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Kang DW, Dawson JK, Barnes O, Wilson RL, Norris MK, Gonzalo-Encabo P, Christopher CN, Ficarra S, Dieli-Conwright CM. Resistance Exercise and Skeletal Muscle-Related Outcomes in Patients with Cancer: A Systematic Review. Med Sci Sports Exerc 2024; 56:1747-1758. [PMID: 38650124 DOI: 10.1249/mss.0000000000003452] [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: 04/25/2024]
Abstract
BACKGROUND Skeletal muscle loss is prevalent throughout the cancer continuum and correlated with morbidity and mortality. Resistance exercise has been trialed to mitigate skeletal muscle loss. This systematic review summarizes and qualitatively synthesizes the effects of resistance exercise on muscle-related outcomes in adult cancer populations, including skeletal muscle mass, performance and muscle-related biomarkers. METHODS The systematic review protocol was developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). We searched electronic databases including AMED, CENTRAL, CINAHL, CIRRIE, EMBASE, MEDLINE, PEDro, REHABDATA, Scopus, and SPORTDiscus from inception to December 2021. We included randomized controlled trials that investigated the effects of resistance exercise on muscle-related outcomes in adult cancer populations. Interventions that involved any resistance exercise were included. Muscle-related outcomes were categorized as skeletal muscle mass (e.g., lean mass, appendicular muscle mass), muscle performance (e.g., muscle strength, physical function), and muscle-related biomarkers (e.g., muscle cells, metabolic/inflammatory markers). Risk of bias (RoB) was assessed using the Cochrane ROB tool. RESULTS A total of 102 studies from 101 randomized controlled trials were included. The majority of studies focused on breast cancer (46%) and those who completed treatment (43%). Resistance exercise interventions were largely 3-4 months long (48%), combined with aerobic exercise (56%), at a vigorous intensity (25%), and in-person/supervised settings (57%). Among the studies assessing muscle mass, performance, and biomarkers ( n = 42, 83, and 22, respectively), resistance exercise interventions improved upper/lower body or appendicular muscle mass (67%-100%), muscle strength (61%-68%), and physical function (74%-100%). Most biomarkers did not show significant changes (75%-100%) or showed inconsistent results. CONCLUSIONS Generally, resistance exercise had positive effects on skeletal muscle mass and performance with no negative effects compared to controls. Our findings demonstrated that resistance exercise may be an effective strategy to attenuate deterioration or exert improvements in muscle mass and performance outcomes.
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Affiliation(s)
| | - Jacqueline K Dawson
- Department of Physical Therapy, California State University, Long Beach, Long Beach, CA
| | - Oscar Barnes
- Green Templeton College, University of Oxford, UNITED KINGDOM
| | | | - Mary K Norris
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Salvatore Ficarra
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, ITALY
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Fourgeaud C, Vignes S. New insights in breast cancer-related lymphedema. JOURNAL DE MEDECINE VASCULAIRE 2024; 49:135-140. [PMID: 39278693 DOI: 10.1016/j.jdmv.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 06/13/2024] [Indexed: 09/18/2024]
Abstract
Upper limb lymphedema after breast cancer treatment including axillary dissection occurs in almost 20% of women. Its treatment consists of complete decongestive physiotherapy based on low-stretch bandage to reduce volume, followed by elastic compression to maintain it. In this article, we will detail recent data on lymphedema risk factors with possible genetic predisposition, prevention (surgical, compression), manual lymphatic drainage, physical activity, weight, advice, and treatments including gene therapy.
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Affiliation(s)
- Caroline Fourgeaud
- Department of Lymphology, Cognacq-Jay Hospital, centre de référence des lymphœdèmes primaires, 15, rue Eugène Millon, 75015 Paris, France
| | - Stéphane Vignes
- Department of Lymphology, Cognacq-Jay Hospital, centre de référence des lymphœdèmes primaires, 15, rue Eugène Millon, 75015 Paris, France.
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Bernas M, Al-Ghadban S, Thiadens SRJ, Ashforth K, Lin WC, Safa B, Buntic R, Paukshto M, Rovnaya A, McNeely ML. Etiology and treatment of cancer-related secondary lymphedema. Clin Exp Metastasis 2024; 41:525-548. [PMID: 37777696 DOI: 10.1007/s10585-023-10232-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/28/2023] [Indexed: 10/02/2023]
Abstract
Lymphedema and specifically cancer-related lymphedema is not the main focus for both patients and physicians dealing with cancer. Its etiology is an unfortunate complication of cancer treatment. Although lymphedema treatments have gained an appreciable consensus, many practitioners have developed and prefer their own specific protocols and this is especially true for conventional (manual) versus surgical treatments. This collection of presentations explores the incidence and genetics of cancer-related lymphedema, early detection and monitoring techniques, both conventional and operative treatment options, and the importance and role of exercise for patients with cancer-related lymphedema. These assembled presentations provide valuable insights into the challenges and opportunities presented by cancer-related lymphedema including the latest research, treatments, and exercises available to improve patient outcomes and quality of life.
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Affiliation(s)
- Michael Bernas
- Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX, USA.
| | - Sara Al-Ghadban
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | - Karen Ashforth
- St. Joseph's Medical Center, University of the Pacific, Stockton, CA, USA
| | - Walter C Lin
- Buncke Clinic, San Francisco, CA, USA
- Department of Surgery, Saint Francis Memorial Hospital, San Francisco, CA, USA
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Wang J, Ma J, Zhang Y, Tian Y, Wang X, Wang Y, Xiang D, Wang D, Huang K, Mao L, Zhang J, Fan H, Li Y. The rehabilitation efficacy of diaphragmatic breathing combined with limb coordination training for lower limb lymphedema following gynecologic cancer surgery. Front Bioeng Biotechnol 2024; 12:1392824. [PMID: 38903184 PMCID: PMC11187277 DOI: 10.3389/fbioe.2024.1392824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/30/2024] [Indexed: 06/22/2024] Open
Abstract
Objective To investigate the impact of diaphragmatic breathing combined with limb training on lower limb lymphedema following surgery for gynecological cancer. Methods From January 2022 to May 2022, 60 patients with lower limb lymphedema post-gynecologic cancer surgery were chosen. They were split into a control group (n = 30) and a treatment group (n = 30). The control group underwent complex decongestive therapy (CDT) for managing lower limb lymphedema after gynecologic cancer surgery, while the treatment group received diaphragmatic breathing combined with limb coordination training alongside CDT. Both groups completed a 4-week treatment regimen. The lower limb lymphedema symptoms were evaluated using the genital, lower limb, buttock, and abdomen (GCLQ) scores; bilateral lower limb circumference measurements; and anxiety and depression scores. Results Compared to sole CDT administration, individuals undergoing diaphragmatic breathing coupled with limb coordination training experienced notable reductions in scores for the self-perceived symptom assessment questionnaire (GCLQ), bilateral lower limb circumference, as well as anxiety and depression scores. Conclusion The incorporation of diaphragmatic breathing combined withalongside limb coordination training can accelerate and augment the efficacy of treating lower limb lymphedema post-gynecologic cancer surgery.
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Affiliation(s)
- Jingxin Wang
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
| | - Jiahui Ma
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
- Xinxiang Medical University, Xinxiang, China
| | - Yujie Zhang
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fujian Key Laboratory of Molecular Neurology and Institute of Neuroscience, Fujian Medical University, Fuzhou, China
| | - Yuan Tian
- Department of Ultrasound Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
| | - Xinxin Wang
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
| | - Yu Wang
- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Dongquan Xiang
- Senior Department of Orthopedics, The Fourth Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Daoyu Wang
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Kun Huang
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
| | - Luxi Mao
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
| | - Jiaxin Zhang
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
| | - Huixuan Fan
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
| | - Yilan Li
- Department of Rehabilitation Medicine, Zhengzhou Central Hospital Affiliated Zhengzhou University, Zhengzhou, China
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Lian Y, Sandhu S, Asefa Y, Gupta A. The Effect of Exercise on Reducing Lymphedema Severity in Breast Cancer Survivors. Cancers (Basel) 2024; 16:1367. [PMID: 38611045 PMCID: PMC11011010 DOI: 10.3390/cancers16071367] [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: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Exercise has been repeatedly shown to be safe and beneficial for cancer survivors. However, there is no normative guideline for exercise prescription, and it is still under exploration. Therefore, this literature review aims to provide some advice for the formulation of exercise prescriptions for patients with breast cancer-related lymphedema (BCRL) from the perspective of reducing lymphedema severity. A review of relevant studies published before November 2023 was conducted using three scientific databases: PubMed, Embase, and Scopus. A total of 2696 articles were found. Eventually, 13 studies fulfilled the inclusion criteria and were included in this literature review. We concluded that daily, or nearly daily, exercise at home can be recommended. Moreover, reduced lymphedema severity may not be maintained after ceasing the exercise program, so exercise should be a lifelong practice.
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Affiliation(s)
| | | | | | - Ananya Gupta
- Department of Physiology, University of Galway, H91-TK33 Galway, Ireland; (Y.L.); (S.S.); (Y.A.)
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Soriano-Maldonado A, Díez-Fernández DM, Esteban-Simón A, Rodríguez-Pérez MA, Artés-Rodríguez E, Casimiro-Artés MA, Moreno-Martos H, Toro-de-Federico A, Hachem-Salas N, Bartholdy C, Henriksen M, Casimiro-Andújar AJ. Effects of a 12-week supervised resistance training program, combined with home-based physical activity, on physical fitness and quality of life in female breast cancer survivors: the EFICAN randomized controlled trial. J Cancer Surviv 2023; 17:1371-1385. [PMID: 35314958 PMCID: PMC10442259 DOI: 10.1007/s11764-022-01192-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/08/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE This study assessed the effects of 12-week supervised resistance training combined with home-based physical activity on physical fitness, cancer-related fatigue, depressive symptoms, health-related quality of life (HRQoL), and life satisfaction in female breast cancer survivors. METHODS A parallel-group, outcome assessor-blinded, randomized controlled trial included 60 female breast cancer survivors who had completed their core treatments within the previous 10 years. Through computer-generated simple randomization, participants were assigned to resistance training (RTG; two sessions/week for 12 weeks plus instructions to undertake ≥ 10,000 steps/d) or control (CG; ≥ 10,000 steps/d only). Outcomes were evaluated at baseline and week 12. Muscular strength was assessed with electromechanical dynamometry. A standardized full-body muscular strength score was the primary outcome. Secondary outcomes included cardiorespiratory fitness, shoulder mobility, cancer-related fatigue, depressive symptoms, HRQoL, and life satisfaction. RESULTS Thirty-two participants were assigned to RTG (29 achieved ≥ 75% attendance) and 28 to CG (all completed the trial). Intention-to-treat analyses revealed that the standardized full-body muscular strength score increased significantly in the RTG compared to the CG (0.718; 95% CI 0.361-1.074, P < 0.001, Cohen's d = 1.04). This increase was consistent for the standardized scores of upper-body (0.727; 95% CI 0.294-1.160, P = 0.001, d = 0.87) and lower-body (0.709; 95% CI 0.324-1.094, P = 0.001, d = 0.96) strength. There was no effect on cardiorespiratory fitness, shoulder flexion, cancer-related fatigue, depressive symptoms, HRQoL, or life satisfaction. The sensitivity analyses confirmed these results. CONCLUSION and implication for cancer survivors. In female breast cancer survivors who had completed their core treatments within the past 10 years, adding two weekly sessions of supervised resistance training to a prescription of home-based physical activity for 12 weeks produced a large increase in upper-, lower-, and full-body muscular strength, while other fitness components and patient-reported outcomes did not improve. TRIAL REGISTRATION NUMBER ISRCTN14601208.
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Affiliation(s)
- Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - David M. Díez-Fernández
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Alba Esteban-Simón
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Manuel A. Rodríguez-Pérez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Eva Artés-Rodríguez
- Area of Statistics and Operative Research, Department of Mathematics, Faculty of Sciences, University of Almería, Almería, Spain
| | | | - Herminia Moreno-Martos
- Servicio Andaluz de Salud, Unidad de Gestión Clínica Almería Periferia, Distrito Sanitario, Almería, Spain
| | - Antonio Toro-de-Federico
- Servicio Andaluz de Salud, Unidad de Gestión Clínica Ciudad Jardín, Distrito Sanitario, Almería, Spain
| | - Nur Hachem-Salas
- Servicio Andaluz de Salud, Unidad de Gestión Clínica Mediterráneo-Torrecárdenas, Distrito Sanitario, Almería, Spain
| | - Cecilie Bartholdy
- The Parker Institute, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Marius Henriksen
- The Parker Institute, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Antonio J. Casimiro-Andújar
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
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Zhao Y, Tang L, Shao J, Chen D, Jiang Y, Tang P, Wang X. The effectiveness of exercise on the symptoms in breast cancer patients undergoing adjuvant treatment: an umbrella review of systematic reviews and meta-analyses. Front Oncol 2023; 13:1222947. [PMID: 37799468 PMCID: PMC10548878 DOI: 10.3389/fonc.2023.1222947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
Background Exercise has the potential to reduce symptoms for breast cancer patients during adjuvant treatment, and high-quality systematic reviews are essential for guiding clinical practice. The objective of this umbrella review is to examine current research evidence concerning the effectiveness of exercise on symptom management in breast cancer patients undergoing adjuvant treatment. Methods An umbrella review was conducted. We searched for eligible systematic reviews through 11 databases until August 13rd, 2023. Two authors independently screened titles and abstracts, assessing the full-text studies based on inclusion criteria. We used AMSTAR-2 to appraise the quality of the meta-analyses. The results would be presented with narrative summaries if the replication rate of the original study for a symptom was higher than 5% (calculated via the Corrected Covered Area, CCA). The protocol was documented in the PROSPERO registry (CRD42023403990). Results Of the 807 systematic reviews identified, 15 met the inclusion criteria, and 7 symptoms were the main focus. The main form of exercise mentioned was aerobic combined resistance exercise. The results of the quality assessment were mostly critically low (10/15). The repetition rate calculated by CCA showed moderate to very high repetition rates (10% to 18.6%). The findings of the included reviews indicated that the effects of exercise on relieving symptoms during breast cancer adjuvant treatment were mixed. Conclusions Research is still needed to confirm the majority of studies' recommendations for exercise during adjuvant treatment for breast cancer patients, as it is crucial for managing symptoms in the rehabilitation process. To increase the efficiency of exercise in symptom management, future studies may focus more on the application of bridge symptoms, symptom networks, and ecological instantaneous assessment.
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Affiliation(s)
- Yuan Zhao
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Leiwen Tang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Jing Shao
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Dandan Chen
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Yueying Jiang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Panpan Tang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Xueqing Wang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
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Aguilera-Eguía RA, Gutiérrez-Arias R, Zaror C, Seron P. Effectiveness of physical exercise programmes in reducing complications associated with secondary lymphoedema to breast cancer: a protocol for an overview of systematic reviews. BMJ Open 2023; 13:e071630. [PMID: 37429694 PMCID: PMC10335487 DOI: 10.1136/bmjopen-2023-071630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION Breast cancer-related lymphoedema (BCRL) is one of the most underestimated and debilitating complications associated with the treatment that women with breast cancer receive. Several systematic reviews (SRs) of different physical exercise programmes have been published, presenting disperse and contradictory clinical results. Therefore, there is a need for access to the best available and summarised evidence to capture and evaluate all the physical exercise programmes that focus on reducing BCRL. OBJECTIVE To evaluate the effectiveness of different physical exercise programmes in reducing the volume of lymphoedema, pain intensity and improving quality of life. METHOD AND ANALYSIS The protocol of this overview is reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, and its methodology is based on Cochrane Handbook for Systematic Reviews of Interventions. Only those SRs involving physical exercise by patients with BCRL will be included, whether on its own or combined with other exercises or other physical therapy interventions.The outcomes of interest to be considered will be lymphoedema volume, quality of life, pain intensity, grip strength, range of motion, upper limb function and any adverse event. The MEDLINE/PubMed, Lilacs, Cochrane Library, PEDro and Embase databases will be searched for reports published from database inception to April 2023.Two researchers will perform study selection, data extraction and risk of bias assessment independently. Any discrepancy will be resolved by consensus, or ultimately, by a third-party reviewer. We will use Grading of Recommendations Assessment, Development and Evaluation System to assess the overall quality of the body of evidence. ETHICS AND DISSEMINATION The results of this overview will be published in peer-reviewed scholarly journals and the scientific dissemination will take place in national or international conferences. This study does not require approval from an ethics committee, as it does not directly collect information from patients. PROSPERO REGISTRATION NUMBER CRD42022334433.
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Affiliation(s)
- Raúl Alberto Aguilera-Eguía
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepcion, Chile
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ruvistay Gutiérrez-Arias
- Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Santiago, Chile
| | - Carlos Zaror
- Pediatric Dentist and Orthodontic, Universidad de La Frontera, Temuco, Chile
| | - Pamela Seron
- CIGES, Universidad de La Frontera, Temuco, Chile
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Petrigna L, Zanghì M, Maugeri G, D'Agata V, Musumeci G. Methodological consideration for a physical activity intervention in breast cancer population: An umbrella review. Heliyon 2023; 9:e17470. [PMID: 37455988 PMCID: PMC10338308 DOI: 10.1016/j.heliyon.2023.e17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Breast cancer patients and survivors are increasing in the last years such as their mean age. A feasible and useful complementary intervention to improve physical and psychological health, and decrease some disease symptoms seems to be physical activity. Consequently, this umbrella review wanted to analyze the protocols of different physical activity interventions and to eventually propose a standard operating procedure for possible exercise training in breast cancer patients.Design, Data sources, Eligibility criteria. The electronic databases PubMed, Scopus, and Web of Science were searched till 25 March 2022 to detect all systematic review and meta-analysis of randomized controlled trials on this topic. The studies were analyzed narratively and evaluated with a scale to assess their quality. Results The studies presented heterogeneity in their population included in terms of disease stage and treatments, intervention protocols and outcomes evaluated. This made difficult to synthesize the findings. Conclusion It was not possible to propose a standard operating procedure but some indications were proposed to provide feedback for future studies. Ideally, an intervention should be composed of combined training (aerobic and resistance training) with a component of a mindfulness intervention, with an intensity from moderate to high, and 3 times a week. The intervention should be supervised in the first period and then it could be home-based. Exercise training should be personalized to the patients treated.
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Affiliation(s)
- Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Velia D'Agata
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Department of Biology, College of Science and Technology, Sbarro Health Research Organization, Temple University, Philadelphia, PA, 19122, USA
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Marotta N, Lippi L, Ammendolia V, Calafiore D, Inzitari MT, Pinto M, Invernizzi M, de Sire A. Efficacy of kinesio taping on upper limb volume reduction in patients with breast cancer-related lymphedema: a systematic review of randomized controlled trials. Eur J Phys Rehabil Med 2023; 59:237-247. [PMID: 36847633 PMCID: PMC10167702 DOI: 10.23736/s1973-9087.23.07752-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/10/2023] [Accepted: 01/27/2023] [Indexed: 03/01/2023]
Abstract
INTRODUCTION One of the most common disabling complications in breast cancer (BC) patients is breast cancer-related lymphedema (BCRL), a pathological condition affecting both physical and psychological function, with detrimental consequences on health-related quality of life (HR-QoL). Rehabilitation has a key role in the comprehensive management of this condition with several studies reporting positive results after performing complex decongestive therapies (CDT) in these women. Kinesio taping (KT) is a rather recent therapeutic approach to treat BCRL, however, evidence in literature regarding its effectiveness is far from being fully characterized. Therefore, this systematic review aimed at assessing the role of KT among the CDT to treat BCRL. EVIDENCE ACQUISITION PubMed, Scopus, and Web of Science were systematically searched from inception until May 5th, 2022 to determine randomized control trials (RCTs) reporting patients with BCRL; KT as intervention; limb volume as outcome (PROSPERO number: CRD42022349720). EVIDENCE SYNTHESIS Out of the documents identified, 123 were eligible for data screening, and only 7 RCTs satisfied the eligibility criteria and were included. We found that KT might have a positive effect on limb volume reduction in patients with BCRL, albeit there is little evidence for low quality of the included studies. CONCLUSIONS Taken together, this systematic review showed that KT did not significantly reduce the upper limb volume in BCRL women, albeit it seemed to increase the flow rate during the passive exercise. Further high-quality-studies are mandatory to improve the knowledge in order to include the KT might into a multidisciplinary rehabilitative approach for the management of BC survivors affected by lymphedema.
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Affiliation(s)
- Nicola Marotta
- Unit of Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Lorenzo Lippi
- Unit of Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
- Unit of Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Valerio Ammendolia
- Unit of Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Dario Calafiore
- Unit of Physical Medicine and Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantua, Italy
| | - Maria T Inzitari
- Unit of Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Monica Pinto
- Unit of Rehabilitation Medicine, Department of Strategic Health Services, IRCCS Istituto Nazionale Tumori - G. Pascale Foundation, Naples, Italy
| | - Marco Invernizzi
- Unit of Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
- Unit of Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Alessandro de Sire
- Unit of Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy -
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Crevenna R, Hasenoehrl T, Wiltschke C, Kainberger F, Keilani M. Prescribing Exercise to Cancer Patients Suffering from Increased Bone Fracture Risk Due to Metastatic Bone Disease or Multiple Myeloma in Austria-An Inter- and Multidisciplinary Evaluation Measure. Cancers (Basel) 2023; 15:cancers15041245. [PMID: 36831587 PMCID: PMC9954683 DOI: 10.3390/cancers15041245] [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: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION In the current absence of specific functional fracture risk assessment technology, the planning of physical exercise interventions for cancer patients suffering from increased bone fracture risk remains a serious clinical challenge. Until a reliable, solely technical solution is available for the clinician, fracture risk assessment remains an inter- and multidisciplinary decision to be made by various medical experts. The aim of this short paper is depicting how this challenge should be approached in the clinical reality according to Austrian experts in cancer rehabilitation, presenting the best-practice model in Austria. Following referral from the specialist responsible for the primary cancer treatment (oncologist, surgeon, etc.), the physiatrist takes on the role of rehabilitation case manager for each individual patient. Fracture risk assessment is then undertaken by specialists in radiology, orthopedics, oncology, and radiation therapy, with the result that the affected bone regions are classified as being at highly/slightly/not increased fracture risk. Following internal clearance, exercise planning is undertaken by a specialist in exercise therapy together with the physiatrist based on the individual's fracture risk assessment. In the case in which the patient shows exercise limitations due to additional musculoskeletal impairments, adjuvant physical modalities such as physiotherapy should be prescribed to increase exercisability. CONCLUSION Exercise prescription for cancer patients suffering from increased fracture risk is an inter- and multidisciplinary team decision for each individual patient.
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Affiliation(s)
- Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-43300; Fax: +43-1-40400-52810
| | - Timothy Hasenoehrl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Christoph Wiltschke
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Franz Kainberger
- Department of Radiology and Osteology, Medical University of Vienna, 1090 Vienna, Austria
| | - Mohammad Keilani
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, 1090 Vienna, Austria
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12
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What are the physiologic effects of Resistance Exercise behind breast cancer-related lymphedema prevention? Med Hypotheses 2023. [DOI: 10.1016/j.mehy.2023.111022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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13
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What do we know about treating breast-cancer-related lymphedema? Review of the current knowledge about therapeutic options. Breast Cancer 2023; 30:187-199. [PMID: 36571707 PMCID: PMC9950281 DOI: 10.1007/s12282-022-01428-z] [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: 08/01/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022]
Abstract
Breast-cancer-related lymphedema (BCRL) is a common consequence of oncological treatment. Its management is a complicated, chronic, and arduous process. Therapeutic options can be divided on non-surgical and surgical methods, although there is still no clear consensus about their effectiveness in preventing or stopping the disease. That brings problems in everyday practice, as there are no guidelines about proper time for starting therapy and no agreement about which management will be beneficial for each patient. The aim of this review is to summarize current knowledge about possible treatment choices, non-surgical so as surgical, indicate knowledge gaps, and try to direct pathways for future studies.
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14
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Dawson JK, Kang DW, Barnes O, Wilson RL, Norris MK, Dieli-Conwright CM. Efficacy of resistive exercise on skeletal muscle-related outcomes in cancer survivors: a systematic review protocol. Syst Rev 2022; 11:252. [PMID: 36419204 PMCID: PMC9686078 DOI: 10.1186/s13643-022-02130-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Symptom burden and adverse treatment effects can negatively impact physical function, health-related outcomes, and quality of life in cancer survivors. Resistive exercise that improves skeletal muscle function can ameliorate these complications, but the central role of the skeletal muscle in mediating improvements in patient-related outcomes has not been explored. This protocol describes the rationale and methods for a systematic review that aims to determine the effects of resistive exercise on the skeletal muscle hypertrophy, muscle performance, and muscle-related biomarkers in cancer survivors. METHODS A systematic review will be conducted on peer-reviewed randomized controlled trials (RCTs) that employ resistive exercise interventions for cancer survivors. The following electronic databases will be searched: AMED, CENTRAL, CINAHL, CIRRIE, EMBASE, MEDLINE, PEDro, REHABDATA, Scopus, and SPORTDiscus. Studies will be considered for inclusion if they present quantitative data in adult cancer survivors on skeletal muscle characteristics (e.g., muscle mass), muscle performance (e.g., strength), or skeletal muscle-related biomarkers (e.g., myocellular satellite cells). Secondary outcomes will be physical function (e.g., stair climb) and patient-reported outcomes (e.g., fatigue). Data will be reported through a narrative that describes study design, participants, interventions, and outcome characteristics. DISCUSSION This systematic review will help clarify the influence of resistive exercise on factors relating to the skeletal muscle in adult cancer survivors. Findings may provide insight into optimal exercise selection for evidence-based practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO: #277791 [under review].
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Affiliation(s)
- Jacqueline K Dawson
- Department of Physical Therapy, California State University, Long Beach, Long Beach, CA, USA
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Oscar Barnes
- Green Templeton College, University of Oxford, Oxford, UK
| | - Rebekah L Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mary K Norris
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. .,Department of Medicine, Harvard Medical School, Boston, MA, USA.
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15
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Aguilera-Eguía RA, Seron P, Gutiérrez-Arias R, Zaror C. Which physical therapy intervention is most effective in reducing secondary lymphoedema associated with breast cancer? Protocol for a systematic review and network meta-analysis. BMJ Open 2022; 12:e065045. [PMID: 36167383 PMCID: PMC9516218 DOI: 10.1136/bmjopen-2022-065045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/31/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Lymphoedema associated with breast cancer is caused by an interruption of the lymphatic system, together with factors such as total mastectomy, axillary dissection, positive lymph nodes, radiotherapy, use of taxanes and obesity. Physiotherapy treatment consists of complex decongestive therapy, manual lymphatic drainage and exercises, among other interventions. Currently, there are several systematic review and randomised controlled trials that evaluate the efficacy of these interventions. However, at present, there are no studies that compare the effectiveness of all these physical therapy interventions. The purpose of this study is to determine which physical therapy treatment is most effective in reducing breast cancer-related lymphoedema, improving quality of life and reducing pain. METHODS AND ANALYSIS MEDLINE, PEDro, CINAHL, EMBASE, LILACS and Cochrane Central Register of Controlled Trials will be searched for reports of randomised controlled trials published from database inception to June 2022. We will only include studies that are written in English, Spanish and Portuguese. We will also search grey literature, preprint servers and clinical trial registries. The primary outcomes are reduction of secondary lymphoedema associated with breast cancer, improvements in quality of life and pain reduction. The risk of bias of individual studies will be evaluated using the Cochrane Risk of Bias 2.0 Tool. A network meta-analysis will be performed using a random-effects model. First, pairs will be directly meta-analysed and indirect comparisons will be made between the different physical therapy treatments. The GRADE system will be used to assess the overall quality of the body of evidence associated with the main results. ETHICS AND DISSEMINATION This protocol does not require approval from an ethics committee. The results will be disseminated via peer-reviewed publications. PROSPERO REGISTRATION NUMBER CDR42022323541.
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Affiliation(s)
- Raúl Alberto Aguilera-Eguía
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepcion, Chile
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pamela Seron
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
- CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Ruvistay Gutiérrez-Arias
- Servicio de Medicina Física y Rehabilitación, Unidad de Kinesiología, Instituto Nacional del Tórax, Santiago, Chile
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile
| | - Carlos Zaror
- CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
- Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
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16
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Martínez‐Jaimez P, Fuster Linares P, Piller N, Masia J, Yamamoto T, López‐Montoya L, Monforte‐Royo C. Multidisciplinary preventive intervention for breast cancer‐related lymphedema: An international consensus. Eur J Cancer Care (Engl) 2022; 31:e13704. [DOI: 10.1111/ecc.13704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Patricia Martínez‐Jaimez
- Breast Reconstruction and Lymphedema Surgery Unit Clínica Planas Barcelona Spain
- Nursing Department, Faculty of Medicine and Health Science Universitat Internacional de Catalunya Barcelona Spain
| | - Pilar Fuster Linares
- Nursing Department, Faculty of Medicine and Health Science Universitat Internacional de Catalunya Barcelona Spain
| | - Neil Piller
- Flinders Medical Centre, College of Medicine and Public Health Lymphoedema Clinical Research Unit, Flinders Centre for Innovation in Cancer Bedford Park SA Australia
| | - Jaume Masia
- Breast Reconstruction and Lymphedema Surgery Unit Clínica Planas Barcelona Spain
- Department of Plastic Surgery, Hospital de la Santa Creu i Sant Pau Universitat Autonòma de Barcelona Barcelona Spain
- Department of Plastic Surgery Hospital del Mar Barcelona Spain
| | - Takumi Yamamoto
- Department of Plastic and Reconstructive Surgery National Center for Global Health and Medicine Tokyo Japan
| | | | - Cristina Monforte‐Royo
- Nursing Department, Faculty of Medicine and Health Science Universitat Internacional de Catalunya Barcelona Spain
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17
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Wang L, Shi YX, Wang TT, Chen KX, Shang SM. Breast cancer-related lymphoedema and resistance exercise: An evidence-based review of guidelines, consensus statements and systematic reviews. J Clin Nurs 2022; 32:2208-2227. [PMID: 35894167 DOI: 10.1111/jocn.16437] [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: 09/09/2021] [Revised: 06/11/2022] [Accepted: 06/20/2022] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES Breast cancer-related lymphoedema (BCRL) is a side effect of cancer treatment and can be alleviated by resistance exercise. This systematic, evidence-based review examined the existing best evidence on resistance exercise for BCRL to accurately describe the current status of the field and offer recommendations for clinicians. METHODS This review adheres to the PRISMA guidelines. Clinical practice guidelines, consensus documents, systematic reviews and other related evidence-based resources about resistance exercise for BCRL were retrieved through the English databases and guideline websites. The publication data limit was set to December 2020. The following search terms were used: 'breast cancer/breast neoplasm/breast carcinoma/breast tumor/breast malignancy, lymphedema/swelling/edema/lymphoedema, resistance/weight/strength training, best practice/clinical practice/guideline/consensus documents'. The quality of the included studies was evaluated by two authors independently using AGREE II and AMSTAR II tools. Evidence-based recommendations on resistance exercise relevant for BCRL were synthesised and categorised. RESULTS Twenty two articles (seven guidelines, four consensus documents and eleven systematic reviews) were included. The overall quality of the eleven eligible guidelines and consensus documents was moderate to high according to the AGREE II criteria. The quality of the eleven systematic reviews was critically low to high according to the AMSTAR criteria. Six clinical topics involving 43 recommendations were identified. Recommendations were categorised by safety of resistance training, effectiveness of resistance training, evaluation prior to resistance exercise, resistance exercise prescription, resistance training outcome index and points for attention. CONCLUSIONS This study summarises 43 recommendations for resistance training for BCRL and provides guidance for clinicians. Based on randomised trials and systematic reviews published in recent years, there is an urgent need to update the guidelines and consensus documents in terms of topics, for example effectiveness of resistance training and resistance training outcome index.
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Affiliation(s)
- Ling Wang
- School of Nursing, Peking University, Beijing, China.,School of Nursing, Wannan Medical College, Wuhu, China
| | - Yue Xian Shi
- School of Nursing, Peking University, Beijing, China
| | - Ting Ting Wang
- Department of Lymphatic Surgery, Beijing Shijitan Hospital, Beijing, China
| | - Ke Xin Chen
- School of Nursing, Peking University, Beijing, China
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18
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Effect of a telehealth-based exercise intervention on the physical activity of patients with breast cancer: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2022; 9:100117. [PMID: 36276881 PMCID: PMC9583041 DOI: 10.1016/j.apjon.2022.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/05/2022] [Indexed: 12/01/2022] Open
Abstract
Telehealth-based exercise intervention as a non-pharmacological intervention has gradually emerged in breast cancer (BC), which shows feasibility and high levels of patient satisfaction. This systematic review aims to identify the effect of telehealth-based exercise interventions on the physical activity (PA) of patients with BC. We searched CENTRAL, CINAHL, PsycINFO, EMBASE, PubMed, Web of Science, ClinicalTrials.gov, CNKI, Wanfang, VIP, and SinoMed. Study selection and quality appraisal were performed independently by two reviewers. The review protocol was registered in PROSPERO (CRD42022326484). Nine studies, which included 1127 patients with BC, were identified. Compared with usual care, the telehealth-based exercise intervention had a significantly positive effect on PA (Standardized mean difference (SMD) = 0.26, 95% confidence interval (CI) 0.09 to 0.43, P = 0.003), aerobic capacity (SMD = 0.20, 95% CI 0.03 to 0.38, P = 0.02), upper body function (Mean difference (MD) = −4.56, 95% CI −7.66 to −1.47, P = 0.004), upper muscle strength (SMD = 0.26, 95% CI 0.09 to 0.42, P = 0.002), lower muscle strength (SMD = −0.95, 95% CI −1.27 to −0.62, P < 0.00001), abdominal muscle strength (MD = 23.85, 95% CI 13.84 to 33.86, P < 0.000,01), fatigue (SMD = 0.56, 95% CI 0.13 to 1.00, P = 0.01), and quality of life (SMD = 0.26, 95% CI 0.04 to 0.49, P = 0.02). Conversely, anthropometric and body composition and pain did not differ significantly between the two groups. Telehealth-based exercise intervention improved PA, physical performance, fatigue, and quality of life of patients with BC compared with routine care, which should be promoted clinically as a comprehensive treatment for BC.
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19
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Pilger TL, Ortolani AJM, Reis FJCDR. Physiotherapy in the prevention and treatment of upper limb complications in women with breast cancer. REVISTA CIÊNCIAS EM SAÚDE 2022. [DOI: 10.21876/rcshci.v12i2.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Breast cancer is the one that most affects the female population in Brazil and the world. Upper limb complications are common after cancer treatment, including conservative procedures. Old studies have already shown the effectiveness of physiotherapy in the rehabilitation of these complications. However, currently, physiotherapeutic care must be initiated from the diagnosis of the disease. Pre-rehabilitation prepares the patient to receive cancer treatment and promotes a reduction in rehabilitation time. Rehabilitation decreased the axillary cord by 57%, increased the range of motion (ROM) by 45º for flexion and 70º for shoulder abduction, the incidence of lymphedema was 11%, and there was a decrease of 3.4 points concerning pain on the Visual Scale Analog (EVA). The physical therapist should work with breast cancer to diagnose, prevent, and rehabilitate after cancer treatment, promoting functionality and quality of life for patients with breast cancer.
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20
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Ramírez-Parada K, Lopez-Garzon M, Sanchez-Rojel C, Petric-Guajardo M, Alfaro-Barra M, Fernández-Verdejo R, Reyes-Ponce A, Merino-Pereira G, Cantarero-Villanueva I. Effect of Supervised Resistance Training on Arm Volume, Quality of Life and Physical Perfomance Among Women at High Risk for Breast Cancer-Related Lymphedema: A Study Protocol for a Randomized Controlled Trial (STRONG-B). Front Oncol 2022; 12:850564. [PMID: 35299753 PMCID: PMC8921986 DOI: 10.3389/fonc.2022.850564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/01/2022] [Indexed: 01/31/2023] Open
Abstract
Objectives To determine the preventive effects of supervised resistance training on arms volume, quality of life, physical performance, and handgrip strength in Chilean women at high risk for breast cancer-related lymphedema (BCRL) undergoing chemotherapy. Design Randomized control trial. Participants One hundred and six women at high risk for breast cancer-related lymphedema aged 18 to 70 years. Interventions Participants will be randomized into two groups: [a] intervention, who will receive 12 weeks of supervised resistance training (STRONG-B) during adjuvant chemotherapy; and [b] control, who will receive education to promote lymphatic and venous return, maintain range of motion, and promote physical activity. Main Outcome Measures The primary outcome will be arms volume measured with an optoelectric device (perometer NT1000). Secondary outcomes will be quality of life, handgrip strength, and physical performance. Primary and secondary outcomes will be measured at baseline, just after the intervention, and 3 and 6 months after. Statistical analysis will be performed following intention-to-treat and per-protocol approaches. The treatment effect will be calculated using linear mixed models. Discussion The STRONG-B will be a tailored supervised resistance training that attempts to prevent or mitigate BCRL in a population that, due to both intrinsic and extrinsic factors, will commonly suffer from BCRL. Clinical Trial Registration [https://clinicaltrials.gov/ct2/show/NCT04821609], identifier NCT04821609.
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Affiliation(s)
- Karol Ramírez-Parada
- Carrera de Kinesiología, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria Lopez-Garzon
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Cesar Sanchez-Rojel
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Militza Petric-Guajardo
- Department of Surgery Dr Sótero del Río Hospital, Santiago, Chile
- Department of Surgery Davila Clinic, Santiago, Chile
| | - Margarita Alfaro-Barra
- Centro de Cáncer, Red de Salud U- Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Fernández-Verdejo
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Alvaro Reyes-Ponce
- Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andrés Bello, Viña del Mar, Chile
| | - Gina Merino-Pereira
- Departamento Manejo Integral del Cáncer y Otros Tumores, Subsecretaria de Salud Pública, Ministerio de Salud de Chile, Santiago, Chile
- Escuela de Medicina, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile
| | - Irene Cantarero-Villanueva
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
- Sport and Health Research Center (iMUDS), Granada, Spain
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21
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Pereira de Godoy AC, Guerreiro Godoy MDF, Pereira de Godoy LM, Pereira de Godoy HJ, Pereira de Godoy JM. Intensive Treatment for Upper Limb Lymphedema. Cureus 2021; 13:e18026. [PMID: 34540515 PMCID: PMC8448274 DOI: 10.7759/cureus.18026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction Breast cancer-related lymphedema (BCRL) is a complication of treatment for breast cancer. The aim of the present study is to report a form of intensive treatment for BCRL. Method A crossover study was conducted involving the evaluation of the change in the volume of the upper limbs of 45 women with BCRL who underwent the intensive Godoy Method® (eight hours/day for five days). Volumetric analyses were performed before and after treatment and differences were analyzed using the paired t-test. Reductions in volume were found in all patients. Results The average reduction was 45.38%. The reduction was between 15% and 20% in 6.67% of the women (n = 3); 20% to 30% in 13.33% (n = 6); 30% to 40% in 20% (n = 9); 40% to 50% in 40% (n = 18); and more than 50% in 20% of the women (n = 9). Conclusion The intensive form of treatment for lymphedema is highly effective in a short period of time, with a 40% to 50% reduction in volume in five days, but requires specialized centers adapted to this form of therapy. This is an option for reference centers in the treatment of lymphedema and the formation of human resources.
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Affiliation(s)
- Ana Carolina Pereira de Godoy
- Pediatric Intensive Care, Hospital da Criança e Maternidade (HCM) Hospital de Base de Sao Jose do Rio Preto, Sao Jose do Rio Preto, BRA.,Pediatric Rehabilitation, Clínica Godoy, Sao Jose do Rio Preto, BRA
| | | | - Lívia Maria Pereira de Godoy
- Dermatology, Instituto Lauro Souza de Lima-Bauru, São José do Rio Preto, BRA.,General Practice, Clínica Godoy, Sao Jose do Rio Preto, BRA
| | - Henrique Jose Pereira de Godoy
- General Surgery, Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP) Clínica Godoy, São José do Rio Preto, BRA.,General Practice, Clínica Godoy, São José do Rio Preto, BRA
| | - Jose Maria Pereira de Godoy
- Cardiology and Cardiovascular Surgery, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, BRA.,Angiology and Vascular Surgery Service, Clínica Godoy, Sao Jose do Rio Preto, BRA
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22
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Yanmin X, Xuyang Z, Wen Y, Suihuai Y, Sinan L. Study on the Design and Optimization of a Portable Monitoring and Auxiliary Treatment Device for Upper Extremity Lymphedema-Focus on the Rehabilitation Function of the Device. Front Bioeng Biotechnol 2021; 9:656716. [PMID: 33869161 PMCID: PMC8047204 DOI: 10.3389/fbioe.2021.656716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/22/2021] [Indexed: 11/16/2022] Open
Abstract
Female patients suffer from the risk of upper limb lymphedema after breast cancer removal surgery. At present, the detection and the adjuvant treatment of this disease are not convenient enough, leading to delay of the disease and increase in the burden of patients. This paper presents a portable monitoring and treatment device for upper extremity lymphedema, enabling patients to monitor the symptoms of upper limb lymphedema and auxiliary rehabilitation. This design utilizes the arm circumference measurement and contrast method to realize symptom monitoring. The device realizes auxiliary rehabilitation using the regional pressure method to imitate traditional manual lymphatic drainage technology. According to the MRI images of volunteers’ upper limbs, the upper arm and forearm’s finite element models are reconstructed in ANSYS. The static simulation experiment is completed. The working mode and parameter design of each rehabilitation module of the device are obtained. The experimental results show that the integrated design principle of monitoring and treatment proposed in this paper has good feasibility, has auxiliary rehabilitation effect, and meets the principle of human comfort. The device can help patients find lymphedema in time and implement auxiliary treatment, which can effectively avoid the further deterioration of lymphedema.
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Affiliation(s)
- Xue Yanmin
- Department of Industrial Design, Xi'an University of Technology, Xi'an, China
| | - Zhang Xuyang
- Department of Industrial Design, Xi'an University of Technology, Xi'an, China
| | - Yan Wen
- Department of Industrial Design, Xi'an University of Technology, Xi'an, China
| | - Yu Suihuai
- Industrial Design Institute, Northwestern Polytechnical University, Xi'an, China
| | - Li Sinan
- School of Life Sciences and Technology, Xi'an Jiaotong University, Xi'an, China
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23
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Fu MR, McTernan ML, Qiu JM, Ko E, Yazicioglu S, Axelrod D, Guth A, Fan Z, Sang A, Miaskowski C, Wang Y. The Effects of Kinect-Enhanced Lymphatic Exercise Intervention on Lymphatic Pain, Swelling, and Lymph Fluid Level. Integr Cancer Ther 2021; 20:15347354211026757. [PMID: 34160294 PMCID: PMC8226364 DOI: 10.1177/15347354211026757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/12/2021] [Accepted: 06/02/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly. OBJECTIVES This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels. METHODS A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman's rank correlation coefficients, linear regressions, and Cohen's d were performed for data analysis. Qualitative data were assessed for common themes. RESULTS The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain (MedΔ = -1.00, CI = [-1.5, -0.1], P = .004), arm/hand swelling (MedΔ = -1.00, CI = [-1.5, -0.5], P = .004), total swelling (MedΔ = -1.5, CI = [-2.0, -1.0], P = .003), number of lymphedema symptoms (MΔ = -3.8, CI = [-5.5, -2.1], P < .001), and lymphedema symptom severity (MΔ = -5.3, CI = [-9.5, -1.1], P = .016). A significant reduction in lymph fluid levels was found in mean L-Dex scores (MΔ = -2.68, CI = [-4.67, -0.69], P = .010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex ≥ 7.1) (MΔ = -5.19, CI = [-1.75, -8.63], P = .008). Patients' qualitative feedback supported the results of the study. CONCLUSIONS The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.
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Affiliation(s)
- Mei R. Fu
- Boston College William F. Connell
School of Nursing, Chestnut Hill, MA, USA
| | | | | | - Eunjung Ko
- The Ohio State University College of
Nursing, Columbus, OH, USA
| | - Simay Yazicioglu
- New York University Tandon School of
Engineering, Brooklyn, NY, USA
| | | | - Amber Guth
- New York University School of Medicine,
New York, NY, USA
| | - Zhipeng Fan
- New York University Tandon School of
Engineering, Brooklyn, NY, USA
| | - Anna Sang
- New York University College of Arts and
Science, New York, NY, USA
| | | | - Yao Wang
- New York University Tandon School of
Engineering, Brooklyn, NY, USA
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Hasenöhrl T, Palma S, Huber DFX, Zdravkovic A, Crevenna R. Effects of a structured exercise program on physical performance and function, quality of life and work ability of physically active breast cancer survivors : A retrospective data analysis. Wien Klin Wochenschr 2020; 133:1-5. [PMID: 32960338 PMCID: PMC7840644 DOI: 10.1007/s00508-020-01739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/21/2020] [Indexed: 11/30/2022]
Abstract
Background Purpose of this retrospective data analysis was to depict the effects of a structured off-season conditioning program with breast cancer survivors competing in dragon boat paddling. Methods In this study 10 breast cancer survivors (mean age 52.0 ± 5.4 years) who had finished the primary cancer treatment and who were paddlers of the Vienna Pink Dragon self-help group underwent a structured 10-week exercise program as part of their routine supportive treatment. Upper extremity strength, endurance capacity, shoulder flexibility, quality of life and work ability were assessed at baseline and after completion of the exercise program. Results Out of 10 patients 8 completed more than 80% of the exercise sessions. A multivariate analysis of variance (MANOVA) of the pooled exercise effects showed a very large effect size (Η2 = 0.982); however, the change from baseline to follow-up was non-significant (p = 0.363). In the European Organisation for Research and Treatment of Cancer Quality of Life of Cancer Patients Questionnaire (EORTC QLQ-C30) the exercise program led to a significant improvement of body image (p = 0.02) and less arm symptoms in the affected arm (p = 0.04). Conclusion A structured and well-planned exercise intervention program can have a large effect on the physical performance of pretrained breast cancer survivors. Moreover, it can increase the body image and decrease the arm symptoms in this population.
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Affiliation(s)
- Timothy Hasenöhrl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stefano Palma
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Dominikus F-X Huber
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Andrej Zdravkovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Relationships between Exercise Modality and Activity Restriction, Quality of Life, and Hematopoietic Profile in Korean Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186899. [PMID: 32967252 PMCID: PMC7559845 DOI: 10.3390/ijerph17186899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 12/31/2022]
Abstract
This study aimed to examine the relationships between activity restriction, quality of life (QoL), and hematopoietic profile in breast cancer survivors according to exercise modality. The subjects in this study were 187 female breast cancer survivors among a total of 32,631 participants in the Korea National Health and Nutrition Examination Survey, which was conducted from 2016 to 2018. The selected subjects participated in a questionnaire survey and blood analysis. A cross-analysis was conducted to determine the relationship between participation in various modality of exercise (e.g., aerobic exercise, resistance exercise, walking exercise). The phi coefficients or Cramer’s V value for activity restriction and QoL were calculated; an independent t-test was conducted to evaluate the differences between hematopoietic profiles based on the modality of exercise. Statistically significant correlations were seen between obesity and aerobic exercise and walking frequency, as well as between diabetes and aerobic exercise and activity restriction. With respect to QoL, there was a statistically significant correlation between participation in aerobic exercise and exercise ability, participation in aerobic exercise and anxiety/depression, participation in resistance exercise and subjective health status, participation in resistance exercise and exercise ability, and participation in weekly walking exercise and self-care ability. Regarding hemodynamic changes, red blood cells increased significantly in breast cancer survivors who participated in weekly resistance exercise compared to in those who did not. In conclusion, exercise participation had a positive effect on activity restriction, QoL, and hematopoietic profile in breast cancer survivors; in particular, some modalities of aerobic exercise were more effective.
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Montaño-Rojas LS, Romero-Pérez EM, Medina-Pérez C, Reguera-García MM, de Paz JA. Resistance Training in Breast Cancer Survivors: A Systematic Review of Exercise Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6511. [PMID: 32906761 PMCID: PMC7558202 DOI: 10.3390/ijerph17186511] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/29/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to identify the characteristics of resistance training (RT) programs for breast cancer survivors (BCS). A systematic review of the literature was performed using PubMed, Medline, Science Direct, the Cochrane Breast Cancer Specialised Register of the Cochrane Library, the Physiotherapy Evidence Database (PEDro), and Scopus, with the aim of identifying all published studies on RT and BCS from 1 January 1990 to 6 December 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias in the studies was assessed using the revised Cochrane Risk of Bias tool (RoB 2.0). Sixteen trials were included for qualitative analysis. More than half of the trials do not adequately report the characteristics that make up the exercise program. The maximal strength was the most frequently monitored manifestation of strength, evaluated mainly as one-repetition maximum (1RM). Resistance training was performed on strength-training machines, twice a week, using a load between 50% and 80% of 1RM. The trials reported significant improvement in muscle strength, fatigue, pain, quality of life, and minor changes in aerobic capacity.
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Reduction of breast lymphoedema secondary to breast cancer: a randomised controlled exercise trial. Breast Cancer Res Treat 2020; 184:459-467. [DOI: 10.1007/s10549-020-05863-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/06/2020] [Indexed: 11/25/2022]
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Kowalczyk L, Deutschmann C, Crevenna R, Konrad S, Singer CF, Farr A. Radiotherapy-Induced Fatigue in Breast Cancer Patients. Breast Care (Basel) 2020; 16:236-242. [PMID: 34248464 DOI: 10.1159/000509410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/15/2020] [Indexed: 11/19/2022] Open
Abstract
Background A large proportion of breast cancer patients who undergo adjuvant radiotherapy suffer from radiotherapy-induced fatigue. The possible causative factors of this specific side effect are diverse. Summary Prevalence, duration, and severity of radiotherapy-induced fatigue are dependent on the type of radiotherapy, as well as on the irradiated volume, dose scheme, on the number of radiation fields, the combination with other treatments, diurnal rhythm, smoking, and time-to-hospitalization. Recommended treatments include non-pharmacologic interventions, such as physical and psychosocial interventions. Pharmacologic therapies include treatment with methylphenidate and modafinil. In addition to its early detection with standardized instruments, adequate education to breast cancer patients about risks and predisposing factors of radiotherapy-induced fatigue is essential. Multidimensional strategies help to maintain the patients' quality of life and therefore guarantee treatment adherence and efficacy. Key Messages Radiotherapy-induced fatigue is an underreported, underdiagnosed, and undertreated side effect. This review provides an overview of radiotherapy-induced fatigue in breast cancer patients receiving adjuvant radiotherapy.
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Affiliation(s)
- Lidia Kowalczyk
- Clinical Unit of Anesthesiology and Perioperative Intensive-Care Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Christine Deutschmann
- Department of Obstetrics and Gynecology, Division of Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Stefan Konrad
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Christian F Singer
- Department of Obstetrics and Gynecology, Division of Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Department of Obstetrics and Gynecology, Division of Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria
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Resistance exercise and breast cancer-related lymphedema-a systematic review update and meta-analysis. Support Care Cancer 2020; 28:3593-3603. [PMID: 32415386 PMCID: PMC7316683 DOI: 10.1007/s00520-020-05521-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/06/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The purpose of this systematic review update and meta-analysis was to analyze resistance exercise (RE) intervention trials in breast cancer survivors (BCS) regarding their effect on breast cancer-related lymphedema (BCRL) status and upper and lower extremity strength. METHODS Systematic literature search was conducted utilizing PubMed, MEDLINE, and Embase databases. Any exercise intervention studies-both randomized controlled and uncontrolled-which assessed the effects of RE on BCRL in BCS in at least one intervention group published between 1966 and 31st January 2020 were included. Included articles were analyzed regarding their level of evidence and their methodological quality using respective tools for randomized and nonrandomized trials of the Cochrane collaboration. Meta-analysis for bioimpedance spectroscopy (BIS) values as well as upper and lower extremity strength was conducted. RESULTS Altogether, 29 studies were included in the systematic review. Results of six studies with altogether twelve RE intervention groups could be pooled for meta-analysis of the BCRL. A significant reduction of BCRL after RE was seen in BIS values (95% CI - 1.10 [- 2.19, - 0.01] L-Dex score). Furthermore, strength results of six studies could be pooled and meta-analysis showed significant improvements of muscular strength in the upper and lower extremities (95% CI 8.96 [3.42, 14.51] kg and 95% CI 23.42 [11.95, 34.88] kg, respectively). CONCLUSION RE does not have a systematic negative effect on BCRL and, on the contrary, potentially decreases it.
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Tan C, Wilson CM. Clinical Outcomes After Physical Therapy Treatment for Secondary Lymphedema After Breast Cancer. Cureus 2019; 11:e4779. [PMID: 31367497 PMCID: PMC6666846 DOI: 10.7759/cureus.4779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is the most commonly diagnosed cancer in women and approximately 33% of survivors will develop lymphedema. Untreated lymphedema may be limb threatening or cause substantial functional limitations. The purpose of this case report is to detail the physical therapy (PT) management and outcomes for a patient with right upper extremity and breast lymphedema. The goal of this case report is to provide rehabilitation clinicians with an example of effective treatment management and the underlying treatment rationale. A 64-year-old female with stage 2A breast cancer underwent neoadjuvant chemotherapy, a lumpectomy with 18 lymph nodes removed, and radiation therapy. She subsequently developed secondary lymphedema of the right breast and upper extremity. Physical therapy interventions included instruction on a complete decongestive therapy program, which consists of manual lymphatic drainage and compression bandaging and exercises to improve shoulder range of motion (ROM), posture, and strength. As a result of PT, her right shoulder ROM and anthropometric measurements improved and the patient achieved independence with self-lymphatic massage and compression bandaging techniques to maintain these gains. This case report is unique as it details the clinical decision making required during a complex course of cancer care that necessitated adjustments to the PT plan of care for sustainable outcomes.
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Affiliation(s)
- Cynthia Tan
- Physical Therapy, Beaumont Health, Royal Oak, USA
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Role of physical medicine for cancer rehabilitation and return to work under the premise of the "Wiedereingliederungsteilzeitgesetz". Wien Klin Wochenschr 2019; 131:455-461. [PMID: 31087151 PMCID: PMC6795628 DOI: 10.1007/s00508-019-1504-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 04/24/2019] [Indexed: 01/26/2023]
Abstract
Background With the intention of enabling people a phased return to work after long-term sick leave the so-called “Wiedereingliederungsteilzeitgesetz” (WIETZ) was implemented in Austria on 1 July 2017. Methods To explore the overall awareness about the WIETZ and the value of physical modalities together with further supporting measures in return to work of cancer survivors, a survey by using a self-constructed questionnaire was performed in 30 experts 6 months after the WIETZ came into force. Results The awareness of Austrian specialists regarding the WIETZ seems to be excellent. Regarding expert opinions, return to work in cancer survivors is notable hampered in workplaces with great physical stress even in times of the WIETZ, whereas for professions in offices and banks it is easier to return to work, with and without WIETZ. The highest impact on return to work seems to be due to exercise, as an intervention of the field of physical medicine and rehabilitation to improve sensorimotor functions and to increase endurance capacity as well as muscular strength. Conclusion Early information about cancer rehabilitation and the WIETZ seems to be necessary to facilitate return to work of cancer survivors. Furthermore, exercise interventions seem to be the most important measures from the field of physical medicine and rehabilitation.
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Cenik F, Steinhart M, Keilani M, Crevenna R. The first online conference for breast cancer survivors-SURVIVA 2018: an innovative information tool. Support Care Cancer 2019; 27:2757-2759. [PMID: 31001693 PMCID: PMC6597587 DOI: 10.1007/s00520-019-04810-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 04/07/2019] [Indexed: 02/07/2023]
Abstract
Purpose The implementation of a new online conference tool, with the goal of providing competent answers, information, and support from experts in their fields, about diagnosis, treatment, and rehabilitation in breast cancer patients. Methods The implementation process and data of the first online conference are described. Results Following the idea and initiative of a breast cancer survivor, and under the umbrella of a leading oncologist in breast cancer treatment, and with the cooperation of further leading experts in the fields, plus their therapeutic teams, the new online conference SURVIVA 2018 was implemented as an innovative platform—free of charge, online, and with easy and anonymous access—to provide breast cancer survivors with in-depth information and help from the leading Austrian experts in their fields. This first online conference for German-speaking breast cancer survivors is an innovative and modern concept, which seems to have been very well accepted. Conclusion This concept could also be of interest to survivors of other cancer entities.
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Affiliation(s)
- Fadime Cenik
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Michaela Steinhart
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.,AINA GmbH, A-2392 Sulz im Wienerwald, Austria
| | - Mohammad Keilani
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
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Blei F. Update March 2019. Lymphat Res Biol 2019. [DOI: 10.1089/lrb.2019.29063.fb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Affiliation(s)
- Richard Crevenna
- Department of Physical Medicine Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Australia
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