieving them of their disease symptoms and its treatment complications.
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Affiliation(s)
- Pegah Matourypour
- Medical-Surgical Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran
| | - Azam Ghorbani
- Medical-Surgical Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran
| | - Mokhtar Mahmoudi
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan university of Medical Science, Sanandaj, Iran
| | - Niloufar Binaei
- Department of Adult Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Iran
| | - Hadi Jafary Manesh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran,Address for correspondence:Dr. Nahid Dehghan Nayeri, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. E-mail:
| | - Imane Bagheri
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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16
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James D, Larkey LK, Evans B, Sebren A, Goldsmith K, Smith L. Pilot study of tai chi and qigong on body composition, sleep, and emotional eating in midlife/older women. J Women Aging 2021; 34:449-459. [PMID: 34962851 DOI: 10.1080/08952841.2021.2018924] [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: 10/19/2022]
Abstract
Weight gain and related adverse changes in body composition are prevalent among midlife and older women and contribute to chronic disease (e.g., type 2 diabetes, hypertension, depression). Tai Chi (TC) and Qigong (QG), forms of Meditative Movement, demonstrate improved physical/psychological symptoms and body composition. Using a standardized TC/QG protocol, we explored pre/post intervention differences in percent body fat and factors related to body composition in midlife/older women. In the context of a single-group pilot study, females ages 45-75 (N = 51) enrolled in an 8-week TC/QG intervention. Primary outcome measures of body composition, sleep quality, emotional eating and select secondary outcome psycho-emotional factors (perceived stress, mood state, mindfulness, self-compassion, body awareness) were collected. Change in percent body fat did not reach statistical significance (p = .30, M = 0.35, 95% CI [- 0.32, 1.0]). Sleep quality improved significantly, p = .04, M = - 0.88, 95% CI [-1.71, - 0.04]. Emotional eating changed in the expected direction, but not significantly, p = .08, M = -0.16, 95% CI [-0.34, 0.02]. Significant differences were found in body awareness, p = .01, M = 0.36, 95% CI [0.08, 0.63] and perceived stress, p = .05, M = -2.36, 95% CI [-4.76, 0.04]. Preliminary results are promising as results showed improvements in factors related to healthy body composition. Refined research is needed to understand if/how TC/QG may improve body composition among midlife and older women.
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Affiliation(s)
- Dara James
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Linda K Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Bronwynne Evans
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Ann Sebren
- College of Health Solutions, Arizona State University, Arizona, USA
| | - Kimberley Goldsmith
- Department of Biostatistics & Informatics Inst. Of Psychiatry, King's College London, London, England
| | - Lisa Smith
- College of Health Solutions, Arizona State University, Arizona, USA
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17
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Yin Z, Martinez CE, Li S, Martinez M, Peng K, Land WM, Ullevig SL, Cantu A, Falk S, Hernández AE, Ortega C, Parra-Medina D, Simmonds MJ. Adapting Chinese Qigong Mind-Body Exercise for Healthy Aging in Older Community-Dwelling Low-income Latino Adults: Pilot Feasibility Study. JMIR Aging 2021; 4:e29188. [PMID: 34723824 PMCID: PMC8593812 DOI: 10.2196/29188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/07/2021] [Accepted: 06/27/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Research translating the evidence for the benefit of mind-body exercise in older Latinos with limited access to community-based healthy aging programs is sparse. OBJECTIVE This study aimed to evaluate the feasibility of Function Improvement Exercises for Older Sedentary Community-Dwelling Latino Residents (FITxOlder), a Community Health Worker (CHW)-led, mobile technology-facilitated Chinese Qigong mind-body exercise program for healthy aging and to explore its impact on physical and cognitive function and quality of life (QoL) in older community-dwelling low-income Latino adults. METHODS This study was designed as a Stage 1 feasibility study to develop and pilot-test FITxOlder. In Phase 1 (Stage 1A), a working group of seniors, CHWs, and senior center staff guided the adaptation of Chinese Qigong into a healthy aging program. In Phase 2 (Stage 1B), 49 older Latino adults participated in a 3-arm controlled study to test the feasibility and preliminary effect of CHW-led FITxOlder on physical and cognitive function and QoL measures over 16 weeks. RESULTS Although the COVID-19 pandemic disrupted the implementation of the study protocol, we found favorable results regarding participant recruitment, retention, and fidelity of implementation. Notable findings included an 89.3% participant retention, 79.4% of the participants completed at least 70% of the weekly exercise goal, and no report of adverse events. The effects on intervention outcome measures were modest. CONCLUSIONS FITxOlder is feasible for promoting healthy aging in older Latino adults; future research needs to compare its feasibility with other low-impact exercise programs for healthy aging using a randomized controlled trial. TRIAL REGISTRATION ClinicalTrials.gov NCT04284137; https://clinicaltrials.gov/ct2/show/NCT04284137.
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Affiliation(s)
- Zenong Yin
- Department of Public Health, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Cristina E Martinez
- Department of Public Health, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Shiyu Li
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Martha Martinez
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Kezhi Peng
- College of Kinesiology and Health, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - William M Land
- Department of Kinesiology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Sarah L Ullevig
- College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Adelita Cantu
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Sharon Falk
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Arthur E Hernández
- Dreeben School of Education, University of the Incarnate Word, San Antonio, TX, United States
| | - Catherine Ortega
- Department of Public Health, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Deborah Parra-Medina
- Latino Research Institute, Latino Studies, The University of Texas at Austin, Austin, TX, United States
| | - Maureen J Simmonds
- Department of Public Health, The University of Texas at San Antonio, San Antonio, TX, United States
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18
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Mind-Body Health Benefits of Traditional Chinese Qigong on Women: A Systematic Review of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:7443498. [PMID: 34567220 PMCID: PMC8457943 DOI: 10.1155/2021/7443498] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/29/2021] [Accepted: 09/02/2021] [Indexed: 11/21/2022]
Abstract
Most women live with an inactive lifestyle, which suggests a need for preference-based choices to promote their participation in physical activity. This systematic review synthesized key findings on the health benefits of Qigong among women. We conducted a systematic search of randomized controlled trials (RCTs) of Qigong among women according to the PRISMA guidelines using the following databases from their inception through March 2021: PubMed/MEDLINE, Web of Science, Cochrane Library, and US National Library of Medicine. The risk of bias was examined using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. Altogether, 18 RCTs were included for final review. Results showed that Qigong was a feasible exercise in improving health outcomes, particularly depressive symptoms (63% of trials), quality of life (43%), and fatigue (29%), among general women, intimate partner violence survivors, and women with chronic conditions (e.g., breast cancer patients or survivors). Almost 90% (7/8) of trials reported high adherence rates ranging from 73 to 95% for supervised group training and 63 to 80% for home self-practice. Thus far, there was no evidence of serious adverse effects from performing Qigong. For the risk of bias across trials, a lack of allocation concealment (72% of trials), no blinding of participants and personnel (67%), and incomplete outcome data (67%) were the major sources. In summary, Qigong is a safe, feasible, and beneficial exercise for general women, abused sufferers, and health-compromised women. However, given the potential risk of bias found in many studies, improved rigor of study design in future trials will be imperatively required.
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19
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Yang L, Winters-Stone K, Rana B, Cao C, Carlson LE, Courneya KS, Friedenreich CM, Schmitz KH. Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines. Cancer Med 2021; 10:7447-7456. [PMID: 34533284 PMCID: PMC8559497 DOI: 10.1002/cam4.4273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/21/2022] Open
Abstract
To manage acute, long‐term, and late effects of cancer, current guidelines recommend moderate‐to‐vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment‐free, multicomponent mind–body exercise performed at light‐to‐moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient‐reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty‐six reports from 14 trials (one non‐randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low‐level evidence emerged to support the benefits of 40–60 min of thrice‐weekly supervised Tai Chi for 8–12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling‐up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer‐related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre‐treatment and end of life phases.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kerri Winters-Stone
- School of Nursing and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Benny Rana
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri, USA
| | - Linda E Carlson
- Departments of Oncology, University of Calgary, Calgary, Canada.,Department of Psychosocial Oncology, Alberta Health Services, Calgary, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kathryn H Schmitz
- Penn State Cancer Institute, Penn State College of Medicine, Hershey, Pennsylvania, USA
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20
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Larkey L, Kim W, James D, Kishida M, Vizcaino M, Huberty J, Krishnamurthi N. Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integr Cancer Ther 2021; 19:1534735420949677. [PMID: 32783546 PMCID: PMC7425257 DOI: 10.1177/1534735420949677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization. Methods: HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction. Results: HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states. Conclusion: Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.
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Affiliation(s)
- Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Wonsun Kim
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dara James
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Moé Kishida
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Jennifer Huberty
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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21
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Sur D, Sabarimurugan S, Advani S. The Effects of Martial Arts on Cancer-Related Fatigue and Quality of Life in Cancer Patients: An Up-to-Date Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116116. [PMID: 34204027 PMCID: PMC8201183 DOI: 10.3390/ijerph18116116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND To evaluate and synthesize the existing evidence of the effects of practicing martial arts by cancer patients and cancer survivors in relation to overall quality of life (QoL) and cancer-related fatigue (CRF). METHODS Randomized controlled trials (RCTs) from 1 January 2000 to 5 November 2020 investigating the impact of martial arts were compared with any control intervention for overall QoL and CRF among cancer patients and survivors. Publication quality and risk of bias were assessed using the Cochrane handbook of systematic reviews. RESULTS According to the electronic search, 17 RCTs were retrieved including 1103 cancer patients. Martial arts significantly improved social function, compared to that in the control group (SMD = -0.88, 95% CI: -1.36, -0.39; p = 0.0004). Moreover, martial arts significantly improved functioning, compared to the control group (SMD = 0.68, 95% CI: 0.39-0.96; p < 0.00001). Martial arts significantly reduced CRF, compared to that in the control group (SMD = -0.51, 95% CI: -0.80, -0.22; p = 0.0005, I2 > 95%). CONCLUSIONS The results of our systematic review and meta-analysis reveal that the effects of practicing martial arts on CRF and QoL in cancer patients and survivors are inconclusive. Some potential effects were seen for social function and CRF, although the results were inconsistent across different measurement methods. There is a need for larger and more homogeneous clinical trials encompassing different cancer types and specific martial arts disciplines to make more extensive and definitive cancer- and symptom-specific recommendations.
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Affiliation(s)
- Daniel Sur
- 11th Department of Medical Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu", 400015 Cluj-Napoca, Romania
- Department of Medical Oncology, Oncology Institute "Prof. Dr. Ion Chiricuta", 400015 Cluj-Napoca, Romania
| | - Shanthi Sabarimurugan
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Western Australia, Nedlands, WA 6009, Australia
| | - Shailesh Advani
- Terasaki Institute of Biomedical Innovation, Los Angeles, CA 90024, USA
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22
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Deng SM, Chiu AF, Wu SC, Huang YC, Huang SC, Chen SY, Tsai MY. Association between cancer-related fatigue and traditional Chinese medicine body constitution in female patients with breast cancer. J Tradit Complement Med 2021; 11:62-67. [PMID: 33511063 PMCID: PMC7817705 DOI: 10.1016/j.jtcme.2020.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a common psychosomatic problem in breast cancer patients. Traditional Chinese medicine (TCM) has been used to address symptoms in patients with CRF. Identification of the specific constitution in TCM is essential for personalized care. AIM To explore the relationship between fatigue and specific constitutions in breast cancer. EXPERIMENTAL PROCEDURE We conducted a cross-sectional study in all breast cancer patients at Kaohsiung Chang Gung Memorial Hospital in Taiwan. The severity of fatigue was determined using the Brief Fatigue Inventory-Taiwanese (BFI-T) form. TCM patterns were determined using the Body Constitution Questionnaire (BCQ). The relationship between constitution and fatigue was analyzed using logistic regression. RESULTS We recruited 110 breast cancer patients with fatigue (mean age: 55 ± 11 years). The mean duration of breast cancer was 17.4 months. The major constitution among these patients with fatigue was Yang-Qi deficiency (50%). Phlegm-Stasis syndrome was correlated with a duration of breast cancer of more than 18 months (p = 0.02). Out of all participants, 42.7% (n = 47) reported clinically significant fatigue (BFI-T score ≥4). According to logistic regression, the score of Yang-Qi deficiency [odds ratio (OR): 3.5, 95% confidence interval (CI): 1.49-8.21, p < 0.01] was also associated with clinically significant fatigue. CONCLUSION Yang-Qi deficiency is associated with clinically significant fatigue in breast cancer patients. However, the association of Phlegm-Stasis syndrome and fatigue as disease duration increases cannot be ignored. Further studies are needed to determine whether treating both constitutions integrating TCM treatment can alleviate patients' fatigue symptoms.
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Key Words
- BCQ, Body Constitution Questionnaire
- BFI-T, Brief Fatigue Inventory–Taiwan
- BMI, body mass index
- Breast cancer
- CAM, complementary and alternative medicine
- CI, confidence interval
- CRF, Cancer-related fatigue
- Chemotherapy
- Constitution
- Fatigue
- Hb, hemoglobin
- OR, odds ratio
- TCM, traditional Chinese medicine
- Traditional Chinese medicine
- VAS, visual analogue scale
- WBC, white blood cell
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Affiliation(s)
- Sheuh-Mei Deng
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
- Department of Nursing, Fooyin University, Kaohsiung, 83102, Taiwan
| | - Aih-Fung Chiu
- Department of Nursing, Meiho University, Pingtung, 91202, Taiwan
| | - Shin-Chung Wu
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital and School of Chinese Medicine, China Medical University, Taichung, 41354, Taiwan
| | - Shu-Chuan Huang
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Shih-Yu Chen
- Department of Pediatrics, E-Da Hospital and I-Shou University, Kaohsiung, 82445, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
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Shaikh H, Bradhurst P, Ma LX, Tan SYC, Egger SJ, Vardy JL. Body weight management in overweight and obese breast cancer survivors. Cochrane Database Syst Rev 2020; 12:CD012110. [PMID: 33305350 PMCID: PMC8094215 DOI: 10.1002/14651858.cd012110.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Studies suggest that overweight and obese breast cancer survivors are at increased risk of cancer recurrence and have higher all-cause mortality. Obesity has an impact on breast cancer survivor's quality of life (QOL) and increases the risk of longer-term morbidities such as type 2 diabetes mellitus and cardiovascular disease. Many cancer guidelines recommend survivors maintain a healthy weight but there is a lack of evidence regarding which weight loss method to recommend. OBJECTIVES To assess the effects of different body weight loss approaches in breast cancer survivors who are overweight or obese (body mass index (BMI) ≥ 25 kg/m2). SEARCH METHODS We carried out a search in the Cochrane Breast Cancer Group's (CBCG's) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 6), MEDLINE (2012 to June 2019), Embase (2015 to June 2019), the World Health Organisation International Clinical Trials Registry Platform (WHO ICTRP) and Clinicaltrials.gov on 17 June 2019. We also searched Mainland Chinese academic literature databases (CNKI), VIP, Wan Fang Data and SinoMed on 25 June 2019. We screened references in relevant manuscripts. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs and randomised cross-over trials evaluating body weight management for overweight and obese breast cancer survivors (BMI ≥ 25 kg/m2). The aim of the intervention had to be weight loss. DATA COLLECTION AND ANALYSIS Two review authors independently performed data extraction and assessed risk of bias for the included studies, and applied the quality of the evidence using the GRADE approach. Dichotomous outcomes were analysed as proportions using the risk ratio (RR) as the measure of effect. Continuous data were analysed as means with the measure of effect being expressed as the mean differences (MDs) between treatment groups in change from baseline values with 95% confidence intervals (CIs), when all studies reported exactly the same outcomes on the same scale. If similar outcomes were reported on different scales the standardised mean difference (SMD) was used as the measure of effect. Quality of life data and relevant biomarkers were extracted where available. MAIN RESULTS We included a total of 20 studies (containing 23 intervention-comparisons) and analysed 2028 randomised women. Participants in the experimental groups received weight loss interventions using the core element of dietary changes, either in isolation or in combination with other core elements such as 'diet and exercise', 'diet and psychosocial support' or 'diet, exercise and psychosocial support'. Participants in the controls groups either received usual care, written materials or placebo, or wait-list controls. The duration of interventions ranged from 0.5 months to 24 months. The duration of follow-up ranged from three months to 36 months. There were no time-to-event data available for overall survival, breast cancer recurrence and disease-free survival. There was a relatively small amount of data available for breast cancer recurrence (281 participants from 4 intervention-comparisons with 14 recurrence events; RR 1.95, 95% CI 0.68 to 5.60; low-quality evidence) and the analysis was likely underpowered. Overall, we found low-quality evidence that weight loss interventions for overweight and obese breast cancer survivors resulted in a reduction in body weight (MD: -2.25 kg, 95% CI: -3.19 to -1.3 kg; 21 intervention-comparisons; 1751 women), body mass index (BMI) (MD: -1.08 kg/m2, 95% CI: -1.61 to -0.56 kg/m2; 17 intervention-comparisons; 1353 women), and waist circumference (MD:-1.73 cm, 95% CI: -3.17 to -0.29 cm; 13 intervention-comparisons; 1193 women), and improved overall quality of life (SMD: 0.74; 95% CI: 0.20 to 1.29; 10 intervention-comparisons; 867 women). No increase was seen in adverse events for women in the intervention groups compared to controls (RR 0.94, 95% CI: 0.76 to 1.17; 4 intervention-comparisons; 394 women; high-quality evidence). Subgroup analyses revealed that decreases in body weight, BMI and waist circumference were present in women regardless of their ethnicity and menopausal status. Multimodal weight loss interventions (which referred to 'diet, exercise and psychosocial support') appeared to result in greater reductions in body weight (MD: -2.88 kg, 95% CI: -3.98 to -1.77 kg; 13 intervention-comparisons; 1526 participants), BMI (MD: -1.44 kg/m2, 95% CI: -2.16 to -0.72 kg/m2; 11 studies; 1187 participants) and waist circumference (MD:-1.66 cm, 95% CI: -3.49 to -0.16 cm; 8 intervention-comparisons; 1021 participants) compared to dietary change alone, however the evidence was low quality. AUTHORS' CONCLUSIONS Weight loss interventions, particularly multimodal interventions (incorporating diet, exercise and psychosocial support), in overweight or obese breast cancer survivors appear to result in decreases in body weight, BMI and waist circumference and improvement in overall quality of life. There was no increase in adverse events. There is a lack of data to determine the impact of weight loss interventions on survival or breast cancer recurrence. This review is based on studies with marked heterogeneity regarding weight loss interventions. Due to the methods used in included studies, there was a high risk of bias regarding blinding of participants and assessors. Further research is required to determine the optimal weight loss intervention and assess the impact of weight loss on survival outcomes. Long-term follow-up in weight loss intervention studies is required to determine if weight changes are sustained beyond the intervention periods.
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Affiliation(s)
- Hassan Shaikh
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | | | - Li Xin Ma
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
- Nutrition and Food Hygiene Department, Hebei University, Baoding, China
| | - Sim Yee Cindy Tan
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
- Nutrition and Dietetics Department, Concord Repatriation General Hospital, Concord, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Sam J Egger
- Cancer Research Division, Cancer Council NSW, Sydney, Australia
| | - Janette L Vardy
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
- Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Sydney, Australia
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Low SLK, Cheema BS, Tan HY, Birling Y, Zhu X. The Feasibility and Effects of Qigong Intervention (Mind-Body Exercise) in Cancer Patients With Insomnia: A Pilot Qualitative Study. Integr Cancer Ther 2020. [PMCID: PMC7716076 DOI: 10.1177/1534735420977671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Up to 80% of cancer patients experience insomnia that significantly affects their quality of life. This pilot qualitative study investigated the feasibility and effects of a 3-week Qigong (mind-body exercise) intervention with a 1-week follow-up in cancer patients experiencing insomnia. Methods: Cancer patients with insomnia who had completed radiotherapy or chemotherapy treatment and/or were at least 8 weeks post-cancer-related surgery were recruited. Primary outcomes were feasibility outcomes, which included recruitment, retention, attendance, completion of assessment, adverse events and participant feedback via a questionnaire and focus group/individual interview. Secondary outcomes on insomnia severity and sleep quality were measured using the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI) at baseline, mid, post-intervention and follow-up. Results: Seven participants were recruited and two withdrew from the study. The participant retention rate was 71.4% with an overall attendance rate of more than 84% and participants were able to complete all required assessments. An adverse event relating to the worsening of existing musculoskeletal condition was reported. Qualitative analysis of participant feedback identified 4 emerging themes: (1) experience from Qigong intervention; (2) class preferences; (3) barriers to participation; and (4) recommendation for improvement. Participants reported increased relaxation, improved sleep and energy level, better upper body flexibility and reduced stress. Both ISI and PSQI scores improved significantly (P < .05). Conclusion: This study demonstrated that it is feasible to employ the current clinical trial design using Qigong intervention on insomnia in cancer patients. Preliminary data suggest that the intervention may improve sleep outcomes, however, these findings need to be confirmed by future robust randomized controlled trials. Trial registration: The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12618001670268) http://www.ANZCTR.org.au/ACTRN12618001670268.aspxon10October2018.
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Affiliation(s)
- Sara L. K. Low
- School of Health Science, Western Sydney University, NSW, Australia
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
| | - Birinder S. Cheema
- School of Health Science, Western Sydney University, NSW, Australia
- NICM Health Research Institute, Western Sydney University, NSW, Australia
| | - Hsiewe Ying Tan
- School of Health Science, Western Sydney University, NSW, Australia
| | - Yoann Birling
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
- NICM Health Research Institute, Western Sydney University, NSW, Australia
| | - Xiaoshu Zhu
- School of Health Science, Western Sydney University, NSW, Australia
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
- NICM Health Research Institute, Western Sydney University, NSW, Australia
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25
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Cheng TC, Lee YH, Mar CL, Huang WT, Chang YP. The Health Promoting Mindfulness or Qigong Educational Programs for Beneficial Lifestyle Changes of Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:743-750. [PMID: 31001740 DOI: 10.1007/s13187-019-01522-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study used heart rate variability (HRV) to monitor levels of cancer-related fatigue (CRF) and quality of life (QOL) of cancer survivors subjected to program measures at different psychosomatic or functional levels. A longitudinal study was conducted at a cancer center in Taiwan. Fifty-two cancer survivals were randomly assigned to either the mindfulness group (n = 25) or the Qigong group (n = 27). Both groups received a 12-week mindfulness and Qigong programs, respectively. Improvements in CRF, QOL, and HRV after a 12-week program and at the 3-month follow-up point. For the long-term effects in both mindfulness and Qigong groups, CRF showed a significant downward trend (p < 0.05), but a significant upward trend was observed in HRV (p < 0.001). Mindfulness and Qigong exhibited different effectiveness in individuals, indicating that the mental and physical aspects of health are equally essential and should be addressed in a complementary combination. These findings are worthy of being shared with cancer survivors to benefit their physical and mental well-being. We suggest that healthcare professionals incorporate mindfulness and Qigong in cancer survivors' daily life as means to encourage lifestyle changes for improving their health.
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Affiliation(s)
- Tse-Chou Cheng
- Department of Urology, Chi Mei Medical Center, Liouying, 201, Taikang, Taikang Vil., Liouying Dist., Tainan City, 73657, Taiwan
| | - Yi-Hua Lee
- Department of Administration, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan
- PhD Program in Management, Da-Yeh University, 168 University Road, Dacun, Changhua, 51591, Taiwan
| | - Chun-Lin Mar
- College of Educational Sciences, Yulin Normal University, 1303 Educational E. Road, Yulin City, Guangxi, 537000, China
| | - Wen-Tsung Huang
- Division of Hematology-Oncology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, 201, Taikang, Taikang Vil., Liouying Dist., Tainan City, 73657, Taiwan
| | - Yuan-Ping Chang
- Nursing Department, Fooyin University, 151 Jinxue Rd., Daliao Dist., Kaohsiung City, 83102, Taiwan.
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26
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Toneti BF, Barbosa RFM, Mano LY, Sawada LO, Oliveira IGD, Sawada NO. Benefits of Qigong as an integrative and complementary practice for health: a systematic review. Rev Lat Am Enfermagem 2020; 28:e3317. [PMID: 32696918 PMCID: PMC7365612 DOI: 10.1590/1518-8345.3718.3317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 04/06/2020] [Indexed: 02/07/2023] Open
Abstract
Objective: to analyze, in the literature, evidence about the benefits of the integrative
and complementary practice of Qigong with regard to the
health of adults and the elderly. Method: a systematic review by searching for studies in the PubMed, CINAHL, LILACS,
EMBASE and Cochrane Library databases. Randomized and non-randomized
clinical trials were included; in Portuguese, English and Spanish; from 2008
to 2018. The Preferred Reporting Items for Systematic Reviews and
Meta-Analyses strategy was adopted, as well as the recommendation of the
Cochrane Collaboration for assessing the risk of bias in the clinical trials
analyzed. Results: 28 studies were selected that indicated the benefit of the practice to the
target audience, which can be used for numerous health conditions, such as:
cancer; fibromyalgia; Parkinson’s disease; Chronic Obstructive Pulmonary
Disease; Burnout; stress; social isolation; chronic low back pain; cervical
pain; buzz; osteoarthritis; fatigue; depression; and cardiovascular
diseases. However, there was a great risk of bias in terms of the blinding
of the research studies. Conclusion: the practice of Qigong produces positive results on health,
mainly in the medium and long term. This study contributes to the
advancement in the use of integrative and complementary practices in
nursing, since it brings together the scientific production in the area from
the best research results available.
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Affiliation(s)
- Bruna Francielle Toneti
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Rafael Fernando Mendes Barbosa
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Leandro Yukio Mano
- Instituto de Ciências Matemáticas e de Computação, Universidade de São Paulo, São Carlos, SP, Brazil
| | - Luana Okino Sawada
- School of Computing and Information Science, Florida International University, Miami, FL, United States of America
| | - Igor Goulart de Oliveira
- Centro de Ciências Tecnológicas, Universidade Estadual do Norte do Paraná, Bandeirantes, PR, Brazil
| | - Namie Okino Sawada
- Escola de Enfermagem, Universidade Federal de Alfenas, Alfenas, MG, Brazil
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27
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Wagner MA, Erickson KI, Bender CM, Conley YP. The Influence of Physical Activity and Epigenomics On Cognitive Function and Brain Health in Breast Cancer. Front Aging Neurosci 2020; 12:123. [PMID: 32457596 PMCID: PMC7225270 DOI: 10.3389/fnagi.2020.00123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022] Open
Abstract
The risk of breast cancer increases with age, with the majority of women diagnosed with breast cancer being postmenopausal. It has been estimated that 25-75% of women with breast cancer experience changes in cognitive function (CF) related to disease and treatment, which compromises psychological well-being, decision making, ability to perform daily activities, and adherence to cancer therapy. Unfortunately, the mechanisms that underlie neurocognitive changes in women with breast cancer remain poorly understood, which in turn limits the development of effective treatments and prevention strategies. Exercise has great potential as a non-pharmaceutical intervention to mitigate the decline in CF in women with breast cancer. Evidence suggests that DNA methylation, an epigenetic mechanism for gene regulation, impacts CF and brain health (BH), that exercise influences DNA methylation, and that exercise impacts CF and BH. Although investigating DNA methylation has the potential to uncover the biologic foundations for understanding neurocognitive changes within the context of breast cancer and its treatment as well as the ability to understand how exercise mitigates these changes, there is a dearth of research on this topic. The purpose of this review article is to compile the research in these areas and to recommend potential areas of opportunity for investigation.
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Affiliation(s)
- Monica A. Wagner
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, Perth Campus, Murdoch, WA, Australia
| | | | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, United States
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28
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Campbell KL, Zadravec K, Bland KA, Chesley E, Wolf F, Janelsins MC. The Effect of Exercise on Cancer-Related Cognitive Impairment and Applications for Physical Therapy: Systematic Review of Randomized Controlled Trials. Phys Ther 2020; 100:523-542. [PMID: 32065236 PMCID: PMC8559683 DOI: 10.1093/ptj/pzz090] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 04/11/2019] [Accepted: 07/02/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI), often called "chemo-brain" or "chemo-fog," is a common side effect among adults with cancer, which can persist well after treatment completion. Accumulating evidence demonstrates exercise can improve cognitive function in healthy older adults and adults with cognitive impairments, suggesting exercise may play a role in managing CRCI. PURPOSE The purpose was to perform a systematic review of randomized controlled trials (RCTs) to understand the effect of exercise on CRCI. DATA SOURCES Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE. STUDY SELECTION Eligible articles were RCTs that prescribed aerobic, resistance, combined aerobic/resistance, or mind-body (eg, yoga or Qigong) exercise during or following cancer treatment and included cognitive function outcome measures. DATA EXTRACTION Descriptive information and Cohen d effect sizes were directly extracted or calculated for included trials. DATA SYNTHESIS Twenty-nine trials were included in the final analysis. A statistically significant effect of exercise on self-reported cognitive function, both during and postadjuvant treatment, was reported in 12 trials (41%) (Cohen d range: 0.24-1.14), most commonly using the EORTC QLQ-C30. Ten trials (34%) performed neuropsychological testing to evaluate cognitive function; however, only 3 trials in women with breast cancer reported a significant effect of exercise (Cohen d range: 0.41-1.47). LIMITATIONS Few RCTs to date have evaluated the effect of exercise on CRCI as a primary outcome. Twenty-six trials (90%) in this review evaluated CRCI as secondary analyses. CONCLUSIONS Evidence supporting exercise as a strategy to address CRCI is limited. Future research evaluating CRCI as a primary outcome, including self-reported and objective measures, is needed to confirm the possible role of exercise in preventing and managing cognitive impairments in adults with cancer.
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Affiliation(s)
- Kristin L Campbell
- Department of Physical Therapy, University of British Columbia 212-2177
Wesbrook Mall, Vancouver, British Columbia, Canada V7J 3K6,Address all correspondence to Dr Campbell at:
| | | | - Kelcey A Bland
- Mary MacKillop Institute for Health Research, Australian Catholic
University, Melbourne, Victoria, Australia
| | | | - Florian Wolf
- Institute for Cardiovascular Research and Sports Medicine, German Sport
University, Cologne, Germany
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29
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The effectiveness of tai chi in breast cancer patients: A systematic review and meta-analysis. Complement Ther Clin Pract 2020; 38:101078. [DOI: 10.1016/j.ctcp.2019.101078] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 12/24/2022]
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30
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Nayeri ND, Bakhshi F, Khosravi A, Najafi Z. The Effect of Complementary and Alternative Medicines on Quality of Life in Patients with Breast Cancer: A Systematic Review. Indian J Palliat Care 2020; 26:95-104. [PMID: 32132792 PMCID: PMC7017686 DOI: 10.4103/ijpc.ijpc_183_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/02/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Breast cancer disease and its classic treatment lead to decrease in patients' quality of life (QOL). This systematic review aimed to compare the effectiveness of complementary and alternative medicines (CAMs) categories on the QOL of women with breast cancer. Methods: English clinical trials from PubMed, Emabase, Scupos, and Google Scholar databases were searched electronically by the end of 2018 with the Cochrane Collaboration protocol. Two researchers independently extracted data such as participants' characteristics, CAM methods, QOL assessment tools. CAMs were classified into three categories of dietary supplements, herbal medicine, and mind-body techniques. Results: During the initial search, 1186 articles were found. After reviewing titles, abstracts, and full texts based on inclusion and exclusion criteria, 28 clinical trials were included in the systematic review, 18 of which was randomized controlled trial (RCT). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or postcancer rehabilitation. Among CAM interventions, one article used a dietary supplement, and the other 27 articles included a variety of mind-body techniques. Twenty-seven studies showed improved QOL (P > 0.05). Conclusion: The findings may indicate the potential benefits of CAMs, especially mind-body techniques on QOL in breast cancer patients. Further RCTs or long-term follow-up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta-analysis and generalizability of results, especially for the development of clinical guidelines.
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Affiliation(s)
- Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bakhshi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Afifeh Khosravi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Najafi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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31
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Zeng Y, Dong J, Huang M, Zhang JE, Zhang X, Xie M, Wefel JS. Nonpharmacological interventions for cancer-related cognitive impairment in adult cancer patients: A network meta-analysis. Int J Nurs Stud 2020; 104:103514. [PMID: 32004776 DOI: 10.1016/j.ijnurstu.2019.103514] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Conventional meta-analyses can only provide direct comparison evidence, and the best options of nonpharmacological interventions for cancer-related cognitive impairment remain largely unknown. OBJECTIVES To evaluate the comparative effects of all known nonpharmacological interventions for cancer-related cognitive impairment, and to rank the best intervention options for adult non- central nervous system cancer patients with cancer-related cognitive impairment. DESIGN Systematic review with a new analytic approach of network meta-analysis. DATA SOURCES Six electronic databases were searched for randomized controlled trials from January 2010 to July 2019. REVIEW METHODS Literature screening, data extraction and quality appraisal was undertaken systematically by two independent reviewers. Quantitative network meta-analysis performed to analyze key study outcomes. The primary outcome was the effectiveness of interventions on subjective cognitive function, and the secondary outcome was the safety of nonpharmacological interventions for cancer-related cognitive impairment. RESULTS There were 29 eligible randomized controlled trials searched, and a total of 10 interventions identified. All 29 randomized controlled trials that were included had no reported significant adverse events, therefore, these 10 nonpharmacological interventions are safe for cancer-related cognitive impairment management. In terms of effectiveness, the pooled overall effects were in favor of these 10 nonpharmacological interventions. The most effective interventions included meditation, cognitive training, cognitive rehabilitation, and exercise interventions, with a mean difference of effective size plus 95% confidence interval 10.26 (1.53, 19.00), 5.02 (1.41, 8.63), 4.88 (0.65, 9.11), and 3.82 (0.52, 7.13), respectively. Other treatment effects did not show statistically significant differences. CONCLUSIONS This network meta-analysis found that meditation interventions, cognitive training, cognitive rehabilitation, and exercise were the most effective interventions for adult non-central nervous system cancer patients to manage cancer-related cognitive impairment. Results of this network meta-analysis contribute evidence-based data to inform medical decision-making.
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Affiliation(s)
- Yingchun Zeng
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Juntao Dong
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meiling Huang
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Jun-E Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Xiaoming Zhang
- The Affiliated Baoan Hospital of Southern Medical University, The People's Hospital of Baoan Shenzhen, Shenzhen, China
| | - Man Xie
- Jieyang People's Hospital, Jieyang, Guangdong Province, China
| | - Jeffrey S Wefel
- Departments of Neuro-Oncology and Radiation Oncology, The University of Texas MD Anderson Cancer Center, TX, US
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32
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Miladi N, Dossa R, Dogba MJ, Cléophat-Jolicoeur MIF, Gagnon B. Psychostimulants for cancer-related cognitive impairment in adult cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2019; 27:3717-3727. [PMID: 31250183 DOI: 10.1007/s00520-019-04907-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/31/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive impairment is recognized as a common symptom experienced by cancer survivors which impacts on quality of life (QoL) and day-to-day activities. One of the treatment options is the use of psychostimulants but the evidence supporting its use remains unclear. OBJECTIVES To identify the level of evidence of psychostimulants' effect on the management of cognitive impairment in adult cancer survivors. METHODS Electronic databases (MEDLINE, EMBASE, CENTRAL, CINAHL) and reference lists of relevant reviews were searched from inception to December 2017, with no language restrictions applied. Randomized controlled trials (RCTs), evaluating the effect of psychostimulants on cognitive impairment among cancer patients with no primary or secondary brain tumor or brain radiation, were included. The primary outcome was cognitive function changes, whereas secondary outcomes were adverse events (AEs) and QoL. RESULTS Six RCTs were included: three studies investigating methylphenidate and three modafinil, with a total of 244 and 146 patients, respectively. Due to important differences in methodologies between studies, a meta-analysis was assumed inappropriate for the primary outcome. A narrative synthesis was performed. One study using methylphenidate and two using modafinil demonstrated improvements in some cognitive functions as measured by objective cognitive assessment tests. Psychostimulants did not improve QoL and were not associated with more AEs. CONCLUSION To date, limited evidence is available to estimate the usefulness (or lack) of psychostimulants on cognitive function in this population.
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Affiliation(s)
- Nadia Miladi
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
| | - Richi Dossa
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
| | - Maman Joyce Dogba
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
| | | | - Bruno Gagnon
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada.
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The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2019; 27:3701-3716. [DOI: 10.1007/s00520-019-04911-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
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34
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Wu C, Tang C. Reply to: Qigong as a Promising Mind-Body Exercise for Cognitive Functioning. J Am Geriatr Soc 2019; 67:1534-1535. [PMID: 31026354 DOI: 10.1111/jgs.15952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Chunxiao Wu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
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Ibañez GE, Fennie K, Larkey L. Qigong as a promising mind-body exercise for cognitive functioning: Letter to Editor. J Am Geriatr Soc 2019; 67:1533-1534. [PMID: 31026350 DOI: 10.1111/jgs.15953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 03/17/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Gladys E Ibañez
- Department of Epidemiology, Florida International University, Miami, Florida
| | - Kristopher Fennie
- Department of Epidemiology, Florida International University, Miami, Florida
| | - Linda Larkey
- College of Nursing and Health Innovations, Arizona State University, Phoenix, Arizona
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Abstract
PURPOSE OF REVIEW Qigong and Tai Chi are two increasingly popular mind-body interventions with the potential to address the multifaceted needs of cancer survivors. The aim of this updated review and meta-analysis was to quantitatively evaluate the treatment effects of Qigong/Tai Chi on cancer survivors since 2014. RECENT FINDINGS There were statistically significant and clinically meaningful effects in favor of Qigong/Tai Chi interventions for symptoms of fatigue and sleep quality. There were positive trends, but not statistically significant effects, observed for anxiety, stress, depressive symptoms, and overall quality of life (QOL). Cancer-related cognitive impairment is a common complaint among cancer survivors that has received increasing attention in this area in recent years. Qigong/Tai Chi in cancer care shows great promise with short-term effects in treating many cancer-related symptoms. Further methodologically sound trials with longer follow-up periods and more active control conditions are required, before definitive conclusions can be recommended for cancer patients.
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A Cognitive-Behavioral Intervention for the Symptom Clusters of Chinese Patients With Gastrointestinal Tract Cancer Undergoing Chemotherapy: A Pilot Study. Cancer Nurs 2018; 42:E24-E31. [PMID: 30045133 DOI: 10.1097/ncc.0000000000000625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with gastrointestinal tract (GIT) cancer undergoing chemotherapy often experience several symptoms that constitute symptom clusters and can cause patients to suffer. Effective interventions are lacking for this kind of patients. OBJECTIVE The aims of this study were to test the feasibility and acceptability of a cognitive-behavioral (CB) intervention developed for Chinese patients with GIT cancer undergoing chemotherapy and to estimate the efficacy of the intervention for symptom clusters. METHODS In this pilot, quasi-randomized controlled trial, 40 patients were assigned to the CB intervention or control group. The CB intervention, considering characteristics of patients and Chinese culture, contained 4 sections including cognitive reframing, cancer-diet education, relaxation, and exercise techniques. Symptom clusters, illness perception, anxiety, and depression were measured. RESULTS Thirty-nine patients (97.5%) completed the study program and expressed willingness to follow the intervention. Compared with the control group, all outcomes were improved (all P < .05) in the CB group after the intervention, except for the gastrointestinal symptom cluster (t = 0.25, P = .802). In the CB group, the scores of all outcomes (all P < .05) decreased except for depression (t = 1.76, P = .095). CONCLUSION The CB intervention is partially feasible and acceptable. It may also help to improve part of the symptom clusters of Chinese patients with GIT cancer undergoing chemotherapy. However, some modifications are needed in future studies to better test effectiveness. IMPLICATIONS FOR PRACTICE Symptom management remains a major problem in clinical nursing. Such a CB intervention can be beneficial to the clinical management of symptom clusters.
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Body Composition Outcomes of Tai Chi and Qigong Practice: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Behav Med 2018; 25:487-501. [PMID: 29856007 DOI: 10.1007/s12529-018-9725-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE Meditative movement (MM) practices are increasingly being studied, including examination of the potential for these modalities to contribute to weight management. METHODS A search was conducted for randomized controlled trials testing one or both of two forms of MM, Tai Chi and Qigong, reporting effects on changes in body composition. Data from these studies were extracted and tabled, and a meta-analysis of studies with inactive control conditions was conducted. Risk of bias was assessed, and seven RCTs had a low risk of bias. Sources of bias include publication bias and selection of English only. RESULTS Publications meeting inclusion criteria yielded 24 studies (N = 1621 participants). Significant improvements in body composition, primarily body mass index, were noted for 41.7% of studies. A synthesis table describes the distribution of design factors, including type of comparison condition (inactive vs. active) and baseline body composition status (whether or not overweight/obese). A meta-analysis was conducted on 12 studies with inactive controls (using a random effects model) finding a small-to-medium treatment effect (SMD = - 0.388, CI = [- 0.732, - 0.044], t = 2.48, p < 0.03) for TC or QG interventions with a high level of heterogeneity. CONCLUSIONS Tai Chi and Qigong show demonstrable effects on body composition, when compared to inactive control conditions. Systematic evaluation and valid conclusions regarding the impact of Tai Chi and Qigong on body composition outcomes will require more targeted study designs and control of comparison conditions.
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Hartman SJ, Nelson SH, Myers E, Natarajan L, Sears DD, Palmer BW, Weiner LS, Parker BA, Patterson RE. Randomized controlled trial of increasing physical activity on objectively measured and self-reported cognitive functioning among breast cancer survivors: The memory & motion study. Cancer 2018; 124:192-202. [PMID: 28926676 PMCID: PMC5735009 DOI: 10.1002/cncr.30987] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/17/2017] [Accepted: 08/16/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Increasing physical activity can improve cognition in healthy and cognitively impaired adults; however, the benefits for cancer survivors are unknown. The current study examined a 12-week physical activity intervention, compared with a control condition, on objective and self-reported cognition among breast cancer survivors. METHODS Sedentary breast cancer survivors were randomized to an exercise arm (n = 43) or a control arm (n = 44). At baseline and at 12 weeks, objective cognition was measured with the National Institutes of Health Cognitive Toolbox, and self-reported cognition using the Patient-Reported Outcomes Measurement Information System scales. Linear mixed-effects regression models tested intervention effects for changes in cognition scores. RESULTS On average, participants (n = 87) were aged 57 years (standard deviation, 10.4 years) and were 2.5 years (standard deviation, 1.3 years) post surgery. Scores on the Oral Symbol Digit subscale (a measure of processing speed) evidenced differential improvement in the exercise arm versus the control arm (b = 2.01; P < .05). The between-group differences in improvement on self-reported cognition were not statistically significant but were suggestive of potential group differences. Time since surgery moderated the correlation, and participants who were ≤2 years post surgery had a significantly greater improvement in Oral Symbol Digit score (exercise vs control (b = 4.00; P < .01), but no significant improvement was observed in patients who were >2 years postsurgery (b = -1.19; P = .40). A significant dose response was observed with greater increased physical activity associated with objective and self-reported cognition in the exercise arm. CONCLUSIONS The exercise intervention significantly improved processing speed, but only among those who had been diagnosed with breast cancer within the past 2 years. Slowed processing speed can have substantial implications for independent functioning, supporting the potential importance of early implementation of an exercise intervention among patients with breast cancer. Cancer 2018;124:192-202. © 2017 American Cancer Society.
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Affiliation(s)
- Sheri J. Hartman
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Sandahl H. Nelson
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Emily Myers
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Loki Natarajan
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Dorothy D. Sears
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
- Department of Medicine, UC San Diego, La Jolla, CA, USA
| | - Barton W. Palmer
- Department of Psychiatry, UC San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Lauren S. Weiner
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Barbara A. Parker
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
- Department of Medicine, UC San Diego, La Jolla, CA, USA
| | - Ruth E. Patterson
- Department of Family Medicine and Public Health, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, USA
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Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. J Cancer Surviv 2017; 12:256-267. [PMID: 29222705 DOI: 10.1007/s11764-017-0665-5] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/29/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aims to summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind-body exercises on symptoms and quality of life (QOL) in cancer survivors. METHODS A systematic search in four electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and QOL in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges' g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed. RESULTS Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n = 7), prostate (n = 2), lymphoma (n = 1), lung (n = 1), or combined (n = 4) cancers. RCT comparison groups included active intervention (n = 7), usual care (n = 5), or both (n = 3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue (ES = - 0.53, p < 0.001), sleep difficulty (ES = - 0.49, p = 0.018), depression (ES = - 0.27, p = 0.001), and overall QOL (ES = 0.33, p = 0.004); a statistically non-significant trend was observed for pain (ES = - 0.38, p = 0.136). Random effects models were used for meta-analysis based on Q test and I 2 criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results. CONCLUSIONS Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made. IMPLICATIONS FOR CANCER SURVIVORS TCQ shows promise in addressing cancer-related symptoms and QOL in cancer survivors.
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Abstract
PURPOSE OF REVIEW Due to medical advances and an aging population, the number of cancer survivors continues to rise. Survivors often experience late and long-term sequelae of cancer and its treatment (e.g., fatigue, pain, fear of recurrence, and stress). As a result, some patients have utilized or expressed interest in integrative medicine (IM) modalities for prevention of recurrence, optimizing health, enhancing quality of life, and managing symptoms. The purpose of this review is to focus on research published during the past year that informs our understanding of the utility of IM for cancer survivors. RECENT FINDINGS Physical activity, diet, dietary supplements, mind-body modalities, acupuncture, and massage therapy all may play a role in the management of the physical (e.g., fatigue and pain) and emotional (e.g., anxiety and fear) issues faced by cancer survivors. SUMMARY IM therapies are appealing to and utilized by many cancer survivors and may reduce symptom burden. Clinicians who provide cancer survivorship care may improve patient care by understanding the evidence for and against their use.
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Subramani R, Lakshmanaswamy R. Complementary and Alternative Medicine and Breast Cancer. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 151:231-274. [DOI: 10.1016/bs.pmbts.2017.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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